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 Treatment Attestation Consent Example for Bulk Member Match - XML Representation

Page standards status: Informative

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    <Consent xmlns="http://hl7.org/fhir">
      <id value="provider-treatment-attestation-1"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-treatment-relationship-consent"/>
      </meta>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Consent provider-treatment-attestation-1</b></p><a name="provider-treatment-attestation-1"> </a><a name="hcprovider-treatment-attestation-1"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-provider-treatment-relationship-consent.html">Provider Attestation to Treatment Relationship</a></p></div><p><b>status</b>: Active</p><p><b>scope</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/consentscope treatment}">Treatment</span></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/consentcategorycodes treat}">Treatment</span>, <span title="Codes:{http://loinc.org 64292-6}">Release of information consent</span></p><p><b>patient</b>: <a href="Patient-1.html">Johnny Appleseed  Male, DoB: 1986-01-01 ( Member Number)</a></p><p><b>dateTime</b>: 2024-11-14 10:30:00+0000</p><p><b>performer</b>: <a href="Practitioner-4.html">Dr. Susan Smith</a></p><p><b>organization</b>: <a href="Organization-ProviderOrg1.html">Provider 1</a></p><p><b>source</b>: <a href="DocumentReference-provider-attestation-doc-1.html">Provider Attestation Form</a></p><h3>Policies</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Authority</b></td><td><b>Uri</b></td></tr><tr><td style="display: none">*</td><td><a href="https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=https://example.org/health-authority">https://example.org/health-authority</a></td><td><a href="https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=https://example.org/provider-attestation-policy">https://example.org/provider-attestation-policy</a></td></tr></table><h3>Verifications</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Verified</b></td><td><b>VerifiedWith</b></td><td><b>VerificationDate</b></td></tr><tr><td style="display: none">*</td><td>true</td><td><a href="Organization-ProviderOrg1.html">Provider 1</a></td><td>2024-11-14 10:30:00+0000</td></tr></table><blockquote><p><b>provision</b></p><p><b>type</b>: Opt In</p><p><b>period</b>: 2024-01-15 --&gt; (ongoing)</p><blockquote><p><b>actor</b></p><p><b>role</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ParticipationType IRCP}">information recipient</span></p><p><b>reference</b>: <a href="Practitioner-4.html">Dr. Susan Smith</a></p></blockquote><blockquote><p><b>actor</b></p><p><b>role</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleClass PROV}">healthcare provider</span></p><p><b>reference</b>: <a href="Organization-ProviderOrg1.html">Provider 1</a></p></blockquote><p><b>purpose</b>: <a href="http://terminology.hl7.org/6.3.0/CodeSystem-v3-ActReason.html#v3-ActReason-TREAT">ActReason: TREAT</a> (treatment), <a href="http://terminology.hl7.org/6.3.0/CodeSystem-v3-ActReason.html#v3-ActReason-HPAYMT">ActReason: HPAYMT</a> (healthcare payment), <a href="http://terminology.hl7.org/6.3.0/CodeSystem-v3-ActReason.html#v3-ActReason-HOPERAT">ActReason: HOPERAT</a> (healthcare operations)</p></blockquote></div>
      </text>
      <status value="active"/>
      <scope>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/consentscope"/>
          <code value="treatment"/>
        </coding>
      </scope>
      <category>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/consentcategorycodes"/>
          <code value="treat"/>
          <display value="Treatment"/>
        </coding>
      </category>
      <category>
        <coding>
          <system value="http://loinc.org"/>
          <code value="64292-6"/>
          <display value="Release of information consent"/>
        </coding>
      </category>
      <patient>🔗
        <reference value="Patient/1"/>
      </patient>
      <dateTime value="2024-11-14T10:30:00Z"/>
      <performer>🔗
        <reference value="Practitioner/4"/>
        <display value="Dr. Susan Smith"/>
      </performer>
      <organization>🔗
        <reference value="Organization/ProviderOrg1"/>
        <display value="Provider 1"/>
      </organization>
      <sourceReference>🔗
        <reference value="DocumentReference/provider-attestation-doc-1"/>
        <display value="Provider Attestation Form"/>
      </sourceReference>
      <policy>
        <authority value="https://example.org/health-authority"/>
        <uri value="https://example.org/provider-attestation-policy"/>
      </policy>
      <verification>
        <verified value="true"/>
        <verifiedWith>🔗
          <reference value="Organization/ProviderOrg1"/>
          <display value="Provider 1"/>
        </verifiedWith>
        <verificationDate value="2024-11-14T10:30:00Z"/>
      </verification>
      <provision>
        <type value="permit"/>
        <period>
          <start value="2024-01-15"/>
        </period>
        <actor>
          <role>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/v3-ParticipationType"/>
              <code value="IRCP"/>
              <display value="information recipient"/>
            </coding>
          </role>
          <reference>🔗
            <reference value="Practitioner/4"/>
            <display value="Dr. Susan Smith"/>
          </reference>
        </actor>
        <actor>
          <role>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v3-RoleClass"/>
              <code value="PROV"/>
              <display value="healthcare provider"/>
            </coding>
          </role>
          <reference>🔗
            <reference value="Organization/ProviderOrg1"/>
            <display value="Provider 1"/>
          </reference>
        </actor>
        <purpose>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
          <code value="TREAT"/>
          <display value="treatment"/>
        </purpose>
        <purpose>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
          <code value="HPAYMT"/>
          <display value="healthcare payment"/>
        </purpose>
        <purpose>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
          <code value="HOPERAT"/>
          <display value="healthcare operations"/>
        </purpose>
      </provision>
    </Consent>