Da Vinci Payer Data Exchange
2.1.0 - STU2 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 2.1.0 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

Table of Contents

.. 0 Table of Contents
... 1 Home
... 2 PDex Implementation Guide
... 3 Overview
... 4 Introduction
... 5 Security and Privacy
... 6 PDex Implementation, Actors, Interactions, Data Payloads and Methods
.... 6.1 Handling Data Provenance
.... 6.2 Provider Access API
.... 6.3 Payer-to-Payer Exchange (single member)
.... 6.4 Payer-to-Payer Exchange (bulk)
.... 6.5 Data Mapping
..... 6.5.1 US Core AllergyIntolerance
..... 6.5.2 US Core CarePlan
..... 6.5.3 US Core CareTeam
..... 6.5.4 US Core Condition
..... 6.5.5 Coverage
..... 6.5.6 PDex Device
..... 6.5.7 US Core DiagnosticReport for Laboratory Results Reporting
..... 6.5.8 US Core DiagnosticReport for Report and Note Exchange
..... 6.5.9 US Core DocumentReference
..... 6.5.10 US Core Encounter
..... 6.5.11 US Core Goal
..... 6.5.12 US Core Immunization
..... 6.5.13 US Core ImplantableDevice
..... 6.5.14 US Core Laboratory Result Observation
..... 6.5.15 US Core Location
..... 6.5.16 US Core Medication
..... 6.5.17 PDex MedicationDispense
..... 6.5.18 US Core MedicationRequest
..... 6.5.19 US Core Organization
..... 6.5.20 US Core Patient
..... 6.5.21 US Core Pediatric BMI for Age Observation
..... 6.5.22 US Core Pediatric Head Occipital-frontal Circumference Observation
..... 6.5.23 US Core Pediatric Weight for Height Observation
..... 6.5.24 US Core Practitioner
..... 6.5.25 US Core PractitionerRole
..... 6.5.26 PDex Prior Authorization
..... 6.5.27 US Core Procedure
..... 6.5.28 PDex Provenance
..... 6.5.29 US Core Provenance
..... 6.5.30 US Core Pulse Oximetry
..... 6.5.31 US Core Smoking Status Observation
..... 6.5.32 VitalSigns
... 7 Use Case Scenarios
... 8 Provider-controlled Information Requests and Filtering
... 9 CDS Hooks
.... 9.1 Workflow Examples
... 10 Member-Authorized OAuth2.0 Exchange
... 11 Change History
... 12 Credits
... 13 Downloads
... 14 FHIR Artifacts
.... 14.1 PDEX Server CapabilityStatement
.... 14.2 PDex Bulk Member Match Operation
.... 14.3 ExplanationOfBenefit_Identifier
.... 14.4 ExplanationOfBenefit_Patient
.... 14.5 ExplanationOfBenefit_ServiceDate
.... 14.6 ExplanationOfBenefit_Type
.... 14.7 ExplanationOfBenefit_Use
.... 14.8 PdexMedicationDispensePatient
.... 14.9 PdexMedicationDispenseStatus
.... 14.10 mTLS Endpoint
.... 14.11 mTLS Endpoint Bundle
.... 14.12 mTLS Organization
.... 14.13 PDex $multi-member-match request
.... 14.14 PDex $multi-member-match response
.... 14.15 PDex Consent Profile
.... 14.16 PDex Device
.... 14.17 PDex MedicationDispense
.... 14.18 PDex Member Match Group
.... 14.19 PDex Member No Match Group
.... 14.20 PDex Prior Authorization
.... 14.21 PDex Provenance
.... 14.22 PDex Provider Group
.... 14.23 An attribute to describe the data source a resource was constructed from
.... 14.24 An attribute to express the amount of a service or item that has been utilized
.... 14.25 An attribute to express the refill number of a prescription
.... 14.26 LevelOfServiceCode
.... 14.27 Member Last Resource Filters
.... 14.28 Member Last Resource Types
.... 14.29 Member Last Transmission
.... 14.30 Member-Match Input Patient Parameter
.... 14.31 mTLS Signed Object
.... 14.32 NDH Associated Servers
.... 14.33 NDH Contactpoint Availabletime
.... 14.34 NDH Dynamic Registration
.... 14.35 NDH Endpoint Access Control Mechanism
.... 14.36 NDH Endpoint Connection Type Version
.... 14.37 NDH Endpoint Rank
.... 14.38 NDH Endpoint Usecase
.... 14.39 NDH FHIR IG
.... 14.40 NDH Identifier Status
.... 14.41 NDH Secure Exchange Artifacts
.... 14.42 NDH Trust Framework
.... 14.43 NDH Verification Status
.... 14.44 ReviewAction
.... 14.45 ReviewActionCode
.... 14.46 Associated Servers Type Value Set
.... 14.47 Endpoint Access Control Mechanism Value Set
