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
Page standards status: Trial-use |
{
"resourceType" : "CapabilityStatement",
"id" : "davinci-pct",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2023-03-28T19:21:32.176+00:00"
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <!-- TODO \n Jurisdiction \n Prohibited extension - http://hl7.org/fhir/StructureDefinition/capabilitystatement-prohibited -->\n <!-- set include_symbols = false to turn off confonrmance symbols and legen, true to turn on -->\n \n \n <h2 id=\"title\">Patient Cost Transparency Implementation Guide Payer Capability Statement</h2>\n <ul>\n <li><b>Title:</b>Patient Cost Transparency Implementation Guide Payer Capability Statement</li>\n <li><b>Implementation Guide Version:</b> 2.0.0-ballot</li>\n <li><b>FHIR Version:</b> 4.0.1</li>\n <li><b>Intended Use:</b> Requirements</li>\n <li><b>Supported Formats: </b> \n\n \n \n \n <strong>SHALL</strong> support \n \n json;\n \n \n \n <strong>SHOULD</strong> support \n \n xml;\n \n\n </li>\n \n <li><b>Published:</b> 2023-03-28 14:21:32-0500</li>\n \n <li><b>Published by:</b> HL7 International / Financial Management</li>\n <li><b>Status:</b> Active</li>\n <li><b>Copyright:</b> <div><p>Used by permission of HL7 International, all rights reserved Creative Commons License</p>\n</div></li>\n </ul>\n <br/>\n\n\n\n \n <strong>Description:</strong> <div><div><p>Payer capability statement for the Da Vinci Patient Cost Transparency Implementation Guide</p>\n</div></div>\n \n <br/>\n \n \n\n\n \n <h3>Support and Requirements for Other Artifacts</h3>\n \n \n <tr>\n <th>Imports other capabilities:</th>\n <td>\n <ul>\n \n <li>\n \n <a href=\"http://hl7.org/fhir/us/core/STU3.1.1/CapabilityStatement-us-core-server.html\">US Core Server CapabilityStatement</a>\n </li>\n \n </ul>\n </td>\n </tr>\n \n \n \n\n <br/>\n <!-- TODO - Make this a summary of capabilities, including system wide and each paradigm -->\n <p>\n <b>Jump to:</b>\n </p>\n <ul>\n \n <li><a href=\"#Server\">REST Server</a></li>\n \n \n \n </ul>\n\n\n\n <!-- REST Capabilities -->\n \n <br/>\n <a name=\"Server\"> </a>\n <h3 id=\"behavior\">FHIR Server RESTful Capabilities</h3>\n \n\n <!-- REST Security -->\n \n\n <!-- REST System wide Capabilities -->\n \n <h3>System-wide Server Capabilities</h3>\n \n <!-- REST System wide interactions -->\n \n\n <!-- REST System wide operations -->\n \n\n\n <!-- REST System wide search parameters -->\n \n \n\n\n\n <!-- Resource Capabilities -->\n \n\n <h4>Summary of Resource/Profile Capabilities</h4>\n <!-- TODO need include conformance verb legend -->\n <p><i>♦ = <b>SHALL</b> expectation</i>; <i>⋄ = <b>SHOULD</b> expectation</i>; <i>▿ = <b>MAY</b> expectation</i>;</p>\n <table class=\"grid\">\n <thead>\n <tr>\n <th>Resource Type</th>\n <th>Supported Interactions</th>\n <th>Supported Profiles</th>\n <th>Supported Searches</th>\n <th>Supported <code>_includes</code></th>\n <th>Supported <code>_revincludes</code></th>\n <th>Supported Operations</th>\n </tr>\n </thead>\n <tbody>\n \n <tr>\n <td>\n <a href=\"#Server_Bundle\"><span style=\"white-space: nowrap;\">Bundle<span title=\"null\"><sup/></span></span></a>\n </td>\n\n <!-- Supported Interactions -->\n <td>\n \n \n <span style=\"white-space: nowrap;\">create<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">search-type<span title=\"SHALL\"><sup>♦</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">read<span title=\"SHALL\"><sup>♦</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">vread<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">update<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">patch<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">delete<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">history-instance<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">history-type<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n \n </td>\n\n <!-- Supported Profiles -->\n <td>\n \n <a href=\"StructureDefinition-davinci-pct-aeob-bundle.html\">PCT AEOB Bundle</a><span title=\"SHALL, SHALL, SHALL\"><sup/></span>,\n \n \n <a href=\"StructureDefinition-davinci-pct-gfe-bundle.html\">PCT GFE Bundle</a><span title=\"SHALL, SHALL, SHALL\"><sup/></span>,\n \n \n <a href=\"StructureDefinition-davinci-pct-gfe-collection-bundle.html\">PCT GFE Collection Bundle</a><span title=\"SHALL, SHALL, SHALL\"><sup/></span>,\n \n \n \n </td>\n\n <!