Finance and Insurance Service (FAIS)
1.0.1-current - ci-build
Finance and Insurance Service (FAIS)
1.0.1-current - ci-build
Finance and Insurance Service (FAIS), published by IHE IT Infrastructure Technical Committee. This guide is not an authorized publication; it is the continuous build for version 1.0.1-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/ITI.Finance/ and changes regularly. See the Directory of published versions
| Active as of 2024-07-17 |
<CapabilityStatement xmlns="http://hl7.org/fhir">
<id value="IHE.FAIS.BeneficiaryManager"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CapabilityStatement IHE.FAIS.BeneficiaryManager</b></p><a name="IHE.FAIS.BeneficiaryManager"> </a><a name="hcIHE.FAIS.BeneficiaryManager"> </a><a name="IHE.FAIS.BeneficiaryManager-en-US"> </a><h2 id="title">IHE FAIS Beneficiary Manager</h2><ul><li>Implementation Guide Version: 1.0.1-current </li><li>FHIR Version: 4.0.1 </li><li>Supported Formats: <code>application/fhir+xml</code>, <code>application/fhir+json</code></li><li>Supported Patch Formats: </li><li>Published on: 2024-07-17 </li><li>Published by: IHE IT Infrastructure Technical Committee </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><p>FAIS Beneficiary Manager processes requests from the Beneficiary Requestor on Insurance Plans and Enrollment Responses and receives the Enrollment Request submission.</p>
</div><div class="lead"><em>Security</em></div><blockquote><div><p>Recommend <a href="https://profiles.ihe.net/ITI/TF/Volume1/ch-9.html">ATNA</a>, encouraged <a href="https://profiles.ihe.net/ITI/IUA/index.html">IHE-IUA</a> or <a href="http://www.hl7.org/fhir/smart-app-launch/">SMART-app-launch</a></p>
</div></blockquote><div class="lead"><em>Summary of System-wide Interactions</em></div><ul><li><strong>SHALL </strong>support the <code>search-system</code>interaction.</li></ul></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 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="POST a new resource (create interaction)">C</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="#InsurancePlan1-1">InsurancePlan</a></td><td>Supported Profiles<br/> <a href="StructureDefinition-IHE.FAIS.InsurancePlan.html">FAIS InsurancePlan Profile</a></td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center"></td><td class="text-center"></td><td>_lastUpdated, _id, status, type, name, identifier, administered-by, owned-by, network, coverage-area, benefit-type</td><td/><td/><td/></tr><tr><td><a href="#EnrollmentRequest1-2">EnrollmentRequest</a></td><td>Supported Profiles<br/> <a href="StructureDefinition-IHE.FAIS.EnrollmentRequest.html">FAIS EnrollmentRequest Profile</a></td><td class="text-center"></td><td class="text-center"></td><td class="text-center"></td><td class="text-center"></td><td></td><td/><td/><td><code>$submit</code></td></tr><tr><td><a href="#EnrollmentResponse1-3">EnrollmentResponse</a></td><td>Supported Profiles<br/> <a href="StructureDefinition-IHE.FAIS.EnrollmentResponse.html">FAIS EnrollmentResponse Profile</a></td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center"></td><td class="text-center"></td><td>_lastUpdated, _id, status, request</td><td/><td/><td/></tr></tbody></table></div><hr/><div class="panel panel-default"><div class="panel-heading"><h4 id="InsurancePlan1-1" class="panel-title"><span style="float: right;">Resource Conformance: SHALL </span>InsurancePlan</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/insuranceplan.html">InsurancePlan</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>read</code>, <code>search-type</code>.</li></ul></div></div><p/><div class="row"><div class="col-6"><span class="lead">Supported Profiles</span><p><a href="StructureDefinition-IHE.FAIS.InsurancePlan.html">FAIS InsurancePlan Profile</a></p></div></div><p/><div class="row"><div class="col-12"><span class="lead">Documentation</span><blockquote><div><p>FAIS Query Insurance Plan transaction <a href="ITI-121.html">[ITI-121]</a></p>
</div></blockquote></div></div><div class="row"><div class="col-lg-7"><span class="lead">Search Parameters</span><table class="table table-condensed table-hover"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>Documentation</th></tr></thead><tbody><tr><td><b>SHALL</b></td><td>_lastUpdated</td><td><code>date</code></td><td><div><p>When the resource version last changed. The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb.</p>
</div></td></tr><tr><td><b>SHALL</b></td><td>_id</td><td><code>token</code></td><td><div><p>Logical id of this artifact</p>
</div></td></tr><tr><td><b>SHALL</b></td><td>status</td><td><code>token</code></td><td><div><p>The status of the Insurance Plan</p>
</div></td></tr><tr><td><b>SHALL</b></td><td>type</td><td><code>token</code></td><td><div><p>The type of the Insurance Plan</p>