.... 14.48 Endpoint Connection Type Version Value Set
.... 14.49 Endpoint Connection Types Value Set
.... 14.50 Endpoint FHIR Mimetype Value Set
.... 14.51 Endpoint Payload Type Value Set
.... 14.52 FDA National Drug Code (NDC)
.... 14.53 Identifier Status Value Set
.... 14.54 mTLS Bundle Type Value Set
.... 14.55 mTLS Signed Object Types
.... 14.56 NDH FHIR Endpoint Usecase Value Set
.... 14.57 NDH Verification Status Value Set
.... 14.58 Organization Type VS
.... 14.59 Payer source of data
.... 14.60 PDex Adjudication
.... 14.61 PDex Adjudication Category Discriminator
.... 14.62 PDex Multi-Member Match Result Value Set
.... 14.63 PDex Payer Benefit Payment Status
.... 14.64 PDex SupportingInfo Type
.... 14.65 Prior Authorization Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
.... 14.66 Prior Authorization Service Type Codes (X12)
.... 14.67 Prior Authorization value categories
.... 14.68 Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
.... 14.69 Provenance Agent Type
.... 14.70 Secure Exchange Artifacts Value Set
.... 14.71 Trust Framework Type Value Set
.... 14.72 Trust Profile Value Set
.... 14.73 X12 278 Review Decision Reason Codes
.... 14.74 X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes
.... 14.75 Credential Status Code System
.... 14.76 Endpoint Access Control Mechanism Code System
.... 14.77 Endpoint Connection Type Version Code System
.... 14.78 Endpoint Connection Types (additional) Code System
.... 14.79 Endpoint FHIR MimeType Code System
.... 14.80 Endpoint HIE Specific Connection Type Code System
.... 14.81 Endpoint Payload Types Code System
.... 14.82 Identifier Type
.... 14.83 mTLS Object Type Code
.... 14.84 NDH Associated Servers Type Code System
.... 14.85 NDH FHIR Endpoint Use Case Code System
.... 14.86 NDH Resource Instance Verification Status Code System
.... 14.87 NDH Secure Exchange Artifacts Code System
.... 14.88 Organization Type
.... 14.89 PDex Adjudication Codes
.... 14.90 PDex Adjudication Discriminator
.... 14.91 PDex Identifier Type
.... 14.92 PDex Multi-Member Match Result Code System
.... 14.93 PDex Payer Adjudication Status
.... 14.94 PDex Supporting Info Type
.... 14.95 Prior Authorization Values
.... 14.96 Provenance Payer Data Source Format
.... 14.97 Provenance Roles
.... 14.98 Trust FrameworkType Code System
.... 14.99 Trust Profile Code System
.... 14.100 $multi-member-match payer example request
.... 14.101 $multi-member-match payer example response
.... 14.102 Acme
.... 14.103 BundleConditionWithProvenance
.... 14.104 BundleExamplePayer1
.... 14.105 BundleExamplePayer2
.... 14.106 BundleExamplePayer3
.... 14.107 BundleWithProvenance
.... 14.108 diamond-mtls-endpoint1
.... 14.109 diamond-mtls-endpoint2
.... 14.110 example-mtls-endpoint-bundle
.... 14.111 ExampleBundle1
.... 14.112 ExampleCoverage
.... 14.113 ExampleDevice
.... 14.114 ExampleDocRefProvenance
.... 14.115 ExampleDocumentReference
.... 14.116 ExampleEncounter1
.... 14.117 ExampleEncounter2
.... 14.118 ExampleEncounter3
.... 14.119 ExampleLocation
.... 14.120 ExampleMedicationDispenseClaim
.... 14.121 ExamplePractitioner
.... 14.122 ExampleProvenanceAuthorEncounter6
.... 14.123 ExampleProvenanceAuthorEncounter7
.... 14.124 ExampleProvenanceBundleTransmitter
.... 14.125 ExampleProvenanceCustodian
.... 14.126 ExampleProvenancePayerModified
.... 14.127 ExampleProvenancePayerSource
.... 14.128 ExampleProvenanceSoloPractitioner
.... 14.129 ExampleProvenanceTransmitter
.... 14.130 mtlsorganization2
.... 14.131 OrganizationPayer1
.... 14.132 OrganizationPayer1-1
.... 14.133 OrganizationPayer2
.... 14.134 OrganizationPayer2-2
.... 14.135 OrganizationProvider1
.... 14.136 OrganizationProvider2
.... 14.137 Patient1
.... 14.138 Patient1-2
.... 14.139 Patient100
.... 14.140 PdexPriorAuth
.... 14.141 PriorAuthCoverage
... 15 Other IG Artifacts