Da Vinci Payer Data Exchange
2.1.1 - STU 2.1

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

## : Provider Attestation Document Reference - JSON Representation

Page standards status: Informative

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    {
      "resourceType" : "DocumentReference",
      "id" : "provider-attestation-doc-1",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: DocumentReference provider-attestation-doc-1</b></p><a name=\"provider-attestation-doc-1\"> </a><a name=\"hcprovider-attestation-doc-1\"> </a><p><b>status</b>: Current</p><p><b>docStatus</b>: Final</p><p><b>type</b>: <span title=\"Codes:{http://loinc.org 64292-6}\">Release of information consent</span></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/consentcategorycodes treat}\">Treatment</span></p><p><b>subject</b>: <a href=\"Patient-1.html\">Patricia Ann Person</a></p><p><b>date</b>: 2024-11-14 10:30:00+0000</p><p><b>author</b>: <a href=\"Practitioner-4.html\">Dr. Susan Smith</a></p><p><b>authenticator</b>: <a href=\"Organization-ProviderOrg1.html\">Provider 1</a></p><p><b>custodian</b>: <a href=\"Organization-ProviderOrg1.html\">Provider 1</a></p><blockquote><p><b>content</b></p><h3>Attachments</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ContentType</b></td><td><b>Url</b></td><td><b>Title</b></td><td><b>Creation</b></td></tr><tr><td style=\"display: none\">*</td><td>application/pdf</td><td><a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=https://example.org/provider1/attestations/2024/attestation-001.pdf\">https://example.org/provider1/attestations/2024/attestation-001.pdf</a></td><td>Provider Treatment Relationship Attestation Form</td><td>2024-11-14 10:30:00+0000</td></tr></table><p><b>format</b>: IHE.FormatCode.codesystem: urn:ihe:iti:xds:2017:mimeTypeSufficient (urn:ihe:iti:xds:2017:mimeTypeSufficient)</p></blockquote><h3>Contexts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Period</b></td><td><b>Related</b></td></tr><tr><td style=\"display: none\">*</td><td>2024-01-15 --&gt; (ongoing)</td><td><a href=\"Encounter-6.html\">Encounter: status = finished; class = Ambulatory (ActCode#AMB); type = Consultation</a></td></tr></table></div>"
      },
      "status" : "current",
      "docStatus" : "final",
      "type" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "64292-6",
            "display" : "Release of information consent"
          }
        ]
      },
      "category" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/consentcategorycodes",
              "code" : "treat",
              "display" : "Treatment"
            }
          ]
        }
      ],
      "subject" : {
        🔗 "reference" : "Patient/1",
        "display" : "Patricia Ann Person"
      },
      "date" : "2024-11-14T10:30:00Z",
      "author" : [
        {
          🔗 "reference" : "Practitioner/4",
          "display" : "Dr. Susan Smith"
        }
      ],
      "authenticator" : {
        🔗 "reference" : "Organization/ProviderOrg1",
        "display" : "Provider 1"
      },
      "custodian" : {
        🔗 "reference" : "Organization/ProviderOrg1",
        "display" : "Provider 1"
      },
      "content" : [
        {
          "attachment" : {
            "contentType" : "application/pdf",
            "url" : "https://example.org/provider1/attestations/2024/attestation-001.pdf",
            "title" : "Provider Treatment Relationship Attestation Form",
            "creation" : "2024-11-14T10:30:00Z"
          },
          "format" : {
            "system" : "http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem",
            "code" : "urn:ihe:iti:xds:2017:mimeTypeSufficient"
          }
        }
      ],
      "context" : {
        "period" : {
          "start" : "2024-01-15"
        },
        "related" : [
          {
            🔗 "reference" : "Encounter/6"
          }
        ]
      }
    }