</div></td></tr><tr><td><b>SHALL</b></td><td>name</td><td><code>string</code></td><td><div><p>The name of the Insurance Plan</p>
</div></td></tr><tr><td><b>SHALL</b></td><td>identifier</td><td><code>token</code></td><td><div><p>The business identifiers of the Insurance Plan</p>
</div></td></tr><tr><td><b>SHALL</b></td><td>administered-by</td><td><code>reference</code></td><td><div><p>Who administers the Insurance Plan</p>
</div></td></tr><tr><td><b>SHALL</b></td><td>owned-by</td><td><code>reference</code></td><td><div><p>Who owns the Insurance Plan</p>
</div></td></tr><tr><td><b>SHOULD</b></td><td><a href="SearchParameter-InsurancePlan-network.html">network</a></td><td><code>reference</code></td><td><div><p>The Insurance Plan network</p>
</div></td></tr><tr><td><b>SHOULD</b></td><td><a href="SearchParameter-InsurancePlan-coverageArea.html">coverage-area</a></td><td><code>reference</code></td><td><div><p>The Insurance Plan coverage area</p>
</div></td></tr><tr><td><b>SHOULD</b></td><td><a href="SearchParameter-InsurancePlan-benefitType.html">benefit-type</a></td><td><code>token</code></td><td><div><p>The Insurance Plan type of benefit</p>
</div></td></tr></tbody></table></div><div class="col-lg-5"> </div></div></div></div></div><div class="panel panel-default"><div class="panel-heading"><h4 id="EnrollmentRequest1-2" class="panel-title"><span style="float: right;">Resource Conformance: supported </span>EnrollmentRequest</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/enrollmentrequest.html">EnrollmentRequest</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/></div></div><p/><div class="row"><div class="col-6"><span class="lead">Supported Profiles</span><p><a href="StructureDefinition-IHE.FAIS.EnrollmentRequest.html">FAIS EnrollmentRequest Profile</a></p></div></div><p/><div class="row"><div class="col-12"><span class="lead">Documentation</span><blockquote><div><p>FAIS Enroll Beneficiary transaction <a href="ITI-122.html">[ITI-122]</a></p>
</div></blockquote></div></div><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-IHE.FAIS.EnrollmentRequest.Submit.html">$submit</a></td><td><div><p>Submits an enrollment request to enroll a new beneficiary with the request coverage. FAIS Enroll Beneficiary transaction <a href="ITI-122.html">[ITI-122]</a></p>
</div></td></tr></tbody></table></div></div></div></div></div><div class="panel panel-default"><div class="panel-heading"><h4 id="EnrollmentResponse1-3" class="panel-title"><span style="float: right;">Resource Conformance: SHALL </span>EnrollmentResponse</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/enrollmentresponse.html">EnrollmentResponse</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>read</code>, <code>search-type</code>.</li></ul></div></div><p/><div class="row"><div class="col-6"><span class="lead">Supported Profiles</span><p><a href="StructureDefinition-IHE.FAIS.EnrollmentResponse.html">FAIS EnrollmentResponse Profile</a></p></div></div><p/><div class="row"><div class="col-12"><span class="lead">Documentation</span><blockquote><div><p>FAIS Check Enrollment Status transaction <a href="ITI-123.html">[ITI-123]</a></p>
</div></blockquote></div></div><div class="row"><div class="col-lg-7"><span class="lead">Search Parameters</span><table class="table table-condensed table-hover"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>Documentation</th></tr></thead><tbody><tr><td><b>SHALL</b></td><td>_lastUpdated</td><td><code>date</code></td><td><div><p>When the resource version last changed. The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb.</p>
</div></td></tr><tr><td><b>SHALL</b></td><td>_id</td><td><code>token</code></td><td><div><p>Logical id of this artifact</p>
</div></td></tr><tr><td><b>SHALL</b></td><td>status</td><td><code>token</code></td><td><div><p>The status of the response</p>
</div></td></tr><tr><td><b>SHALL</b></td><td>request</td><td><code>reference</code></td><td><div><p>The enrollment request</p>
</div></td></tr></tbody></table></div><div class="col-lg-5"> </div></div></div></div></div></div>
</text>
<url
value="https://profiles.ihe.net/ITI/FAIS/CapabilityStatement/IHE.FAIS.BeneficiaryManager"/>
<version value="1.0.1-current"/>
<name value="IHE_FAIS_BeneficiaryManager"/>
<title value="IHE FAIS Beneficiary Manager"/>
<status value="active"/>
<experimental value="false"/>
<date value="2024-07-17"/>
<publisher value="IHE IT Infrastructure Technical Committee"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.ihe.net/ihe_domains/it_infrastructure/"/>
</telecom>
</contact>
<contact>
<telecom>
<system value="email"/>
<value value="iti@ihe.net"/>
</telecom>
</contact>
<contact>
<name value="IHE IT Infrastructure Technical Committee"/>
<telecom>
<system value="email"/>
<value value="iti@ihe.net"/>
</telecom>
</contact>
<description
value="CapabilityStatement for [Beneficiary Manager Actor](volume-1.html#beneficiary-manager).
