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

Table of Contents

Page standards status: Informative
.. 0 Table of Contents
... 1 Home
... 2 Overview
... 3 Introduction
... 4 PDex Implementation Guide
... 5 Security and Privacy
.... 5.1 FHIR Access Permissions
... 6 PDex Implementation, Actors, Interactions, Data Payloads and Methods
.... 6.1 Handling Data Provenance
.... 6.2 Provider Access API
.... 6.3 Provider Access API(v2)
.... 6.4 Payer-to-Payer Exchange (single member)
.... 6.5 Payer-to-Payer Exchange (bulk)
.... 6.6 Data Mapping
..... 6.6.1 US Core AllergyIntolerance
..... 6.6.2 US Core CarePlan
..... 6.6.3 US Core CareTeam
..... 6.6.4 US Core Condition
..... 6.6.5 Consent
..... 6.6.6 Coverage
..... 6.6.7 PDex Device
..... 6.6.8 US Core DiagnosticReport for Laboratory Results Reporting
..... 6.6.9 US Core DiagnosticReport for Report and Note Exchange
..... 6.6.10 US Core DocumentReference
..... 6.6.11 US Core Encounter
..... 6.6.12 US Core Goal
..... 6.6.13 US Core Immunization
..... 6.6.14 US Core ImplantableDevice
..... 6.6.15 US Core Laboratory Result Observation
..... 6.6.16 US Core Location
..... 6.6.17 US Core Medication
..... 6.6.18 PDex MedicationDispense
..... 6.6.19 US Core MedicationRequest
..... 6.6.20 US Core Organization
..... 6.6.21 US Core Patient
..... 6.6.22 US Core Pediatric BMI for Age Observation
..... 6.6.23 US Core Pediatric Head Occipital-frontal Circumference Observation
..... 6.6.24 US Core Pediatric Weight for Height Observation
..... 6.6.25 US Core Practitioner
..... 6.6.26 US Core PractitionerRole
..... 6.6.27 PDex Prior Authorization
..... 6.6.28 US Core Procedure
..... 6.6.29 PDex Provenance
..... 6.6.30 US Core Provenance
..... 6.6.31 US Core Pulse Oximetry
..... 6.6.32 US Core Smoking Status Observation
..... 6.6.33 VitalSigns
... 7 Use Case Scenarios
... 8 CDS Hooks
.... 8.1 Workflow Examples
... 9 Member-Authorized OAuth2.0 Exchange
... 10 Change History
... 11 Credits
... 12 Downloads
... 13 FHIR Artifacts
.... 13.1 PDex Payer-Access Server CapabilityStatement
.... 13.2 PDex provider-access Server CapabilityStatement
.... 13.3 PDEX Server CapabilityStatement
.... 13.4 PDex Server CapabilityStatement with US core 6.1 support
.... 13.5 Bulk Member Match Data Export
.... 13.6 PDex Bulk Member Match Operation
.... 13.7 PDex Provider-Member-Match Operation
.... 13.8 ExplanationOfBenefit_Identifier
.... 13.9 ExplanationOfBenefit_Patient
.... 13.10 ExplanationOfBenefit_ServiceDate
.... 13.11 ExplanationOfBenefit_Type
.... 13.12 ExplanationOfBenefit_Use
.... 13.13 Group_Code
.... 13.14 PdexMedicationDispensePatient
.... 13.15 PdexMedicationDispenseStatus
.... 13.16 Member Opt-Out Group
.... 13.17 Member-Provider Treatment Relationship Group
.... 13.18 mTLS Endpoint
.... 13.19 mTLS Endpoint Bundle
.... 13.20 mTLS Organization
.... 13.21 PDex $multi-member-match request
.... 13.22 PDex $multi-member-match response
.... 13.23 PDex Device
.... 13.24 PDex MedicationDispense
.... 13.25 PDex Member Match Group
.... 13.26 PDex Member No Match Group
.... 13.27 PDex Prior Authorization
.... 13.28 PDex Provenance
.... 13.29 PDex Provider Access Consent Profile
.... 13.30 PDex Provider Group
.... 13.31 Provider $multi-member-match Request
.... 13.32 Provider $multi-member-match Response
.... 13.33 Provider Attestation to Treatment Relationship
.... 13.34 Provider Member Match Group
.... 13.35 Provider Member No Match Group
.... 13.36 An attribute to describe the data source a resource was constructed from
.... 13.37 An attribute to express the amount of a service or item that has been utilized
.... 13.38 An attribute to express the refill number of a prescription
.... 13.39 LevelOfServiceCode
.... 13.40 Member Last Resource Filters
.... 13.41 Member Last Resource Types
.... 13.42 Member Last Transmission
.... 13.43 Member-Match Input Patient Parameter
.... 13.44 Members Opted-out
.... 13.45 mTLS Signed Object
.... 13.46 NDH Associated Servers
.... 13.47 NDH Contactpoint Availabletime
.... 13.48 NDH Dynamic Registration
.... 13.49 NDH Endpoint Access Control Mechanism
.... 13.50 NDH Endpoint Rank
.... 13.51 NDH Endpoint Usecase
.... 13.52 NDH FHIR IG
.... 13.53 NDH Identifier Status
.... 13.54 NDH Secure Exchange Artifacts
.... 13.55 NDH Trust Framework
.... 13.56 NDH Verification Status
.... 13.57 Opt-Out Details
.... 13.58 Opt-Out Reason
.... 13.59 ReviewAction
.... 13.60 ReviewActionCode
