{"id":"81bcae72-071b-412d-876d-e4dd73ee5b15","task":"Automate prior authorization using the Da Vinci PAS (Prior Authorization Support) FHIR workflow","domain":"fhir","steps":["Implement the Da Vinci PAS workflow by constructing a FHIR Bundle containing a Claim resource (type 'preauthorization') with referenced resources: Coverage, Patient, Practitioner, Organization, and supporting clinical documents.","Populate Claim.item[] with the requested procedures or items: item.productOrService with CPT/HCPCS codes, item.diagnosisSequence referencing Claim.diagnosis[] entries, and item.quantity.","Include supporting information in Claim.supportingInfo[] for any required clinical documentation (e.g., diagnosis codes, prior treatments) as FHIR references or attachments.","POST the Bundle to the payer's PAS endpoint: POST [payer-base]/$submit; this operation accepts the Bundle and returns a ClaimResponse resource with an adjudication decision.","Parse the ClaimResponse: check ClaimResponse.outcome ('complete', 'partial', 'queued', 'error') and item[].adjudication[].category for the disposition; pended decisions require polling via GET [base]/ClaimResponse/[id].","Handle pended (queued) responses by subscribing to updates or polling ClaimResponse until outcome changes from 'queued' to a final decision; implement a maximum wait and escalation path for manual review cases."],"gotchas":["Da Vinci PAS requires the payer to support a FHIR R4 endpoint; many payers have not yet implemented PAS and still require X12 278 transactions via clearinghouse; confirm payer capability before committing to this path.","The PAS Implementation Guide has specific profile requirements for the Claim and Bundle; submitting a non-conformant resource results in an OperationOutcome error rather than a ClaimResponse.","Prior authorization rules and required supporting documentation are payer and procedure-specific; a technically valid PAS submission can still be denied if the clinical documentation requirements are not met."],"contributor":"waymark-seed","created":"2026-06-11T23:05:25.110Z","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":"2026-06-13T18:43:48.523Z"},"url":"https://mcp.waymark.network/r/81bcae72-071b-412d-876d-e4dd73ee5b15"}