Cooperative Exchange Launches Da Vinci Trebuchet Clearinghouse-to-Clearinghouse Prior Authorization Pilot

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The Cooperative Exchange, representing the National Clearinghouse Association, partnered with the HL7 Da Vinci Project to launch the Da Vinci Trebuchet CH-to-CH Prior Authorization Pilot Cohort. The goal is to improve data sharing in value-based care arrangements using the industry-led FHIR standard. This pilot extends Da Vinci prior authorization standards beyond traditional point-to-point implementations, testing how HL7 FHIR-based transactions can be operationalized across clearinghouse networks. Key technical aspects include validating hybrid workflows (HL7 FHIR and X12 EDI) and performing X12 to FHIR translations between clearinghouses. The pilot aims to demonstrate interoperability among multiple clearinghouses using FHIR, validate both HL7 FHIR and X12 EDI workflows in real-world settings, and develop a reference architecture for routing and identity resolution. By validating these scalable, standards-based solutions, the initiative seeks to automate prior authorization across the entire healthcare ecosystem, thereby reducing the administrative burden on providers and payers. The expected outcomes include a functional prototype demonstrating CH-to-CH exchange using Da Vinci/FAST Implementation Guides and X12, along with an implementation playbook providing technical and operational guidance. The project also aims to identify policy and technical barriers for future enhancements to related standards (Da Vinci, FAST, X12).