Da Vinci Payer Data Exchange
2.1.1 - STU2 Ballot 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 2.1.1 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

Resource Profile: PDex $multi-member-match request

Official URL: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-in Version: 2.1.1
Standards status: Trial-use Computable Name: PDexMultiMemberMatchRequestParameters

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

A Parameters profile defining the inputs to a $bulk-member-match operation performed by a payer system

Request Parameters

The Multiple Member Match Operation Request Profile is based upon the original PDex Member Match Operation Request Parameters.

The Multiple Member Match Request specifies a repeating parameter bundle element, with one parameter bundle per Member. Each Bundle includes:

  • MemberPatient: - HRex Patient demographics
  • CoverageToMatch - details of prior health plan coverage provided by the member, typically from their health plan coverage card. Uses the HRex Coverage Profile.
  • CoverageToLink - Optional element. Details of new or prospective health plan coverage, provided by the health plan based upon the member’s enrolment. Uses the HRex Coverage Profile.
  • Consent - Record of consent received by requesting payer from Member to retrieve their records from the prior payer. This is an opt-in. Uses the HRex Consent Profile.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Parameters

NameFlagsCard.TypeDescription & Constraintsdoco
.. Parameters 0..* Parameters Operation Request or Response
... parameter S 0..* BackboneElement Operation Parameter
.... name 1..1 string Name from the definition
Required Pattern: MemberBundle
.... Slices for part S 3..4 Named part of a multi-part parameter
Slice: Unordered, Open At End by value:$this.name
..... part:MemberPatient S 1..1 BackboneElement Named part of a multi-part parameter
...... name S 1..1 string Name from the definition
Fixed Value: MemberPatient
...... resource S 1..1 HRexPatientDemographics(1.1.0) Information about an individual or animal receiving health care services
..... part:CoverageToMatch S 1..1 BackboneElement Named part of a multi-part parameter
...... name S 1..1 string Name from the definition
Fixed Value: CoverageToMatch
...... resource S 1..1 HRexCoverage(1.1.0) Insurance or medical plan or a payment agreement
..... part:CoverageToLink S 0..1 BackboneElement Named part of a multi-part parameter
...... name S 1..1 string Name from the definition
Fixed Value: CoverageToLink
...... resource S 1..1 HRexCoverage(1.1.0) Insurance or medical plan or a payment agreement
..... part:Consent S 1..1 BackboneElement Named part of a multi-part parameter
...... name S 1..1 string Name from the definition
Fixed Value: Consent
...... resource S 1..1 HRexConsent(1.1.0) A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Parameters 0..* Parameters Operation Request or Response
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... parameter SΣC 0..* BackboneElement Operation Parameter
inv-1: A parameter must have one and only one of (value, resource, part)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... name Σ 1..1 string Name from the definition
Required Pattern: MemberBundle
.... Slices for part SΣ 3..4 See parameter (Parameters) Named part of a multi-part parameter
Slice: Unordered, Open At End by value:$this.name
..... part:MemberPatient SΣ 1..1 BackboneElement Named part of a multi-part parameter
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: MemberPatient
...... resource S 1..1 HRexPatientDemographics(1.1.0) Information about an individual or animal receiving health care services
..... part:CoverageToMatch SΣ 1..1 BackboneElement Named part of a multi-part parameter
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: CoverageToMatch
...... resource S 1..1 HRexCoverage(1.1.0) Insurance or medical plan or a payment agreement
..... part:CoverageToLink SΣ 0..1 BackboneElement Named part of a multi-part parameter
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: CoverageToLink
...... resource S 1..1 HRexCoverage(1.1.0) Insurance or medical plan or a payment agreement
..... part:Consent SΣ 1..1 BackboneElement Named part of a multi-part parameter
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: Consent
...... resource S 1..1 HRexConsent(1.1.0) A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Parameters 0..* Parameters Operation Request or Response
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... parameter SΣC 0..* BackboneElement Operation Parameter
inv-1: A parameter must have one and only one of (value, resource, part)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... name Σ 1..1 string Name from the definition
Required Pattern: MemberBundle
