Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot
Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot
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 |
@prefix fhir: <http://hl7.org/fhir/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- a fhir:CapabilityStatement ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "davinci-pct"] ; # fhir:meta [ fhir:versionId [ fhir:v "1" ] ; fhir:lastUpdated [ fhir:v "2023-03-28T19:21:32.176+00:00"^^xsd:dateTime ] ] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2 id=\"title\">Patient Cost Transparency Implementation Guide Payer Capability Statement</h2><ul><li>Implementation Guide Version: 2.0.0-ballot</li><li>FHIR Version: 4.0.1</li><li>Supported Formats: <strong>SHALL</strong> support <code>json</code>, <strong>SHOULD</strong> support <code>xml</code></li><li>Supported Patch Formats: </li><li>Published on: 2023-03-28 14:21:32-0500</li><li>Published by: HL7 International / Financial Management</li></ul><blockquote class=\"impl-note\"><p><strong>Note to Implementers: FHIR Capabilities</strong></p><p>Any FHIR capability may be 'allowed' by the system unless explicitly marked as "SHALL NOT". A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.</p></blockquote><h2 id=\"rest\">FHIR RESTful Capabilities</h2><div class=\"panel panel-default\"><div class=\"panel-heading\"><h3 id=\"mode1\" class=\"panel-title\">Mode: <code>server</code></h3></div><div class=\"panel-body\"><div class=\"lead\"><em>Summary of System-wide Interactions</em></div></div></div><h3 id=\"resourcesCap1\">Capabilities by Resource/Profile</h3><h4 id=\"resourcesSummary1\">Summary</h4><p>The summary table lists the resources that are part of this configuration, and for each resource it lists:</p><ul><li>The relevant profiles (if any)</li><li>The interactions supported by each resource (<b><span class=\"bg-info\">R</span></b>ead, <b><span class=\"bg-info\">S</span></b>earch, <b><span class=\"bg-info\">U</span></b>pdate, and <b><span class=\"bg-info\">C</span></b>reate, are always shown, while <b><span class=\"bg-info\">VR</span></b>ead, <b><span class=\"bg-info\">P</span></b>atch, <b><span class=\"bg-info\">D</span></b>elete, <b><span class=\"bg-info\">H</span></b>istory on <b><span class=\"bg-info\">I</span></b>nstance, or <b><span class=\"bg-info\">H</span></b>istory on <b><span class=\"bg-info\">T</span></b>ype are only present if at least one of the resources has support for them.</li><li><span>The required, recommended, and some optional search parameters (if any). </span></li><li>The linked resources enabled for <code>_include</code></li><li>The other resources enabled for <code>_revinclude</code></li><li>The operations on the resource (if any)</li></ul><div class=\"table-responsive\"><table class=\"table table-condensed table-hover\"><thead><tr><th><b>Resource Type</b></th><th><b>Profile</b></th><th class=\"text-center\"><b title=\"GET a resource (read interaction)\">R</b></th><th class=\"text-center\"><b title=\"GET past versions of resources (vread interaction)\">V-R</b></th><th class=\"text-center\"><b title=\"GET all set of resources of the type (search interaction)\">S</b></th><th class=\"text-center\"><b title=\"PUT a new resource version (update interaction)\">U</b></th><th class=\"text-center\"><b title=\"PATCH a new resource version (patch interaction)\">P</b></th><th class=\"text-center\"><b title=\"POST a new resource (create interaction)\">C</b></th><th class=\"text-center\"><b title=\"DELETE a resource (delete interaction)\">D</b></th><th class=\"text-center\"><b title=\"GET changes to a resource (history interaction on instance)\">H-I</b></th><th class=\"text-center\"><b title=\"GET changes for all resources of the type (history interaction on type)\">H-T</b></th><th><b title=\"Required and recommended search parameters\">Searches</b></th><th><code><b>_include</b></code></th><th><code><b>_revinclude</b></code></th><th><b>Operations</b></th></tr></thead><tbody><tr><td><a href=\"#Bundle1-1\">Bundle</a></td><td>Supported profiles:<br/> <a href=\"StructureDefinition-davinci-pct-aeob-bundle.html\">PCT AEOB Bundle</a><br/> <a href=\"StructureDefinition-davinci-pct-gfe-bundle.html\">PCT GFE Bundle</a><br/> <a href=\"StructureDefinition-davinci-pct-gfe-collection-bundle.html\">PCT GFE Collection Bundle</a></td><td>y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td></td><td/><td/><td><code>$GFESubmit</code></td></tr><tr><td><a href=\"#ExplanationOfBenefit1-2\">ExplanationOfBenefit</a></td><td>Supported profiles:<br/> <a href=\"StructureDefinition-davinci-pct-aeob.html\">PCT Advanced EOB</a></td><td>y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td></td><td/><td/><td/></tr><tr><td><a href=\"#Coverage1-3\">Coverage</a></td><td>Supported profiles:<br/> <a href=\"StructureDefinition-davinci-pct-coverage.html\">PCT Coverage</a></td><td>y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td></td><td/><td/><td/></tr><tr><td><a href=\"#Claim1-4\">Claim</a></td><td>Supported profiles:<br/> <a href=\"StructureDefinition-davinci-pct-gfe-professional.html\">PCT Good Faith Estimate Professional</a><br/> <a href=\"StructureDefinition-davinci-pct-gfe-institutional.html\">PCT Good Faith Estimate Institutional</a></td><td>y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td></td><td/><td/><td/></tr><tr><td><a href=\"#Organization1-5\">Organization</a></td><td>Supported profiles:<br/> <a href=\"StructureDefinition-davinci-pct-organization.html\">PCT Organization</a></td><td>y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td></td><td/><td/><td/></tr><tr><td><a href=\"#Practitioner1-6\">Practitioner</a></td><td>Supported profiles:<br/> <a href=\"StructureDefinition-davinci-pct-practitioner.html\">PCT Practitioner</a></td><td>y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td></td><td/><td/><td/></tr></tbody></table></div><hr/><div class=\"panel panel-default\"><div class=\"panel-heading\"><h4 id=\"Bundle1-1\" class=\"panel-title\"><span style=\"float: right;\">Resource Conformance: SHALL</span>Bundle</h4></div><div class=\"panel-body\"><div class=\"container\"><div class=\"row\"><div class=\"col-lg-4\"><span class=\"lead\">Core FHIR Resource</span><br/><a href=\"http://hl7.org/fhir/R4/bundle.html\">Bundle</a></div><div class=\"col-lg-4\"><span class=\"lead\">Reference Policy</span><br/></div><div class=\"col-lg-4\"><span class=\"lead\">Interaction summary</span><br/><ul><li><strong>SHALL</strong> support <code>search-type</code>, <code>read</code>.</li><li><strong>MAY</strong> support <code>create</code>, <code>vread</code>, <code>update</code>, <code>patch</code>, <code>delete</code>, <code>history-instance</code>, <code>history-type</code>.</li></ul></div></div><p/><div class=\"row\"><div class=\"col-6\"><span class=\"lead\">Supported Profiles</span><p><a href=\"StructureDefinition-davinci-pct-aeob-bundle.html\">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob-bundle</a><br/><a href=\"StructureDefinition-davinci-pct-gfe-bundle.html\">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-bundle</a><br/><a href=\"StructureDefinition-davinci-pct-gfe-collection-bundle.html\">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-collection-bundle</a></p></div></div><p/><div class=\"row\"><div class=\"col-12\"><span class=\"lead\">Extended Operations</span><table class=\"table table-condensed table-hover\"><thead><tr><th>Conformance</th><th>Operation</th><th>Documentation</th></tr></thead><tbody><tr><td><b>SHALL</b></td><td><a href=\"OperationDefinition-GFE-submit.html\">$GFESubmit</a></td><td><div><p>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 <a href=\"https://hl7.org/fhir/R5/async-bundle.html\">async pattern</a>. 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.</p>\n</div></td></tr></tbody></table></div></div></div></div></div><div class=\"panel panel-default\"><div class=\"panel-heading\"><h4 id=\"ExplanationOfBenefit1-2\" class=\"panel-title\"><span style=\"float: right;\">Resource Conformance: SHALL</span>ExplanationOfBenefit</h4></div><div class=\"panel-body\"><div class=\"container\"><div class=\"row\"><div class=\"col-lg-4\"><span class=\"lead\">Core FHIR Resource</span><br/><a href=\"http://hl7.org/fhir/R4/explanationofbenefit.html\">ExplanationOfBenefit</a></div><div class=\"col-lg-4\"><span class=\"lead\">Reference Policy</span><br/></div><div class=\"col-lg-4\"><span class=\"lead\">Interaction summary</span><br/><ul><li><strong>SHALL</strong> support <code>search-type</code>, <code>read</code>.</li><li><strong>MAY</strong> support <code>create</code>, <code>vread</code>, <code>update</code>, <code>patch</code>, <code>delete</code>, <code>history-instance</code>, <code>history-type</code>.</li></ul></div></div><p/><div class=\"row\"><div class=\"col-6\"><span class=\"lead\">Supported Profiles</span><p><a href=\"StructureDefinition-davinci-pct-aeob.html\">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob</a></p></div></div><p/></div></div></div><div class=\"panel panel-default\"><div class=\"panel-heading\"><h4 id=\"Coverage1-3\" class=\"panel-title\"><span style=\"float: right;\">Resource Conformance: SHALL</span>Coverage</h4></div><div class=\"panel-body\"><div class=\"container\"><div class=\"row\"><div class=\"col-lg-4\"><span class=\"lead\">Core FHIR Resource</span><br/><a href=\"http://hl7.org/fhir/R4/coverage.html\">Coverage</a></div><div class=\"col-lg-4\"><span class=\"lead\">Reference Policy</span><br/></div><div class=\"col-lg-4\"><span class=\"lead\">Interaction summary</span><br/><ul><li><strong>SHALL</strong> support <code>search-type</code>, <code>read</code>.</li><li><strong>MAY</strong> support <code>create</code>, <code>vread</code>, <code>update</code>, <code>patch</code>, <code>delete</code>, <code>history-instance</code>, <code>history-type</code>.</li></ul></div></div><p/><div class=\"row\"><div class=\"col-6\"><span class=\"lead\">Supported Profiles</span><p><a href=\"StructureDefinition-davinci-pct-coverage.html\">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage</a></p></div></div><p/></div></div></div><div class=\"panel panel-default\"><div class=\"panel-heading\"><h4 id=\"Claim1-4\" class=\"panel-title\"><span style=\"float: right;\">Resource Conformance: SHALL</span>Claim</h4></div><div class=\"panel-body\"><div class=\"container\"><div class=\"row\"><div class=\"col-lg-4\"><span class=\"lead\">Core FHIR Resource</span><br/><a href=\"http://hl7.org/fhir/R4/claim.html\">Claim</a></div><div class=\"col-lg-4\"><span class=\"lead\">Reference Policy</span><br/></div><div class=\"col-lg-4\"><span class=\"lead\">Interaction summary</span><br/><ul><li><strong>SHALL</strong> support <code>search-type</code>, <code>read</code>.</li><li><strong>MAY</strong> support <code>create</code>, <code>vread</code>, <code>update</code>, <code>patch</code>, <code>delete</code>, <code>history-instance</code>, <code>history-type</code>.</li></ul></div></div><p/><div class=\"row\"><div class=\"col-6\"><span class=\"lead\">Supported Profiles</span><p><a href=\"StructureDefinition-davinci-pct-gfe-professional.html\">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional</a><br/><a href=\"StructureDefinition-davinci-pct-gfe-institutional.html\">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-institutional</a></p></div></div><p/></div></div></div><div class=\"panel panel-default\"><div class=\"panel-heading\"><h4 id=\"Organization1-5\" class=\"panel-title\"><span style=\"float: right;\">Resource Conformance: SHALL</span>Organization</h4></div><div class=\"panel-body\"><div class=\"container\"><div class=\"row\"><div class=\"col-lg-4\"><span class=\"lead\">Core FHIR Resource</span><br/><a href=\"http://hl7.org/fhir/R4/organization.html\">Organization</a></div><div class=\"col-lg-4\"><span class=\"lead\">Reference Policy</span><br/></div><div class=\"col-lg-4\"><span class=\"lead\">Interaction summary</span><br/><ul><li><strong>SHALL</strong> support <code>search-type</code>, <code>read</code>.</li><li><strong>MAY</strong> support <code>create</code>, <code>vread</code>, <code>update</code>, <code>patch</code>, <code>delete</code>, <code>history-instance</code>, <code>history-type</code>.</li></ul></div></div><p/><div class=\"row\"><div class=\"col-6\"><span class=\"lead\">Supported Profiles</span><p><a href=\"StructureDefinition-davinci-pct-organization.html\">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization</a></p></div></div><p/></div></div></div><div class=\"panel panel-default\"><div class=\"panel-heading\"><h4 id=\"Practitioner1-6\" class=\"panel-title\"><span style=\"float: right;\">Resource Conformance: SHALL</span>Practitioner</h4></div><div class=\"panel-body\"><div class=\"container\"><div class=\"row\"><div class=\"col-lg-4\"><span class=\"lead\">Core FHIR Resource</span><br/><a href=\"http://hl7.org/fhir/R4/practitioner.html\">Practitioner</a></div><div class=\"col-lg-4\"><span class=\"lead\">Reference Policy</span><br/></div><div class=\"col-lg-4\"><span class=\"lead\">Interaction summary</span><br/><ul><li><strong>SHALL</strong> support <code>search-type</code>, <code>read</code>.</li><li><strong>MAY</strong> support <code>create</code>, <code>vread</code>, <code>update</code>, <code>patch</code>, <code>delete</code>, <code>history-instance</code>, <code>history-type</code>.</li></ul></div></div><p/><div class=\"row\"><div class=\"col-6\"><span class=\"lead\">Supported Profiles</span><p><a href=\"StructureDefinition-davinci-pct-practitioner.html\">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner</a></p></div></div><p/></div></div></div></div>" ] ; # fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ] ; fhir:value [ fhir:v "fm" ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ] ; fhir:value [ fhir:v "trial-use" ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ] ; fhir:value [ fhir:v "http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct> ] ] ) ] ] ) ; # fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pct/CapabilityStatement/davinci-pct"^^xsd:anyURI] ; # fhir:version [ fhir:v "2.0.0-ballot"] ; # fhir:name [ fhir:v "PatientCostTransparencyCapabilityStatement"] ; # fhir:title [ fhir:v "Patient Cost Transparency Implementation Guide Payer Capability Statement"] ; # fhir:status [ fhir:v "active"] ; # fhir:date [ fhir:v "2023-03-28T14:21:32-05:00"^^xsd:dateTime] ; # fhir:publisher [ fhir:v "HL7 International / Financial Management"] ; # fhir:contact ( [ fhir:name [ fhir:v "HL7 International / Financial Management" ] ; ( fhir:telecom [ fhir:system [ fhir:v "url" ] ; fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fm" ] ] [ fhir:system [ fhir:v "email" ] ; fhir:value [ fhir:v "fmlists@lists.hl7.org" ] ] ) ] ) ; # fhir:description [ fhir:v "Payer capability statement for the Da Vinci Patient Cost Transparency Implementation Guide"] ; # fhir:jurisdiction ( [ ( fhir:coding [ fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ] ; fhir:code [ fhir:v "US" ] ] ) ] ) ; # fhir:copyright [ fhir:v "Used by permission of HL7 International, all rights reserved Creative Commons License"] ; # fhir:kind [ fhir:v "requirements"] ; # fhir:imports ( [ fhir:v "http://hl7.org/fhir/us/core/CapabilityStatement/us-core-server"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/core/CapabilityStatement/us-core-server> ] ) ; # fhir:fhirVersion [ fhir:v "4.0.1"] ; # fhir:format ( [ fhir:v "json" ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ] [ fhir:v "xml" ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHOULD" ] ] ) ] ) ; # fhir:rest ( [ fhir:mode [ fhir:v "server" ] ; ( fhir:resource [ fhir:type [ fhir:v "Bundle" ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ] ; ( fhir:supportedProfile [ fhir:v "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob-bundle"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob-bundle> ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ] [ fhir:v "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-bundle"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-bundle> ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ] [ fhir:v "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-collection-bundle"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-collection-bundle> ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ] ) ; ( fhir:interaction [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "create" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:code [ fhir:v "search-type" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:code [ fhir:v "read" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "vread" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "update" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "patch" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "delete" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "history-instance" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "history-type" ] ] ) ; ( fhir:operation [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:name [ fhir:v "GFESubmit" ] ; fhir:definition [ fhir:v "http://hl7.org/fhir/us/davinci-pct/OperationDefinition/GFE-submit"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pct/OperationDefinition/GFE-submit> ] ; fhir:documentation [ fhir:v "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." ] ] ) ] [ fhir:type [ fhir:v "ExplanationOfBenefit" ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHOULD" ] ] ) ] ; ( fhir:supportedProfile [ fhir:v "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob> ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ] ) ; ( fhir:interaction [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "create" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:code [ fhir:v "search-type" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:code [ fhir:v "read" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "vread" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "update" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "patch" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "delete" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "history-instance" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "history-type" ] ] ) ] [ fhir:type [ fhir:v "Coverage" ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHOULD" ] ] ) ] ; ( fhir:supportedProfile [ fhir:v "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage> ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ] ) ; ( fhir:interaction [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "create" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:code [ fhir:v "search-type" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:code [ fhir:v "read" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "vread" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "update" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "patch" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "delete" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "history-instance" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "history-type" ] ] ) ] [ fhir:type [ fhir:v "Claim" ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHOULD" ] ] ) ] ; ( fhir:supportedProfile [ fhir:v "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional> ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ] [ fhir:v "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-institutional"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-institutional> ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ] ) ; ( fhir:interaction [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "create" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:code [ fhir:v "search-type" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:code [ fhir:v "read" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "vread" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "update" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "patch" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "delete" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "history-instance" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "history-type" ] ] ) ] [ fhir:type [ fhir:v "Organization" ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHOULD" ] ] ) ] ; ( fhir:supportedProfile [ fhir:v "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization> ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ] ) ; ( fhir:interaction [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "create" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:code [ fhir:v "search-type" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:code [ fhir:v "read" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "vread" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "update" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "patch" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "delete" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "history-instance" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "history-type" ] ] ) ] [ fhir:type [ fhir:v "Practitioner" ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHOULD" ] ] ) ] ; ( fhir:supportedProfile [ fhir:v "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner> ; ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ] ) ; ( fhir:interaction [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "create" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:code [ fhir:v "search-type" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "SHALL" ] ] ) ; fhir:code [ fhir:v "read" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "vread" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "update" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "patch" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "delete" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "history-instance" ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation"^^xsd:anyURI ] ; fhir:value [ fhir:v "MAY" ] ] ) ; fhir:code [ fhir:v "history-type" ] ] ) ] ) ] ) . #
IG © 2023+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pct#2.0.0-ballot based on FHIR 4.0.1. Generated 2024-04-08
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