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
| Page standards status: Informative |
Definitions for the provider-parameters-multi-member-match-bundle-in resource profile.
Guidance on how to interpret the contents of this table can be foundhere
| 0. Parameters | |
| Definition | This resource is a non-persisted resource used to pass information into and back from an operation. It has no other use, and there is no RESTful endpoint associated with it. |
| Short | Operation Request or Response |
| Comments | The parameters that may be used are defined by the OperationDefinition resource. |
| Control | 0..* |
| Is Modifier | false |
| Summary | false |
| 2. Parameters.implicitRules | |
| Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
| Short | A set of rules under which this content was created |
| Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
| Control | 0..1 |
| Type | uri |
| Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 4. Parameters.parameter | |
| Definition | Parameters for a provider-initiated bulk member match request containing current member demographics, current coverage, and provider treatment attestation. A parameter passed to or received from the operation. |
| Short | Provider member match request parametersOperation Parameter |
| Control | 10..* |
| Type | BackboneElement |
| Is Modifier | false |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) inv-1: A parameter must have one and only one of (value, resource, part) ( (part.exists() and value.empty() and resource.empty()) or (part.empty() and (value.exists() xor resource.exists())))inv-1: A parameter must have one and only one of (value, resource, part) ((part.exists() and value.empty() and resource.empty()) or (part.empty() and (value.exists() xor resource.exists()))) |
| Slicing | This element introduces a set of slices on Parameters.parameter. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 6. Parameters.parameter.modifierExtension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored even if unrecognized |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content, modifiers |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 8. Parameters.parameter.name | |
| Definition | The name of the parameter (reference to the operation definition). |
| Short | Name from the definition |
| Control | 1..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 10. Parameters.parameter:MemberBundle | |
| Slice Name | MemberBundle |
| Definition | A parameter passed to or received from the operation. |
| Short | Operation Parameter |
| Control | 10..* |
| Type | BackboneElement |
| Is Modifier | false |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) inv-1: A parameter must have one and only one of (value, resource, part) ( (part.exists() and value.empty() and resource.empty()) or (part.empty() and (value.exists() xor resource.exists())))inv-1: A parameter must have one and only one of (value, resource, part) ((part.exists() and value.empty() and resource.empty()) or (part.empty() and (value.exists() xor resource.exists()))) |
| 12. Parameters.parameter:MemberBundle.modifierExtension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored even if unrecognized |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content, modifiers |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 14. Parameters.parameter:MemberBundle.name | |
| Definition | A bundle containing current member demographics, current coverage information, and provider treatment attestation for a single member. The name of the parameter (reference to the operation definition). |
| Short | Bundle of member elements to match for provider accessName from the definition |
| Control | 1..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Pattern Value | MemberBundle |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 16. Parameters.parameter:MemberBundle.part | |
| Definition | The individual components required for a provider to request access to member data: current patient demographics, current coverage, and provider treatment attestation. A named part of a multi-part parameter. |
| Short | Components of provider member match requestNamed part of a multi-part parameter |
| Comments | Only one level of nested parameters is allowed. |
| Control | 30..* |
| Type | Seettp://hl7.org/fhir/StructureDefinition/Parameters#Parameters.parameter |
| Is Modifier | false |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Parameters.parameter.part. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 18. Parameters.parameter:MemberBundle.part.modifierExtension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored even if unrecognized |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content, modifiers |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 20. Parameters.parameter:MemberBundle.part.name | |
| Definition | The name of the parameter (reference to the operation definition). |
| Short | Name from the definition |
| Control | 1..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 22. Parameters.parameter:MemberBundle.part:MemberPatient | |
| Slice Name | MemberPatient |