.... value[x] ΣC 0..1 If parameter is a data type
..... valueBase64Binary base64Binary
..... valueBoolean boolean
..... valueCanonical canonical(Any)
..... valueCode code
..... valueDate date
..... valueDateTime dateTime
..... valueDecimal decimal
..... valueId id
..... valueInstant instant
..... valueInteger integer
..... valueMarkdown markdown
..... valueOid oid
..... valuePositiveInt positiveInt
..... valueString string
..... valueTime time
..... valueUnsignedInt unsignedInt
..... valueUri uri
..... valueUrl url
..... valueUuid uuid
..... valueAddress Address
..... valueAge Age
..... valueAnnotation Annotation
..... valueAttachment Attachment
..... valueCodeableConcept CodeableConcept
..... valueCoding Coding
..... valueContactPoint ContactPoint
..... valueCount Count
..... valueDistance Distance
..... valueDuration Duration
..... valueHumanName HumanName
..... valueIdentifier Identifier
..... valueMoney Money
..... valuePeriod Period
..... valueQuantity Quantity
..... valueRange Range
..... valueRatio Ratio
..... valueReference Reference(Any)
..... valueSampledData SampledData
..... valueSignature Signature
..... valueTiming Timing
..... valueContactDetail ContactDetail
..... valueContributor Contributor
..... valueDataRequirement DataRequirement
..... valueExpression Expression
..... valueParameterDefinition ParameterDefinition
..... valueRelatedArtifact RelatedArtifact
..... valueTriggerDefinition TriggerDefinition
..... valueUsageContext UsageContext
..... valueDosage Dosage
..... valueMeta Meta
.... resource ΣC 0..1 Resource If parameter is a whole resource
.... Slices for part SΣ 3..4 See parameter (Parameters) Named part of a multi-part parameter
Slice: Unordered, Open At End by value:$this.name
..... part:MemberPatient SΣ 1..1 BackboneElement Named part of a multi-part parameter
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: MemberPatient
...... value[x] ΣC 0..1 If parameter is a data type
....... valueBase64Binary base64Binary
....... valueBoolean boolean
....... valueCanonical canonical(Any)
....... valueCode code
....... valueDate date
....... valueDateTime dateTime
....... valueDecimal decimal
....... valueId id
....... valueInstant instant
....... valueInteger integer
....... valueMarkdown markdown
....... valueOid oid
....... valuePositiveInt positiveInt
....... valueString string
....... valueTime time
....... valueUnsignedInt unsignedInt
....... valueUri uri
....... valueUrl url
....... valueUuid uuid
....... valueAddress Address
....... valueAge Age
....... valueAnnotation Annotation
....... valueAttachment Attachment
....... valueCodeableConcept CodeableConcept
....... valueCoding Coding
....... valueContactPoint ContactPoint
....... valueCount Count
....... valueDistance Distance
....... valueDuration Duration
....... valueHumanName HumanName
....... valueIdentifier Identifier
....... valueMoney Money
....... valuePeriod Period
....... valueQuantity Quantity
....... valueRange Range
....... valueRatio Ratio
....... valueReference Reference(Any)
....... valueSampledData SampledData
....... valueSignature Signature
....... valueTiming Timing
....... valueContactDetail ContactDetail
....... valueContributor Contributor
....... valueDataRequirement DataRequirement
....... valueExpression Expression
....... valueParameterDefinition ParameterDefinition
....... valueRelatedArtifact RelatedArtifact
....... valueTriggerDefinition TriggerDefinition
....... valueUsageContext UsageContext
....... valueDosage Dosage
....... valueMeta Meta
...... resource S 1..1 HRexPatientDemographics(1.1.0) Information about an individual or animal receiving health care services
...... part Σ 0..* See parameter (Parameters) Named part of a multi-part parameter
..... part:CoverageToMatch SΣ 1..1 BackboneElement Named part of a multi-part parameter
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: CoverageToMatch
...... value[x] ΣC 0..1 If parameter is a data type
....... valueBase64Binary base64Binary
....... valueBoolean boolean
....... valueCanonical canonical(Any)
....... valueCode code
....... valueDate date
....... valueDateTime dateTime
....... valueDecimal decimal
....... valueId id
....... valueInstant instant
....... valueInteger integer
....... valueMarkdown markdown
....... valueOid oid
....... valuePositiveInt positiveInt
....... valueString string
....... valueTime time
....... valueUnsignedInt unsignedInt
....... valueUri uri
....... valueUrl url
....... valueUuid uuid
....... valueAddress Address
....... valueAge Age
....... valueAnnotation Annotation
....... valueAttachment Attachment
....... valueCodeableConcept CodeableConcept
....... valueCoding Coding
....... valueContactPoint ContactPoint
....... valueCount Count
....... valueDistance Distance
....... valueDuration Duration
....... valueHumanName HumanName
....... valueIdentifier Identifier
....... valueMoney Money
....... valuePeriod Period
....... valueQuantity Quantity
....... valueRange Range
....... valueRatio Ratio
....... valueReference Reference(Any)
....... valueSampledData SampledData
....... valueSignature Signature
....... valueTiming Timing
....... valueContactDetail ContactDetail
....... valueContributor Contributor
....... valueDataRequirement DataRequirement
....... valueExpression Expression
....... valueParameterDefinition ParameterDefinition
....... valueRelatedArtifact RelatedArtifact
....... valueTriggerDefinition TriggerDefinition
....... valueUsageContext UsageContext
....... valueDosage Dosage
....... valueMeta Meta
...... resource S 1..1 HRexCoverage(1.1.0) Insurance or medical plan or a payment agreement
...... part Σ 0..* See parameter (Parameters) Named part of a multi-part parameter
..... part:CoverageToLink SΣ 0..1 BackboneElement Named part of a multi-part parameter
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: CoverageToLink
...... value[x] ΣC 0..1 If parameter is a data type
....... valueBase64Binary base64Binary
....... valueBoolean boolean
....... valueCanonical canonical(Any)
....... valueCode code
....... valueDate date
....... valueDateTime dateTime
....... valueDecimal decimal
....... valueId id
....... valueInstant instant
....... valueInteger integer
....... valueMarkdown markdown
....... valueOid oid
....... valuePositiveInt positiveInt
....... valueString string
....... valueTime time
....... valueUnsignedInt unsignedInt
....... valueUri uri
....... valueUrl url
....... valueUuid uuid
....... valueAddress Address
....... valueAge Age
....... valueAnnotation Annotation
....... valueAttachment Attachment
....... valueCodeableConcept CodeableConcept
....... valueCoding Coding
....... valueContactPoint ContactPoint
....... valueCount Count
....... valueDistance Distance
....... valueDuration Duration
....... valueHumanName HumanName
....... valueIdentifier Identifier
....... valueMoney Money
....... valuePeriod Period
....... valueQuantity Quantity
....... valueRange Range
....... valueRatio Ratio
....... valueReference Reference(Any)
....... valueSampledData SampledData
....... valueSignature Signature
....... valueTiming Timing
....... valueContactDetail ContactDetail
....... valueContributor Contributor
....... valueDataRequirement DataRequirement
....... valueExpression Expression
....... valueParameterDefinition ParameterDefinition
....... valueRelatedArtifact RelatedArtifact
....... valueTriggerDefinition TriggerDefinition
....... valueUsageContext UsageContext
....... valueDosage Dosage
....... valueMeta Meta
...... resource S 1..1 HRexCoverage(1.1.0) Insurance or medical plan or a payment agreement
...... part Σ 0..* See parameter (Parameters) Named part of a multi-part parameter
..... part:Consent SΣ 1..1 BackboneElement Named part of a multi-part parameter
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: Consent
...... value[x] ΣC 0..1 If parameter is a data type
....... valueBase64Binary base64Binary
....... valueBoolean boolean
....... valueCanonical canonical(Any)
....... valueCode code
....... valueDate date
....... valueDateTime dateTime
....... valueDecimal decimal
....... valueId id
....... valueInstant instant
....... valueInteger integer
....... valueMarkdown markdown
....... valueOid oid
....... valuePositiveInt positiveInt
....... valueString string
....... valueTime time
....... valueUnsignedInt unsignedInt
....... valueUri uri
....... valueUrl url
....... valueUuid uuid
....... valueAddress Address
....... valueAge Age
....... valueAnnotation Annotation
....... valueAttachment Attachment
....... valueCodeableConcept CodeableConcept
....... valueCoding Coding
....... valueContactPoint ContactPoint
....... valueCount Count
....... valueDistance Distance
....... valueDuration Duration
....... valueHumanName HumanName
....... valueIdentifier Identifier
....... valueMoney Money
....... valuePeriod Period
....... valueQuantity Quantity
....... valueRange Range
....... valueRatio Ratio
....... valueReference Reference(Any)
....... valueSampledData SampledData
....... valueSignature Signature
....... valueTiming Timing
....... valueContactDetail ContactDetail
....... valueContributor Contributor
....... valueDataRequirement DataRequirement
....... valueExpression Expression
....... valueParameterDefinition ParameterDefinition
....... valueRelatedArtifact RelatedArtifact
....... valueTriggerDefinition TriggerDefinition
....... valueUsageContext UsageContext
....... valueDosage Dosage
....... valueMeta Meta
...... resource S 1..1 HRexConsent(1.1.0) A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time
...... part Σ 0..* See parameter (Parameters) Named part of a multi-part parameter

