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 |
<CapabilityStatement xmlns="http://hl7.org/fhir">
<id value="davinci-pct"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2023-03-28T19:21:32.176+00:00"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<!-- TODO
Jurisdiction
Prohibited extension - http://hl7.org/fhir/StructureDefinition/capabilitystatement-prohibited -->
<!-- set include_symbols = false to turn off confonrmance symbols and legen, true to turn on -->
<h2 id="title">Patient Cost Transparency Implementation Guide Payer Capability Statement</h2>
<ul>
<li><b>Title:</b>Patient Cost Transparency Implementation Guide Payer Capability Statement</li>
<li><b>Implementation Guide Version:</b> 2.0.0-ballot</li>
<li><b>FHIR Version:</b> 4.0.1</li>
<li><b>Intended Use:</b> Requirements</li>
<li><b>Supported Formats: </b>
<strong>SHALL</strong> support
json;
<strong>SHOULD</strong> support
xml;
</li>
<li><b>Published:</b> 2023-03-28 14:21:32-0500</li>
<li><b>Published by:</b> HL7 International / Financial Management</li>
<li><b>Status:</b> Active</li>
<li><b>Copyright:</b> <div><p>Used by permission of HL7 International, all rights reserved Creative Commons License</p>
</div></li>
</ul>
<br/>
<strong>Description:</strong> <div><div><p>Payer capability statement for the Da Vinci Patient Cost Transparency Implementation Guide</p>
</div></div>
<br/>
<h3>Support and Requirements for Other Artifacts</h3>
<tr>
<th>Imports other capabilities:</th>
<td>
<ul>
<li>
<a href="http://hl7.org/fhir/us/core/STU3.1.1/CapabilityStatement-us-core-server.html">US Core Server CapabilityStatement</a>
</li>
</ul>
</td>
</tr>
<br/>
<!-- TODO - Make this a summary of capabilities, including system wide and each paradigm -->
<p>
<b>Jump to:</b>
</p>
<ul>
<li><a href="#Server">REST Server</a></li>
</ul>
<!-- REST Capabilities -->
<br/>
<a name="Server"> </a>
<h3 id="behavior">FHIR Server RESTful Capabilities</h3>
<!-- REST Security -->
<!-- REST System wide Capabilities -->
<h3>System-wide Server Capabilities</h3>
<!-- REST System wide interactions -->
<!-- REST System wide operations -->
<!-- REST System wide search parameters -->
<!-- Resource Capabilities -->
<h4>Summary of Resource/Profile Capabilities</h4>
<!-- TODO need include conformance verb legend -->
<p><i>♦ = <b>SHALL</b> expectation</i>; <i>⋄ = <b>SHOULD</b> expectation</i>; <i>▿ = <b>MAY</b> expectation</i>;</p>
<table class="grid">
<thead>
<tr>
<th>Resource Type</th>
<th>Supported Interactions</th>
<th>Supported Profiles</th>
<th>Supported Searches</th>
<th>Supported <code>_includes</code></th>
<th>Supported <code>_revincludes</code></th>
<th>Supported Operations</th>
</tr>
</thead>
<tbody>
<tr>
<td>
<a href="#Server_Bundle"><span style="white-space: nowrap;">Bundle<span title="null"><sup/></span></span></a>
</td>
<!-- Supported Interactions -->
<td>
<span style="white-space: nowrap;">create<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">search-type<span title="SHALL"><sup>♦</sup></span></span>,
<span style="white-space: nowrap;">read<span title="SHALL"><sup>♦</sup></span></span>,
<span style="white-space: nowrap;">vread<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">update<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">patch<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">delete<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">history-instance<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">history-type<span title="MAY"><sup>▿</sup></span></span>,
</td>
<!-- Supported Profiles -->
<td>
<a href="StructureDefinition-davinci-pct-aeob-bundle.html">PCT AEOB Bundle</a><span title="SHALL, SHALL, SHALL"><sup/></span>,
<a href="StructureDefinition-davinci-pct-gfe-bundle.html">PCT GFE Bundle</a><span title="SHALL, SHALL, SHALL"><sup/></span>,
<a href="StructureDefinition-davinci-pct-gfe-collection-bundle.html">PCT GFE Collection Bundle</a><span title="SHALL, SHALL, SHALL"><sup/></span>,
</td>
<!-- Supported Searches will need to do some sort of mapping instead of join to get the expectations printed out -->
<td>
</td>
<!-- Supported _includes -->
<td>
</td>
<!-- Supported _revincludes -->
<td>
</td>
<!-- Supported Operations -->
<td>
<span style="white-space: nowrap;">$GFESubmit<span title="SHALL"><sup>♦</sup></span></span>
</td>
</tr>
<tr>
<td>
<a href="#Server_ExplanationOfBenefit"><span style="white-space: nowrap;">ExplanationOfBenefit<span title="null"><sup/></span></span></a>
</td>
<!-- Supported Interactions -->
<td>
<span style="white-space: nowrap;">create<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">search-type<span title="SHALL"><sup>♦</sup></span></span>,
<span style="white-space: nowrap;">read<span title="SHALL"><sup>♦</sup></span></span>,
<span style="white-space: nowrap;">vread<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">update<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">patch<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">delete<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">history-instance<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">history-type<span title="MAY"><sup>▿</sup></span></span>,