| Definition | A named part of a multi-part parameter. |
| Short | Named part of a multi-part parameter |
| Comments | Only one level of nested parameters is allowed. |
| Control | 10..1* |
| Type | BackboneElement |
| Is Modifier | false |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 24. Parameters.parameter:MemberBundle.part:MemberPatient.modifierExtension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored even if unrecognized |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content, modifiers |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 26. Parameters.parameter:MemberBundle.part:MemberPatient.name | |
| Definition | Current patient demographic information as known by the provider (from provider's EMR or patient-provided information). The name of the parameter (reference to the operation definition). |
| Short | Current member demographicsName from the definition |
| Control | 1..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Pattern Value | MemberPatient |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 28. Parameters.parameter:MemberBundle.part:MemberPatient.resource | |
| Definition | The patient's current demographic information including name, date of birth, gender, and identifiers from the provider's system. If the parameter is a whole resource. |
| Short | Patient demographic detailsIf parameter is a whole resource |
| Comments | When resolving references in resources, the operation definition may specify how references may be resolved between parameters. If a reference cannot be resolved between the parameters, the application should fall back to it's general resource resolution methods. |
| Control | 10..1 This element is affected by the following invariants: inv-1 |
| Type | PatientResource(HRex Member Match Patient) |
| Is Modifier | false |
| Must Support | false |
| Summary | false |
| Alternate Names | SubjectOfCare Client Resident |
| 30. Parameters.parameter:MemberBundle.part:CoverageToMatch | |
| Slice Name | CoverageToMatch |
| Definition | A named part of a multi-part parameter. |
| Short | Named part of a multi-part parameter |
| Comments | Only one level of nested parameters is allowed. |
| Control | 10..1* |
| Type | BackboneElement |
| Is Modifier | false |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 32. Parameters.parameter:MemberBundle.part:CoverageToMatch.modifierExtension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored even if unrecognized |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content, modifiers |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 34. Parameters.parameter:MemberBundle.part:CoverageToMatch.name | |
| Definition | The member's current active coverage with the payer (typically from insurance card or eligibility verification). The name of the parameter (reference to the operation definition). |
| Short | Current member coverageName from the definition |
| Control | 1..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Pattern Value | CoverageToMatch |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 36. Parameters.parameter:MemberBundle.part:CoverageToMatch.resource | |
| Definition | The member's active coverage information including member ID, subscriber ID, group number, plan details, and payer identifier. If the parameter is a whole resource. |
| Short | Current coverage detailsIf parameter is a whole resource |
| Comments | The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers. When resolving references in resources, the operation definition may specify how references may be resolved between parameters. If a reference cannot be resolved between the parameters, the application should fall back to it's general resource resolution methods. |
| Control | 10..1 This element is affected by the following invariants: inv-1 |
| Type | CoverageResource(HRex Member Match Coverage Profile) |
| Is Modifier | false |
| Must Support | false |
| Summary | false |
| 38. Parameters.parameter:MemberBundle.part:Consent | |
| Slice Name | Consent |
| Definition | A named part of a multi-part parameter. |
| Short | Named part of a multi-part parameter |
| Comments | Only one level of nested parameters is allowed. |
| Control | 10..1* |
| Type | BackboneElement |
| Is Modifier | false |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 40. Parameters.parameter:MemberBundle.part:Consent.modifierExtension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored even if unrecognized |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content, modifiers |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 42. Parameters.parameter:MemberBundle.part:Consent.name | |
| Definition | Provider's attestation of an active treatment relationship with the member. This is NOT patient consent for payer-to-payer data exchange, but rather the provider's certification that they have a treatment relationship justifying access to the member's data. The name of the parameter (reference to the operation definition). |
| Short | Provider treatment attestationName from the definition |
