Da Vinci - Member Attribution (ATR) List
1.0.0 - STU 1 Publication

Da Vinci - Member Attribution (ATR) List, published by HL7 International - Financial Management Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/davinci-atr/ and changes regularly. See the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

DaVinci ATR Producer

This profile defines the expected capabilities of the ‘‘Producer’’ role when conforming to the DaVinci Risk Based Contracts Member Attribution List Implementation Guide. This role is responsible for creating and publishing the Member Attribution List for usage by Consumers based on specific Risk Based Contracts.

DaVinci ATR Consumer

This profile defines the expected capabilities of the ‘‘Consumer’’ role when conforming to the DaVinci Risk Based Contracts Member Attribution List Implementation Guide. This role is responsible for retrieving and using the Member Attribution List for DaVinci use cases such as CDex, PDex. The Member Attribution List can be used for other purposes also.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide

ATRCoverage

This is the Coverage Resource profile for the IG.

ATRGroup

This is the Group Resource profile for the IG.

ATRLocation

This is the Location Resource profile for the IG.

ATROrganization

This is the Organization Resource profile for the IG.

ATRPatient

This is the Patient Resource profile for the IG.

ATRPractitioner

This is the Practitioner Resource profile for the IG.

ATRPractitionerRole

This is the PractitionerRole Resource profile for the IG.

ATRRelatedPerson

This is the RelatedPerson Resource profile for the IG.

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide

InsuranceProductType

Indicates the specific insurance product type related to the instance of the coverage resource.

ChangeType

changeType can be new (member added), dropped (member removed), changed (member information has changed), nochange (no change in member information since group was created).

CoverageReference

Indicates the Coverage assocaited with the member placing them on the attribution list.

AttributedProvider

Indicates the attributed provider.

ContractValidityPeriod

Indicates the validity period for Contract which is the basis for the Member Attribution List.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide

Da Vinci ATR Change Types

The Da Vinci ATR Change Type Value Set is a ‘starter set’ of codes for identifying the detailed changes associated with Member Attribution Lists.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide

Davinci ATR Change Type Codes

The Da Vinci Change Type CodeSystem is a ‘starter set’ of codes supported for identifying changes in member attribution list.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like

Group Member Attribution List example

An example showing a fully populated Member Attribution List

Payer Organization Example

An example showing a Payer Organization

PRovider Organization Example

An example showing a Provider Organization

Coverage For Patient 1 - Example

An example showing a Coverage for a Patient

Coverage For Patient 2 - Example

An example showing a Coverage for a Patient

Coverage For Patient 3 - Example

An example showing a Coverage for a Patient

Patient 1 - Example

An example showing a Patient

Patient 2 - Example

An example showing a Patient

Patient 3 - Example

An example showing a Patient

Practitioner - Example

An example showing a Practitioner

PractitionerRole - Example

An example showing a PractitionerRole

Location - Example

An example showing a Location used in Practitioner Role

Related Person (1) used as a Subscriber in Coverage

An example showing a Related Person as a subscriber

Related Person (2) used as a Subscriber in Coverage

An example showing a Related Person as a subscriber