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

## : $multi-member-match payer example request - JSON Representation

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    {
      "resourceType" : "Parameters",
      "id" : "payer-multi-member-match-in",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-parameters-multi-member-match-bundle-in"
        ]
      },
      "parameter" : [
        {
          "name" : "MemberBundle",
          "part" : [
            {
              "name" : "MemberPatient",
              "resource" : {
                "resourceType" : "Patient",
                "id" : "patient-1",
                "text" : {
                  "status" : "generated",
                  "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>"
                },
                "identifier" : [
                  {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "MB"
                        }
                      ]
                    },
                    "system" : "http://example.org/old-payer/identifiers/member",
                    "value" : "55678",
                    "assigner" : {
                      "display" : "Old Payer"
                    }
                  }
                ],
                "name" : [
                  {
                    "use" : "official",
                    "family" : "Person",
                    "given" : [
                      "Patricia",
                      "Ann"
                    ]
                  }
                ],
                "gender" : "female",
                "birthDate" : "1974-12-25"
              }
            },
            {
              "name" : "CoverageToMatch",
              "resource" : {
                "resourceType" : "Coverage",
                "id" : "coverage-1",
                "text" : {
                  "status" : "generated",
                  "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>"
                },
                "identifier" : [
                  {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "MB"
                        }
                      ]
                    },
                    "system" : "http://example.org/old-payer",
                    "value" : "DH10001235"
                  }
                ],
                "status" : "draft",
                "subscriberId" : "1234564321",
                "beneficiary" : {
                  🔗 "reference" : "Patient/1"
                },
                "relationship" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                      "code" : "self"
                    }
                  ]
                },
                "period" : {
                  "start" : "2011-05-23",
                  "end" : "2012-05-23"
                },
                "payor" : [
                  {
                    "identifier" : {
                      "system" : "http://hl7.org/fhir/sid/us-npi",
                      "value" : "9876543210"
                    },
                    "display" : "Old Health Plan"
                  }
                ],
                "class" : [
                  {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                          "code" : "group"
                        },
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                          "code" : "subplan"
                        }
                      ]
                    },
                    "value" : "P7"
                  },
                  {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                          "code" : "plan"
                        },
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                          "code" : "class"
                        }
                      ]
                    },
                    "value" : "SILVER"
                  }
                ]
              }
            },
            {
              "name" : "Consent",
              "resource" : {
                "resourceType" : "Consent",
                "id" : "consent-1",
                "text" : {
                  "status" : "generated",
                  "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>"
                },
                "status" : "active",
                "scope" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/consentscope",
                      "code" : "patient-privacy"
                    }
                  ]
                },
                "category" : [
                  {
                    "coding" : [
                      {
                        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                        "code" : "IDSCL"
                      }
                    ]
                  }
                ],
                "patient" : {
                  🔗 "reference" : "Patient/1"
                },
                "performer" : [
                  {
                    🔗 "reference" : "Patient/1"
                  }
                ],
                "sourceReference" : {
                  "reference" : "http://example.org/DocumentReference/someconsent-1"
                },
                "policy" : [
                  {
                    "uri" : "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition-hrex-consent.html#regular"
                  }
                ],
                "provision" : {
                  "type" : "permit",
                  "period" : {
                    "start" : "2023-12-01",
                    "end" : "2024-03-31"
                  },
                  "actor" : [
                    {
                      "role" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
                            "code" : "performer"
                          }
                        ]
                      },
                      "reference" : {
                        "identifier" : {
                          "system" : "http://hl7.org/fhir/sid/us-npi",
                          "value" : "9876543210"
                        },
                        "display" : "Old Health Plan"
                      }
                    },
                    {
                      "role" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                            "code" : "IRCP"
                          }
                        ]
                      },
                      "reference" : {
                        "identifier" : {
                          "system" : "http://hl7.org/fhir/sid/us-npi",
                          "value" : "0123456789"
                        },
                        "display" : "New Health Plan"
                      }
                    }
                  ],
                  "action" : [
                    {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/consentaction",
                          "code" : "disclose"
                        }
                      ]
                    }
                  ]
                }
              }
            },
            {
              "name" : "CoverageToLink",
              "resource" : {
                "resourceType" : "Coverage",
                "id" : "coverage-link-1",
                "text" : {
                  "status" : "generated",
                  "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Default Generated text for resource.</div>"
                },
                "identifier" : [
                  {
                    "type" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                          "code" : "MB"
                        }
                      ]
                    },
                    "system" : "http://example.org/old-payer",
                    "value" : "234567"
                  }
                ],
                "status" : "draft",
                "subscriberId" : "432156789",
                "beneficiary" : {
                  🔗 "reference" : "Patient/1"
                },
                "relationship" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                      "code" : "self"
                    }
                  ]
                },
                "period" : {
                  "start" : "2011-05-23",
                  "end" : "2012-05-23"
                },
                "payor" : [
                  {
                    "identifier" : {
                      "system" : "http://hl7.org/fhir/sid/us-npi",
                      "value" : "0123456789"
                    },
                    "display" : "New Health Plan"
                  }
                ]
              }
            }
          ]
        }
      ]
    }