Da Vinci Payer Data Exchange
2.2.0 - STU 2.2 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 2.2.0 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

Table of Contents

Page standards status: Informative
.. 0 Table of Contents
... 1 Home
... 2 Overview
... 3 Introduction
... 4 Narrative Conformance
... 5 PDex Implementation Guide
... 6 Security and Privacy
.... 6.1 FHIR Access Permissions
... 7 PDex Implementation, Actors, Interactions, Data Payloads and Methods
.... 7.1 Handling Data Provenance
.... 7.2 Provider Access API
.... 7.3 Provider Access API(v2)
.... 7.4 Payer-to-Payer Exchange (single member)
.... 7.5 Payer-to-Payer Exchange (bulk)
.... 7.6 Data Mapping
..... 7.6.1 US Core AllergyIntolerance
..... 7.6.2 US Core CarePlan
..... 7.6.3 US Core CareTeam
..... 7.6.4 US Core Condition
..... 7.6.5 Consent
..... 7.6.6 Coverage
..... 7.6.7 PDex Device
..... 7.6.8 US Core DiagnosticReport for Laboratory Results Reporting
..... 7.6.9 US Core DiagnosticReport for Report and Note Exchange
..... 7.6.10 US Core DocumentReference
..... 7.6.11 US Core Encounter
..... 7.6.12 US Core Goal
..... 7.6.13 US Core Immunization
..... 7.6.14 US Core ImplantableDevice
..... 7.6.15 US Core Laboratory Result Observation
..... 7.6.16 US Core Location
..... 7.6.17 US Core Medication
..... 7.6.18 PDex MedicationDispense
..... 7.6.19 US Core MedicationRequest
..... 7.6.20 US Core Organization
..... 7.6.21 US Core Patient
..... 7.6.22 US Core Pediatric BMI for Age Observation
..... 7.6.23 US Core Pediatric Head Occipital-frontal Circumference Observation
..... 7.6.24 US Core Pediatric Weight for Height Observation
..... 7.6.25 US Core Practitioner
..... 7.6.26 US Core PractitionerRole
..... 7.6.27 PDex Prior Authorization
..... 7.6.28 US Core Procedure
..... 7.6.29 PDex Provenance
..... 7.6.30 US Core Provenance
..... 7.6.31 US Core Pulse Oximetry
..... 7.6.32 US Core Smoking Status Observation
..... 7.6.33 VitalSigns
... 8 Use Case Scenarios
... 9 CDS Hooks
.... 9.1 Workflow Examples
... 10 Member-Authorized OAuth2.0 Exchange
... 11 Change History
... 12 Credits
... 13 Downloads
... 14 FHIR Artifacts
.... 14.1 PDex Payer-Access Server CapabilityStatement
.... 14.2 PDex provider-access Server CapabilityStatement
.... 14.3 PDEX Server CapabilityStatement
.... 14.4 PDex Server CapabilityStatement with US core 6.1 support
.... 14.5 PDex Bulk Member Match Operation
.... 14.6 PDex Provider-Member-Match Operation
.... 14.7 ExplanationOfBenefit_Identifier
.... 14.8 ExplanationOfBenefit_Patient
.... 14.9 ExplanationOfBenefit_ServiceDate
.... 14.10 ExplanationOfBenefit_Type
.... 14.11 ExplanationOfBenefit_Use
.... 14.12 Group_Code
.... 14.13 PDex Consent Action Search Parameter
.... 14.14 PDex Consent Provider Access Use Case Search Parameter
.... 14.15 PDex Consent Provision Type Search Parameter
.... 14.16 PDex Group Characteristic Value Reference Search Parameter
.... 14.17 PdexMedicationDispensePatient
.... 14.18 PdexMedicationDispenseStatus
.... 14.19 Member Opt-Out Group
.... 14.20 Member-Provider Treatment Relationship Group
.... 14.21 mTLS Endpoint
.... 14.22 mTLS Endpoint Bundle
.... 14.23 mTLS Organization
.... 14.24 PDex $multi-member-match request
.... 14.25 PDex $multi-member-match response
.... 14.26 PDex Device
