HCX Protocol
v0.9
v0.9
  • Summary*
  • Glossary*
  • Context
  • Introduction to HCX*
  • Technical Specifications
    • Open Protocol
      • Registries*
        • QR Code Specifications*
      • Claims Data Exchange (HCX) Protocol
        • Message Flows*
          • Primary Message Flow
          • Additional Message Flows
            • Redirect
            • Forward
            • Intra Cycle Communication*
              • Seeking Supporting Information
              • Seeking Beneficiary Consent
              • Seeking Account Information
            • Relay
            • Third party Information sharing
          • Notifications
            • Categories
            • List of key topics
        • Message Structure
        • API Specifications*
          • Registry APIs
          • Primary Flow APIs
          • Supporting APIs
          • Notification APIs
        • Error Handling
      • Data Security and Privacy
        • Transport Security
        • Message Security and Integrity
        • API Security*
      • Audit and Reporting
    • Digital Network Policies
  • Domain Specifications
    • Domain Data Models
      • Handling Attachments
      • Handling Processing Errors
    • Terminologies
    • Domain Specific Languages (DSLs)
    • FHIR Implementation Guide*
  • Business Policy Specifications
    • Access Control (Roles)*
    • Guidelines for Participant Onboarding*
      • Sandbox process
      • Production onboarding (Go live)*
      • Potential De-boarding scenarios
    • Guidelines for Grievance Redressal
      • Scope of disputes
      • Involved participants
      • Guideline process for dispute resolution
      • Guidelines for leveraging FTA
      • Next steps
    • Guidelines for SLAs and ecosystem satisfaction
    • Guidelines for Operating charges
    • Guidelines for Beneficiary Authentication by Providers/Payors
    • Guidelines for Event audits
    • Reference Templates
      • HCX - Terms of use
      • Payer-Provider addendum
      • Payer-Policyholder addendum
    • Next steps
  • Use cases*
    • OPD
      • Typical Workflows
        • Cashless
        • Reimbursement
      • Mapping to the HCX protocol
        • Cashless
        • Reimbursement
    • IPD
      • Typical Workflows
        • Cashless
        • Reimbursement
      • Mapping to the HCX protocol
        • Cashless
        • Reimbursement
    • Implementation Considerations
  • Contributing to the protocol
  • Future Focus Areas*
Powered by GitBook
On this page

Was this helpful?

Edit on GitHub
  1. Technical Specifications

Open Protocol

Technology backbone for the Health Claims Data Exchange

PreviousTechnical SpecificationsNextRegistries*

Last updated 1 year ago

Was this helpful?

As described in Key Specifications, Open protocol defines the technology backbone for the Health Claims Data Exchange. In order to fulfil architectural principles listed , the protocol needs to consider the following key design elements:

Key Design Considerations

  • The protocol must be designed to support the asynchronous exchange of information to support the scale and asynchronous nature of processes in the industry

  • The protocol must support the federated deployment of multiple HCX instances.

  • In order to ensure the security and privacy of sensitive data

    • The protocol must allow for separation of transport (and any other common information) from sensitive information in the respective flows

    • The protocol must provide for encryption, signing, and auditing of relevant information

  • The protocol should allow creating unique identifiers for each message exchange

  • The protocol should allow related multiple messages that are part of a single business flow

  • The protocol should allow using existing registries for key entities - beneficiary, provider, and payor with a facility to extend them for the specific use case

  • The protocol should be designed to allow for the inclusion of the new types of use cases

  • The protocol should be designed to allow extending a use case as per the need of the use case/program (for example, a particular government scheme or innovative health financing solution may need different information about the beneficiary, provider, or intervention)

Based on these principles and design considerations, subsections below define the following key elements of the proposed Open Protocol:

  1. Registries - Definition of key registries needed for the functioning of the exchange.

  2. Health Claims data Exchange (HCX) Protocol - Details of the exchange flows including terminologies used, key constructs, message structures, unbundled APIs and error handling.

  3. Data Privacy and Security - Details of key security features of the protocol.

  4. Audit and Reporting

Following sub-section provides details on the HCX registries and different participant registries.

here