Support Needed for Claim Information Retrieval in CMS DPC Sandbox Environment

[Mukesh Kumar]

Hi Team,

I hope you are doing well.

I'm currently working in the CMS DPC sandbox environment and have created a Postman collection with reference to the DPC documentation. I need to obtain claim details, claim status, and payment information, but I'm unable to retrieve these details.

Could you please let me know the steps required to obtain claim information through the sandbox?

Thanks and regards,
Mukesh

[Data at the Point of Care (DPC) Community]

Hi Mukesh,

Thanks for your question. We're reviewing the information you shared and will get back to you shortly.

Thank you,

The DPC Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Data at the Point of Care (DPC) Community]

Hi Mukesh,

Thanks again for your question!

It appears that you were able to create the Postman collection to execute a sample request in the sandbox environment. To retrieve data from DPC, you'll need to initiate an export operation and specify the type of FHIR resource you need.

Have you started the export operation? Please provide any additional context about the steps you've taken so we can assist you effectively.

Note: The DPC pilot API currently supports only the Explanation of Benefit (EOB), Patient, and Coverage FHIR STU3 resources (see sample DPC files). The EOB resource does include a set of claims data and benefits statuses, but you may review the resource in more detail here.

Thanks,
The DPC team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Mukesh Kumar]

Hi Team,

I hope you are doing well.

I've followed the steps you suggested for exporting data. However, when creating a group, I encountered the following error:

{
    "resourceType": "OperationOutcome",
    "id": "c04fd100bd060a9a",
    "issue": [
        {
            "severity": "fatal"
        }
    ]
}

Please review the Postman collection for the above issue and share the export steps so I can obtain claim details (claim status, payment info, etc.) for all patients.

Thanks,
Mukesh

[Mukesh Kumar]

here is postman collection link:
https://drive.google.com/file/d/1JE4eoXWd8wf6v909zAm2G7-s1aidamdE/view?usp=sharing
thanks

[Data at the Point of Care (DPC) Community]

Hi Mukesh,

Thanks for your update on this issue! We're reviewing the information you shared and will get back to you shortly.

Thank you,

The DPC Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Mukesh Kumar]

Hi team,
hope you are doing well,
is there any update for me, on shared issue?

thanks

[Data at the Point of Care (DPC) Community]

Hi Mukesh,

Thanks for your question. We're reviewing the information you shared and will get back to you shortly.

Thank you,

The DPC Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Data at the Point of Care (DPC) Community]

Hi Mukesh,

We reviewed the postman collection and identified a problem with the Group resource. In the message body, you have:

• "characteristic": [ { "code": { "coding": [ { "System": null, "Code": "attributed-to", "Display": null } ] }

The System and Display fields cannot be null. Try removing them and see if the export works!

Thanks,

The DPC Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Mukesh Kumar]

Hi team, 
Hope you are doing well,

I've updated collection as per suggested above. I'm getting error, please have a look at the attached screen-shot and Rest API Request as well:
https://prnt.sc/gouQBrAOASyg

{

    "resourceType": "OperationOutcome",

    "id": "446e8d2f1e915306",

    "issue": [

        {

            "severity": "fatal"

        }

    ]

} thanks

[Data at the Point of Care (DPC) Community]

Hi Mukesh,

Thanks for your question regarding the error you received. We're reviewing the information you shared and will get back to you shortly.

Thank you,

The DPC API Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Data at the Point of Care (DPC) Community]

Hi Mukesh,

Thank you for sending us attachments of your code and your patience on this issue! For the Group resource and attestation header, the practitioner/NPI ID must be the same. According to the code snippet, you have "3492092028" but the group resource seems to be linked to "1234329724". Try making this update and let us know if you were able to proceed!

Thanks,

The DPC API Team
Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Mukesh Kumar]

Hi Team,
Hope you are doing well.
I've used the same Id but it throws error un-processed Entity.
could you please let me know what I have missing?

thanks

[Data at the Point of Care (DPC) Community]

Hi Mukesh,

Thanks for your question regarding the error you received. We're reviewing the information you shared and will get back to you shortly.

Thank you,

The DPC API Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Mukesh Kumar]

Hi Team, 
Hope you are doing well

Any update for me on the shared error while adding Groups?

regards,
mukesh

[Data at the Point of Care (DPC) Community]

Hi Mukesh,

Thanks for your patience on this issue! We checked our logs and believe a potential error may be due to using "https://sandbox.dpc.cms.gov/api/v1/StructureDefinition/dpc-profile-attestation", instead of "https://dpc.cms.gov/api/v1/StructureDefinition/dpc-profile-attestation" in the provenance header for your attestation. However, in order for us to accurately review this issue, we will need a snippet of your request.

Best,

The DPC API Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission