Da Vinci Payer Data Exchange
2.1.0 - STU2 Ballot
Da Vinci Payer Data Exchange
2.1.0 - STU2 Ballot
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
<Parameters xmlns="http://hl7.org/fhir">
<id value="payer-multi-member-match-in"/>
<meta>
<profile
value="http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-in"/>
</meta>
<parameter>
<name value="MemberBundle"/>
<part>
<name value="MemberPatient"/>
<resource>
<Patient>
<id value="1"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Default Generated text for resource.</div>
</text>
<identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MB"/>
</coding>
</type>
<system value="http://example.org/old-payer/identifiers/member"/>
<value value="55678"/>
<assigner>
<display value="Old Payer"/>
</assigner>
</identifier>
<name>
<use value="official"/>
<family value="Person"/>
<given value="Patricia"/>
<given value="Ann"/>
</name>
<gender value="female"/>
<birthDate value="1974-12-25"/>
</Patient>
</resource>
</part>
<part>
<name value="CoverageToMatch"/>
<resource>
<Coverage>
<id value="9876B1"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Default Generated text for resource.</div>
</text>
<identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MB"/>
</coding>
</type>
<system value="http://example.org/old-payer"/>
<value value="DH10001235"/>
</identifier>
<status value="draft"/>
<subscriberId value="1234564321"/>
<beneficiary>🔗
<reference value="Patient/1"/>
</beneficiary>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
</coding>
</relationship>
<period>
<start value="2011-05-23"/>
<end value="2012-05-23"/>
</period>
<payor>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9876543210"/>
</identifier>
<display value="Old Health Plan"/>
</payor>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="group"/>
</coding>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="subplan"/>
</coding>
</type>
<value value="P7"/>
</class>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="plan"/>
</coding>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="class"/>
</coding>
</type>
<value value="SILVER"/>
</class>
</Coverage>
</resource>
</part>
<part>
<name value="Consent"/>
<resource>
<Consent>
<id value="consent-1"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Default Generated text for resource.</div>
</text>
<status value="active"/>
<scope>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/consentscope"/>
<code value="patient-privacy"/>
</coding>
</scope>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="IDSCL"/>
</coding>
</category>
<patient>🔗
<reference value="Patient/1"/>
</patient>
<performer>🔗
<reference value="Patient/1"/>
</performer>
<sourceReference>
<reference
value="http://example.org/DocumentReference/someconsent-1"/>
</sourceReference>
<policy>
<uri
value="http://hl7.org/fhir/us/davinci-hrex/StructureDefinition-hrex-consent.html#regular"/>
</policy>
<provision>
<type value="permit"/>
<period>
<start value="2023-12-01"/>
<end value="2024-03-31"/>
</period>
<actor>
<role>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>
<code value="performer"/>
</coding>
</role>
<reference>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9876543210"/>
</identifier>
<display value="Old Health Plan"/>
</reference>
</actor>
<actor>
<role>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-ParticipationType"/>
<code value="IRCP"/>
</coding>
</role>
<reference>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="0123456789"/>
</identifier>
<display value="New Health Plan"/>
</reference>
</actor>
<action>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/consentaction"/>
<code value="disclose"/>
</coding>
</action>
</provision>
</Consent>
</resource>
</part>
<part>
<name value="CoverageToLink"/>
<resource>
<Coverage>
<id value="AA87654"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Default Generated text for resource.</div>
</text>
<identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MB"/>
</coding>
</type>
<system
value="http://example.org/new-payer/identifiers/coverage"/>
<value value="234567"/>
</identifier>
<status value="active"/>
<subscriberId value="23456754321"/>
<beneficiary>🔗
<reference value="Patient/1"/>
</beneficiary>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
</coding>
</relationship>
<payor>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="0123456789"/>
</identifier>
<display value="New Health Plan"/>
</payor>
</Coverage>
</resource>
</part>
</parameter>
<parameter>
<name value="MemberBundle"/>
<part>
<name value="MemberPatient"/>
<resource>
<Patient>
<id value="2"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Default Generated text for resource.</div>
</text>
<identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MB"/>
</coding>
</type>
<system value="http://example.org/old-payer/identifiers/member"/>
<value value="45567"/>
<assigner>
<display value="Old Payer"/>
</assigner>
</identifier>
<name>
<use value="official"/>
<family value="Smith"/>
<given value="William"/>
<given value="John"/>
</name>
<gender value="female"/>
<birthDate value="1958-12-25"/>
</Patient>
</resource>
</part>
<part>
<name value="CoverageToMatch"/>
<resource>
<Coverage>
<id value="876B10"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Default Generated text for resource.</div>
</text>
<identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MB"/>
</coding>
</type>
<system value="http://example.org/old-payer"/>
<value value="DH10001235"/>
</identifier>
<status value="draft"/>
<subscriberId value="9876543789"/>
<beneficiary>
<reference value="Patient/2"/>
</beneficiary>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
</coding>
</relationship>
<period>
<start value="2011-05-23"/>
<end value="2012-05-23"/>
</period>
<payor>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9876543210"/>
</identifier>
<display value="Old Health Plan"/>
</payor>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="group"/>
</coding>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="subplan"/>
</coding>
</type>
<value value="P7"/>
</class>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="plan"/>
</coding>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="class"/>
</coding>
</type>
<value value="SILVER"/>
</class>
</Coverage>
</resource>
</part>
<part>
<name value="Consent"/>
<resource>
<Consent>
<id value="consent-2"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Default Generated text for resource.</div>
</text>
<status value="active"/>
<scope>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/consentscope"/>
<code value="patient-privacy"/>
</coding>
</scope>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="IDSCL"/>
</coding>
</category>
<patient>
<reference value="Patient/2"/>
</patient>
<performer>
<reference value="Patient/2"/>
</performer>
<sourceReference>
<reference
value="http://example.org/DocumentReference/someconsen-2"/>
</sourceReference>
<policy>
<uri
value="http://hl7.org/fhir/us/davinci-hrex/StructureDefinition-hrex-consent.html#regular"/>
</policy>
<provision>
<type value="permit"/>
<period>
<start value="2023-12-01"/>
<end value="2024-03-31"/>
</period>
<actor>
<role>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>
<code value="performer"/>
</coding>
</role>
<reference>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9876543210"/>
</identifier>
<display value="Old Health Plan"/>
</reference>
</actor>
<actor>
<role>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-ParticipationType"/>
<code value="IRCP"/>
</coding>
</role>
<reference>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="0123456789"/>
</identifier>
<display value="New Health Plan"/>
</reference>
</actor>
<action>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/consentaction"/>
<code value="disclose"/>
</coding>
</action>
</provision>
</Consent>
</resource>
</part>
<part>
<name value="CoverageToLink"/>
<resource>
<Coverage>
<id value="AA87654"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Default Generated text for resource.</div>
</text>
<identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MB"/>
</coding>
</type>
<system
value="http://example.org/new-payer/identifiers/coverage"/>
<value value="234567"/>
</identifier>
<status value="active"/>
<subscriberId value="432156789"/>
<beneficiary>
<reference value="Patient/2"/>
</beneficiary>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
</coding>
</relationship>
<payor>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="0123456789"/>
</identifier>
<display value="New Health Plan"/>
</payor>
</Coverage>
</resource>
</part>
</parameter>
</Parameters>
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
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