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Parameters.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard

This structure is derived from Parameters

Summary

Mandatory: 0 element(7 nested mandatory elements)
Must-Support: 14 elements
Fixed: 4 elements

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Parameters.parameter.part (Open at End)

Differential View

This structure is derived from Parameters

NameFlagsCard.TypeDescription & Constraintsdoco
.. Parameters 0..* Parameters Operation Request or Response
... parameter S 0..* BackboneElement Operation Parameter
.... name 1..1 string Name from the definition
Required Pattern: MemberBundle
.... Slices for part S 3..4 Named part of a multi-part parameter
Slice: Unordered, Open At End by value:$this.name
..... part:MemberPatient S 1..1 BackboneElement Named part of a multi-part parameter
...... name S 1..1 string Name from the definition
Fixed Value: MemberPatient
...... resource S 1..1 HRexPatientDemographics(1.1.0) Information about an individual or animal receiving health care services
..... part:CoverageToMatch S 1..1 BackboneElement Named part of a multi-part parameter
...... name S 1..1 string Name from the definition
Fixed Value: CoverageToMatch
...... resource S 1..1 HRexCoverage(1.1.0) Insurance or medical plan or a payment agreement
..... part:CoverageToLink S 0..1 BackboneElement Named part of a multi-part parameter
...... name S 1..1 string Name from the definition
Fixed Value: CoverageToLink
...... resource S 1..1 HRexCoverage(1.1.0) Insurance or medical plan or a payment agreement
..... part:Consent S 1..1 BackboneElement Named part of a multi-part parameter
...... name S 1..1 string Name from the definition
Fixed Value: Consent
...... resource S 1..1 HRexConsent(1.1.0) A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Parameters 0..* Parameters Operation Request or Response
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... parameter SΣC 0..* BackboneElement Operation Parameter
inv-1: A parameter must have one and only one of (value, resource, part)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... name Σ 1..1 string Name from the definition
Required Pattern: MemberBundle
.... Slices for part SΣ 3..4 See parameter (Parameters) Named part of a multi-part parameter
Slice: Unordered, Open At End by value:$this.name
..... part:MemberPatient SΣ 1..1 BackboneElement Named part of a multi-part parameter
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: MemberPatient
...... resource S 1..1 HRexPatientDemographics(1.1.0) Information about an individual or animal receiving health care services
..... part:CoverageToMatch SΣ 1..1 BackboneElement Named part of a multi-part parameter
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: CoverageToMatch
...... resource S 1..1 HRexCoverage(1.1.0) Insurance or medical plan or a payment agreement
..... part:CoverageToLink SΣ 0..1 BackboneElement Named part of a multi-part parameter
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: CoverageToLink
...... resource S 1..1 HRexCoverage(1.1.0) Insurance or medical plan or a payment agreement
..... part:Consent SΣ 1..1 BackboneElement Named part of a multi-part parameter
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: Consent
...... resource S 1..1 HRexConsent(1.1.0) A healthcare consumer's choices to permit or deny recipients or roles to perform actions for specific purposes and periods of time

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Parameters 0..* Parameters Operation Request or Response
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... parameter SΣC 0..* BackboneElement Operation Parameter
inv-1: A parameter must have one and only one of (value, resource, part)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... name Σ 1..1 string Name from the definition
Required Pattern: MemberBundle
.... value[x] ΣC 0..1 If parameter is a data type
..... valueBase64Binary base64Binary
..... valueBoolean boolean
..... valueCanonical canonical(Any)
..... valueCode code
..... valueDate date
..... valueDateTime dateTime
..... valueDecimal decimal
..... valueId id
..... valueInstant instant
..... valueInteger integer
..... valueMarkdown markdown
..... valueOid oid
..... valuePositiveInt positiveInt
..... valueString string
..... valueTime time
..... valueUnsignedInt unsignedInt
..... valueUri uri
..... valueUrl url
..... valueUuid uuid
..... valueAddress Address
..... valueAge Age
..... valueAnnotation Annotation
..... valueAttachment Attachment
..... valueCodeableConcept CodeableConcept
..... valueCoding Coding
..... valueContactPoint ContactPoint
..... valueCount Count
..... valueDistance Distance
..... valueDuration Duration
..... valueHumanName HumanName
..... valueIdentifier Identifier
..... valueMoney Money
..... valuePeriod Period
..... valueQuantity Quantity
..... valueRange Range
..... valueRatio Ratio
..... valueReference Reference(Any)
..... valueSampledData SampledData
..... valueSignature Signature
..... valueTiming Timing
..... valueContactDetail ContactDetail
..... valueContributor Contributor
..... valueDataRequirement DataRequirement
..... valueExpression Expression
..... valueParameterDefinition ParameterDefinition
..... valueRelatedArtifact RelatedArtifact
..... valueTriggerDefinition TriggerDefinition
..... valueUsageContext UsageContext
..... valueDosage Dosage
..... valueMeta Meta
.... resource ΣC 0..1 Resource If parameter is a whole resource
.... Slices for part SΣ 3..4 See parameter (Parameters) Named part of a multi-part parameter
Slice: Unordered, Open At End by value:$this.name
..... part:MemberPatient SΣ 1..1 BackboneElement Named part of a multi-part parameter
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... name SΣ 1..1 string Name from the definition
Fixed Value: MemberPatient
...... value[x] ΣC 0..1 If parameter is a data type
....... valueBase64Binary base64Binary
....... valueBoolean boolean