The Beneficiary Manager processes requests from the Beneficiary Requestor actor. It follows internal business processes to enroll beneficiaries from the Beneficiary Requestor that are beyond the scope of this profile and will return the result of the enrollment. It also responds to queries about insurance plans."/>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<kind value="requirements"/>
<fhirVersion value="4.0.1"/>
<format value="application/fhir+xml"/>
<format value="application/fhir+json"/>
<rest>
<mode value="server"/>
<documentation
value="FAIS Beneficiary Manager processes requests from the Beneficiary Requestor on Insurance Plans and Enrollment Responses and receives the Enrollment Request submission."/>
<security>
<description
value="Recommend [ATNA](https://profiles.ihe.net/ITI/TF/Volume1/ch-9.html), encouraged [IHE-IUA](https://profiles.ihe.net/ITI/IUA/index.html) or [SMART-app-launch](http://www.hl7.org/fhir/smart-app-launch/)"/>
</security>
<resource>
<type value="InsurancePlan"/>
<supportedProfile
value="https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.InsurancePlan"/>
<documentation
value="FAIS Query Insurance Plan transaction [[ITI-121]](ITI-121.html)"/>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="read"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="_lastUpdated"/>
<type value="date"/>
<documentation
value="When the resource version last changed. The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb."/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="_id"/>
<type value="token"/>
<documentation value="Logical id of this artifact"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="status"/>
<type value="token"/>
<documentation value="The status of the Insurance Plan"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="type"/>
<type value="token"/>
<documentation value="The type of the Insurance Plan"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="name"/>
<type value="string"/>
<documentation value="The name of the Insurance Plan"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="identifier"/>
<type value="token"/>
<documentation
value="The business identifiers of the Insurance Plan"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="administered-by"/>
<type value="reference"/>
<documentation value="Who administers the Insurance Plan"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="owned-by"/>
<type value="reference"/>
<documentation value="Who owns the Insurance Plan"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
<name value="network"/>
<definition
value="https://profiles.ihe.net/ITI/FAIS/SearchParameter/InsurancePlan-network"/>
<type value="reference"/>
<documentation value="The Insurance Plan network"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
<name value="coverage-area"/>
<definition
value="https://profiles.ihe.net/ITI/FAIS/SearchParameter/InsurancePlan-coverageArea"/>
<type value="reference"/>
<documentation value="The Insurance Plan coverage area"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
<name value="benefit-type"/>
<definition
value="https://profiles.ihe.net/ITI/FAIS/SearchParameter/InsurancePlan-benefitType"/>
<type value="token"/>
<documentation value="The Insurance Plan type of benefit"/>
</searchParam>
</resource>
<resource>
<type value="EnrollmentRequest"/>
<supportedProfile
value="https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.EnrollmentRequest"/>
<documentation
value="FAIS Enroll Beneficiary transaction [[ITI-122]](ITI-122.html)"/>
<operation>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="submit"/>
<definition
value="https://profiles.ihe.net/ITI/FAIS/OperationDefinition/IHE.FAIS.EnrollmentRequest.Submit"/>
<documentation
value="Submits an enrollment request to enroll a new beneficiary with the request coverage. FAIS Enroll Beneficiary transaction [[ITI-122]](ITI-122.html)"/>
</operation>
</resource>
<resource>
<type value="EnrollmentResponse"/>
<supportedProfile
value="https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.EnrollmentResponse"/>
<documentation
value="FAIS Check Enrollment Status transaction [[ITI-123]](ITI-123.html)"/>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="read"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="_lastUpdated"/>
<type value="date"/>
<documentation
value="When the resource version last changed. The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb."/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="_id"/>
<type value="token"/>
<documentation value="Logical id of this artifact"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="status"/>
<type value="token"/>
<documentation value="The status of the response"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="request"/>
<type value="reference"/>
<documentation value="The enrollment request"/>
</searchParam>
</resource>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="search-system"/>
</interaction>
</rest>
</CapabilityStatement>
IG © 2024+ IHE IT Infrastructure Technical Committee. Package ihe.iti.fais#1.0.1-current based on FHIR 4.0.1. Generated 2024-11-22
Links: Table of Contents |
QA Report
| New Issue | Issues
Version History |
|
Propose a change