</td>
<!-- Supported Profiles -->
<td>
<a href="StructureDefinition-davinci-pct-aeob.html">PCT Advanced EOB</a><span title="SHALL"><sup>♦</sup></span>,
</td>
<!-- Supported Searches will need to do some sort of mapping instead of join to get the expectations printed out -->
<td>
</td>
<!-- Supported _includes -->
<td>
</td>
<!-- Supported _revincludes -->
<td>
</td>
<!-- Supported Operations -->
<td>
</td>
</tr>
<tr>
<td>
<a href="#Server_Coverage"><span style="white-space: nowrap;">Coverage<span title="null"><sup/></span></span></a>
</td>
<!-- Supported Interactions -->
<td>
<span style="white-space: nowrap;">create<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">search-type<span title="SHALL"><sup>♦</sup></span></span>,
<span style="white-space: nowrap;">read<span title="SHALL"><sup>♦</sup></span></span>,
<span style="white-space: nowrap;">vread<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">update<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">patch<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">delete<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">history-instance<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">history-type<span title="MAY"><sup>▿</sup></span></span>,
</td>
<!-- Supported Profiles -->
<td>
<a href="StructureDefinition-davinci-pct-coverage.html">PCT Coverage</a><span title="SHALL"><sup>♦</sup></span>,
</td>
<!-- Supported Searches will need to do some sort of mapping instead of join to get the expectations printed out -->
<td>
</td>
<!-- Supported _includes -->
<td>
</td>
<!-- Supported _revincludes -->
<td>
</td>
<!-- Supported Operations -->
<td>
</td>
</tr>
<tr>
<td>
<a href="#Server_Claim"><span style="white-space: nowrap;">Claim<span title="null"><sup/></span></span></a>
</td>
<!-- Supported Interactions -->
<td>
<span style="white-space: nowrap;">create<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">search-type<span title="SHALL"><sup>♦</sup></span></span>,
<span style="white-space: nowrap;">read<span title="SHALL"><sup>♦</sup></span></span>,
<span style="white-space: nowrap;">vread<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">update<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">patch<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">delete<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">history-instance<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">history-type<span title="MAY"><sup>▿</sup></span></span>,
</td>
<!-- Supported Profiles -->
<td>
<a href="StructureDefinition-davinci-pct-gfe-professional.html">PCT Good Faith Estimate Professional</a><span title="SHALL, SHALL"><sup/></span>,
<a href="StructureDefinition-davinci-pct-gfe-institutional.html">PCT Good Faith Estimate Institutional</a><span title="SHALL, SHALL"><sup/></span>,
</td>
<!-- Supported Searches will need to do some sort of mapping instead of join to get the expectations printed out -->
<td>
</td>
<!-- Supported _includes -->
<td>
</td>
<!-- Supported _revincludes -->
<td>
</td>
<!-- Supported Operations -->
<td>
</td>
</tr>
<tr>
<td>
<a href="#Server_Organization"><span style="white-space: nowrap;">Organization<span title="null"><sup/></span></span></a>
</td>
<!-- Supported Interactions -->
<td>
<span style="white-space: nowrap;">create<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">search-type<span title="SHALL"><sup>♦</sup></span></span>,
<span style="white-space: nowrap;">read<span title="SHALL"><sup>♦</sup></span></span>,
<span style="white-space: nowrap;">vread<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">update<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">patch<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">delete<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">history-instance<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">history-type<span title="MAY"><sup>▿</sup></span></span>,
</td>
<!-- Supported Profiles -->
<td>
<a href="StructureDefinition-davinci-pct-organization.html">PCT Organization</a><span title="SHALL"><sup>♦</sup></span>,
</td>
<!-- Supported Searches will need to do some sort of mapping instead of join to get the expectations printed out -->
<td>
</td>
<!-- Supported _includes -->
<td>
</td>
<!-- Supported _revincludes -->
<td>
</td>
<!-- Supported Operations -->
<td>
</td>
</tr>
<tr>
<td>
<a href="#Server_Practitioner"><span style="white-space: nowrap;">Practitioner<span title="null"><sup/></span></span></a>
</td>
<!-- Supported Interactions -->
<td>
<span style="white-space: nowrap;">create<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">search-type<span title="SHALL"><sup>♦</sup></span></span>,
<span style="white-space: nowrap;">read<span title="SHALL"><sup>♦</sup></span></span>,
<span style="white-space: nowrap;">vread<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">update<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">patch<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">delete<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">history-instance<span title="MAY"><sup>▿</sup></span></span>,
<span style="white-space: nowrap;">history-type<span title="MAY"><sup>▿</sup></span></span>,
