Da Vinci Prior Authorization Support (PAS) FHIR IG, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions
Generated Narrative: Bundle ErrorResponseBundleExample
Bundle ErrorResponseBundleExample of type collection
Entry 1 - fullUrl = http://example.org/fhir/ClaimResponse/ErrorResponseExample
Resource ClaimResponse:
Generated Narrative: ClaimResponse ErrorResponseExample
identifier:
http://example.org/PATIENT_EVENT_TRACE_NUMBER
/111099status: Active
type: Professional
use: Preauthorization
patient: JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)
created: 2005-05-02 11:02:00+0500
insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY
requestor: Organization DR. JOE SMITH CORPORATION
outcome: Error
error
code: 04
error
ErrorElement: 2010A-NM103
ErrorPath: Bundle.entry[1].Organization.name
ErrorFollowupAction: C
code: T4
Entry 2 - fullUrl = http://example.org/fhir/Organization/UMOExample
Resource Organization:
Generated Narrative: Organization UMOExample
identifier: United States National Provider Identifier/8189991234
active: true
type: X3
name: DR. JOE SMITH CORPORATION
address: 111 1ST STREET SAN DIEGO CA 92101 US
Entry 3 - fullUrl = http://example.org/fhir/Organization/InsurerExample
Resource Organization:
Generated Narrative: Organization InsurerExample
identifier: United States National Provider Identifier/1234567893
active: true
type: PR
name: MARYLAND CAPITAL INSURANCE COMPANY
Entry 4 - fullUrl = http://example.org/fhir/Patient/SubscriberExample
Resource Patient:
Generated Narrative: Patient SubscriberExample
JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)
RU
Entry 5 - fullUrl = http://example.org/fhir/Claim/ReferralAuthorizationExample
Resource Claim:
Generated Narrative: Claim ReferralAuthorizationExample
LevelOfServiceCode: Urgent
identifier:
http://example.org/PATIENT_EVENT_TRACE_NUMBER
/111099status: Active
type: Professional
use: Preauthorization
patient: JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)
created: 2005-05-02 11:01:00+0500
insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY
provider: Organization DR. JOE SMITH CORPORATION
priority: Normal
CareTeams
Extension Sequence Provider 1 PractitionerRole Diagnoses
Extension Sequence Diagnosis[x] 1 Chronic pain syndrome Insurances
Sequence Focal Coverage 1 true Coverage: status = active; subscriberId = 1122334455; relationship = Self item
ServiceItemRequestType: Specialty Care Review
CertificationType: Initial
ItemTraceNumber:
http://example.org/ITEM_TRACE_NUMBER
/1122334AuthorizationNumber: 1122445
AdministrationReferenceNumber: 9988311
RequestedService: ServiceRequest Consultation
EPSDTIndicator: false
NursingHomeResidentialStatus: Newly Admitted
NursingHomeLevelOfCare: Intermediate Care Facility (ICF)
RevenueUnitRateLimit: 100
sequence: 1
careTeamSequence: 1
diagnosisSequence: 1
category: Consultation
productOrService: Consultation
location: 11