.... 13.61 Treatment Relationship Details
.... 13.62 When Adjudicated
.... 13.63 Endpoint Payload Type Value Set
.... 13.64 FDA National Drug Code (NDC)
.... 13.65 mTLS Signed Object Types
.... 13.66 Opt-Out Reason
.... 13.67 Opt-Out Scope
.... 13.68 Organization Type VS
.... 13.69 Payer source of data
.... 13.70 PDex Adjudication
.... 13.71 PDex Adjudication Category Discriminator
.... 13.72 PDex Multi-Member Match Result Value Set
.... 13.73 PDex Payer Benefit Payment Status
.... 13.74 PDex SupportingInfo Type
.... 13.75 Prior Authorization Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
.... 13.76 Prior Authorization Service Type Codes (X12)
.... 13.77 Prior Authorization value categories
.... 13.78 Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
.... 13.79 Provenance Agent Type
.... 13.80 Treatment Attestation Provision Type
.... 13.81 Treatment Attestation Status
.... 13.82 Treatment Relationship Type
.... 13.83 Trust Framework Type Value Set
.... 13.84 X12 278 Review Decision Reason Codes
.... 13.85 X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes
.... 13.86 Endpoint Payload Types Code System
.... 13.87 mTLS Object Type Code
.... 13.88 Opt-Out Reason
.... 13.89 Opt-Out Scope
.... 13.90 Organization Type
.... 13.91 PDex Adjudication Discriminator
.... 13.92 PDex Identifier Type
.... 13.93 PDex Member Characteristic Code
.... 13.94 PDex Multi-Member Match Result Code System
.... 13.95 PDex Payer Adjudication Status
.... 13.96 PDex Provider Access API Attribution Code System
.... 13.97 PDex Supporting Info Type
.... 13.98 Prior Authorization Values
.... 13.99 Provenance Payer Data Source Format
.... 13.100 Provenance Roles
.... 13.101 Treatment Relationship Type
.... 13.102 Trust FrameworkType Code System
.... 13.103 Trust Profile Code System
.... 13.104 $multi-member-match payer example request
.... 13.105 $multi-member-match payer example response
.... 13.106 Acme
.... 13.107 BundleConditionWithProvenance
.... 13.108 BundleExamplePayer1
.... 13.109 BundleExamplePayer2
.... 13.110 BundleExamplePayer3
.... 13.111 BundleWithProvenance
.... 13.112 consentin2
.... 13.113 Coverage to Link Example 1
.... 13.114 Coverage to Match Example 1
.... 13.115 Coverage to Match Example 2
.... 13.116 coveragein2
.... 13.117 coveragelink2
.... 13.118 diamond-mtls-endpoint1
.... 13.119 diamond-mtls-endpoint2
.... 13.120 example-mtls-endpoint-bundle
.... 13.121 example-pdex-member-consent-constraint-group
.... 13.122 example-pdex-member-match-group
.... 13.123 example-pdex-member-no-match-group
.... 13.124 Example-PDex-Provider-Group
.... 13.125 ExampleBundle1
.... 13.126 ExampleCoverage
.... 13.127 ExampleDevice
.... 13.128 ExampleDocRefProvenance
.... 13.129 ExampleDocumentReference
.... 13.130 ExampleEncounter1
.... 13.131 ExampleEncounter2
.... 13.132 ExampleEncounter3
.... 13.133 ExampleLocation
.... 13.134 ExampleMedicationDispenseClaim
.... 13.135 ExamplePractitioner
.... 13.136 ExampleProvenanceAuthorEncounter6
.... 13.137 ExampleProvenanceAuthorEncounter7
.... 13.138 ExampleProvenanceBundleTransmitter
.... 13.139 ExampleProvenanceCustodian
.... 13.140 ExampleProvenancePayerModified
.... 13.141 ExampleProvenancePayerSource
.... 13.142 ExampleProvenanceSoloPractitioner
.... 13.143 ExampleProvenanceTransmitter
.... 13.144 mtlsorganization2
.... 13.145 OrganizationPayer1
.... 13.146 OrganizationPayer1-1
.... 13.147 OrganizationPayer2
.... 13.148 OrganizationPayer2-2
.... 13.149 OrganizationProvider1
.... 13.150 OrganizationProvider2
.... 13.151 Patient for Member Match Example 1
.... 13.152 Patient for Member Match Example 2
.... 13.153 Patient1
.... 13.154 Patient1-2
.... 13.155 Patient100
.... 13.156 Patient1001
.... 13.157 Patient2002
.... 13.158 patientin2
.... 13.159 Payer's Patient Record for Member 1001
.... 13.160 Payer's Patient Record for Member 2002
.... 13.161 PDex Provider Access Consent Example
.... 13.162 PDexCoverageExample
.... 13.163 PdexPriorAuth
.... 13.164 Provider Attestation Document Reference
.... 13.165 Provider Bulk Member Match Request Example
.... 13.166 Provider Bulk Member Match Response Example
.... 13.167 Provider Treatment Attestation Consent Example for Bulk Member Match
.... 13.168 Provider-Member-Match Request Example
.... 13.169 Provider-Member-Match Response Example
.... 13.170 Treatment Attestation Example 1
.... 13.171 Treatment Attestation Example 2
... 14 Other IG Artifacts