</td>
<!-- Supported Profiles -->
<td>
<a href="StructureDefinition-davinci-pct-practitioner.html">PCT Practitioner</a><span title="SHALL"><sup>♦</sup></span>,
</td>
<!-- Supported Searches will need to do some sort of mapping instead of join to get the expectations printed out -->
<td>
</td>
<!-- Supported _includes -->
<td>
</td>
<!-- Supported _revincludes -->
<td>
</td>
<!-- Supported Operations -->
<td>
</td>
</tr>
</tbody>
</table>
<br/>
<h3 id="resource-details" class="no_toc">RESTful Server Capabilities by Resource/Profile:</h3>
<!-- Each REST Resource Detail -->
<h4 id="Server_Bundle" class="no_toc">Bundle</h4>
<p>Conformance Expectation: <strong/></p>
<p>Supported Profiles:</p>
<ul>
<li><strong>SHALL</strong> support
<a href="StructureDefinition-davinci-pct-aeob-bundle.html">PCT AEOB Bundle</a>
</li>
<li><strong>SHALL</strong> support
<a href="StructureDefinition-davinci-pct-gfe-bundle.html">PCT GFE Bundle</a>
</li>
<li><strong>SHALL</strong> support
<a href="StructureDefinition-davinci-pct-gfe-collection-bundle.html">PCT GFE Collection Bundle</a>
</li>
</ul>
<p>
</p>
<!-- Resource Interactions -->
<p>Bundle Interaction Summary:</p>
<ul>
<li><strong>SHALL</strong> support search-type, read, </li>
<li><strong>MAY</strong> support create, vread, update, patch, delete, history-instance, history-type, </li>
</ul>
<!-- Resource Operations -->
<!-- TODO Nexted ul items do not appear with a subbullet style -->
<br/>
<p>Modify Criteria:</p>
<ul>
<li>
A Server <strong>MAY</strong> be capable of a <code>create</code> interaction creating a Bundle resource using:
<code class="highlighter-rouge">POST [base]/Bundle/[id]{?_format=[mime-type]}</code>
</li>
<li>
<!-- TODO change note if server allows putting of a new one (with a specified ID) -->
A Server <strong>MAY</strong> be capable of updating a existing Bundle resource using:
<code class="highlighter-rouge">PUT [base]/Bundle/[id]{?_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of patching an existing Bundle resource using:
<code class="highlighter-rouge">PATCH [base]/Bundle/[id]{?_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of deleting a Bundle resource using:
<code class="highlighter-rouge">DELETE [base]//[id]</code>
</li>
</ul>
<br/>
<p>Fetch and Search Criteria:</p>
<ul>
<li>
A Server <strong>SHALL</strong> be capable of a <code>search-type</code> interaction returning Bundle resources matching a search query using:
<code class="highlighter-rouge">GET [base]/Bundle/[id]{?[parameters]{&_format=[mime-type]}}</code>
</li>
<li>
A Server <strong>SHALL</strong> be capable of a <code>read</code> interaction returning a Bundle resource using:
<code class="highlighter-rouge">GET [base]/Bundle/[id]</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>vread</code> interaction returning a Bundle resource using:
<code class="highlighter-rouge">GET [base]/Bundle/[id]/_history/vid</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>history-instance</code> interaction returning a history of a Bundle using:
<code class="highlighter-rouge">GET [base]/Bundle/[id]/_history{?[parameters]&_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>history-type</code> interaction returning the history of Bundle resources using:
<code class="highlighter-rouge">GET [base]/Bundle/_history{?[parameters]&_format=[mime-type]}</code>
</li>
</ul>
<!-- Search Combination -->
<h4 id="Server_ExplanationOfBenefit" class="no_toc">ExplanationOfBenefit</h4>
<p>Conformance Expectation: <strong/></p>
<p>Supported Profiles:</p>
<ul>
<li><strong>SHALL</strong> support
<a href="StructureDefinition-davinci-pct-aeob.html">PCT Advanced EOB</a>
</li>
</ul>
<p>
</p>
<!-- Resource Interactions -->
<!-- Resource Operations -->
<!-- TODO Nexted ul items do not appear with a subbullet style -->
<br/>
<p>Modify Criteria:</p>
<ul>
<li>
A Server <strong>MAY</strong> be capable of a <code>create</code> interaction creating a ExplanationOfBenefit resource using:
<code class="highlighter-rouge">POST [base]/ExplanationOfBenefit/[id]{?_format=[mime-type]}</code>
</li>
<li>
<!-- TODO change note if server allows putting of a new one (with a specified ID) -->
A Server <strong>MAY</strong> be capable of updating a existing ExplanationOfBenefit resource using:
<code class="highlighter-rouge">PUT [base]/ExplanationOfBenefit/[id]{?_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of patching an existing ExplanationOfBenefit resource using:
<code class="highlighter-rouge">PATCH [base]/ExplanationOfBenefit/[id]{?_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of deleting a ExplanationOfBenefit resource using:
<code class="highlighter-rouge">DELETE [base]//[id]</code>
</li>
</ul>
<br/>
<p>Fetch and Search Criteria:</p>
<ul>
<li>
A Server <strong>SHALL</strong> be capable of a <code>search-type</code> interaction returning ExplanationOfBenefit resources matching a search query using:
<code class="highlighter-rouge">GET [base]/ExplanationOfBenefit/[id]{?[parameters]{&_format=[mime-type]}}</code>
</li>
<li>
A Server <strong>SHALL</strong> be capable of a <code>read</code> interaction returning a ExplanationOfBenefit resource using:
