Da Vinci Payer Data Exchange
2.1.0 - 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 2.1.0 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 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 Payer-to-Payer Exchange (single member)
.... 6.4 Payer-to-Payer Exchange (bulk)
.... 6.5 Data Mapping
..... 6.5.1 US Core AllergyIntolerance
..... 6.5.2 US Core CarePlan
..... 6.5.3 US Core CareTeam
..... 6.5.4 US Core Condition
..... 6.5.5 Consent
..... 6.5.6 Coverage
..... 6.5.7 PDex Device
..... 6.5.8 US Core DiagnosticReport for Laboratory Results Reporting
..... 6.5.9 US Core DiagnosticReport for Report and Note Exchange
..... 6.5.10 US Core DocumentReference
..... 6.5.11 US Core Encounter
..... 6.5.12 US Core Goal
..... 6.5.13 US Core Immunization
..... 6.5.14 US Core ImplantableDevice
..... 6.5.15 US Core Laboratory Result Observation
..... 6.5.16 US Core Location
..... 6.5.17 US Core Medication
..... 6.5.18 PDex MedicationDispense
..... 6.5.19 US Core MedicationRequest
..... 6.5.20 US Core Organization
..... 6.5.21 US Core Patient
..... 6.5.22 US Core Pediatric BMI for Age Observation
..... 6.5.23 US Core Pediatric Head Occipital-frontal Circumference Observation
..... 6.5.24 US Core Pediatric Weight for Height Observation
..... 6.5.25 US Core Practitioner
..... 6.5.26 US Core PractitionerRole
..... 6.5.27 PDex Prior Authorization
..... 6.5.28 US Core Procedure
..... 6.5.29 PDex Provenance
..... 6.5.30 US Core Provenance
..... 6.5.31 US Core Pulse Oximetry
..... 6.5.32 US Core Smoking Status Observation
..... 6.5.33 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 PDex Bulk Member Match Operation
.... 13.6 ExplanationOfBenefit_Identifier
.... 13.7 ExplanationOfBenefit_Patient
.... 13.8 ExplanationOfBenefit_ServiceDate
.... 13.9 ExplanationOfBenefit_Type
.... 13.10 ExplanationOfBenefit_Use
.... 13.11 Group_Code
.... 13.12 PdexMedicationDispensePatient
.... 13.13 PdexMedicationDispenseStatus
.... 13.14 mTLS Endpoint
.... 13.15 mTLS Endpoint Bundle
.... 13.16 mTLS Organization
.... 13.17 PDex $multi-member-match request
.... 13.18 PDex $multi-member-match response
.... 13.19 PDex Device
.... 13.20 PDex MedicationDispense
.... 13.21 PDex Member Match Group
.... 13.22 PDex Member No Match Group
.... 13.23 PDex Prior Authorization
.... 13.24 PDex Provenance
.... 13.25 PDex Provider Access Consent Profile
.... 13.26 PDex Provider Group
.... 13.27 An attribute to describe the data source a resource was constructed from
.... 13.28 An attribute to express the amount of a service or item that has been utilized
.... 13.29 An attribute to express the refill number of a prescription
.... 13.30 LevelOfServiceCode
.... 13.31 Member Last Resource Filters
.... 13.32 Member Last Resource Types
.... 13.33 Member Last Transmission
.... 13.34 Member-Match Input Patient Parameter
.... 13.35 Members Opted-out
.... 13.36 mTLS Signed Object
.... 13.37 NDH Associated Servers
.... 13.38 NDH Contactpoint Availabletime
.... 13.39 NDH Dynamic Registration
.... 13.40 NDH Endpoint Access Control Mechanism
.... 13.41 NDH Endpoint Connection Type Version
.... 13.42 NDH Endpoint Rank
.... 13.43 NDH Endpoint Usecase
