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 Members Opted-out
.... 14.32 mTLS Signed Object
.... 14.33 NDH Associated Servers
.... 14.34 NDH Contactpoint Availabletime
.... 14.35 NDH Dynamic Registration
.... 14.36 NDH Endpoint Access Control Mechanism
.... 14.37 NDH Endpoint Connection Type Version
.... 14.38 NDH Endpoint Rank
.... 14.39 NDH Endpoint Usecase
.... 14.40 NDH FHIR IG
.... 14.41 NDH Identifier Status
.... 14.42 NDH Secure Exchange Artifacts
.... 14.43 NDH Trust Framework
.... 14.44 NDH Verification Status
.... 14.45 ReviewAction
.... 14.46 ReviewActionCode
.... 14.47 Associated Servers Type Value Set
.... 14.48 Endpoint Access Control Mechanism Value Set
.... 14.49 Endpoint Connection Type Version Value Set
.... 14.50 Endpoint Connection Types Value Set
.... 14.51 Endpoint FHIR Mimetype Value Set
.... 14.52 Endpoint Payload Type Value Set
.... 14.53 FDA National Drug Code (NDC)
.... 14.54 Identifier Status Value Set
.... 14.55 mTLS Bundle Type Value Set
.... 14.56 mTLS Signed Object Types
.... 14.57 NDH FHIR Endpoint Usecase Value Set
.... 14.58 NDH Verification Status Value Set
.... 14.59 Organization Type VS
.... 14.60 Payer source of data
.... 14.61 PDex Adjudication
.... 14.62 PDex Adjudication Category Discriminator
.... 14.63 PDex Multi-Member Match Result Value Set
.... 14.64 PDex Payer Benefit Payment Status
.... 14.65 PDex SupportingInfo Type
.... 14.66 Prior Authorization Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
.... 14.67 Prior Authorization Service Type Codes (X12)
.... 14.68 Prior Authorization value categories
.... 14.69 Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
.... 14.70 Provenance Agent Type
.... 14.71 Secure Exchange Artifacts Value Set
.... 14.72 Trust Framework Type Value Set
.... 14.73 Trust Profile Value Set
.... 14.74 X12 278 Review Decision Reason Codes
.... 14.75 X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes
.... 14.76 Credential Status Code System
.... 14.77 Endpoint Access Control Mechanism Code System
.... 14.78 Endpoint Connection Type Version Code System
.... 14.79 Endpoint Connection Types (additional) Code System
.... 14.80 Endpoint FHIR MimeType Code System
.... 14.81 Endpoint HIE Specific Connection Type Code System
.... 14.82 Endpoint Payload Types Code System
.... 14.83 Identifier Type
.... 14.84 mTLS Object Type Code
.... 14.85 NDH Associated Servers Type Code System
.... 14.86 NDH FHIR Endpoint Use Case Code System
.... 14.87 NDH Resource Instance Verification Status Code System
.... 14.88 NDH Secure Exchange Artifacts Code System
.... 14.89 Organization Type
.... 14.90 PDex Adjudication Codes
.... 14.91 PDex Adjudication Discriminator
.... 14.92 PDex Identifier Type
.... 14.93 PDex Multi-Member Match Result Code System
.... 14.94 PDex Payer Adjudication Status
.... 14.95 PDex Supporting Info Type
.... 14.96 Prior Authorization Values
.... 14.97 Provenance Payer Data Source Format
.... 14.98 Provenance Roles
.... 14.99 Trust FrameworkType Code System
.... 14.100 Trust Profile Code System
.... 14.101 $multi-member-match payer example request
.... 14.102 $multi-member-match payer example response
.... 14.103 Acme
.... 14.104 BundleConditionWithProvenance
.... 14.105 BundleExamplePayer1
.... 14.106 BundleExamplePayer2
.... 14.107 BundleExamplePayer3
.... 14.108 BundleWithProvenance
.... 14.109 diamond-mtls-endpoint1
.... 14.110 diamond-mtls-endpoint2
.... 14.111 example-mtls-endpoint-bundle
.... 14.112 ExampleBundle1
.... 14.113 ExampleCoverage
.... 14.114 ExampleDevice
.... 14.115 ExampleDocRefProvenance
.... 14.116 ExampleDocumentReference
.... 14.117 ExampleEncounter1
.... 14.118 ExampleEncounter2
.... 14.119 ExampleEncounter3
.... 14.120 ExampleLocation
.... 14.121 ExampleMedicationDispenseClaim
.... 14.122 ExamplePractitioner
.... 14.123 ExampleProvenanceAuthorEncounter6
.... 14.124 ExampleProvenanceAuthorEncounter7
.... 14.125 ExampleProvenanceBundleTransmitter
.... 14.126 ExampleProvenanceCustodian
.... 14.127 ExampleProvenancePayerModified
.... 14.128 ExampleProvenancePayerSource
.... 14.129 ExampleProvenanceSoloPractitioner
.... 14.130 ExampleProvenanceTransmitter
.... 14.131 mtlsorganization2
.... 14.132 OrganizationPayer1
.... 14.133 OrganizationPayer1-1
.... 14.134 OrganizationPayer2
.... 14.135 OrganizationPayer2-2
.... 14.136 OrganizationProvider1
.... 14.137 OrganizationProvider2
.... 14.138 Patient1
.... 14.139 Patient1-2
.... 14.140 Patient100
.... 14.141 Patient1001
.... 14.142 Patient2002
.... 14.143 PdexPriorAuth
.... 14.144 PriorAuthCoverage
... 15 Other IG Artifacts