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
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:Parameters ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "payer-multi-member-match-in"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-in"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-in> ] )
] ; #
fhir:parameter ( [
fhir:name [ fhir:v "MemberBundle" ] ;
( fhir:part [
fhir:name [ fhir:v "MemberPatient" ] ;
( fhir:Parameters.parameter.resource [
a fhir:Patient ;
fhir:id [ fhir:v "1" ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>" ] ;
( fhir:identifier [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ] ] ) ] ;
fhir:system [ fhir:v "http://example.org/old-payer/identifiers/member"^^xsd:anyURI ] ;
fhir:value [ fhir:v "55678" ] ;
fhir:assigner [
fhir:display [ fhir:v "Old Payer" ] ] ] ) ;
( fhir:name [
fhir:use [ fhir:v "official" ] ;
fhir:family [ fhir:v "Person" ] ;
( fhir:given [ fhir:v "Patricia" ] [ fhir:v "Ann" ] ) ] ) ;
fhir:gender [ fhir:v "female" ] ;
fhir:birthDate [ fhir:v "1974-12-25"^^xsd:date ] ] ) ] [
fhir:name [ fhir:v "CoverageToMatch" ] ;
( fhir:Parameters.parameter.resource [
a fhir:Coverage ;
fhir:id [ fhir:v "9876B1" ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>" ] ;
( fhir:identifier [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ] ] ) ] ;
fhir:system [ fhir:v "http://example.org/old-payer"^^xsd:anyURI ] ;
fhir:value [ fhir:v "DH10001235" ] ] ) ;
fhir:status [ fhir:v "draft" ] ;
fhir:subscriberId [ fhir:v "1234564321" ] ;
fhir:beneficiary [
fhir:reference [ fhir:v "Patient/1" ] ] ;
fhir:relationship [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ] ;
fhir:code [ fhir:v "self" ] ] ) ] ;
fhir:period [
fhir:start [ fhir:v "2011-05-23"^^xsd:date ] ;
fhir:end [ fhir:v "2012-05-23"^^xsd:date ] ] ;
( fhir:payor [
fhir:identifier [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "9876543210" ] ] ;
fhir:display [ fhir:v "Old Health Plan" ] ] ) ;
( fhir:class [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "group" ] ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "subplan" ] ] ) ] ;
fhir:value [ fhir:v "P7" ] ] [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "plan" ] ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "class" ] ] ) ] ;
fhir:value [ fhir:v "SILVER" ] ] ) ] ) ] [
fhir:name [ fhir:v "Consent" ] ;
( fhir:Parameters.parameter.resource [
a fhir:Consent ;
fhir:id [ fhir:v "consent-1" ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>" ] ;
fhir:status [ fhir:v "active" ] ;
fhir:scope [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/consentscope"^^xsd:anyURI ] ;
fhir:code [ fhir:v "patient-privacy" ] ] ) ] ;
( fhir:category [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "IDSCL" ] ] ) ] ) ;
fhir:patient [
fhir:reference [ fhir:v "Patient/1" ] ] ;
( fhir:performer [
fhir:reference [ fhir:v "Patient/1" ] ] ) ;
fhir:source [
a fhir:Reference ;
fhir:link <http://example.org/DocumentReference/someconsent-1> ;
fhir:reference [ fhir:v "http://example.org/DocumentReference/someconsent-1" ] ] ;
( fhir:policy [
fhir:uri [ fhir:v "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition-hrex-consent.html#regular"^^xsd:anyURI ] ] ) ;
fhir:provision [
fhir:type [ fhir:v "permit" ] ;
fhir:period [
fhir:start [ fhir:v "2023-12-01"^^xsd:date ] ;
fhir:end [ fhir:v "2024-03-31"^^xsd:date ] ] ;
( fhir:actor [
fhir:role [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/provenance-participant-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "performer" ] ] ) ] ;
fhir:reference [
fhir:identifier [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "9876543210" ] ] ;
fhir:display [ fhir:v "Old Health Plan" ] ] ] [
fhir:role [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ParticipationType"^^xsd:anyURI ] ;
fhir:code [ fhir:v "IRCP" ] ] ) ] ;
fhir:reference [
fhir:identifier [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "0123456789" ] ] ;
fhir:display [ fhir:v "New Health Plan" ] ] ] ) ;
( fhir:action [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/consentaction"^^xsd:anyURI ] ;
fhir:code [ fhir:v "disclose" ] ] ) ] ) ] ] ) ] [
fhir:name [ fhir:v "CoverageToLink" ] ;
( fhir:Parameters.parameter.resource [
a fhir:Coverage ;
fhir:id [ fhir:v "AA87654" ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>" ] ;
( fhir:identifier [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ] ] ) ] ;
fhir:system [ fhir:v "http://example.org/new-payer/identifiers/coverage"^^xsd:anyURI ] ;
fhir:value [ fhir:v "234567" ] ] ) ;
fhir:status [ fhir:v "active" ] ;
fhir:subscriberId [ fhir:v "23456754321" ] ;
fhir:beneficiary [
fhir:reference [ fhir:v "Patient/1" ] ] ;
fhir:relationship [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ] ;
fhir:code [ fhir:v "self" ] ] ) ] ;
( fhir:payor [
fhir:identifier [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "0123456789" ] ] ;