| Control | 1..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Pattern Value | Consent |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 44. Parameters.parameter:MemberBundle.part:Consent.resource | |
| Definition | A Consent resource conforming to the ProviderTreatmentAttestation profile, documenting that the provider has an active treatment relationship with the member and the purposes for which they are requesting access to the member's data. If the parameter is a whole resource. |
| Short | Provider attestation to treatment relationshipIf parameter is a whole resource |
| Comments | Unlike the payer-to-payer multi-member-match which includes patient consent for data exchange between payers, the provider version includes the provider's attestation to a treatment relationship. This attestation serves as the legal basis for the payer to release data to the provider under HIPAA treatment, payment, and operations (TPO) provisions. When resolving references in resources, the operation definition may specify how references may be resolved between parameters. If a reference cannot be resolved between the parameters, the application should fall back to it's general resource resolution methods. |
| Control | 10..1 This element is affected by the following invariants: inv-1 |
| Type | ConsentResource(Provider Attestation to Treatment Relationship) |
| Is Modifier | false |
| Summary | false |
| 46. Parameters.parameter:MemberBundle.part:CoverageToLink | |
| Slice Name | CoverageToLink |
| Definition | CoverageToLink is not used in provider-initiated member match requests as providers are not linking historical coverage to new coverage. This element is only relevant for payer-to-payer member match operations. A named part of a multi-part parameter. |
| Short | Not used in provider requestsNamed part of a multi-part parameter |
| Comments | Only one level of nested parameters is allowed. |
| Control | 0..0* |
| Type | Seettp://hl7.org/fhir/StructureDefinition/Parameters#Parameters.parameter |
| Is Modifier | false |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be foundhere
| 0. Parameters | |
| 2. Parameters.parameter | |
| Definition | Parameters for a provider-initiated bulk member match request containing current member demographics, current coverage, and provider treatment attestation. |
| Short | Provider member match request parameters |
| Control | 1..? |
| Slicing | This element introduces a set of slices on Parameters.parameter. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 4. Parameters.parameter:MemberBundle | |
| Slice Name | MemberBundle |
| Control | 1..* |
| 6. Parameters.parameter:MemberBundle.name | |
| Definition | A bundle containing current member demographics, current coverage information, and provider treatment attestation for a single member. |
| Short | Bundle of member elements to match for provider access |
| Pattern Value | MemberBundle |
| 8. Parameters.parameter:MemberBundle.part | |
| Definition | The individual components required for a provider to request access to member data: current patient demographics, current coverage, and provider treatment attestation. |
| Short | Components of provider member match request |
| Control | 3..? |
| Slicing | This element introduces a set of slices on Parameters.parameter.part. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 10. Parameters.parameter:MemberBundle.part:MemberPatient | |
| Slice Name | MemberPatient |
| Control | 1..1 |
| Type | BackboneElement |
| 12. Parameters.parameter:MemberBundle.part:MemberPatient.name | |
| Definition | Current patient demographic information as known by the provider (from provider's EMR or patient-provided information). |
| Short | Current member demographics |
| Pattern Value | MemberPatient |
| 14. Parameters.parameter:MemberBundle.part:MemberPatient.resource | |
| Definition | The patient's current demographic information including name, date of birth, gender, and identifiers from the provider's system. |
| Short | Patient demographic details |
| Control | 1..? |
| Type | Patient(HRex Member Match Patient) |
| 16. Parameters.parameter:MemberBundle.part:CoverageToMatch | |
| Slice Name | CoverageToMatch |
| Control | 1..1 |
| Type | BackboneElement |
| 18. Parameters.parameter:MemberBundle.part:CoverageToMatch.name | |
| Definition | The member's current active coverage with the payer (typically from insurance card or eligibility verification). |
| Short | Current member coverage |
| Pattern Value | CoverageToMatch |
| 20. Parameters.parameter:MemberBundle.part:CoverageToMatch.resource | |
| Definition | The member's active coverage information including member ID, subscriber ID, group number, plan details, and payer identifier. |
| Short | Current coverage details |
| Control | 1..? |
| Type | Coverage(HRex Member Match Coverage Profile) |
| 22. Parameters.parameter:MemberBundle.part:Consent | |
| Slice Name | Consent |
| Control | 1..1 |
| Type | BackboneElement |
| 24. Parameters.parameter:MemberBundle.part:Consent.name | |
| Definition | Provider's attestation of an active treatment relationship with the member. This is NOT patient consent for payer-to-payer data exchange, but rather the provider's certification that they have a treatment relationship justifying access to the member's data. |
