Da Vinci Payer Data Exchange
2.1.0 - ballot 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

Page standards status: Informative
.. 0 Table of Contents
... 1 Home
... 2 Overview
... 3 Introduction
... 4 PDex Implementation Guide
... 5 Security and Privacy
.... 5.1 FHIR Access Permissions
... 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 Capability Statements
..... 6.5.2 US Core AllergyIntolerance
..... 6.5.3 US Core CarePlan
..... 6.5.4 US Core CareTeam
..... 6.5.5 US Core Condition
..... 6.5.6 Consent
..... 6.5.7 Coverage
..... 6.5.8 PDex Device
..... 6.5.9 US Core DiagnosticReport for Laboratory Results Reporting
..... 6.5.10 US Core DiagnosticReport for Report and Note Exchange
..... 6.5.11 US Core DocumentReference
..... 6.5.12 US Core Encounter
..... 6.5.13 US Core Goal
..... 6.5.14 US Core Immunization
..... 6.5.15 US Core ImplantableDevice
..... 6.5.16 US Core Laboratory Result Observation
..... 6.5.17 US Core Location
..... 6.5.18 US Core Medication
..... 6.5.19 PDex MedicationDispense
..... 6.5.20 US Core MedicationRequest
..... 6.5.21 US Core Organization
..... 6.5.22 US Core Patient
..... 6.5.23 US Core Pediatric BMI for Age Observation
..... 6.5.24 US Core Pediatric Head Occipital-frontal Circumference Observation
..... 6.5.25 US Core Pediatric Weight for Height Observation
..... 6.5.26 US Core Practitioner
..... 6.5.27 US Core PractitionerRole
..... 6.5.28 PDex Prior Authorization
..... 6.5.29 US Core Procedure
..... 6.5.30 PDex Provenance
..... 6.5.31 US Core Provenance
..... 6.5.32 US Core Pulse Oximetry
..... 6.5.33 US Core Smoking Status Observation
..... 6.5.34 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 Payer-Access Server CapabilityStatement
.... 14.2 PDex provider-access Server CapabilityStatement
.... 14.3 PDEX Server CapabilityStatement
.... 14.4 PDex Server CapabilityStatement with US core 6.1 support
.... 14.5 PDex Bulk Member Match Operation
.... 14.6 ExplanationOfBenefit_Identifier
.... 14.7 ExplanationOfBenefit_Patient
.... 14.8 ExplanationOfBenefit_ServiceDate
.... 14.9 ExplanationOfBenefit_Type
.... 14.10 ExplanationOfBenefit_Use
.... 14.11 Group_Code
.... 14.12 PdexMedicationDispensePatient
.... 14.13 PdexMedicationDispenseStatus
.... 14.14 mTLS Endpoint
.... 14.15 mTLS Endpoint Bundle
.... 14.16 mTLS Organization
.... 14.17 PDex $multi-member-match request
.... 14.18 PDex $multi-member-match response
.... 14.19 PDex Device
.... 14.20 PDex MedicationDispense
.... 14.21 PDex Member Match Group
.... 14.22 PDex Member No Match Group
.... 14.23 PDex Prior Authorization
.... 14.24 PDex Provenance
.... 14.25 PDex Provider Access Consent Profile
.... 14.26 PDex Provider Group
.... 14.27 An attribute to describe the data source a resource was constructed from
.... 14.28 An attribute to express the amount of a service or item that has been utilized
.... 14.29 An attribute to express the refill number of a prescription
.... 14.30 LevelOfServiceCode
.... 14.31 Member Last Resource Filters
.... 14.32 Member Last Resource Types
.... 14.33 Member Last Transmission
.... 14.34 Member-Match Input Patient Parameter
.... 14.35 Members Opted-out
.... 14.36 mTLS Signed Object
.... 14.37 NDH Associated Servers
.... 14.38 NDH Contactpoint Availabletime
.... 14.39 NDH Dynamic Registration
.... 14.40 NDH Endpoint Access Control Mechanism