fhir:display [ fhir:v "New Health Plan" ] ] ) ] ) ] )
] [
fhir:name [ fhir:v "MemberBundle" ] ;
( fhir:part [
fhir:name [ fhir:v "MemberPatient" ] ;
( fhir:Parameters.parameter.resource [
a fhir:Patient ;
fhir:id [ fhir:v "2" ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>" ] ;
( fhir:identifier [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ] ] ) ] ;
fhir:system [ fhir:v "http://example.org/old-payer/identifiers/member"^^xsd:anyURI ] ;
fhir:value [ fhir:v "45567" ] ;
fhir:assigner [
fhir:display [ fhir:v "Old Payer" ] ] ] ) ;
( fhir:name [
fhir:use [ fhir:v "official" ] ;
fhir:family [ fhir:v "Smith" ] ;
( fhir:given [ fhir:v "William" ] [ fhir:v "John" ] ) ] ) ;
fhir:gender [ fhir:v "female" ] ;
fhir:birthDate [ fhir:v "1958-12-25"^^xsd:date ] ] ) ] [
fhir:name [ fhir:v "CoverageToMatch" ] ;
( fhir:Parameters.parameter.resource [
a fhir:Coverage ;
fhir:id [ fhir:v "876B10" ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>" ] ;
( fhir:identifier [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ] ] ) ] ;
fhir:system [ fhir:v "http://example.org/old-payer"^^xsd:anyURI ] ;
fhir:value [ fhir:v "DH10001235" ] ] ) ;
fhir:status [ fhir:v "draft" ] ;
fhir:subscriberId [ fhir:v "9876543789" ] ;
fhir:beneficiary [
fhir:reference [ fhir:v "Patient/2" ] ] ;
fhir:relationship [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ] ;
fhir:code [ fhir:v "self" ] ] ) ] ;
fhir:period [
fhir:start [ fhir:v "2011-05-23"^^xsd:date ] ;
fhir:end [ fhir:v "2012-05-23"^^xsd:date ] ] ;
( fhir:payor [
fhir:identifier [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "9876543210" ] ] ;
fhir:display [ fhir:v "Old Health Plan" ] ] ) ;
( fhir:class [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "group" ] ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "subplan" ] ] ) ] ;
fhir:value [ fhir:v "P7" ] ] [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "plan" ] ] [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "class" ] ] ) ] ;
fhir:value [ fhir:v "SILVER" ] ] ) ] ) ] [
fhir:name [ fhir:v "Consent" ] ;
( fhir:Parameters.parameter.resource [
a fhir:Consent ;
fhir:id [ fhir:v "consent-2" ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>" ] ;
fhir:status [ fhir:v "active" ] ;
fhir:scope [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/consentscope"^^xsd:anyURI ] ;
fhir:code [ fhir:v "patient-privacy" ] ] ) ] ;
( fhir:category [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "IDSCL" ] ] ) ] ) ;
fhir:patient [
fhir:reference [ fhir:v "Patient/2" ] ] ;
( fhir:performer [
fhir:reference [ fhir:v "Patient/2" ] ] ) ;
fhir:source [
a fhir:Reference ;
fhir:link <http://example.org/DocumentReference/someconsen-2> ;
fhir:reference [ fhir:v "http://example.org/DocumentReference/someconsen-2" ] ] ;
( fhir:policy [
fhir:uri [ fhir:v "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition-hrex-consent.html#regular"^^xsd:anyURI ] ] ) ;
fhir:provision [
fhir:type [ fhir:v "permit" ] ;
fhir:period [
fhir:start [ fhir:v "2023-12-01"^^xsd:date ] ;
fhir:end [ fhir:v "2024-03-31"^^xsd:date ] ] ;
( fhir:actor [
fhir:role [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/provenance-participant-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "performer" ] ] ) ] ;
fhir:reference [
fhir:identifier [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "9876543210" ] ] ;
fhir:display [ fhir:v "Old Health Plan" ] ] ] [
fhir:role [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ParticipationType"^^xsd:anyURI ] ;
fhir:code [ fhir:v "IRCP" ] ] ) ] ;
fhir:reference [
fhir:identifier [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "0123456789" ] ] ;
fhir:display [ fhir:v "New Health Plan" ] ] ] ) ;
( fhir:action [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/consentaction"^^xsd:anyURI ] ;
fhir:code [ fhir:v "disclose" ] ] ) ] ) ] ] ) ] [
fhir:name [ fhir:v "CoverageToLink" ] ;
( fhir:Parameters.parameter.resource [
a fhir:Coverage ;
fhir:id [ fhir:v "AA87654" ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>" ] ;
( fhir:identifier [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ] ] ) ] ;
fhir:system [ fhir:v "http://example.org/new-payer/identifiers/coverage"^^xsd:anyURI ] ;
fhir:value [ fhir:v "234567" ] ] ) ;
fhir:status [ fhir:v "active" ] ;
fhir:subscriberId [ fhir:v "432156789" ] ;
fhir:beneficiary [
fhir:reference [ fhir:v "Patient/2" ] ] ;
fhir:relationship [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ] ;
fhir:code [ fhir:v "self" ] ] ) ] ;
( fhir:payor [
fhir:identifier [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "0123456789" ] ] ;
fhir:display [ fhir:v "New Health Plan" ] ] ) ] ) ] )
] ) . #
IG © 2024+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pdex#2.1.0 based on FHIR 4.0.1. Generated 2024-12-13
Links: Table of Contents |
QA Report
| Version History |
|
Propose a change