-- Supported Searches will need to do some sort of mapping instead of join to get the expectations printed out -->\n <td>\n \n </td>\n\n <!-- Supported _includes -->\n <td>\n \n </td>\n\n <!-- Supported _revincludes -->\n <td>\n \n </td>\n\n <!-- Supported Operations -->\n <td>\n \n \n <span style=\"white-space: nowrap;\">$GFESubmit<span title=\"SHALL\"><sup>♦</sup></span></span>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n <a href=\"#Server_ExplanationOfBenefit\"><span style=\"white-space: nowrap;\">ExplanationOfBenefit<span title=\"null\"><sup/></span></span></a>\n </td>\n\n <!-- Supported Interactions -->\n <td>\n \n \n <span style=\"white-space: nowrap;\">create<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">search-type<span title=\"SHALL\"><sup>♦</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">read<span title=\"SHALL\"><sup>♦</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">vread<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">update<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">patch<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">delete<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">history-instance<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">history-type<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n \n </td>\n\n <!-- Supported Profiles -->\n <td>\n \n <a href=\"StructureDefinition-davinci-pct-aeob.html\">PCT Advanced EOB</a><span title=\"SHALL\"><sup>♦</sup></span>,\n \n \n \n </td>\n\n <!-- Supported Searches will need to do some sort of mapping instead of join to get the expectations printed out -->\n <td>\n \n </td>\n\n <!-- Supported _includes -->\n <td>\n \n </td>\n\n <!-- Supported _revincludes -->\n <td>\n \n </td>\n\n <!-- Supported Operations -->\n <td>\n \n </td>\n </tr>\n \n <tr>\n <td>\n <a href=\"#Server_Coverage\"><span style=\"white-space: nowrap;\">Coverage<span title=\"null\"><sup/></span></span></a>\n </td>\n\n <!-- Supported Interactions -->\n <td>\n \n \n <span style=\"white-space: nowrap;\">create<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">search-type<span title=\"SHALL\"><sup>♦</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">read<span title=\"SHALL\"><sup>♦</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">vread<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">update<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">patch<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">delete<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">history-instance<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">history-type<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n \n </td>\n\n <!-- Supported Profiles -->\n <td>\n \n <a href=\"StructureDefinition-davinci-pct-coverage.html\">PCT Coverage</a><span title=\"SHALL\"><sup>♦</sup></span>,\n \n \n \n </td>\n\n <!-- Supported Searches will need to do some sort of mapping instead of join to get the expectations printed out -->\n <td>\n \n </td>\n\n <!-- Supported _includes -->\n <td>\n \n </td>\n\n <!-- Supported _revincludes -->\n <td>\n \n </td>\n\n <!-- Supported Operations -->\n <td>\n \n </td>\n </tr>\n \n <tr>\n <td>\n <a href=\"#Server_Claim\"><span style=\"white-space: nowrap;\">Claim<span title=\"null\"><sup/></span></span></a>\n </td>\n\n <!-- Supported Interactions -->\n <td>\n \n \n <span style=\"white-space: nowrap;\">create<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">search-type<span title=\"SHALL\"><sup>♦</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">read<span title=\"SHALL\"><sup>♦</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">vread<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">update<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">patch<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">delete<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">history-instance<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">history-type<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n \n </td>\n\n <!