HCX Protocol
v0.8
v0.6v0.7v0.8v0.7.1v0.9
v0.8
v0.6v0.7v0.8v0.7.1v0.9
  • Summary
  • Context
  • Introduction to HCX
  • Approach
    • Design Principles
    • Key Specifications
    • Governance
  • Technical Specifications
    • Open Protocol
      • Registries
      • Claims Data Exchange (HCX) Protocol
        • Exchange Protocol
        • Message Structure
        • API Structure
        • Error Handling
      • Data Security and Privacy
        • Transport Security
        • Message Security and Integrity
        • API Security
      • Audit and Reporting
      • Notifications
        • Terminology
        • Categories
        • API specifications
        • List of key topics
        • Future considerations
      • Third party Information sharing
    • Digital Network Policies
  • Domain Specifications
    • Domain Data Models
      • Handling Attachments
      • Handling Processing Errors
    • Terminologies (Code sets or Metadata standards)
    • Domain Specific Languages (DSLs)
    • Implementation Guide
  • Business Policy Specifications
    • Access Control (Roles)
    • Guidelines for Participant Onboarding
    • 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
  • Contributing to the specifications
  • Future Roadmap
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Future Roadmap

Key enhancements planned in future releases

Following are the list of key enhancements planned by the working groups in the future releases of the protocol:

  • Mapping of new use cases - Reimbursement, OPD, Pharmacy, Diagnostics etc.

  • Detailed approach on handling attchements/supporting information

  • Improvement in semantic interoperability

    • Defining higher confidence, harmonised valuesets based on ecosystem input

    • Valueset discoverabiility through terminology registry and services

  • Further detailing of the domain objects - descriptions, examples, etc.

  • Examples of typical use cases

  • Guidelines on Technical Operations of the HCX swicth(es)/network

  • Enhancements to digital encoding of insurance plans

  • Enhancements in model business policies in various operational areas

PreviousContributing to the specifications

Last updated 2 years ago

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