Consumer Real-Time Pharmacy Benefit Check FHIR IG, published by HL7 International / Pharmacy. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-rtpbc/ and changes regularly. See the Directory of published versions

Submission Method

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Operation: $process-message

The RTPBC request is submitted using the $process-message operation on the processor's claim server…

• URL: [base]/$process-message

Process-message parameter and response

Like the option above, the $process-message operation takes a single FHIR® resource input parameter consisting of a Bundle containing the Claim resource and referenced supporting resources, and returns a Bundle containing a ClaimResponse and supporting resources.

In addition, this method includes a MessageHeader resource in both the request and response.

• In the request, the MessageHeader's focus.reference points to the Bundle's Claim resource, per the RtpbcRequestMessageDefinition.
• In the response, the focus.reference points to the Bundle's ClaimResponse, per the RtpbcResponseMessageDefinition.

Synchronous response

The response in the RTPBC exchange is expected to be synchronous, with real-time response times to support use in interactive patient-facing applications.

Examples

​Example bundled RTPBC request to payer/PBM. Using messaging ($process-message operation, with MessageHeaders)

Example bundled RTPBC response from payer/PBM. Using messaging ($process-message operation, with MessageHeaders)

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