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 Response Example - XML Representation

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