-- Supported Profiles -->\n <td>\n \n <a href=\"StructureDefinition-davinci-pct-gfe-professional.html\">PCT Good Faith Estimate Professional</a><span title=\"SHALL, SHALL\"><sup/></span>,\n \n \n <a href=\"StructureDefinition-davinci-pct-gfe-institutional.html\">PCT Good Faith Estimate Institutional</a><span title=\"SHALL, SHALL\"><sup/></span>,\n \n \n \n </td>\n\n <!-- Supported Searches will need to do some sort of mapping instead of join to get the expectations printed out -->\n <td>\n \n </td>\n\n <!-- Supported _includes -->\n <td>\n \n </td>\n\n <!-- Supported _revincludes -->\n <td>\n \n </td>\n\n <!-- Supported Operations -->\n <td>\n \n </td>\n </tr>\n \n <tr>\n <td>\n <a href=\"#Server_Organization\"><span style=\"white-space: nowrap;\">Organization<span title=\"null\"><sup/></span></span></a>\n </td>\n\n <!-- Supported Interactions -->\n <td>\n \n \n <span style=\"white-space: nowrap;\">create<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">search-type<span title=\"SHALL\"><sup>♦</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">read<span title=\"SHALL\"><sup>♦</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">vread<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">update<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">patch<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">delete<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">history-instance<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">history-type<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n \n </td>\n\n <!-- Supported Profiles -->\n <td>\n \n <a href=\"StructureDefinition-davinci-pct-organization.html\">PCT Organization</a><span title=\"SHALL\"><sup>♦</sup></span>,\n \n \n \n </td>\n\n <!-- Supported Searches will need to do some sort of mapping instead of join to get the expectations printed out -->\n <td>\n \n </td>\n\n <!-- Supported _includes -->\n <td>\n \n </td>\n\n <!-- Supported _revincludes -->\n <td>\n \n </td>\n\n <!-- Supported Operations -->\n <td>\n \n </td>\n </tr>\n \n <tr>\n <td>\n <a href=\"#Server_Practitioner\"><span style=\"white-space: nowrap;\">Practitioner<span title=\"null\"><sup/></span></span></a>\n </td>\n\n <!-- Supported Interactions -->\n <td>\n \n \n <span style=\"white-space: nowrap;\">create<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">search-type<span title=\"SHALL\"><sup>♦</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">read<span title=\"SHALL\"><sup>♦</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">vread<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">update<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">patch<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">delete<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">history-instance<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n <span style=\"white-space: nowrap;\">history-type<span title=\"MAY\"><sup>▿</sup></span></span>,\n \n \n </td>\n\n <!-- Supported Profiles -->\n <td>\n \n <a href=\"StructureDefinition-davinci-pct-practitioner.html\">PCT Practitioner</a><span title=\"SHALL\"><sup>♦</sup></span>,\n \n \n \n </td>\n\n <!-- Supported Searches will need to do some sort of mapping instead of join to get the expectations printed out -->\n <td>\n \n </td>\n\n <!-- Supported _includes -->\n <td>\n \n </td>\n\n <!-- Supported _revincludes -->\n <td>\n \n </td>\n\n <!-- Supported Operations -->\n <td>\n \n </td>\n </tr>\n \n </tbody>\n </table>\n <br/>\n\n <h3 id=\"resource-details\" class=\"no_toc\">RESTful Server Capabilities by Resource/Profile:</h3>\n <!-- Each REST Resource Detail -->\n \n <h4 id=\"Server_Bundle\" class=\"no_toc\">Bundle</h4>\n\n <p>Conformance Expectation:\t<strong/></p>\n\n \n\n \n\n <p>Supported Profiles:</p>\n <ul>\n \n <li><strong>SHALL</strong> support \n <a href=\"StructureDefinition-davinci-pct-aeob-bundle.html\">PCT AEOB Bundle</a>\n </li>\n \n <li><strong>SHALL</strong> support \n <a href=\"StructureDefinition-davinci-pct-gfe-bundle.html\">PCT GFE Bundle</a>\n </li>\n \n <li><strong>SHALL</strong> support \n <a href=\"StructureDefinition-davinci-pct-gfe-collection-bundle.html\">PCT GFE Collection Bundle</a>\n </li>\n \n </ul>\n \n \n\n\n <p>\n \n\n \n\n \n\n \n </p>\n\n\n\n\n\n\n <!-- Resource Interactions -->\n <p>Bundle Interaction Summary:</p>\n <ul>\n \n <li><strong>SHALL</strong> support search-type, read, </li>\n \n \n \n \n <li><strong>MAY</strong> support create, vread, update, patch, delete, history-instance, history-type, </li>\n \n \n </ul>\n\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n\n <!