.... 14.41 NDH Endpoint Connection Type Version
.... 14.42 NDH Endpoint Rank
.... 14.43 NDH Endpoint Usecase
.... 14.44 NDH FHIR IG
.... 14.45 NDH Identifier Status
.... 14.46 NDH Secure Exchange Artifacts
.... 14.47 NDH Trust Framework
.... 14.48 NDH Verification Status
.... 14.49 ReviewAction
.... 14.50 ReviewActionCode
.... 14.51 When Adjudicated
.... 14.52 FDA National Drug Code (NDC)
.... 14.53 mTLS Signed Object Types
.... 14.54 Organization Type VS
.... 14.55 Payer source of data
.... 14.56 PDex Adjudication
.... 14.57 PDex Adjudication Category Discriminator
.... 14.58 PDex Multi-Member Match Result Value Set
.... 14.59 PDex Payer Benefit Payment Status
.... 14.60 PDex SupportingInfo Type
.... 14.61 Prior Authorization Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
.... 14.62 Prior Authorization Service Type Codes (X12)
.... 14.63 Prior Authorization value categories
.... 14.64 Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
.... 14.65 Provenance Agent Type
.... 14.66 X12 278 Review Decision Reason Codes
.... 14.67 X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes
.... 14.68 Identifier Type
.... 14.69 mTLS Object Type Code
.... 14.70 Organization Type
.... 14.71 PDex Adjudication Codes
.... 14.72 PDex Adjudication Discriminator
.... 14.73 PDex Identifier Type
.... 14.74 PDex Multi-Member Match Result Code System
.... 14.75 PDex Payer Adjudication Status
.... 14.76 PDex Provider Access API Attribution Code System
.... 14.77 PDex Supporting Info Type
.... 14.78 Prior Authorization Values
.... 14.79 Provenance Payer Data Source Format
.... 14.80 Provenance Roles
.... 14.81 $multi-member-match payer example request
.... 14.82 $multi-member-match payer example response
.... 14.83 Acme
.... 14.84 BundleConditionWithProvenance
.... 14.85 BundleExamplePayer1
.... 14.86 BundleExamplePayer2
.... 14.87 BundleExamplePayer3
.... 14.88 BundleWithProvenance
.... 14.89 diamond-mtls-endpoint1
.... 14.90 diamond-mtls-endpoint2
.... 14.91 example-mtls-endpoint-bundle
.... 14.92 example-pdex-member-consent-constraint-group
.... 14.93 example-pdex-member-match-group
.... 14.94 example-pdex-member-no-match-group
.... 14.95 Example-PDex-Provider-Group
.... 14.96 ExampleBundle1
.... 14.97 ExampleCoverage
.... 14.98 ExampleDevice
.... 14.99 ExampleDocRefProvenance
.... 14.100 ExampleDocumentReference
.... 14.101 ExampleEncounter1
.... 14.102 ExampleEncounter2
.... 14.103 ExampleEncounter3
.... 14.104 ExampleLocation
.... 14.105 ExampleMedicationDispenseClaim
.... 14.106 ExamplePractitioner
.... 14.107 ExampleProvenanceAuthorEncounter6
.... 14.108 ExampleProvenanceAuthorEncounter7
.... 14.109 ExampleProvenanceBundleTransmitter
.... 14.110 ExampleProvenanceCustodian
.... 14.111 ExampleProvenancePayerModified
.... 14.112 ExampleProvenancePayerSource
.... 14.113 ExampleProvenanceSoloPractitioner
.... 14.114 ExampleProvenanceTransmitter
.... 14.115 mtlsorganization2
.... 14.116 OrganizationPayer1
.... 14.117 OrganizationPayer1-1
.... 14.118 OrganizationPayer2
.... 14.119 OrganizationPayer2-2
.... 14.120 OrganizationProvider1
.... 14.121 OrganizationProvider2
.... 14.122 Patient1
.... 14.123 Patient1-2
.... 14.124 Patient100
.... 14.125 Patient1001
.... 14.126 Patient2002
.... 14.127 PDex Provider Access Consent Example
.... 14.128 PDexCoverageExample
.... 14.129 PdexPriorAuth
... 15 Other IG Artifacts