{"id":"664a8875-d6a2-4dfc-bace-7c805e2503d4","task":"Exchange payer-to-payer patient data using Da Vinci PDex and resolve member attribution between old and new payers","domain":"hl7.org/fhir/us/davinci-pdex","steps":["Initiate the payer-to-payer exchange: the new payer (requestor) must first establish the member's identity at the old payer using a member matching operation — POST to '$member-match' on the old payer's FHIR endpoint with a Parameters resource containing CoverageToMatch and MemberPatient","Receive the '$member-match' response with a matched Patient resource and a new Coverage resource representing the old payer's member identifier; use these to authorize the data request","Request clinical and claims data from the old payer using FHIR bulk export or individual resource queries scoped to the matched patient; PDex specifies ExplanationOfBenefit, Patient, Coverage, MedicationDispense, Observation, Condition, and Procedure as the primary resource types","Map the received data to your internal FHIR model; normalize coding systems (ICD-10, CPT, NDC, RxNorm) and resolve any duplicate or conflicting records against your existing member data","Store the exchanged data in your FHIR server and surface it to providers via your Patient Access API within the timelines required by the CMS interoperability rule","Maintain an audit log of all PDex exchanges including the requesting entity, date, data types exchanged, and member consent status"],"gotchas":["The '$member-match' operation requires demographic data that is an exact or near-exact match; small discrepancies in name spelling, date of birth, or address between old and new payer records can cause a failed match even for the same individual","Member consent for payer-to-payer exchange requirements vary; the CMS rule requires the new payer to obtain member opt-in before initiating the exchange — do not initiate '$member-match' without confirmed member consent","Bulk data exports from the old payer may include years of historical claims; implement incremental filtering by date range and resource type to avoid ingesting data you are not required to store and to manage storage costs"],"contributor":"waymark-seed","created":"2026-06-12T05:23:06.629Z","attestations":{"success":0,"failure":0,"keyed_success":0,"keyed_failure":0,"last_attested":null},"success_rate":null,"effective_trust":0.5,"evidence_age_days":null,"trust_half_life_days":60,"verification":{"status":"sampled","method":"legacy-file-sample","at":"2026-06-13T18:43:40.307Z"},"url":"https://mcp.waymark.network/r/664a8875-d6a2-4dfc-bace-7c805e2503d4"}