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

## Example Consent: Provider Treatment Attestation Consent Example for Bulk Member Match

Page standards status: Informative

Profile: Provider Attestation to Treatment Relationship

status: Active

scope: Treatment

category: Treatment, Release of information consent

patient: Johnny Appleseed Male, DoB: 1986-01-01 ( Member Number)

dateTime: 2024-11-14 10:30:00+0000

performer: Dr. Susan Smith

organization: Provider 1

source: Provider Attestation Form

### Policies

- | Authority | Uri
* | https://example.org/health-authority | https://example.org/provider-attestation-policy

### Verifications

- | Verified | VerifiedWith | VerificationDate
* | true | Provider 1 | 2024-11-14 10:30:00+0000

> provision

> type: Opt In

> period: 2024-01-15 --> (ongoing)

> > actor

> > role: information recipient

> > reference: Dr. Susan Smith

> > actor

> > role: healthcare provider

> > reference: Provider 1

> purpose: ActReason: TREAT (treatment), ActReason: HPAYMT (healthcare payment), ActReason: HOPERAT (healthcare operations)