Da Vinci Payer Data Exchange
2.1.0 - STU2 United States of America flag

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

: PDex Bulk Member Match Operation - JSON Representation

Page standards status: Trial-use

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{
  "resourceType" : "OperationDefinition",
  "id" : "bulk-member-match",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>URL: [base]/Group/$bulk-member-match</p><p>Input parameters Profile:<a href=\"StructureDefinition-pdex-parameters-multi-member-match-bundle-in.html\">PDex $multi-member-match request</a></p><p>Output parameters Profile:<a href=\"StructureDefinition-pdex-parameters-multi-member-match-bundle-out.html\">PDex $multi-member-match response</a></p><p>Parameters</p><table class=\"grid\"><tr><td><b>Use</b></td><td><b>Name</b></td><td><b>Scope</b></td><td><b>Cardinality</b></td><td><b>Type</b></td><td><b>Binding</b></td><td><b>Documentation</b></td></tr><tr><td>IN</td><td>MatchRequest</td><td/><td>1..1</td><td><a href=\"http://hl7.org/fhir/R4/references.html#Reference\">Reference</a> (<a href=\"StructureDefinition-pdex-parameters-multi-member-match-bundle-in.html\" title=\"http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-in\">PDex $multi-member-match request</a>)</td><td/><td><div><p>Bundle of Member information. Repeat bundle for each member to be submitted to bulk member-match, as defined in PDex $multi-member-match request.</p>\n</div></td></tr><tr><td>OUT</td><td>MatchResponse</td><td/><td>1..1</td><td><a href=\"http://hl7.org/fhir/R4/references.html#Reference\">Reference</a> (<a href=\"StructureDefinition-pdex-parameters-multi-member-match-bundle-out.html\" title=\"http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-out\">PDex $multi-member-match response</a>)</td><td/><td><div><p>Bundle of Groups returned from Member Match Operation. There can be up to three (3) groups: Matched, Not-Matched and ConsentConstrained.</p>\n</div></td></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-pdex/OperationDefinition/bulk-member-match",
  "version" : "2.1.0",
  "name" : "BulkMemberMatch",
  "title" : "PDex Bulk Member Match Operation",
  "status" : "draft",
  "kind" : "operation",
  "date" : "2024-06-12T18:39:20+00:00",
  "publisher" : "HL7 International / Financial Management",
  "contact" : [
    {
      "name" : "HL7 International / Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        },
        {
          "system" : "email",
          "value" : "fm@lists.HL7.org"
        }
      ]
    },
    {
      "name" : "Mark Scrimshire (mark.scrimshire@onyxhealth.io)",
      "telecom" : [
        {
          "system" : "email",
          "value" : "mailto:mark.scrimshire@onyxhealth.io"
        }
      ]
    },
    {
      "name" : "HL7 International - Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description" : "The **$bulk-member-match** operation that can be invoked by either a payer or an EHR or other system, allows one health plan to retrieve a unique identifier for a group resource containing matched members from another health plan using a member's demographic, coverage information with an accompanying consent record.  This identifier can then be used to perform subsequent queries and operations. Health Plans implementing a deterministic match will require a match on member id or subscriber id at a minimum (i.e. A pure demographic match will not be supported by such implementations.).",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "affectsState" : true,
  "code" : "bulk-member-match",
  "resource" : [
    "Group"
  ],
  "system" : false,
  "type" : true,
  "instance" : false,
  "inputProfile" : "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-in",
  "outputProfile" : "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-out",
  "parameter" : [
    {
      "name" : "MatchRequest",
      "use" : "in",
      "min" : 1,
      "max" : "1",
      "documentation" : "Bundle of Member information. Repeat bundle for each member to be submitted to bulk member-match, as defined in PDex $multi-member-match request.",
      "type" : "Reference",
      "targetProfile" : [
        🔗 "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-in"
      ]
    },
    {
      "name" : "MatchResponse",
      "use" : "out",
      "min" : 1,
      "max" : "1",
      "documentation" : "Bundle of Groups returned from Member Match Operation. There can be up to three (3) groups: Matched, Not-Matched and ConsentConstrained.",
      "type" : "Reference",
      "targetProfile" : [
        🔗 "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-out"
      ]
    }
  ]
}