.... 14.27 PDex MedicationDispense
.... 14.28 PDex Member Match Group
.... 14.29 PDex Member No Match Group
.... 14.30 PDex Prior Authorization
.... 14.31 PDex Provenance
.... 14.32 PDex Provider Access Consent Profile
.... 14.33 PDex Provider Group
.... 14.34 Provider $multi-member-match Request
.... 14.35 Provider $multi-member-match Response
.... 14.36 Provider Attestation to Treatment Relationship
.... 14.37 Provider Member Match Group
.... 14.38 Provider Member No Match Group
.... 14.39 An attribute to describe the data source a resource was constructed from
.... 14.40 An attribute to express the amount of a service or item that has been utilized
.... 14.41 An attribute to express the refill number of a prescription
.... 14.42 LevelOfServiceCode
.... 14.43 Member-Match Input Coverage Parameter
.... 14.44 Member-Match Input Patient Parameter
.... 14.45 Members Opted-out
.... 14.46 mTLS Signed Object
.... 14.47 NDH Associated Servers
.... 14.48 NDH Contactpoint Availabletime
.... 14.49 NDH Dynamic Registration
.... 14.50 NDH Endpoint Access Control Mechanism
.... 14.51 NDH Endpoint Rank
.... 14.52 NDH Endpoint Usecase
.... 14.53 NDH FHIR IG
.... 14.54 NDH Identifier Status
.... 14.55 NDH Secure Exchange Artifacts
.... 14.56 NDH Trust Framework
.... 14.57 NDH Verification Status
.... 14.58 Opt-Out Details
.... 14.59 Opt-Out Reason
.... 14.60 Provider Access Use Case
.... 14.61 ReviewAction
.... 14.62 ReviewActionCode
.... 14.63 Treatment Relationship Details
.... 14.64 When Adjudicated
.... 14.65 Endpoint Payload Type Value Set
.... 14.66 FDA National Drug Code (NDC)
.... 14.67 mTLS Signed Object Types
.... 14.68 Opt-Out Reason
.... 14.69 Opt-Out Scope
.... 14.70 Organization Type VS
.... 14.71 Payer source of data
.... 14.72 PDex Adjudication
.... 14.73 PDex Adjudication Category Discriminator
.... 14.74 PDex Consent API Purpose Value Set
.... 14.75 PDex Multi-Member Match Result Value Set
.... 14.76 PDex Payer Benefit Payment Status
.... 14.77 PDex SupportingInfo Type
.... 14.78 Prior Authorization Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
.... 14.79 Prior Authorization Service Type Codes (X12)
.... 14.80 Prior Authorization value categories
.... 14.81 Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
.... 14.82 Provenance Agent Type
.... 14.83 Treatment Attestation Provision Type
.... 14.84 Treatment Attestation Status
.... 14.85 Treatment Relationship Type
.... 14.86 Trust Framework Type Value Set
.... 14.87 X12 278 Review Decision Reason Codes
.... 14.88 X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes
.... 14.89 Endpoint Payload Types Code System
.... 14.90 mTLS Object Type Code
.... 14.91 Opt-Out Reason
.... 14.92 Opt-Out Scope
.... 14.93 Organization Type
.... 14.94 PDex Adjudication Discriminator
.... 14.95 PDex Consent API Purpose
.... 14.96 PDex Identifier Type
.... 14.97 PDex Member Characteristic Code
.... 14.98 PDex Multi-Member Match Result Code System
.... 14.99 PDex Payer Adjudication Status
.... 14.100 PDex Provider Access API Attribution Code System
.... 14.101 PDex Supporting Info Type
.... 14.102 Prior Authorization Values
.... 14.103 Provenance Payer Data Source Format
.... 14.104 Provenance Roles
.... 14.105 Treatment Relationship Type