| Short | Provider treatment attestation |
| Pattern Value | Consent |
| 26. Parameters.parameter:MemberBundle.part:Consent.resource | |
| Definition | A Consent resource conforming to the ProviderTreatmentAttestation profile, documenting that the provider has an active treatment relationship with the member and the purposes for which they are requesting access to the member's data. |
| Short | Provider attestation to treatment relationship |
| Comments | Unlike the payer-to-payer multi-member-match which includes patient consent for data exchange between payers, the provider version includes the provider's attestation to a treatment relationship. This attestation serves as the legal basis for the payer to release data to the provider under HIPAA treatment, payment, and operations (TPO) provisions. |
| Control | 1..? |
| Type | Consent(Provider Attestation to Treatment Relationship) |
| 28. Parameters.parameter:MemberBundle.part:CoverageToLink | |
| Slice Name | CoverageToLink |
| Definition | CoverageToLink is not used in provider-initiated member match requests as providers are not linking historical coverage to new coverage. This element is only relevant for payer-to-payer member match operations. |
| Short | Not used in provider requests |
| Control | 0..0 |
Guidance on how to interpret the contents of this table can be foundhere
| 0. Parameters | |||||
| Definition | This resource is a non-persisted resource used to pass information into and back from an operation. It has no other use, and there is no RESTful endpoint associated with it. | ||||
| Short | Operation Request or Response | ||||
| Comments | The parameters that may be used are defined by the OperationDefinition resource. | ||||
| Control | 0..* | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| 2. Parameters.id | |||||
| Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | ||||
| Short | Logical id of this artifact | ||||
| Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||||
| Control | 0..1 | ||||
| Type | id | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| 4. Parameters.meta | |||||
| Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. | ||||
| Short | Metadata about the resource | ||||
| Control | 0..1 | ||||
| Type | Meta | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 6. Parameters.implicitRules | |||||
| Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. | ||||
| Short | A set of rules under which this content was created | ||||
| Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. | ||||
| Control | 0..1 | ||||
| Type | uri | ||||
| Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 8. Parameters.language | |||||
| Definition | The base language in which the resource is written. | ||||
| Short | Language of the resource content | ||||
| Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). | ||||
| Control | 0..1 | ||||
| Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)A human language.
| ||||
| Type | code | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | false | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 10. Parameters.parameter | |||||
| Definition | Parameters for a provider-initiated bulk member match request containing current member demographics, current coverage, and provider treatment attestation. | ||||
| Short | Provider member match request parameters | ||||
| Control | 1..* | ||||
| Type | BackboneElement | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))inv-1: A parameter must have one and only one of (value, resource, part) ( (part.exists() and value.empty() and resource.empty()) or (part.empty() and (value.exists() xor resource.exists()))) | ||||
| Slicing | This element introduces a set of slices on Parameters.parameter. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 12. Parameters.parameter.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 14. Parameters.parameter.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Short | Additional content defined by implementations | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 16. Parameters.parameter.modifierExtension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
| Summary | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensions, user content, modifiers | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 18. Parameters.parameter.name | |||||
| Definition | The name of the parameter (reference to the operation definition). | ||||
| Short | Name from the definition | ||||
| Control | 1..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 20. Parameters.parameter.value[x] | |||||
| Definition | If the parameter is a data type. | ||||
| Short | If parameter is a data type | ||||
| Control | 0..1 This element is affected by the following invariants: inv-1 | ||||
| Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 22. Parameters.parameter.resource | |||||
| Definition | If the parameter is a whole resource. | ||||
| Short | If parameter is a whole resource | ||||