-- Resource Operations -->\n \n\n\n\n <!-- TODO Nexted ul items do not appear with a subbullet style -->\n \n <br/>\n <p>Modify Criteria:</p> \n <ul>\n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>create</code> interaction creating a Bundle resource using:\n <code class=\"highlighter-rouge\">POST [base]/Bundle/[id]{?_format=[mime-type]}</code>\n \n </li>\n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n <li>\n <!-- TODO change note if server allows putting of a new one (with a specified ID) -->\n A Server <strong>MAY</strong> be capable of updating a existing Bundle resource using:\n <code class=\"highlighter-rouge\">PUT [base]/Bundle/[id]{?_format=[mime-type]}</code>\n \n </li>\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n <li>\n A Server <strong>MAY</strong> be capable of patching an existing Bundle resource using:\n <code class=\"highlighter-rouge\">PATCH [base]/Bundle/[id]{?_format=[mime-type]}</code>\n </li>\n \n\n \n \n\n \n\n \n <li>\n A Server <strong>MAY</strong> be capable of deleting a Bundle resource using:\n <code class=\"highlighter-rouge\">DELETE [base]//[id]</code>\n \n </li>\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n </ul>\n \n\n\n \n <br/>\n <p>Fetch and Search Criteria:</p>\n <ul>\n \n \n \n \n \n \n \n \n \n \n <li>\n A Server <strong>SHALL</strong> be capable of a <code>search-type</code> interaction returning Bundle resources matching a search query using:\n <code class=\"highlighter-rouge\">GET [base]/Bundle/[id]{?[parameters]{&_format=[mime-type]}}</code>\n </li>\n \n \n \n \n \n <li>\n A Server <strong>SHALL</strong> be capable of a <code>read</code> interaction returning a Bundle resource using:\n <code class=\"highlighter-rouge\">GET [base]/Bundle/[id]</code>\n \n </li>\n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>vread</code> interaction returning a Bundle resource using:\n <code class=\"highlighter-rouge\">GET [base]/Bundle/[id]/_history/vid</code>\n </li>\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>history-instance</code> interaction returning a history of a Bundle using:\n <code class=\"highlighter-rouge\">GET [base]/Bundle/[id]/_history{?[parameters]&_format=[mime-type]}</code>\n </li>\n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>history-type</code> interaction returning the history of Bundle resources using:\n <code class=\"highlighter-rouge\">GET [base]/Bundle/_history{?[parameters]&_format=[mime-type]}</code>\n </li>\n \n \n\n \n\n \n\n </ul>\n \n\n \n\n <!-- Search Combination -->\n \n \n \n\n \n <h4 id=\"Server_ExplanationOfBenefit\" class=\"no_toc\">ExplanationOfBenefit</h4>\n\n <p>Conformance Expectation:\t<strong/></p>\n\n \n\n \n\n <p>Supported Profiles:</p>\n <ul>\n \n <li><strong>SHALL</strong> support \n <a href=\"StructureDefinition-davinci-pct-aeob.html\">PCT Advanced EOB</a>\n </li>\n \n </ul>\n \n \n\n\n <p>\n \n\n \n\n \n\n \n </p>\n\n\n\n\n\n\n <!-- Resource Interactions -->\n \n\n <!-- Resource Operations -->\n \n\n\n\n <!-- TODO Nexted ul items do not appear with a subbullet style -->\n \n <br/>\n <p>Modify Criteria:</p> \n <ul>\n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>create</code> interaction creating a ExplanationOfBenefit resource using:\n <code class=\"highlighter-rouge\">POST [base]/ExplanationOfBenefit/[id]{?_format=[mime-type]}</code>\n \n </li>\n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n <li>\n <!-- TODO change note if server allows putting of a new one (with a specified ID) -->\n A Server <strong>MAY</strong> be capable of updating a existing ExplanationOfBenefit resource using:\n <code class=\"highlighter-rouge\">PUT [base]/ExplanationOfBenefit/[id]{?_format=[mime-type]}</code>\n \n </li>\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n <li>\n A Server <strong>MAY</strong> be capable of patching an existing ExplanationOfBenefit resource using:\n <code class=\"highlighter-rouge\">PATCH [base]/ExplanationOfBenefit/[id]{?