.... 14.106 Trust FrameworkType Code System
.... 14.107 Trust Profile Code System
.... 14.108 $multi-member-match payer example request
.... 14.109 $multi-member-match payer example response
.... 14.110 Acme
.... 14.111 BundleConditionWithProvenance
.... 14.112 BundleExamplePayer1
.... 14.113 BundleExamplePayer2
.... 14.114 BundleExamplePayer3
.... 14.115 BundleWithProvenance
.... 14.116 consentin2
.... 14.117 Coverage to Match Example 1
.... 14.118 Coverage to Match Example 2
.... 14.119 coveragein2
.... 14.120 coveragelink2
.... 14.121 diamond-mtls-endpoint1
.... 14.122 diamond-mtls-endpoint2
.... 14.123 Example Member Opt-Out Group
.... 14.124 Example Member-Provider Treatment Relationship Group
.... 14.125 Example Provider Consent Constrained Group
.... 14.126 Example Provider Matched Members Group
.... 14.127 Example Provider No Match Group
.... 14.128 example-mtls-endpoint-bundle
.... 14.129 example-pdex-member-consent-constraint-group
.... 14.130 example-pdex-member-match-group
.... 14.131 example-pdex-member-no-match-group
.... 14.132 Example-PDex-Provider-Group
.... 14.133 ExampleBundle1
.... 14.134 ExampleCoverage
.... 14.135 ExampleDevice
.... 14.136 ExampleDocRefProvenance
.... 14.137 ExampleDocumentReference
.... 14.138 ExampleEncounter1
.... 14.139 ExampleEncounter2
.... 14.140 ExampleEncounter3
.... 14.141 ExampleLocation
.... 14.142 ExampleMedicationDispenseClaim
.... 14.143 ExamplePractitioner
.... 14.144 ExampleProvenanceAuthorEncounter6
.... 14.145 ExampleProvenanceAuthorEncounter7
.... 14.146 ExampleProvenanceBundleTransmitter
.... 14.147 ExampleProvenanceCustodian
.... 14.148 ExampleProvenancePayerModified
.... 14.149 ExampleProvenancePayerSource
.... 14.150 ExampleProvenanceSoloPractitioner
.... 14.151 ExampleProvenanceTransmitter
.... 14.152 mtlsorganization2
.... 14.153 Organization Provider Example 1
.... 14.154 Organization Provider Example 2
.... 14.155 OrganizationPayer1
.... 14.156 OrganizationPayer1-1
.... 14.157 OrganizationPayer2
.... 14.158 OrganizationPayer2-2
.... 14.159 OrganizationProvider1
.... 14.160 OrganizationProvider2
.... 14.161 Patient for Member Match Example 1
.... 14.162 Patient for Member Match Example 2
.... 14.163 Patient Provider Example 1 - Robert Johnson
.... 14.164 Patient Provider Example 2 - Sarah Williams
.... 14.165 Patient1
.... 14.166 Patient1-2
.... 14.167 Patient100
.... 14.168 Patient1001
.... 14.169 Patient2002
.... 14.170 patientin2
.... 14.171 Payer Member Example 1 - Robert Johnson
.... 14.172 Payer Member Example 2 - Sarah Williams
.... 14.173 PDex Provider Access Consent Opt-Out Example
.... 14.174 PDex Provider Access Consent Permit Example
.... 14.175 PDexCoverageExample
.... 14.176 PdexPriorAuth
.... 14.177 Practitioner Provider Example 1 - Dr. Smith
.... 14.178 Practitioner Provider Example 2 - Dr. Jones
.... 14.179 Provider Attestation Document Reference
.... 14.180 Provider Treatment Attestation Consent Example for Bulk Member Match
.... 14.181 Provider-Member-Match Request Example
.... 14.182 Provider-Member-Match Response Example
.... 14.183 Treatment Attestation Example 1
.... 14.184 Treatment Attestation Example 2
.... 14.185 Treatment Attestation Form Example 1
.... 14.186 Treatment Attestation Form Example 2
... 15 Other IG Artifacts