| Comments | When resolving references in resources, the operation definition may specify how references may be resolved between parameters. If a reference cannot be resolved between the parameters, the application should fall back to it's general resource resolution methods. | ||||
| Control | 0..1 This element is affected by the following invariants: inv-1 | ||||
| Type | Resource | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| 24. Parameters.parameter.part | |||||
| Definition | A named part of a multi-part parameter. | ||||
| Short | Named part of a multi-part parameter | ||||
| Comments | Only one level of nested parameters is allowed. | ||||
| Control | 0..* | ||||
| Type | Seettp://hl7.org/fhir/StructureDefinition/Parameters#Parameters.parameter | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 26. Parameters.parameter:MemberBundle | |||||
| Slice Name | MemberBundle | ||||
| Definition | A parameter passed to or received from the operation. | ||||
| Short | Operation Parameter | ||||
| Control | 1..* | ||||
| Type | BackboneElement | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))inv-1: A parameter must have one and only one of (value, resource, part) ( (part.exists() and value.empty() and resource.empty()) or (part.empty() and (value.exists() xor resource.exists()))) | ||||
| 28. Parameters.parameter:MemberBundle.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 30. Parameters.parameter:MemberBundle.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Short | Additional content defined by implementations | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 32. Parameters.parameter:MemberBundle.modifierExtension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
| Summary | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensions, user content, modifiers | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 34. Parameters.parameter:MemberBundle.name | |||||
| Definition | A bundle containing current member demographics, current coverage information, and provider treatment attestation for a single member. | ||||
| Short | Bundle of member elements to match for provider access | ||||
| Control | 1..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Pattern Value | MemberBundle | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 36. Parameters.parameter:MemberBundle.value[x] | |||||
| Definition | If the parameter is a data type. | ||||
| Short | If parameter is a data type | ||||
| Control | 0..1 This element is affected by the following invariants: inv-1 | ||||
| Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 38. Parameters.parameter:MemberBundle.resource | |||||
| Definition | If the parameter is a whole resource. | ||||
| Short | If parameter is a whole resource | ||||
| Comments | When resolving references in resources, the operation definition may specify how references may be resolved between parameters. If a reference cannot be resolved between the parameters, the application should fall back to it's general resource resolution methods. | ||||
| Control | 0..1 This element is affected by the following invariants: inv-1 | ||||
| Type | Resource | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| 40. Parameters.parameter:MemberBundle.part | |||||
| Definition | The individual components required for a provider to request access to member data: current patient demographics, current coverage, and provider treatment attestation. | ||||
| Short | Components of provider member match request | ||||
| Comments | Only one level of nested parameters is allowed. | ||||
| Control | 3..* | ||||
| Type | Seettp://hl7.org/fhir/StructureDefinition/Parameters#Parameters.parameter | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| Slicing | This element introduces a set of slices on Parameters.parameter.part. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 42. Parameters.parameter:MemberBundle.part.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 44. Parameters.parameter:MemberBundle.part.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Short | Additional content defined by implementations | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 46. Parameters.parameter:MemberBundle.part.modifierExtension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
| Summary | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensions, user content, modifiers | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 48. Parameters.parameter:MemberBundle.part.name | |||||
| Definition | The name of the parameter (reference to the operation definition). | ||||
| Short | Name from the definition | ||||
| Control | 1..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 50. Parameters.parameter:MemberBundle.part.value[x] | |||||
| Definition | If the parameter is a data type. | ||||
| Short | If parameter is a data type | ||||
| Control | 0..1 This element is affected by the following invariants: inv-1 | ||||
| Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 52. Parameters.parameter:MemberBundle.part.resource | |||||
| Definition | If the parameter is a whole resource. | ||||
| Short | If parameter is a whole resource | ||||