<code class="highlighter-rouge">GET [base]/ExplanationOfBenefit/[id]</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>vread</code> interaction returning a ExplanationOfBenefit resource using:
<code class="highlighter-rouge">GET [base]/ExplanationOfBenefit/[id]/_history/vid</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>history-instance</code> interaction returning a history of a ExplanationOfBenefit using:
<code class="highlighter-rouge">GET [base]/ExplanationOfBenefit/[id]/_history{?[parameters]&_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>history-type</code> interaction returning the history of ExplanationOfBenefit resources using:
<code class="highlighter-rouge">GET [base]/ExplanationOfBenefit/_history{?[parameters]&_format=[mime-type]}</code>
</li>
</ul>
<!-- Search Combination -->
<h4 id="Server_Coverage" class="no_toc">Coverage</h4>
<p>Conformance Expectation: <strong/></p>
<p>Supported Profiles:</p>
<ul>
<li><strong>SHALL</strong> support
<a href="StructureDefinition-davinci-pct-coverage.html">PCT Coverage</a>
</li>
</ul>
<p>
</p>
<!-- Resource Interactions -->
<!-- Resource Operations -->
<!-- TODO Nexted ul items do not appear with a subbullet style -->
<br/>
<p>Modify Criteria:</p>
<ul>
<li>
A Server <strong>MAY</strong> be capable of a <code>create</code> interaction creating a Coverage resource using:
<code class="highlighter-rouge">POST [base]/Coverage/[id]{?_format=[mime-type]}</code>
</li>
<li>
<!-- TODO change note if server allows putting of a new one (with a specified ID) -->
A Server <strong>MAY</strong> be capable of updating a existing Coverage resource using:
<code class="highlighter-rouge">PUT [base]/Coverage/[id]{?_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of patching an existing Coverage resource using:
<code class="highlighter-rouge">PATCH [base]/Coverage/[id]{?_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of deleting a Coverage resource using:
<code class="highlighter-rouge">DELETE [base]//[id]</code>
</li>
</ul>
<br/>
<p>Fetch and Search Criteria:</p>
<ul>
<li>
A Server <strong>SHALL</strong> be capable of a <code>search-type</code> interaction returning Coverage resources matching a search query using:
<code class="highlighter-rouge">GET [base]/Coverage/[id]{?[parameters]{&_format=[mime-type]}}</code>
</li>
<li>
A Server <strong>SHALL</strong> be capable of a <code>read</code> interaction returning a Coverage resource using:
<code class="highlighter-rouge">GET [base]/Coverage/[id]</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>vread</code> interaction returning a Coverage resource using:
<code class="highlighter-rouge">GET [base]/Coverage/[id]/_history/vid</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>history-instance</code> interaction returning a history of a Coverage using:
<code class="highlighter-rouge">GET [base]/Coverage/[id]/_history{?[parameters]&_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>history-type</code> interaction returning the history of Coverage resources using:
<code class="highlighter-rouge">GET [base]/Coverage/_history{?[parameters]&_format=[mime-type]}</code>
</li>
</ul>
<!-- Search Combination -->
<h4 id="Server_Claim" class="no_toc">Claim</h4>
<p>Conformance Expectation: <strong/></p>
<p>Supported Profiles:</p>
<ul>
<li><strong>SHALL</strong> support
<a href="StructureDefinition-davinci-pct-gfe-professional.html">PCT Good Faith Estimate Professional</a>
</li>
<li><strong>SHALL</strong> support
<a href="StructureDefinition-davinci-pct-gfe-institutional.html">PCT Good Faith Estimate Institutional</a>
</li>
</ul>
<p>
</p>
<!-- Resource Interactions -->
<!-- Resource Operations -->
<!-- TODO Nexted ul items do not appear with a subbullet style -->
<br/>
<p>Modify Criteria:</p>
<ul>
<li>
A Server <strong>MAY</strong> be capable of a <code>create</code> interaction creating a Claim resource using:
<code class="highlighter-rouge">POST [base]/Claim/[id]{?_format=[mime-type]}</code>
</li>
<li>
<!-- TODO change note if server allows putting of a new one (with a specified ID) -->
A Server <strong>MAY</strong> be capable of updating a existing Claim resource using:
<code class="highlighter-rouge">PUT [base]/Claim/[id]{?_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of patching an existing Claim resource using:
<code class="highlighter-rouge">PATCH [base]/Claim/[id]{?_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of deleting a Claim resource using:
<code class="highlighter-rouge">DELETE [base]//[id]</code>
</li>
</ul>
<br/>
<p>Fetch and Search Criteria:</p>
<ul>
<li>
A Server <strong>SHALL</strong> be capable of a <code>search-type</code> interaction returning Claim resources matching a search query using:
<code class="highlighter-rouge">GET [base]/Claim/[id]{?[parameters]{&_format=[mime-type]}}</code>
</li>
<li>
A Server <strong>SHALL</strong> be capable of a <code>read</code> interaction returning a Claim resource using:
<code class="highlighter-rouge">GET [base]/Claim/[id]</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>vread</code> interaction returning a Claim resource using:
