List of key topics

List of key topics identified by working groups as most important to serve the ecosystem use cases

Network Notifications

Broadcast

List of network notifications essential for efficient HCX operations. These notifications will always be triggered by the HCX.

Notification Title	Description	Trigger Condition	Initiating Participant	Receiving Participants
Participant Onboarding	Notification about new participants joining the ecosystem.	Participant Onboarded	HCX	Everyone (By default)
Participant De-boarding	Notification about new participants leaving the ecosystem.	Participant De-boarded	HCX	Everyone (By default)
New Feature Support	Notification about new feature launch for the participants on the network.	New feature added	HCX	Everyone (By default)
End of support for old feature	Notification about removing an old feature for the participants on the network.	Feature removed	HCX	Everyone (By default)
End of support for old protocol version	Notification about ending support for an older version of the protocol by the HCX.	Support ended	HCX	Everyone (By default)
Network maintenance/Downtime	Notification about planned downtime/maintenance of the gateway switch.	System down	HCX	Everyone (By default)
Policy change - SLA	Notification about the policy changes about the SLAs for the participant in the ecosystem.	SLA change	HCX	Everyone (By default)
Policy change - Security & Privacy	Notification about the data security & privacy standards for the participant in the ecosystem.	Security updated	HCX	Everyone (By default)

Targeted Network Notifications:

List of notification to be supported by HCX for timely actions by participant to prevent ecosystem breakdown -

Notification Title	Description	Trigger Condition	Initiating Participant	Receiving Participants
Compliance expiry	Notification about the compliance certificate expiration for the participant in the ecosystem.	Expiry date	HCX	Relevant participant
Subscription expiry/renew	Notification about the notification subscription expiration for the participant in the ecosystem.	Expiry date	HCX	Relevant participant
Encryption Key expiration	Notification about the encryption key expiration for the participant in the ecosystem.	Expiry date	HCX	Relevant participant

Participant Notifications

List of notification about actions/events of any participant that the ecosystem should be informed about -

Notification Title	Description	Condition detail	Initiating Participant	Receiving Participants
System maintenance/Downtime	Notification about participant system downtime/maintenance	System down	Any participant	Subscribed participants
Support for new version of protocol	Notification about the participant system supporting the new version of the HCX protocol.	Protocol version supported	Any participant	Subscribed participants
Support for prescribed terminologies	Notification about a participant system supporting a particular format of terminologies of the HCX protocol.	Terminology version supported	Any participant	Subscribed participants
End of life for an existing capability	Notification about participant system ending/discontinuing a particular feature of the HCX protocol.	Feature remove/discontinued	Any participant	Subscribed participants
New insurance plans/products, end of support for existing products/plans	Notification about a participant system adding a new product or a particular feature of the HCX protocol.	Feature supported/launched	Payor	Subscribed participants
Policy Compliance changes - terms of services	Notification about the participant system changing terms of the services.	Policy Updated	Any participant	Subscribed participants
Policy Compliance changes - SLAs	Notification about participant system SLA of the services.	Service SLA Updated	Any participant	Subscribed participants

Workflow notifications

Non-PII (public information)

Notifications on key use cases that the regulators, educational institutions, etc would like to track -

Notification Title	Description	Condition detail	Initiating Participant	Receiving Participants
Status change - Initiation, closure, approved, etc.	Notification about workflow updates on a policy.	Workflow updated	Payor	Subscribed participants
Admission case - For a particular disease	Notification about patient admission for a particular disease	Workflow updated	Provider	Subscribed participants
Claim initiation for a particular disease	Notification about workflow updates for claim initiation for a particular disease..	Workflow updated	Payor	Subscribed participants/IIB

PII carrying workflow notification:

Notifications for key business use cases requiring PII to third party participants that are not involved in the data exchange. Please note that these would be enabled through the combination of existing data exchange APIs.

Notification Title	Description	Condition detail	Initiating Participant	Receiving Participants
Status change of claims of a patient	Notification about workflow updates on an identified policy.	Workflow initiation/update	Payor	Subscribed participants/HIU
Change in coverage eligibility of a patient	Notification about change in coverage eligibility on an identified policy.	Workflow initiation/update	Payor	Subscribed participants/HIU
Reimbursements of claim for a patient	Notification about claim reimbursement..	Workflow initiation/update	Payor	Subscribed participants/HIU
Claim verification	Notification about claim verification status based on the beneficiary consent authentication by payor	Workflow initiation/update	Payor	Subscribed BSPs/HIUs