| Comments | When resolving references in resources, the operation definition may specify how references may be resolved between parameters. If a reference cannot be resolved between the parameters, the application should fall back to it's general resource resolution methods. | ||||
| Control | 0..1 This element is affected by the following invariants: inv-1 | ||||
| Type | Resource | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| 54. Parameters.parameter:MemberBundle.part.part | |||||
| Definition | A named part of a multi-part parameter. | ||||
| Short | Named part of a multi-part parameter | ||||
| Comments | Only one level of nested parameters is allowed. | ||||
| Control | 0..* | ||||
| Type | Seettp://hl7.org/fhir/StructureDefinition/Parameters#Parameters.parameter | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 56. Parameters.parameter:MemberBundle.part:MemberPatient | |||||
| Slice Name | MemberPatient | ||||
| Definition | A named part of a multi-part parameter. | ||||
| Short | Named part of a multi-part parameter | ||||
| Comments | Only one level of nested parameters is allowed. | ||||
| Control | 1..1 | ||||
| Type | BackboneElement | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 58. Parameters.parameter:MemberBundle.part:MemberPatient.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 60. Parameters.parameter:MemberBundle.part:MemberPatient.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Short | Additional content defined by implementations | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 62. Parameters.parameter:MemberBundle.part:MemberPatient.modifierExtension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
| Summary | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensions, user content, modifiers | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 64. Parameters.parameter:MemberBundle.part:MemberPatient.name | |||||
| Definition | Current patient demographic information as known by the provider (from provider's EMR or patient-provided information). | ||||
| Short | Current member demographics | ||||
| Control | 1..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Pattern Value | MemberPatient | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 66. Parameters.parameter:MemberBundle.part:MemberPatient.value[x] | |||||
| Definition | If the parameter is a data type. | ||||
| Short | If parameter is a data type | ||||
| Control | 0..1 This element is affected by the following invariants: inv-1 | ||||
| Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 68. Parameters.parameter:MemberBundle.part:MemberPatient.resource | |||||
| Definition | The patient's current demographic information including name, date of birth, gender, and identifiers from the provider's system. | ||||
| Short | Patient demographic details | ||||
| Comments | When resolving references in resources, the operation definition may specify how references may be resolved between parameters. If a reference cannot be resolved between the parameters, the application should fall back to it's general resource resolution methods. | ||||
| Control | 1..1 | ||||
| Type | Patient(HRex Member Match Patient) | ||||
| Is Modifier | false | ||||
| Must Support | false | ||||
| Summary | false | ||||
| Alternate Names | SubjectOfCare Client Resident | ||||
| 70. Parameters.parameter:MemberBundle.part:MemberPatient.part | |||||
| Definition | A named part of a multi-part parameter. | ||||
| Short | Named part of a multi-part parameter | ||||
| Comments | Only one level of nested parameters is allowed. | ||||
| Control | 0..* | ||||
| Type | Seettp://hl7.org/fhir/StructureDefinition/Parameters#Parameters.parameter | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 72. Parameters.parameter:MemberBundle.part:CoverageToMatch | |||||
| Slice Name | CoverageToMatch | ||||
| Definition | A named part of a multi-part parameter. | ||||
| Short | Named part of a multi-part parameter | ||||
| Comments | Only one level of nested parameters is allowed. | ||||
| Control | 1..1 | ||||
| Type | BackboneElement | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 74. Parameters.parameter:MemberBundle.part:CoverageToMatch.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 76. Parameters.parameter:MemberBundle.part:CoverageToMatch.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Short | Additional content defined by implementations | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 78. Parameters.parameter:MemberBundle.part:CoverageToMatch.modifierExtension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
| Summary | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensions, user content, modifiers | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 80. Parameters.parameter:MemberBundle.part:CoverageToMatch.name | |||||
| Definition | The member's current active coverage with the payer (typically from insurance card or eligibility verification). | ||||
| Short | Current member coverage | ||||
| Control | 1..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Pattern Value | CoverageToMatch | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 82. Parameters.parameter:MemberBundle.part:CoverageToMatch.value[x] | |||||