.... 13.44 NDH FHIR IG
.... 13.45 NDH Identifier Status
.... 13.46 NDH Secure Exchange Artifacts
.... 13.47 NDH Trust Framework
.... 13.48 NDH Verification Status
.... 13.49 ReviewAction
.... 13.50 ReviewActionCode
.... 13.51 When Adjudicated
.... 13.52 FDA National Drug Code (NDC)
.... 13.53 mTLS Signed Object Types
.... 13.54 Organization Type VS
.... 13.55 Payer source of data
.... 13.56 PDex Adjudication
.... 13.57 PDex Adjudication Category Discriminator
.... 13.58 PDex Multi-Member Match Result Value Set
.... 13.59 PDex Payer Benefit Payment Status
.... 13.60 PDex SupportingInfo Type
.... 13.61 Prior Authorization Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
.... 13.62 Prior Authorization Service Type Codes (X12)
.... 13.63 Prior Authorization value categories
.... 13.64 Procedure Codes - AMA CPT - CMS HCPCS - CMS HIPPS
.... 13.65 Provenance Agent Type
.... 13.66 X12 278 Review Decision Reason Codes
.... 13.67 X12 Claim Adjustment Reason Codes - Remittance Advice Remark Codes
.... 13.68 mTLS Object Type Code
.... 13.69 PDex Adjudication Discriminator
.... 13.70 PDex Identifier Type
.... 13.71 PDex Multi-Member Match Result Code System
.... 13.72 PDex Payer Adjudication Status
.... 13.73 PDex Provider Access API Attribution Code System
.... 13.74 PDex Supporting Info Type
.... 13.75 Prior Authorization Values
.... 13.76 Provenance Payer Data Source Format
.... 13.77 Provenance Roles
.... 13.78 $multi-member-match payer example request
.... 13.79 $multi-member-match payer example response
.... 13.80 Acme
.... 13.81 BundleConditionWithProvenance
.... 13.82 BundleExamplePayer1
.... 13.83 BundleExamplePayer2
.... 13.84 BundleExamplePayer3
.... 13.85 BundleWithProvenance
.... 13.86 diamond-mtls-endpoint1
.... 13.87 diamond-mtls-endpoint2
.... 13.88 example-mtls-endpoint-bundle
.... 13.89 example-pdex-member-consent-constraint-group
.... 13.90 example-pdex-member-match-group
.... 13.91 example-pdex-member-no-match-group
.... 13.92 Example-PDex-Provider-Group
.... 13.93 ExampleBundle1
.... 13.94 ExampleCoverage
.... 13.95 ExampleDevice
.... 13.96 ExampleDocRefProvenance
.... 13.97 ExampleDocumentReference
.... 13.98 ExampleEncounter1
.... 13.99 ExampleEncounter2
.... 13.100 ExampleEncounter3
.... 13.101 ExampleLocation
.... 13.102 ExampleMedicationDispenseClaim
.... 13.103 ExamplePractitioner
.... 13.104 ExampleProvenanceAuthorEncounter6
.... 13.105 ExampleProvenanceAuthorEncounter7
.... 13.106 ExampleProvenanceBundleTransmitter
.... 13.107 ExampleProvenanceCustodian
.... 13.108 ExampleProvenancePayerModified
.... 13.109 ExampleProvenancePayerSource
.... 13.110 ExampleProvenanceSoloPractitioner
.... 13.111 ExampleProvenanceTransmitter
.... 13.112 mtlsorganization2
.... 13.113 OrganizationPayer1
.... 13.114 OrganizationPayer1-1
.... 13.115 OrganizationPayer2
.... 13.116 OrganizationPayer2-2
.... 13.117 OrganizationProvider1
.... 13.118 OrganizationProvider2
.... 13.119 Patient1
.... 13.120 Patient1-2
.... 13.121 Patient100
.... 13.122 Patient1001
.... 13.123 Patient2002
.... 13.124 PDex Provider Access Consent Example
.... 13.125 PDexCoverageExample
.... 13.126 PdexPriorAuth
... 14 Other IG Artifacts