<code class="highlighter-rouge">GET [base]/Claim/[id]/_history/vid</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>history-instance</code> interaction returning a history of a Claim using:
<code class="highlighter-rouge">GET [base]/Claim/[id]/_history{?[parameters]&_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>history-type</code> interaction returning the history of Claim resources using:
<code class="highlighter-rouge">GET [base]/Claim/_history{?[parameters]&_format=[mime-type]}</code>
</li>
</ul>
<!-- Search Combination -->
<h4 id="Server_Organization" class="no_toc">Organization</h4>
<p>Conformance Expectation: <strong/></p>
<p>Supported Profiles:</p>
<ul>
<li><strong>SHALL</strong> support
<a href="StructureDefinition-davinci-pct-organization.html">PCT Organization</a>
</li>
</ul>
<p>
</p>
<!-- Resource Interactions -->
<!-- Resource Operations -->
<!-- TODO Nexted ul items do not appear with a subbullet style -->
<br/>
<p>Modify Criteria:</p>
<ul>
<li>
A Server <strong>MAY</strong> be capable of a <code>create</code> interaction creating a Organization resource using:
<code class="highlighter-rouge">POST [base]/Organization/[id]{?_format=[mime-type]}</code>
</li>
<li>
<!-- TODO change note if server allows putting of a new one (with a specified ID) -->
A Server <strong>MAY</strong> be capable of updating a existing Organization resource using:
<code class="highlighter-rouge">PUT [base]/Organization/[id]{?_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of patching an existing Organization resource using:
<code class="highlighter-rouge">PATCH [base]/Organization/[id]{?_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of deleting a Organization resource using:
<code class="highlighter-rouge">DELETE [base]//[id]</code>
</li>
</ul>
<br/>
<p>Fetch and Search Criteria:</p>
<ul>
<li>
A Server <strong>SHALL</strong> be capable of a <code>search-type</code> interaction returning Organization resources matching a search query using:
<code class="highlighter-rouge">GET [base]/Organization/[id]{?[parameters]{&_format=[mime-type]}}</code>
</li>
<li>
A Server <strong>SHALL</strong> be capable of a <code>read</code> interaction returning a Organization resource using:
<code class="highlighter-rouge">GET [base]/Organization/[id]</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>vread</code> interaction returning a Organization resource using:
<code class="highlighter-rouge">GET [base]/Organization/[id]/_history/vid</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>history-instance</code> interaction returning a history of a Organization using:
<code class="highlighter-rouge">GET [base]/Organization/[id]/_history{?[parameters]&_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>history-type</code> interaction returning the history of Organization resources using:
<code class="highlighter-rouge">GET [base]/Organization/_history{?[parameters]&_format=[mime-type]}</code>
</li>
</ul>
<!-- Search Combination -->
<h4 id="Server_Practitioner" class="no_toc">Practitioner</h4>
<p>Conformance Expectation: <strong/></p>
<p>Supported Profiles:</p>
<ul>
<li><strong>SHALL</strong> support
<a href="StructureDefinition-davinci-pct-practitioner.html">PCT Practitioner</a>
</li>
</ul>
<p>
</p>
<!-- Resource Interactions -->
<!-- Resource Operations -->
<!-- TODO Nexted ul items do not appear with a subbullet style -->
<br/>
<p>Modify Criteria:</p>
<ul>
<li>
A Server <strong>MAY</strong> be capable of a <code>create</code> interaction creating a Practitioner resource using:
<code class="highlighter-rouge">POST [base]/Practitioner/[id]{?_format=[mime-type]}</code>
</li>
<li>
<!-- TODO change note if server allows putting of a new one (with a specified ID) -->
A Server <strong>MAY</strong> be capable of updating a existing Practitioner resource using:
<code class="highlighter-rouge">PUT [base]/Practitioner/[id]{?_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of patching an existing Practitioner resource using:
<code class="highlighter-rouge">PATCH [base]/Practitioner/[id]{?_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of deleting a Practitioner resource using:
<code class="highlighter-rouge">DELETE [base]//[id]</code>
</li>
</ul>
<br/>
<p>Fetch and Search Criteria:</p>
<ul>
<li>
A Server <strong>SHALL</strong> be capable of a <code>search-type</code> interaction returning Practitioner resources matching a search query using:
<code class="highlighter-rouge">GET [base]/Practitioner/[id]{?[parameters]{&_format=[mime-type]}}</code>
</li>
<li>
A Server <strong>SHALL</strong> be capable of a <code>read</code> interaction returning a Practitioner resource using:
<code class="highlighter-rouge">GET [base]/Practitioner/[id]</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>vread</code> interaction returning a Practitioner resource using:
<code class="highlighter-rouge">GET [base]/Practitioner/[id]/_history/vid</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>history-instance</code> interaction returning a history of a Practitioner using:
<code class="highlighter-rouge">GET [base]/Practitioner/[id]/_history{?[parameters]&_format=[mime-type]}</code>