_format=[mime-type]}</code>\n </li>\n \n\n \n \n\n \n\n \n <li>\n A Server <strong>MAY</strong> be capable of deleting a ExplanationOfBenefit resource using:\n <code class=\"highlighter-rouge\">DELETE [base]//[id]</code>\n \n </li>\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n </ul>\n \n\n\n \n <br/>\n <p>Fetch and Search Criteria:</p>\n <ul>\n \n \n \n \n \n \n \n \n \n \n <li>\n A Server <strong>SHALL</strong> be capable of a <code>search-type</code> interaction returning ExplanationOfBenefit resources matching a search query using:\n <code class=\"highlighter-rouge\">GET [base]/ExplanationOfBenefit/[id]{?[parameters]{&_format=[mime-type]}}</code>\n </li>\n \n \n \n \n \n <li>\n A Server <strong>SHALL</strong> be capable of a <code>read</code> interaction returning a ExplanationOfBenefit resource using:\n <code class=\"highlighter-rouge\">GET [base]/ExplanationOfBenefit/[id]</code>\n \n </li>\n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>vread</code> interaction returning a ExplanationOfBenefit resource using:\n <code class=\"highlighter-rouge\">GET [base]/ExplanationOfBenefit/[id]/_history/vid</code>\n </li>\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>history-instance</code> interaction returning a history of a ExplanationOfBenefit using:\n <code class=\"highlighter-rouge\">GET [base]/ExplanationOfBenefit/[id]/_history{?[parameters]&_format=[mime-type]}</code>\n </li>\n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>history-type</code> interaction returning the history of ExplanationOfBenefit resources using:\n <code class=\"highlighter-rouge\">GET [base]/ExplanationOfBenefit/_history{?[parameters]&_format=[mime-type]}</code>\n </li>\n \n \n\n \n\n \n\n </ul>\n \n\n \n\n <!-- Search Combination -->\n \n \n \n\n \n <h4 id=\"Server_Coverage\" class=\"no_toc\">Coverage</h4>\n\n <p>Conformance Expectation:\t<strong/></p>\n\n \n\n \n\n <p>Supported Profiles:</p>\n <ul>\n \n <li><strong>SHALL</strong> support \n <a href=\"StructureDefinition-davinci-pct-coverage.html\">PCT Coverage</a>\n </li>\n \n </ul>\n \n \n\n\n <p>\n \n\n \n\n \n\n \n </p>\n\n\n\n\n\n\n <!-- Resource Interactions -->\n \n\n <!-- Resource Operations -->\n \n\n\n\n <!-- TODO Nexted ul items do not appear with a subbullet style -->\n \n <br/>\n <p>Modify Criteria:</p> \n <ul>\n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>create</code> interaction creating a Coverage resource using:\n <code class=\"highlighter-rouge\">POST [base]/Coverage/[id]{?_format=[mime-type]}</code>\n \n </li>\n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n <li>\n <!-- TODO change note if server allows putting of a new one (with a specified ID) -->\n A Server <strong>MAY</strong> be capable of updating a existing Coverage resource using:\n <code class=\"highlighter-rouge\">PUT [base]/Coverage/[id]{?_format=[mime-type]}</code>\n \n </li>\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n <li>\n A Server <strong>MAY</strong> be capable of patching an existing Coverage resource using:\n <code class=\"highlighter-rouge\">PATCH [base]/Coverage/[id]{?_format=[mime-type]}</code>\n </li>\n \n\n \n \n\n \n\n \n <li>\n A Server <strong>MAY</strong> be capable of deleting a Coverage resource using:\n <code class=\"highlighter-rouge\">DELETE [base]//[id]</code>\n \n </li>\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n </ul>\n \n\n\n \n <br/>\n <p>Fetch and Search Criteria:</p>\n <ul>\n \n \n \n \n \n \n \n \n \n \n <li>\n A Server <strong>SHALL</strong> be capable of a <code>search-type</code> interaction returning Coverage resources matching a search query using:\n <code class=\"highlighter-rouge\">GET [base]/Coverage/[id]{?[parameters]{&_format=[mime-type]}}</code>\n </li>\n \n \n \n \n \n <li>\n A Server <strong>SHALL</strong> be capable of a <code>read</code> interaction returning a Coverage resource using:\n <code class=\"highlighter-rouge\">GET [base]/Coverage/[id]</code>\n \n </li>\n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>vread</code> interaction returning a Coverage resource using:\n <code class=\"highlighter-rouge\">GET [base]/Coverage/[id]/_history/vid</code>\n </li>\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>history-instance</code> interaction returning a history of a Coverage using:\n <code class=\"highlighter-rouge\">GET [base]/Coverage/[id]/_history{?[parameters]&_format=[mime-type]}</code>\n </li>\n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>history-type</code> interaction returning the history of Coverage resources using:\n <code class=\"highlighter-rouge\">GET [base]/Coverage/_history{?