Access Solutions Enrollment Experience UAPI
External - Business Description
FHIR IG Examples
Enrollment Workflow Queries in FHIR IG
Use Cases
Access Solutions requires 2 main aspects to initiate their services. They are:
- Prescriber Service
- Patient Consent
The Prescriber Service includes patient, insurance and prescription information used when Genentech Access Solutions contacts a patient's health insurance plan to determine his or her coverage.
The Patient Consent is acknowledged and dated by the patient giving permission for Genentech Access Solutions to discuss his or her health information with the Doctor's office and the patient's health insurance plan. This consent is valid for 6 years from the sign date and valid for 1 year from the sign date for residents in Maryland.
Access Solutions understands that both of these requirements may not be obtained at the same time. Thus, the following scenarios are accepted in the API:
| Use Case | Description | Bundle Example |
|---|---|---|
| Prescriber Service with Patient Consent | This is the ideal package. Access Solutions will be able to immediately initiate their services if both have been submitted. | Link |
| Prescriber Service Only | Sometimes the patient is not available to their Prescriber Office to provide patient consent. Thus, the Prescriber Service can be submitted by itself without the Patient Consent. However, if the patient has an existing Patient Consent on file with Access Solutions, then only the Prescriber Service is needed. | Link |
| Patient Consent Only | When a patient is able to provide Patient Consent and a Prescriber Service is unneeded to be submitted, because the Prescriber Service has already been submitted prior or the Patient Consent on file with Access Solutions is close to expiring. | Link |
Patient Enrollment Resources:
Below are the list of Resources used for Patient enrollment:
| Fhir Resource Name | Profile Link | Used for |
|---|---|---|
| Bundle | UAPI Bundle - Access Solutions Enrollment | A container for a collection of resources. Contains Transaction id |
| MessageHeader | UAPI MessageHeader | To identify type of Request and high level information for Request Like Sender info and end points |
| List | List | A resource containing reference to all the resources in incoming bundle request (except bundle and MessageHeader) |
| Patient | UAPI Patient | Resource containing Patient Information |
| Practitioner | UAPI Practitioner | Resource Containing Prescriber details |
| Organization | UAPI Organization | This Resource is used for capturing either of below details like Practice Info, Payer address and Site of Treatment Info |
| MedicationRequest | UAPI MedicationRequest | To identify the type of dosage of Medication |
| QuestionnaireResponse | QuestionnaireResponse | To Capture the questions related to Medication , Patient or Services being applied during Enrollment |
| Condition | UAPI Condition | Resource to Capture clinical condition, problem, diagnosis |
| Coverage | UAPI Coverage | To Capture the Insurance information of Patient |
| Consent | UAPI Consent | Resource to Capture different patient consents |
| Provenance | UAPI Provenance | Resource to Capture patients or Practitioner Signature |
| ServiceRequest | UAPI ServiceRequest | Service request is used to Capture the services requested during enrollment Like GPF, BI/PA, Copay, Starter, Appeal |
| RelatedPerson | UAPI RelatedPerson | Resource to Capture person related to patient |