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 Bulk Member Match Response Example - JSON Representation

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    {
      "resourceType" : "Parameters",
      "id" : "provider-bulk-member-match-out",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-parameters-multi-member-match-bundle-out"
        ]
      },
      "parameter" : [
        {
          "name" : "MatchedMembers",
          "resource" : {
            "resourceType" : "Group",
            "id" : "provider-matched-group-001",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Matched members group - members authorized for provider access</div>"
            },
            "contained" : [
              {
                "resourceType" : "Patient",
                "id" : "provider-submitted-patient-1",
                "identifier" : [
                  {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "MR"
                        }
                      ]
                    },
                    "system" : "http://example.org/provider-emr/identifiers/patient",
                    "value" : "EMR-98765",
                    "assigner" : {
                      "display" : "Provider 1 EMR System"
                    }
                  }
                ],
                "name" : [
                  {
                    "use" : "official",
                    "family" : "Person",
                    "given" : [
                      "Patricia",
                      "Ann"
                    ]
                  }
                ],
                "gender" : "female",
                "birthDate" : "1974-12-25"
              },
              {
                "resourceType" : "Patient",
                "id" : "provider-submitted-patient-2",
                "identifier" : [
                  {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "MR"
                        }
                      ]
                    },
                    "system" : "http://example.org/provider-emr/identifiers/patient",
                    "value" : "EMR-45678",
                    "assigner" : {
                      "display" : "Provider 1 EMR System"
                    }
                  }
                ],
                "name" : [
                  {
                    "use" : "official",
                    "family" : "Doe",
                    "given" : [
                      "John",
                      "Michael"
                    ]
                  }
                ],
                "gender" : "male",
                "birthDate" : "1985-06-15"
              }
            ],
            "identifier" : [
              {
                "system" : "http://hl7.org/fhir/sid/us-npi",
                "value" : "1982947230",
                "assigner" : {
                  "display" : "Provider 1"
                }
              }
            ],
            "type" : "person",
            "actual" : true,
            "code" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS",
                  "code" : "match",
                  "display" : "Matched"
                }
              ]
            },
            "managingEntity" : {
              "identifier" : {
                "system" : "http://hl7.org/fhir/sid/us-npi",
                "value" : "1234567890"
              },
              "display" : "Example Health Plan"
            },
            "characteristic" : [
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS",
                      "code" : "match",
                      "display" : "Matched"
                    }
                  ]
                },
                "valueReference" : {
                  "identifier" : {
                    "system" : "http://hl7.org/fhir/sid/us-npi",
                    "value" : "1982947230"
                  },
                  "display" : "Provider 1"
                },
                "exclude" : false,
                "period" : {
                  "start" : "2024-11-14"
                }
              }
            ],
            "member" : [
              {
                "entity" : {
                  🔗 "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters",
                      "valueReference" : {
                        "reference" : "#provider-submitted-patient-1"
                      }
                    }
                  ],
                  "reference" : "Patient/payer-patient-1001",
                  "display" : "Patricia Ann Person - Payer Record"
                }
              },
              {
                "entity" : {
                  🔗 "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters",
                      "valueReference" : {
                        "reference" : "#provider-submitted-patient-2"
                      }
                    }
                  ],
                  "reference" : "Patient/payer-patient-2002",
                  "display" : "John Michael Doe - Payer Record"
                }
              }
            ]
          }
        },
        {
          "name" : "NonMatchedMembers",
          "resource" : {
            "resourceType" : "Group",
            "id" : "provider-nomatch-group-001",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Non-matched members group - members not found in payer system</div>"
            },
            "contained" : [
              {
                "resourceType" : "Patient",
                "id" : "provider-submitted-patient-3",
                "identifier" : [
                  {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "MR"
                        }
                      ]
                    },
                    "system" : "http://example.org/provider-emr/identifiers/patient",
                    "value" : "EMR-99999",
                    "assigner" : {
                      "display" : "Provider 1 EMR System"
                    }
                  }
                ],
                "name" : [
                  {
                    "use" : "official",
                    "family" : "Smith",
                    "given" : [
                      "Jane",
                      "Marie"
                    ]
                  }
                ],
                "gender" : "female",
                "birthDate" : "1990-03-20"
              }
            ],
            "identifier" : [
              {
                "system" : "http://hl7.org/fhir/sid/us-npi",
                "value" : "1982947230",
                "assigner" : {
                  "display" : "Provider 1"
                }
              }
            ],
            "type" : "person",
            "actual" : true,
            "code" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS",
                  "code" : "nomatch",
                  "display" : "Not Matched"
                }
              ]
            },
            "managingEntity" : {
              "identifier" : {
                "system" : "http://hl7.org/fhir/sid/us-npi",
                "value" : "1234567890"
              },
              "display" : "Example Health Plan"
            },
            "member" : [
              {
                "entity" : {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters",
                      "valueReference" : {
                        "reference" : "#provider-submitted-patient-3"
                      }
                    }
                  ],
                  "reference" : "#provider-submitted-patient-3",
                  "display" : "Jane Marie Smith - Not Found"
                }
              }
            ]
          }
        },
        {
          "name" : "ConsentConstrainedMembers",
          "resource" : {
            "resourceType" : "Group",
            "id" : "provider-consent-constraint-group-001",
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Consent-constrained members group - members who opted out of Provider Access API</div>"
            },
            "contained" : [
              {
                "resourceType" : "Patient",
                "id" : "provider-submitted-patient-4",
                "identifier" : [
                  {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "MR"
                        }
                      ]
                    },
                    "system" : "http://example.org/provider-emr/identifiers/patient",
                    "value" : "EMR-77777",
                    "assigner" : {
                      "display" : "Provider 1 EMR System"
                    }
                  }
                ],
                "name" : [
                  {
                    "use" : "official",
                    "family" : "Wilson",
                    "given" : [
                      "Robert",
                      "James"
                    ]
                  }
                ],
                "gender" : "male",
                "birthDate" : "1978-11-30"
              }
            ],
            "identifier" : [
              {
                "system" : "http://hl7.org/fhir/sid/us-npi",
                "value" : "1982947230",
                "assigner" : {
                  "display" : "Provider 1"
                }
              }
            ],
            "type" : "person",
            "actual" : true,
            "code" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS",
                  "code" : "consentconstraint",
                  "display" : "Consent Constraint"
                }
              ]
            },
            "managingEntity" : {
              "identifier" : {
                "system" : "http://hl7.org/fhir/sid/us-npi",
                "value" : "1234567890"
              },
              "display" : "Example Health Plan"
            },
            "member" : [
              {
                "entity" : {
                  "extension" : [
                    {
                      "url" : "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters",
                      "valueReference" : {
                        "reference" : "#provider-submitted-patient-4"
                      }
                    }
                  ],
                  "reference" : "#provider-submitted-patient-4",
                  "display" : "Robert James Wilson - Opted Out"
                }
              }
            ]
          }
        }
      ]
    }