[parameters]&_format=[mime-type]}</code>\n </li>\n \n \n\n \n\n \n\n </ul>\n \n\n \n\n <!-- Search Combination -->\n \n \n \n\n \n <h4 id=\"Server_Claim\" class=\"no_toc\">Claim</h4>\n\n <p>Conformance Expectation:\t<strong/></p>\n\n \n\n \n\n <p>Supported Profiles:</p>\n <ul>\n \n <li><strong>SHALL</strong> support \n <a href=\"StructureDefinition-davinci-pct-gfe-professional.html\">PCT Good Faith Estimate Professional</a>\n </li>\n \n <li><strong>SHALL</strong> support \n <a href=\"StructureDefinition-davinci-pct-gfe-institutional.html\">PCT Good Faith Estimate Institutional</a>\n </li>\n \n </ul>\n \n \n\n\n <p>\n \n\n \n\n \n\n \n </p>\n\n\n\n\n\n\n <!-- Resource Interactions -->\n \n\n <!-- Resource Operations -->\n \n\n\n\n <!-- TODO Nexted ul items do not appear with a subbullet style -->\n \n <br/>\n <p>Modify Criteria:</p> \n <ul>\n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>create</code> interaction creating a Claim resource using:\n <code class=\"highlighter-rouge\">POST [base]/Claim/[id]{?_format=[mime-type]}</code>\n \n </li>\n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n <li>\n <!-- TODO change note if server allows putting of a new one (with a specified ID) -->\n A Server <strong>MAY</strong> be capable of updating a existing Claim resource using:\n <code class=\"highlighter-rouge\">PUT [base]/Claim/[id]{?_format=[mime-type]}</code>\n \n </li>\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n <li>\n A Server <strong>MAY</strong> be capable of patching an existing Claim resource using:\n <code class=\"highlighter-rouge\">PATCH [base]/Claim/[id]{?_format=[mime-type]}</code>\n </li>\n \n\n \n \n\n \n\n \n <li>\n A Server <strong>MAY</strong> be capable of deleting a Claim resource using:\n <code class=\"highlighter-rouge\">DELETE [base]//[id]</code>\n \n </li>\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n </ul>\n \n\n\n \n <br/>\n <p>Fetch and Search Criteria:</p>\n <ul>\n \n \n \n \n \n \n \n \n \n \n <li>\n A Server <strong>SHALL</strong> be capable of a <code>search-type</code> interaction returning Claim resources matching a search query using:\n <code class=\"highlighter-rouge\">GET [base]/Claim/[id]{?[parameters]{&_format=[mime-type]}}</code>\n </li>\n \n \n \n \n \n <li>\n A Server <strong>SHALL</strong> be capable of a <code>read</code> interaction returning a Claim resource using:\n <code class=\"highlighter-rouge\">GET [base]/Claim/[id]</code>\n \n </li>\n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>vread</code> interaction returning a Claim resource using:\n <code class=\"highlighter-rouge\">GET [base]/Claim/[id]/_history/vid</code>\n </li>\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>history-instance</code> interaction returning a history of a Claim using:\n <code class=\"highlighter-rouge\">GET [base]/Claim/[id]/_history{?[parameters]&_format=[mime-type]}</code>\n </li>\n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>history-type</code> interaction returning the history of Claim resources using:\n <code class=\"highlighter-rouge\">GET [base]/Claim/_history{?[parameters]&_format=[mime-type]}</code>\n </li>\n \n \n\n \n\n \n\n </ul>\n \n\n \n\n <!-- Search Combination -->\n \n \n \n\n \n <h4 id=\"Server_Organization\" class=\"no_toc\">Organization</h4>\n\n <p>Conformance Expectation:\t<strong/></p>\n\n \n\n \n\n <p>Supported Profiles:</p>\n <ul>\n \n <li><strong>SHALL</strong> support \n <a href=\"StructureDefinition-davinci-pct-organization.html\">PCT Organization</a>\n </li>\n \n </ul>\n \n \n\n\n <p>\n \n\n \n\n \n\n \n </p>\n\n\n\n\n\n\n <!-- Resource Interactions -->\n \n\n <!-- Resource Operations -->\n \n\n\n\n <!-- TODO Nexted ul items do not appear with a subbullet style -->\n \n <br/>\n <p>Modify Criteria:</p> \n <ul>\n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>create</code> interaction creating a Organization resource using:\n <code class=\"highlighter-rouge\">POST [base]/Organization/[id]{?_format=[mime-type]}</code>\n \n </li>\n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n <li>\n <!-- TODO change note if server allows putting of a new one (with a specified ID) -->\n A Server <strong>MAY</strong> be capable of updating a existing Organization resource using:\n <code class=\"highlighter-rouge\">PUT [base]/Organization/[id]{?_format=[mime-type]}</code>\n \n </li>\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n <li>\n A Server <strong>MAY</strong> be capable of patching an existing Organization resource using:\n <code class=\"highlighter-rouge\">PATCH [base]/Organization/[id]{?_format=[mime-type]}</code>\n </li>\n \n\n \n \n\n \n\n \n <li>\n A Server <strong>MAY</strong> be capable of deleting a Organization resource using:\n <code class=\"highlighter-rouge\">DELETE [base]//[id]</code>\n \n </li>\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n </ul>\n \n\n\n \n <br/>\n <p>Fetch and Search Criteria:</p>\n <ul>\n \n \n \n \n \n \n \n \n \n \n <li>\n A Server <strong>SHALL</strong> be capable of a <code>search-type</code> interaction returning Organization resources matching a search query using:\n <code class=\"highlighter-rouge\">GET [base]/Organization/[id]{?[parameters]{&_format=[mime-type]}}</code>\n </li>\n \n \n \n \n \n <li>\n A Server <strong>SHALL</strong> be capable of a <code>read</code> interaction returning a Organization resource using:\n <code class=\"highlighter-rouge\">GET [base]/Organization/[id]</code>\n \n </li>\n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>vread</code> interaction returning a Organization resource using:\n <code class=\"highlighter-rouge\">GET [base]/Organization/[id]/_history/vid</code>\n </li>\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>history-instance</code> interaction returning a history of a Organization using:\n <code class=\"highlighter-rouge\">GET [base]/Organization/[id]/_history{?[parameters]&_format=[mime-type]}</code>\n </li>\n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>history-type</code> interaction returning the history of Organization resources using:\n <code class=\"highlighter-rouge\">GET [base]/Organization/_history{?[parameters]&_format=[mime-type]}</code>\n </li>\n \n \n\n \n\n \n\n </ul>\n \n\n \n\n <!-- Search Combination -->\n \n \n \n\n \n <h4 id=\"Server_Practitioner\" class=\"no_toc\">Practitioner</h4>\n\n <p>Conformance Expectation:\t<strong/></p>\n\n \n\n \n\n <p>Supported Profiles:</p>\n <ul>\n \n <li><strong>SHALL</strong> support \n <a href=\"StructureDefinition-davinci-pct-practitioner.html\">PCT Practitioner</a>\n </li>\n \n </ul>\n \n \n\n\n <p>\n \n\n \n\n \n\n \n </p>\n\n\n\n\n\n\n <!-- Resource Interactions -->\n \n\n <!-- Resource Operations -->\n \n\n\n\n <!-- TODO Nexted ul items do not appear with a subbullet style -->\n \n <br/>\n <p>Modify Criteria:</p> \n <ul>\n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>create</code> interaction creating a Practitioner resource using:\n <code class=\"highlighter-rouge\">POST [base]/Practitioner/[id]{?_format=[mime-type]}</code>\n \n </li>\n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n <li>\n <!-- TODO change note if server allows putting of a new one (with a specified ID) -->\n A Server <strong>MAY</strong> be capable of updating a existing Practitioner resource using:\n <code class=\"highlighter-rouge\">PUT [base]/Practitioner/[id]{?_format=[mime-type]}</code>\n \n </li>\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n <li>\n A Server <strong>MAY</strong> be capable of patching an existing Practitioner resource using:\n <code class=\"highlighter-rouge\">PATCH [base]/Practitioner/[id]{?_format=[mime-type]}</code>\n </li>\n \n\n \n \n\n \n\n \n <li>\n A Server <strong>MAY</strong> be capable of deleting a Practitioner resource using:\n <code class=\"highlighter-rouge\">DELETE [base]//[id]</code>\n \n </li>\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n \n\n \n\n \n\n\n \n\n \n </ul>\n \n\n\n \n <br/>\n <p>Fetch and Search Criteria:</p>\n <ul>\n \n \n \n \n \n \n \n \n \n \n <li>\n A Server <strong>SHALL</strong> be capable of a <code>search-type</code> interaction returning Practitioner resources matching a search query using:\n <code class=\"highlighter-rouge\">GET [base]/Practitioner/[id]{?