Da Vinci Payer Data Exchange
2.2.0 - STU 2.2
Da Vinci Payer Data Exchange
2.2.0 - STU 2.2
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 2.2.0 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 -------------------------------------------------------------------
<http://hl7.org/fhir/Parameters/provider-member-match-response-001> a fhir:Parameters ;
fhir:nodeRole fhir:treeRoot ;
fhir:Resource.id [ fhir:value "provider-member-match-response-001"] ;
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-parameters-multi-member-match-bundle-out" ;
fhir:index 0 ;
fhir:link <http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-parameters-multi-member-match-bundle-out>
]
] ;
fhir:Parameters.parameter [
fhir:index 0 ;
fhir:Parameters.parameter.name [ fhir:value "MatchedMembers" ] ;
fhir:Parameters.parameter.resource [
a fhir:Group ;
fhir:Resource.id [ fhir:value "matched-treatment-relationship-group-001" ] ;
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ] ;
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Matched Members with Treatment Relationships</h2><p>Members with confirmed treatment relationships who are authorized for provider data access</p></div>"
] ;
fhir:Group.identifier [
fhir:index 0 ;
fhir:Identifier.system [ fhir:value "http://example.org/payer/match-groups" ] ;
fhir:Identifier.value [ fhir:value "MTG-2024-12-16-001" ] ;
fhir:Identifier.assigner [
fhir:Reference.display [ fhir:value "Example Payer" ]
]
], [
fhir:index 1 ;
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ] ;
fhir:Identifier.value [ fhir:value "1982947230" ] ;
fhir:Identifier.assigner [
fhir:Reference.display [ fhir:value "Provider Organization" ]
]
] ;
fhir:Group.active [ fhir:value "true"^^xsd:boolean ] ;
fhir:Group.type [ fhir:value "person" ] ;
fhir:Group.actual [ fhir:value "true"^^xsd:boolean ] ;
fhir:Group.code [
fhir:CodeableConcept.coding [
fhir:index 0 ;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS" ] ;
fhir:Coding.code [ fhir:value "match" ] ;
fhir:Coding.display [ fhir:value "Matched" ]
]
] ;
fhir:Group.quantity [ fhir:value "2"^^xsd:nonNegativeInteger ] ;
fhir:Group.managingEntity [
fhir:Reference.identifier [
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ] ;
fhir:Identifier.value [ fhir:value "5555555555" ]
] ;
fhir:Reference.display [ fhir:value "Current Payer" ]
] ;
fhir:Group.characteristic [
fhir:index 0 ;
fhir:Group.characteristic.code [
fhir:CodeableConcept.coding [
fhir:index 0 ;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS" ] ;
fhir:Coding.code [ fhir:value "match" ] ;
fhir:Coding.display [ fhir:value "Matched" ]
]
] ;
fhir:Group.characteristic.valueReference [
fhir:Reference.identifier [
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ] ;
fhir:Identifier.value [ fhir:value "1982947230" ]
] ;
fhir:Reference.display [ fhir:value "Provider Organization" ]
] ;
fhir:Group.characteristic.exclude [ fhir:value "false"^^xsd:boolean ] ;
fhir:Group.characteristic.period [
fhir:Period.start [ fhir:value "2024-12-16"^^xsd:date ]
]
] ;
fhir:Group.member [
fhir:index 0 ;
fhir:Group.member.entity [
fhir:link <http://hl7.org/fhir/Patient/payer-member-001> ;
fhir:Reference.reference [ fhir:value "Patient/payer-member-001" ] ;
fhir:Reference.display [ fhir:value "Robert Michael Johnson - Payer Member" ]
] ;
fhir:Group.member.inactive [ fhir:value "false"^^xsd:boolean ]
], [
fhir:index 1 ;
fhir:Group.member.entity [
fhir:link <http://hl7.org/fhir/Patient/payer-member-002> ;
fhir:Reference.reference [ fhir:value "Patient/payer-member-002" ] ;
fhir:Reference.display [ fhir:value "Sarah Elizabeth Williams - Payer Member" ]
] ;
fhir:Group.member.inactive [ fhir:value "false"^^xsd:boolean ]
]
]
], [
fhir:index 1 ;
fhir:Parameters.parameter.name [ fhir:value "NonMatchedMembers" ] ;
fhir:Parameters.parameter.resource [
a fhir:Group ;
fhir:Resource.id [ fhir:value "nomatch-group-001" ] ;
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ] ;
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Non-Matched Members</h2><p>Members submitted by provider that were not found in payer system</p></div>"
] ;
fhir:Group.identifier [
fhir:index 0 ;
fhir:Identifier.system [ fhir:value "http://example.org/payer/match-groups" ] ;
fhir:Identifier.value [ fhir:value "NMG-2024-12-16-001" ] ;
fhir:Identifier.assigner [
fhir:Reference.display [ fhir:value "Example Payer" ]
]
], [
fhir:index 1 ;
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ] ;
fhir:Identifier.value [ fhir:value "1982947230" ] ;
fhir:Identifier.assigner [
fhir:Reference.display [ fhir:value "Provider Organization" ]
]
] ;
fhir:Group.active [ fhir:value "true"^^xsd:boolean ] ;
fhir:Group.type [ fhir:value "person" ] ;
fhir:Group.actual [ fhir:value "true"^^xsd:boolean ] ;
fhir:Group.code [
fhir:CodeableConcept.coding [
fhir:index 0 ;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS" ] ;
fhir:Coding.code [ fhir:value "nomatch" ] ;
fhir:Coding.display [ fhir:value "Not Matched" ]
]
] ;
fhir:Group.quantity [ fhir:value "1"^^xsd:nonNegativeInteger ] ;
fhir:Group.managingEntity [
fhir:Reference.identifier [
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ] ;
fhir:Identifier.value [ fhir:value "5555555555" ]
] ;
fhir:Reference.display [ fhir:value "Current Payer" ]
] ;
fhir:Group.characteristic [
fhir:index 0 ;
fhir:Group.characteristic.code [
fhir:CodeableConcept.coding [
fhir:index 0 ;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS" ] ;
fhir:Coding.code [ fhir:value "nomatch" ] ;
fhir:Coding.display [ fhir:value "Not Matched" ]
]
] ;
fhir:Group.characteristic.valueBoolean [ fhir:value "true"^^xsd:boolean ] ;
fhir:Group.characteristic.exclude [ fhir:value "false"^^xsd:boolean ] ;
fhir:Group.characteristic.period [
fhir:Period.start [ fhir:value "2024-12-16"^^xsd:date ]
]
] ;
fhir:Group.member [
fhir:index 0 ;
fhir:Group.member.entity [
fhir:link <http://hl7.org/fhir/Patient/patient-prov-002> ;
fhir:Reference.reference [ fhir:value "Patient/patient-prov-002" ] ;
fhir:Reference.display [ fhir:value "Jane Smith (submitted demographics - no match found)" ]
] ;
fhir:Group.member.inactive [ fhir:value "false"^^xsd:boolean ]
]
]
], [
fhir:index 2 ;
fhir:Parameters.parameter.name [ fhir:value "ConsentConstrainedMembers" ] ;
fhir:Parameters.parameter.resource [
a fhir:Group ;
fhir:Resource.id [ fhir:value "consent-constrained-group-001" ] ;
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ] ;
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Consent-Constrained Members</h2><p>Members found but who have exercised their right to opt out of Provider Access data sharing</p></div>"
] ;
fhir:Group.identifier [
fhir:index 0 ;
fhir:Identifier.system [ fhir:value "http://example.org/payer/match-groups" ] ;
fhir:Identifier.value [ fhir:value "CCG-2024-12-16-001" ] ;
fhir:Identifier.assigner [
fhir:Reference.display [ fhir:value "Example Payer" ]
]
], [
fhir:index 1 ;
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ] ;
fhir:Identifier.value [ fhir:value "1982947230" ] ;
fhir:Identifier.assigner [
fhir:Reference.display [ fhir:value "Provider Organization" ]
]
] ;
fhir:Group.active [ fhir:value "true"^^xsd:boolean ] ;
fhir:Group.type [ fhir:value "person" ] ;
fhir:Group.actual [ fhir:value "true"^^xsd:boolean ] ;
fhir:Group.code [
fhir:CodeableConcept.coding [
fhir:index 0 ;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS" ] ;
fhir:Coding.code [ fhir:value "consentconstraint" ] ;
fhir:Coding.display [ fhir:value "Consent Constraint" ]
]
] ;
fhir:Group.quantity [ fhir:value "1"^^xsd:nonNegativeInteger ] ;
fhir:Group.managingEntity [
fhir:Reference.identifier [
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ] ;
fhir:Identifier.value [ fhir:value "5555555555" ]
] ;
fhir:Reference.display [ fhir:value "Current Payer" ]
] ;
fhir:Group.characteristic [
fhir:index 0 ;
fhir:Group.characteristic.code [
fhir:CodeableConcept.coding [
fhir:index 0 ;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS" ] ;
fhir:Coding.code [ fhir:value "consentconstraint" ] ;
fhir:Coding.display [ fhir:value "Consent Constraint" ]
]
] ;
fhir:Group.characteristic.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0 ;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/opt-out-scope" ] ;
fhir:Coding.code [ fhir:value "provider-specific" ] ;
fhir:Coding.display [ fhir:value "Provider-Specific Opt-Out" ]
]
] ;
fhir:Group.characteristic.exclude [ fhir:value "false"^^xsd:boolean ] ;
fhir:Group.characteristic.period [
fhir:Period.start [ fhir:value "2024-12-16"^^xsd:date ]
]
] ;
fhir:Group.member [
fhir:index 0 ;
fhir:Group.member.entity [
fhir:link <http://hl7.org/fhir/Patient/payer-member-002> ;
fhir:Reference.reference [ fhir:value "Patient/payer-member-002" ] ;
fhir:Reference.display [ fhir:value "Sarah Elizabeth Williams (matched but opted out of Provider Access)" ]
] ;
fhir:Group.member.inactive [ fhir:value "false"^^xsd:boolean ]
]
]
] .
<http://hl7.org/fhir/Patient/payer-member-001> a fhir:Patient .
<http://hl7.org/fhir/Patient/payer-member-002> a fhir:Patient .
<http://hl7.org/fhir/Patient/patient-prov-002> a fhir:Patient .
# - ontology header ------------------------------------------------------------
<http://hl7.org/fhir/Parameters/provider-member-match-response-001.ttl> a owl:Ontology ;
owl:imports fhir:fhir.ttl ;
owl:versionIRI <http://build.fhir.org/Parameters/provider-member-match-response-001.ttl> .
IG © 2024+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pdex#2.2.0 based on FHIR 4.0.1. Generated 2026-06-29
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