Payer Effective Time for QRDA III & QRDA I

XMLWordPrintable

    • Type: QRDA-I Standard
    • Resolution: Delivered
    • Priority: Minor
    • Component/s: None
    • High, Development is on Hold
    • Hide
      For QRDA-I, the effectiveTime is the active time range of the payer (health plan) for a particular patient.

      For QRDA-III, effectiveTime in the Payer Supplemental Data Element was inherited from the Patient Characteristic Payer template (shared by QRDA-I), because CONF:26933 was added as part of the June 2014 errata update to the HL7 QRDA-I, R2 standard. Since QRDA-III is an aggregated report for multiple patients, having effectiveTime is not really necessary, we hope to improve how payer supplemental data element is modeled in QRDA-III in the future. However, because the effectiveTime/low is a SHALL as currently specified, you could populate the effectiveTime/low with the start date of the reporting period, until there is a clear guidance on this in the future.
      Show
      For QRDA-I, the effectiveTime is the active time range of the payer (health plan) for a particular patient. For QRDA-III, effectiveTime in the Payer Supplemental Data Element was inherited from the Patient Characteristic Payer template (shared by QRDA-I), because CONF:26933 was added as part of the June 2014 errata update to the HL7 QRDA-I, R2 standard. Since QRDA-III is an aggregated report for multiple patients, having effectiveTime is not really necessary, we hope to improve how payer supplemental data element is modeled in QRDA-III in the future. However, because the effectiveTime/low is a SHALL as currently specified, you could populate the effectiveTime/low with the start date of the reporting period, until there is a clear guidance on this in the future.

      For Payer Source, Conf: 26933,SHALL contain exactly one [1..1] effectiveTime. If the Patient has Monthly or Quarterly or half yearly Health plan, which date should the effective time contain while submitting QRDA to quality agency.
      Below is the sample snippet of xml about the section in QRDA -I.

      <observation classCode="OBS" moodCode="EVN">
      <templateId root="2.16.840.1.113883.10.20.24.3.55" />
      <id root="4ddf1cc3-e325-472e-ad76-b2c66a5ee164" />
      <code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment source" />
      <statusCode code="completed" />
      <effectiveTime>
      <low value="20120328080000" />
      <high value="20120328153000" />
      </effectiveTime>
      <value xsi:type="CD" code="9999" codeSystem="2.16.840.1.113883.3.221.5" codeSystemName="Source of Payment Typology" displayName="Unavailable" />
      </observation>

            Assignee:
            Yan Heras
            Reporter:
            Jyoti Moryani (Inactive)
            Votes:
            0 Vote for this issue
            Watchers:
            3 Start watching this issue

              Created:
              Updated:
              Resolved: