Da Vinci Payer Data Exchange
2.1.1 - STU 2.1 United States of America flag

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

: Treatment Attestation Example 2 - JSON Representation

Page standards status: Informative

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{
  "resourceType" : "Consent",
  "id" : "treatment-attestation-ex2",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-treatment-relationship-consent"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Treatment Attestation by Dr. James Brown for Sarah Williams - Treatment relationship since 2024-02-01</p></div>"
  },
  "status" : "active",
  "scope" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/consentscope",
        "code" : "treatment"
      }
    ]
  },
  "category" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code" : "IDSCL",
          "display" : "Information Disclosure"
        }
      ]
    },
    {
      "coding" : [
        {
          "system" : "http://loinc.org",
          "code" : "64292-6",
          "display" : "Release of information consent"
        }
      ]
    }
  ],
  "patient" : {
    🔗 "reference" : "Patient/patient-prov-002"
  },
  "dateTime" : "2024-12-09T10:15:00Z",
  "performer" : [
    {
      🔗 "reference" : "Practitioner/provider-002",
      "display" : "Dr. James Brown, MD"
    }
  ],
  "organization" : [
    {
      🔗 "reference" : "Organization/provider-org-002",
      "display" : "Columbus Clinic"
    }
  ],
  "sourceReference" : {
    🔗 "reference" : "DocumentReference/treatment-attestation-form-002",
    "display" : "Provider Attestation Form"
  },
  "policy" : [
    {
      "uri" : "https://example.org/provider-attestation-policy"
    }
  ],
  "provision" : {
    "type" : "permit",
    "period" : {
      "start" : "2024-02-01"
    },
    "actor" : [
      {
        "role" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
              "code" : "IRCP",
              "display" : "information recipient"
            }
          ]
        },
        "reference" : {
          🔗 "reference" : "Practitioner/provider-002",
          "display" : "Dr. James Brown"
        }
      }
    ],
    "purpose" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code" : "TREAT",
        "display" : "treatment"
      }
    ]
  }
}