</li>
<li>
A Server <strong>MAY</strong> be capable of a <code>history-type</code> interaction returning the history of Practitioner resources using:
<code class="highlighter-rouge">GET [base]/Practitioner/_history{?[parameters]&_format=[mime-type]}</code>
</li>
</ul>
<!-- Search Combination -->
<!-- Messaging Capabilities -->
<!-- Document Capabilities -->
</div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="fm"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
<valueCode value="trial-use">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
<valueCanonical
value="http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct"/>
</extension>
</valueCode>
</extension>
<url
value="http://hl7.org/fhir/us/davinci-pct/CapabilityStatement/davinci-pct"/>
<version value="2.0.0-ballot"/>
<name value="PatientCostTransparencyCapabilityStatement"/>
<title
value="Patient Cost Transparency Implementation Guide Payer Capability Statement"/>
<status value="active"/>
<date value="2023-03-28T14:21:32-05:00"/>
<publisher value="HL7 International / Financial Management"/>
<contact>
<name value="HL7 International / Financial Management"/>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/fm"/>
</telecom>
<telecom>
<system value="email"/>
<value value="fmlists@lists.hl7.org"/>
</telecom>
</contact>
<description
value="Payer capability statement for the Da Vinci Patient Cost Transparency Implementation Guide"/>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="US"/>
</coding>
</jurisdiction>
<copyright
value="Used by permission of HL7 International, all rights reserved Creative Commons License"/>
<kind value="requirements"/>
<imports
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<fhirVersion value="4.0.1"/>
<format value="json">
<extension
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<valueCode value="SHALL"/>
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</format>
<format value="xml">
<extension
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<valueCode value="SHOULD"/>
</extension>
</format>
<rest>
<mode value="server"/>
<resource>
<type value="Bundle">
<extension
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<valueCode value="SHALL"/>
</extension>
</type>
<supportedProfile
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<extension
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<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<supportedProfile
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<extension
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<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<supportedProfile
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<extension
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<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="create"/>
</interaction>
<interaction>
<extension
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<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<interaction>
<extension
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<valueCode value="SHALL"/>
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<code value="read"/>
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<interaction>
<extension
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<valueCode value="MAY"/>
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<code value="vread"/>
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<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="update"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="patch"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="delete"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-instance"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-type"/>
</interaction>
<operation>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="GFESubmit"/>
<definition
value="http://hl7.org/fhir/us/davinci-pct/OperationDefinition/GFE-submit"/>
<documentation
value="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."/>
</operation>
</resource>
<resource>
<type value="ExplanationOfBenefit">
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
</type>
<supportedProfile
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<extension
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<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="create"/>
</interaction>
<interaction>
<extension
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<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<interaction>
<extension
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<valueCode value="SHALL"/>
</extension>
<code value="read"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="vread"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="update"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="patch"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="delete"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-instance"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-type"/>
</interaction>
</resource>
<resource>
<type value="Coverage">
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
</type>
<supportedProfile
