Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot United States of America flag

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

Example Bundle: PCT-GFE-Information-Bundle-1

Generated Narrative: Bundle PCT-GFE-Information-Bundle-1

Bundle PCT-GFE-Information-Bundle-1 of type collection

Entry 1 - fullUrl = http://example.org/fhir/Patient/patient1001

Resource Patient:

Eve Betterhalf female, DoB: 1955-07-23 ( http://example.com/identifiers/patient/1001)

Marital Status:unmarried
Contact Details:
  • ph: 781-949-4949(MOBILE)
  • 222 Burlington Road, Bedford MA 01730
Language:English (United States) (preferred)

Entry 2 - fullUrl = http://example.org/fhir/Coverage/coverage1001

Resource Coverage:

Resource Coverage "coverage1001"

Profile: PCT Coverage

Extension Definition for Coverage.kind for Version 5.0: insurance

status: active

subscriberId: PFP123450000

beneficiary: Patient/patient1001 " BETTERHALF"

relationship: Self ​(SubscriberPolicyholder Relationship Codes#self)

period: 2021-01-01 --> 2022-01-01

payor: Organization/org1001 "Umbrella Insurance Company"

Classes

-TypeValueName
*Plan ​(Coverage Class Codes#plan)Premim Family PlusPremim Family Plus Plan

CostToBeneficiaries

-TypeValue[x]
*Copay Percentage ​(Coverage Copay Type Codes#copaypct)20

Entry 3 - fullUrl = http://example.org/fhir/Organization/org1001

Resource Organization:

Resource Organization "org1001"

Profile: PCT Organization

identifier: Electronic Transmitter Identification Number/ETIN-3200002

active: true

type: Payer ​(Organization type#pay)

name: Umbrella Insurance Company

telecom: ph: 860-547-5001(WORK)

address: 680 Asylum Street Hartford CT 06155 US

Entry 4 - fullUrl = http://example.org/fhir/Location/PCT-ServiceLocation-1

Resource Location:

Generated Narrative: Location PCT-ServiceLocation-1

status: Active

name: Hospital

type: Hospital

Entry 5 - fullUrl = http://example.org/fhir/ServiceRequest/PCT-ServiceRequest-1

Resource ServiceRequest:

Generated Narrative: ServiceRequest PCT-ServiceRequest-1

status: Active

intent: Proposal

code: No display for ServiceRequest.code (concept: Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s))

subject: Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)

Entry 6 - fullUrl = http://example.org/fhir/DeviceRequest/PCT-DeviceRequest-1

Resource DeviceRequest:

Resource DeviceRequest "PCT-DeviceRequest-1"

Profile: PCT GFE DeviceRequest

status: active

intent: proposal

code: KNEE ORTHOSIS, ELASTIC WITH CONDYLAR PADS AND JOINTS, WITH OR WITHOUT PATELLAR CONTROL, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (HCPCSReleaseCodeSets#L1820)

subject: Patient/patient1001 " BETTERHALF"