Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0 - STU 2.2 United States of America flag

Da Vinci Prior Authorization Support (PAS) FHIR IG, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions

Example Claim: Homecare Authorization Example

Page standards status: Informative

Language: en

Profile: PAS Claim

Home Health Care Information

  • prognosis: 1
  • date: 2005-05-02

identifier: http://example.org/PATIENT_EVENT_TRACE_NUMBER/111099

status: Active

type: Professional

use: Preauthorization

patient: JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)

created: 2019-07-20 11:01:00+0500

insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY

provider: Organization DR. JOE SMITH CORPORATION

priority: Normal

Insurances

-SequenceFocalCoverage
*1trueCoverage: identifier = Member Number; status = active; subscriberId = 1122334455; relationship = Self

item

Service Item Request Type: Health Services Review

Certification Type: Initial

sequence: 1

category: Home Health Care

productOrService: health or hospice setting, each 15 minutes

location: Office

item

Service Item Request Type: Health Services Review

Certification Type: Initial

sequence: 2

category: Home Health Care

productOrService: B4184

location: Office