Prior Auth Breaks in Production
Coverage Requirements Discovery looks straightforward on paper. In practice, a payer returns the wrong coverage decision, or none at all. Authentication fails on a token you thought was valid. These defects rarely show up until a real trading partner hits them, and by then the fix is expensive and public.
This session walked through what ten weeks of multi-party CRD testing actually exposed, and what it means for your own implementation.
- Learn which CRD failures were most common, so you can check your system against them first.
- See how testing partners resolved authentication issues once, cleanly, with no production incident.
- Understand where payer coverage logic and provider prefetch templates drift apart.
- Get the Q3–Q4 testing roadmap, including CRD-PAS and intermediary connect.
What You'll Learn
Watch the engaging presentation of the Q2 FHIRplace FHIR interoperability testing results.
- The full CRD testing picture: 7 organizations, 9 roles, 1,134 test attempts over 10 weeks
- Why 56% of all issues traced to rule evaluation and coverage determination, and what that signals for payers
- How 89% of actively executed scenarios reached a resolved or actively remediated state inside the testing window
- What the two engaged intermediaries, KONZA and ZeOmega, mean for real-world data exchange
FAQs
I work on the payer side. Is this relevant to me?
Yes. Most Q2 issues traced to coverage determination logic, which is a payer-side concern. The session covers both provider and payer findings.
What companies participated in the Q2 FHIRplace FHIR Interoperability testing sprint?
The participating members found on the FHIRplace Validated products page.
Will I get the full Q2 report?
The full Q2 report is already available and can be found on the FHIRplace Validated products page.