How to Check PAS Authorization Status using $inquire Operation in HealthLake

Details

This article describes the use of the FHIR-based `$inquire` operation within AWS HealthLake. This feature is designed to check the status of pre-authorizations for medical services that were previously submitted. It adheres to a standardized workflow defined by the Da Vinci PAS Implementation Guide, allowing users to query the current authorization status using application details and associated patient information. The process is read-only, meaning it does not modify any resources in the data store. The API endpoint is `POST /datastore/{datastoreId}/r4/Claim/$inquire`. The request must be a FHIR Bundle containing multiple referenced resources: the target Claim, Patient details (Patient), Insurer (Organization/Insurer), and Provider (Organization/Provider). HealthLake uses these references to search the data store for the corresponding `ClaimResponse`, returning the current authorization status. This capability is crucial for standardizing the process of checking service eligibility before insurance coverage in healthcare settings, making it highly relevant for improving workflow efficiency in Japanese healthcare IT systems as well.