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

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