| Definition | If the parameter is a data type. | ||||
| Short | If parameter is a data type | ||||
| Control | 0..1 This element is affected by the following invariants: inv-1 | ||||
| Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 84. Parameters.parameter:MemberBundle.part:CoverageToMatch.resource | |||||
| Definition | The member's active coverage information including member ID, subscriber ID, group number, plan details, and payer identifier. | ||||
| Short | Current coverage details | ||||
| Comments | The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers. | ||||
| Control | 1..1 | ||||
| Type | Coverage(HRex Member Match Coverage Profile) | ||||
| Is Modifier | false | ||||
| Must Support | false | ||||
| Summary | false | ||||
| 86. Parameters.parameter:MemberBundle.part:CoverageToMatch.part | |||||
| Definition | A named part of a multi-part parameter. | ||||
| Short | Named part of a multi-part parameter | ||||
| Comments | Only one level of nested parameters is allowed. | ||||
| Control | 0..* | ||||
| Type | Seettp://hl7.org/fhir/StructureDefinition/Parameters#Parameters.parameter | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 88. Parameters.parameter:MemberBundle.part:Consent | |||||
| Slice Name | Consent | ||||
| Definition | A named part of a multi-part parameter. | ||||
| Short | Named part of a multi-part parameter | ||||
| Comments | Only one level of nested parameters is allowed. | ||||
| Control | 1..1 | ||||
| Type | BackboneElement | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 90. Parameters.parameter:MemberBundle.part:Consent.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 92. Parameters.parameter:MemberBundle.part:Consent.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Short | Additional content defined by implementations | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 94. Parameters.parameter:MemberBundle.part:Consent.modifierExtension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Short | Extensions that cannot be ignored even if unrecognized | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
| Summary | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensions, user content, modifiers | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 96. Parameters.parameter:MemberBundle.part:Consent.name | |||||
| Definition | Provider's attestation of an active treatment relationship with the member. This is NOT patient consent for payer-to-payer data exchange, but rather the provider's certification that they have a treatment relationship justifying access to the member's data. | ||||
| Short | Provider treatment attestation | ||||
| Control | 1..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Pattern Value | Consent | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 98. Parameters.parameter:MemberBundle.part:Consent.value[x] | |||||
| Definition | If the parameter is a data type. | ||||
| Short | If parameter is a data type | ||||
| Control | 0..1 This element is affected by the following invariants: inv-1 | ||||
| Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 100. Parameters.parameter:MemberBundle.part:Consent.resource | |||||
| Definition | A Consent resource conforming to the ProviderTreatmentAttestation profile, documenting that the provider has an active treatment relationship with the member and the purposes for which they are requesting access to the member's data. | ||||
| Short | Provider attestation to treatment relationship | ||||
| Comments | Unlike the payer-to-payer multi-member-match which includes patient consent for data exchange between payers, the provider version includes the provider's attestation to a treatment relationship. This attestation serves as the legal basis for the payer to release data to the provider under HIPAA treatment, payment, and operations (TPO) provisions. | ||||
| Control | 1..1 | ||||
| Type | Consent(Provider Attestation to Treatment Relationship) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| 102. Parameters.parameter:MemberBundle.part:Consent.part | |||||
| Definition | A named part of a multi-part parameter. | ||||
| Short | Named part of a multi-part parameter | ||||
| Comments | Only one level of nested parameters is allowed. | ||||
| Control | 0..* | ||||
| Type | Seettp://hl7.org/fhir/StructureDefinition/Parameters#Parameters.parameter | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 104. Parameters.parameter:MemberBundle.part:CoverageToLink | |||||
| Slice Name | CoverageToLink | ||||
| Definition | CoverageToLink is not used in provider-initiated member match requests as providers are not linking historical coverage to new coverage. This element is only relevant for payer-to-payer member match operations. | ||||
| Short | Not used in provider requests | ||||
| Comments | Only one level of nested parameters is allowed. | ||||
| Control | 0..0 | ||||
| Type | Seettp://hl7.org/fhir/StructureDefinition/Parameters#Parameters.parameter | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||