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HCX Specifications
v0.6
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Future roadmap

Next steps on specifications and open-source reference implementation
As indicated in Key User cases/Workflows, the current version of specifications mainly covers cashless insurance use cases. Also, the real test of specifications and approach defined so far would be in using them in live scenarios. With these two objectives in mind, below are two key dimensions of the proposed roadmap:

Specifications roadmap

Following key focus areas are proposed to be further worked upon while the first version of the open-source HCX tech platform is made available for implementation:
  1. 1.
    Enhancements of the specifications for the reimbursement use case
  2. 2.
    Further detailing of formulation approach and model policies for
    1. 1.
      Participant onboarding/deboarding
    2. 2.
      Grievance redressal
    3. 3.
      Event audits
    4. 4.
      Beneficiary authentication (by participants)
    5. 5.
      Market rules around charges and fees
    6. 6.
      Claims adjudication
  3. 3.
    Guidelines for Technical Operations
  4. 4.
    Domain Specific Languages:
    1. 1.
      Policy Markup language - To assist auto-adjudication and eligibility checks through the machine-readable encoding of policies
    2. 2.
      Bill Markup Language - To assist auto-adjudication through the machine-readable encoding of bills
    3. 3.
      Explanation Markup Language (Low priority)

HCX Development roadmap

To enable the Learn-Do-Learn cycle of taking the HCX work forward, Swasth proposes to build the first version of Open Source reference implementation of the HCX software. Following timelines are proposed for this reference version:
  1. 1.
    V1 of the open-source reference software - December 2021
  2. 2.
    Availability of sandbox for pilot integrations - January 2022
  3. 3.
    Production readiness/Go Live of HCX and integrations - March 2022

Questions for Consultation

Question 1

The Roadmap on specifications provides a list of areas that are being planned for further work. Please provide your priority order for these areas. Kindly feel free to add additional areas that you may want to include in the specification work.
Instructions to send responses to the consultation questions are available here.