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 - XML Representation

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