value="http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage">🔗
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="create"/>
</interaction>
<interaction>
<extension
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<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<interaction>
<extension
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<valueCode value="SHALL"/>
</extension>
<code value="read"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="vread"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="update"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="patch"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="delete"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-instance"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-type"/>
</interaction>
</resource>
<resource>
<type value="Claim">
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
</type>
<supportedProfile
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<extension
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<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<supportedProfile
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<extension
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<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<interaction>
<extension
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<valueCode value="MAY"/>
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<code value="create"/>
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<interaction>
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<code value="search-type"/>
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<interaction>
<extension
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<valueCode value="SHALL"/>
</extension>
<code value="read"/>
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<interaction>
<extension
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<valueCode value="MAY"/>
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<code value="vread"/>
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<interaction>
<extension
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<valueCode value="MAY"/>
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<code value="update"/>
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<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="patch"/>
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<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="delete"/>
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<interaction>
<extension
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<valueCode value="MAY"/>
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<code value="history-instance"/>
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<interaction>
<extension
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<valueCode value="MAY"/>
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<code value="history-type"/>
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<resource>
<type value="Organization">
<extension
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<valueCode value="SHOULD"/>
</extension>
</type>
<supportedProfile
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<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="create"/>
</interaction>
<interaction>
<extension
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<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="read"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="vread"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="update"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="patch"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="delete"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="history-instance"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="history-type"/>
</interaction>
</resource>
<resource>
<type value="Practitioner">
<extension
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<valueCode value="SHOULD"/>
</extension>
</type>
<supportedProfile
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<extension
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<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="create"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<interaction>
<extension
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<valueCode value="SHALL"/>
</extension>
<code value="read"/>
</interaction>
<interaction>
<extension
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<valueCode value="MAY"/>
</extension>
<code value="vread"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="update"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="patch"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="delete"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-instance"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-type"/>
</interaction>
</resource>
</rest>
</CapabilityStatement>
IG © 2023+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pct#2.0.0-ballot based on FHIR 4.0.1. Generated 2024-11-20
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