Da Vinci Payer Data Exchange
2.1.1 - STU 2.1 United States of America flag

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 Request Example - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <https://loinc.org/rdf/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Parameters ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "provider-bulk-member-match-in"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-parameters-multi-member-match-bundle-in"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-parameters-multi-member-match-bundle-in>     ] )
  ] ; # 
  fhir:parameter ( [
fhir:name [ fhir:v "MemberBundle" ] ;
    ( fhir:part [
fhir:name [ fhir:v "MemberPatient" ] ;
      ( fhir:Parameters.parameter.resource [
a fhir:Patient ;
fhir:id [ fhir:v "patient-provider-1" ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">Patient Patricia Ann Person</div>"^^rdf:XMLLiteral ]         ] ;
        ( fhir:identifier [
fhir:type [
            ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v2-0203>               ] ;
fhir:code [ fhir:v "MB" ]             ] )           ] ;
fhir:system [
fhir:v "http://example.org/provider-emr/identifiers/patient"^^xsd:anyURI ;
fhir:l <http://example.org/provider-emr/identifiers/patient>           ] ;
fhir:value [ fhir:v "EMR-98765" ] ;
fhir:assigner [
fhir:display [ fhir:v "Provider 1 EMR System" ]           ]         ] ) ;
        ( fhir:name [
fhir:use [ fhir:v "official" ] ;
fhir:family [ fhir:v "Person" ] ;
          ( fhir:given [ fhir:v "Patricia" ] [ fhir:v "Ann" ] )         ] ) ;
fhir:gender [ fhir:v "female" ] ;
fhir:birthDate [ fhir:v "1974-12-25"^^xsd:date ]       ] )     ] [
fhir:name [ fhir:v "CoverageToMatch" ] ;
      ( fhir:Parameters.parameter.resource [
a fhir:Coverage ;
fhir:id [ fhir:v "coverage-provider-1" ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">Coverage information from insurance card</div>"^^rdf:XMLLiteral ]         ] ;
        ( fhir:identifier [
fhir:type [
            ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v2-0203>               ] ;
fhir:code [ fhir:v "MB" ]             ] )           ] ;
fhir:system [
fhir:v "http://example.org/health-plan"^^xsd:anyURI ;
fhir:l <http://example.org/health-plan>           ] ;
fhir:value [ fhir:v "HP-12345678" ]         ] ) ;
fhir:status [ fhir:v "active" ] ;
fhir:subscriberId [ fhir:v "SUB-987654321" ] ;
fhir:beneficiary [
fhir:l fhir:Patient/patient-provider-1 ;
fhir:reference [ fhir:v "Patient/patient-provider-1" ]         ] ;
fhir:relationship [
          ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/subscriber-relationship>             ] ;
fhir:code [ fhir:v "self" ]           ] )         ] ;
fhir:period [
fhir:start [ fhir:v "2024-01-01"^^xsd:date ] ;
fhir:end [ fhir:v "2024-12-31"^^xsd:date ]         ] ;
        ( fhir:payor [
fhir:identifier [
fhir:system [
fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/sid/us-npi>             ] ;
fhir:value [ fhir:v "1234567890" ]           ] ;
fhir:display [ fhir:v "Example Health Plan" ]         ] ) ;
        ( fhir:class [
fhir:type [
            ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/coverage-class>               ] ;
fhir:code [ fhir:v "group" ]             ] )           ] ;
fhir:value [ fhir:v "GRP-001" ]         ] [
fhir:type [
            ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/coverage-class>               ] ;
fhir:code [ fhir:v "plan" ]             ] )           ] ;
fhir:value [ fhir:v "PLAN-GOLD" ]         ] )       ] )     ] [
fhir:name [ fhir:v "Consent" ] ;
      ( fhir:Parameters.parameter.resource [
a fhir:Consent ;
fhir:id [ fhir:v "consent-provider-1" ] ;
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provider attestation to treatment relationship</div>"^^rdf:XMLLiteral ]         ] ;
fhir:status [ fhir:v "active" ] ;
fhir:scope [
          ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/consentscope"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/consentscope>             ] ;
fhir:code [ fhir:v "treatment" ]           ] )         ] ;
        ( fhir:category [
          ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/consentcategorycodes"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/consentcategorycodes>             ] ;
fhir:code [ fhir:v "treat" ] ;
fhir:display [ fhir:v "Treatment" ]           ] )         ] [
          ( fhir:coding [
a loinc:64292-6 ;
fhir:system [
fhir:v "http://loinc.org"^^xsd:anyURI ;
fhir:l <http://loinc.org>             ] ;
fhir:code [ fhir:v "64292-6" ] ;
fhir:display [ fhir:v "Release of information consent" ]           ] )         ] ) ;
fhir:patient [
fhir:l fhir:Patient/patient-provider-1 ;
fhir:reference [ fhir:v "Patient/patient-provider-1" ]         ] ;
fhir:dateTime [ fhir:v "2024-11-14T10:30:00Z"^^xsd:dateTime ] ;
        ( fhir:performer [
fhir:l fhir:Practitioner/4 ;
fhir:reference [ fhir:v "Practitioner/4" ] ;
fhir:display [ fhir:v "Dr. Susan Smith" ]         ] ) ;
fhir:source [
a fhir:Reference ;
fhir:l fhir:DocumentReference/provider-attestation-doc-1 ;
fhir:reference [ fhir:v "DocumentReference/provider-attestation-doc-1" ]         ] ;
        ( fhir:policy [
fhir:uri [
fhir:v "https://example.org/provider-attestation-policy"^^xsd:anyURI ;
fhir:l <https://example.org/provider-attestation-policy>           ]         ] ) ;
        ( fhir:verification [
fhir:verified [ fhir:v true ] ;
fhir:verifiedWith [
fhir:l fhir:Organization/ProviderOrg1 ;
fhir:reference [ fhir:v "Organization/ProviderOrg1" ]           ] ;
fhir:verificationDate [ fhir:v "2024-11-14T10:30:00Z"^^xsd:dateTime ]         ] ) ;
fhir:provision [
fhir:type [ fhir:v "permit" ] ;
fhir:period [
fhir:start [ fhir:v "2024-01-15"^^xsd:date ]           ] ;
          ( fhir:actor [
fhir:role [
              ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ParticipationType"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ParticipationType>                 ] ;
fhir:code [ fhir:v "IRCP" ]               ] )             ] ;
fhir:reference [
fhir:identifier [
fhir:system [
fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/sid/us-npi>                 ] ;
fhir:value [ fhir:v "1982943213" ]               ] ;
fhir:display [ fhir:v "Dr. Susan Smith" ]             ]           ] [
fhir:role [
              ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-RoleClass"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-RoleClass>                 ] ;
fhir:code [ fhir:v "PROV" ]               ] )             ] ;
fhir:reference [
fhir:identifier [
fhir:system [
fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/sid/us-npi>                 ] ;
fhir:value [ fhir:v "1982947230" ]               ] ;
fhir:display [ fhir:v "Provider 1" ]             ]           ] ) ;
          ( fhir:purpose [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActReason"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActReason>             ] ;
fhir:code [ fhir:v "TREAT" ]           ] [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActReason"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActReason>             ] ;
fhir:code [ fhir:v "HPAYMT" ]           ] [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActReason"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActReason>             ] ;
fhir:code [ fhir:v "HOPERAT" ]           ] )         ]       ] )     ] )
  ] ) . #