[parameters]{&_format=[mime-type]}}</code>\n </li>\n \n \n \n \n \n <li>\n A Server <strong>SHALL</strong> be capable of a <code>read</code> interaction returning a Practitioner resource using:\n <code class=\"highlighter-rouge\">GET [base]/Practitioner/[id]</code>\n \n </li>\n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>vread</code> interaction returning a Practitioner resource using:\n <code class=\"highlighter-rouge\">GET [base]/Practitioner/[id]/_history/vid</code>\n </li>\n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>history-instance</code> interaction returning a history of a Practitioner using:\n <code class=\"highlighter-rouge\">GET [base]/Practitioner/[id]/_history{?[parameters]&_format=[mime-type]}</code>\n </li>\n \n \n \n \n \n \n \n \n <li>\n A Server <strong>MAY</strong> be capable of a <code>history-type</code> interaction returning the history of Practitioner resources using:\n <code class=\"highlighter-rouge\">GET [base]/Practitioner/_history{?[parameters]&_format=[mime-type]}</code>\n </li>\n \n \n\n \n\n \n\n </ul>\n \n\n \n\n <!-- Search Combination -->\n \n \n \n\n \n \n\n\n\n \n\n\n\n\n\n\n\n\n\n <!-- Messaging Capabilities -->\n \n\n <!-- Document Capabilities -->\n \n\n</div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "fm"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
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],
"url" : "http://hl7.org/fhir/us/davinci-pct/CapabilityStatement/davinci-pct",
"version" : "2.0.0-ballot",
"name" : "PatientCostTransparencyCapabilityStatement",
"title" : "Patient Cost Transparency Implementation Guide Payer Capability Statement",
"status" : "active",
"date" : "2023-03-28T14:21:32-05:00",
"publisher" : "HL7 International / Financial Management",
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],
"description" : "Payer capability statement for the Da Vinci Patient Cost Transparency Implementation Guide",
"jurisdiction" : [
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"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"copyright" : "Used by permission of HL7 International, all rights reserved Creative Commons License",
"kind" : "requirements",
"imports" : [
🔗 "http://hl7.org/fhir/us/core/CapabilityStatement/us-core-server"
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"xml"
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"_format" : [
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"valueCode" : "SHALL"
}
]
},
{
"extension" : [
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"url" : "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
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🔗 "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob-bundle"🔗 ,
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🔗 "extension" : [
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🔗 "extension" : [
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🔗 "extension" : [
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"url" : "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
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"interaction" : [
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}
],
"name" : "GFESubmit",
"definition" : "http://hl7.org/fhir/us/davinci-pct/OperationDefinition/GFE-submit",
"documentation" : "This operation is used by an entity to submit one or multiple GFEs as a Bundle containing the GFE(s) and other referenced resources for processing. The only input parameter is the single Bundle resource with one or multiple GFE(s) - each of which is based on the Claim resource (along with other referenced resources). The only output is a url for subsequent polling per [async pattern](https://hl7.org/fhir/R5/async-bundle.html). If after polling the response is complete, then the result will either be a single Bundle with the AEOB - which is based on the ExplanationOfBenefit resource, (and other referenced resources) or an OperationOutcome resource indicating the AEOB will be sent directly to the patient."
}
]
},
{
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}
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},
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🔗 "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage"
],
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🔗 "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional"🔗 ,
"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-institutional"
],
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}
]
},
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}
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}