Skip to content

Commit

Permalink
BCDA-8099: Update Patient and Group endpoint descriptions (#204)
Browse files Browse the repository at this point in the history
## 🎫 Ticket

https://jira.cms.gov/browse/BCDA-8099

## 🛠 Changes

- removed ambiguous language in Group and Patient endpoint descriptions
- updated differences between the two

## ℹ️ Context for reviewers

Group and Patient endpoint descriptions didn't clearly highlight the
similarities and differences between the two.

## ✅ Acceptance Validation

Ran locally, proof-read against [content team's
document](https://docs.google.com/document/d/1b899C9SBvw8JLMpP2bXE6Ja1eLkREmVyx11Qi42l7O0/edit).

## 🔒 Security Implications

- [ ] This PR adds a new software dependency or dependencies.
- [ ] This PR modifies or invalidates one or more of our security
controls.
- [ ] This PR stores or transmits data that was not stored or
transmitted before.
- [ ] This PR requires additional review of its security implications
for other reasons.

If any security implications apply, add Jason Ashbaugh (GitHub username:
StewGoin) as a reviewer and do not merge this PR without his approval.
  • Loading branch information
laurenkrugen-navapbc authored Jun 18, 2024
1 parent b392d2e commit 1b8fb78
Show file tree
Hide file tree
Showing 3 changed files with 18 additions and 11 deletions.
11 changes: 5 additions & 6 deletions _includes/guide/endpoint_alert.html
Original file line number Diff line number Diff line change
@@ -1,12 +1,11 @@
<p>
The /Patient and /Group endpoints have a key difference in how new beneficiaries are treated. New beneficiaries are those that are newly assigned to you since your last attribution date.
Using the _since parameter with the /Patient endpoint will return claims last updated after the date provided. This includes claims for existing and newly attributed enrollees, those who have been assigned to your model entity since your last attribution date.
</p>
<p>
If you use _since within the /Patient endpoint, you will receive data filtered since the selected date for ALL of your assigned and assignable beneficiaries. Here, new beneficiary data is filtered along with all other beneficiaries.
Using _since with the /Group endpoint will return claims last updated after the date provided for existing enrollees only. For newly attributed enrollees, this parameter will return all historic claims for the /Group endpoint, regardless of when it was last updated. This is so you can retrieve all of your organization's new claims data with a single request.

</p>
<p>
If you use _since within the /Group endpoint, you will receive data filtered since the selected date for your existing beneficiaries AND you will receive historical data as far back as 2014 unfiltered by date for new beneficiaries. Here, new beneficiaries are excluded from the _since filter so that your organization can retrieve all new data with a single request.
</p>
<p>
For more detail on these differences and examples of how to make the requests, see the <a href="/build.html#requesting-filtered-data" class="in-text__link"><em>Requesting Filtered Data</em></a> section of the Building Your Application page.
<a href="https://bcda.cms.gov/build.html#requesting-filtered-data" target="_blank" rel="noopener" class="in-text__link">Learn more about the differences and how to make these requests. </a>
</p>

10 changes: 7 additions & 3 deletions _includes/guide/group_endpoint.html
Original file line number Diff line number Diff line change
@@ -1,9 +1,13 @@
<p>
The <a href="https://build.fhir.org/ig/HL7/bulk-data/export.html#endpoint---group-of-patients" target="_blank" rel="noopener" class="in-text__link"> /Group endpoint</a> allows you to request ExplanationOfBenefit, Patient, and/or Coverage data for all beneficiaries assigned or assignable to your model entity. For partially adjudicated claims, the resource types that are available include Claim and ClaimResponse (REACH ACOs only).
Similar to the /Patient endpoint, the <a href="https://build.fhir.org/ig/HL7/bulk-data/export.html#endpoint---group-of-patients" target="_blank" rel="noopener" class="in-text__link"> /Group endpoint</a> allows you to request resource types for enrollees assigned or assignable to your model entity. For adjudicated claims, this includes ExplanationOfBenefit, Patient, and/or Coverage. For partially adjudicated claims, this includes Claim and ClaimResponse (REACH ACOs only).
</p>
<p>
You must supply a group parameter. The only supported parameter currently is ‘all’.
You must provide one of the identifiers `all` or `runout` when using this endpoint. These group identifiers inform BCDA which Medicare enrollees should have their data included in your request.
</p>
<ul>
<li>/Group/all - returns data for all Medicare enrollees who are currently attributed to your model entity.</li>
<li>/Group/runout - returns data for Medicare enrollees who were attributed to your model entity during the previous year, but not the current year. These claims will have a service date no later than December 31st of the previous year.</li>
</ul>
<p>
You may also filter data by date using the _since parameter. If no filter is applied, a request to the /Group endpoint in BCDA returns historical data for all assigned and assignable beneficiaries as far back as 2014.
You may also use the <a href="https://bcda.cms.gov/guide.html#since-parameter" target="_blank" rel="noopener" class="in-text__link">_since parameter</a> to filter for claims last updated after a specified date. If no filter is applied, BCDA will return data as far back as 2014.
</p>
8 changes: 6 additions & 2 deletions _includes/guide/patient_endpoint.html
Original file line number Diff line number Diff line change
@@ -1,7 +1,11 @@
<p>
The <a href="https://build.fhir.org/ig/HL7/bulk-data/export.html#endpoint---all-patients" target="_blank" rel="noopener" class="in-text__link"> /Patient endpoint</a> allows you to request ExplanationOfBenefit. For adjudicated claims the resource types that are available include Patient and/or Coverage data (all eligible model entities), while for partially adjudicated claims the resource types that are available include Claim and ClaimResponse (REACH ACOs only). Both kinds of data are available for all enrollees assigned or assignable to your model entity. Note that the /Patient endpoint does not allow requests for data patient-by-patient. By the Bulk FHIR specification, only data for all patients associated with the authorized users’ credentials can be returned.
The <a href="https://build.fhir.org/ig/HL7/bulk-data/export.html#endpoint---all-patients" target="_blank" rel="noopener" class="in-text__link"> /Patient endpoint</a> allows you to request resource types for Medicare enrollees assigned or assignable to your model entity. For adjudicated claims, this includes ExplanationOfBenefit, Patient, and/or Coverage. For partially adjudicated claims, this includes Claim and ClaimResponse (REACH ACOs only).
</p>

<p>
You may also filter data by date using the _since parameter. If no filter is applied, a request to the /Patient endpoint in BCDA returns historical data for all assigned and assignable beneficiaries as far back as 2014.
However, this does not allow requests for data patient-by-patient. By the Bulk FHIR specification, only data for all patients associated with the authorized users’ credentials can be returned.
</p>

<p>
You may also use the <a href="https://bcda.cms.gov/guide.html#since-parameter" target="_blank" rel="noopener" class="in-text__link">_since parameter</a> to filter for claims last updated after a specified date. If no filter is applied, BCDA will return data as far back as 2014.
</p>

0 comments on commit 1b8fb78

Please sign in to comment.