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 2.0.1 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
Bundle ReferralAuthorizationBundleExample of type collection
Entry 1 - fullUrl = http://example.org/fhir/Claim/ReferralAuthorizationExample
Resource Claim:
ResourceClaim "ReferralAuthorizationExample"
Profile: PAS Claim
LevelOfServiceCode: Urgent (1338#U)
identifier:
http://example.org/PATIENT_EVENT_TRACE_NUMBER
/111099status: ACTIVE
type: Professional (Claim Type Codes#professional)
use: PREAUTHORIZATION
patient: See on this page: Patient/SubscriberExample
created: 2005-05-02 11:01:00+0500
insurer: See on this page: Organization/InsurerExample
provider: See on this page: Organization/UMOExample
priority: Normal (Process Priority Codes#normal)
CareTeams
Extension Sequence Provider 1 See on this page: PractitionerRole/ReferralPractitionerRoleExample Diagnoses
Extension Sequence Diagnosis[x] 1 Chronic pain syndrome (International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)#G89.4) Insurances
Sequence Focal Coverage 1 true See on this page: Coverage/InsuranceExample Items
Extension Sequence CareTeamSequence DiagnosisSequence Category ProductOrService Location[x] , , , , , , , , , 1 1 1 Consultation (1365#3) Consultation (1365#3) 11 (CMS Place of Service Codes (POS)#11)
Entry 2 - fullUrl = http://example.org/fhir/Organization/UMOExample
Resource Organization:
Generated Narrative: Organization
ResourceOrganization "UMOExample"
Profile: PAS Requestor Organization
identifier: NPI/8189991234
active: true
type: X3 (98#X3)
name: DR. JOE SMITH CORPORATION
Contacts
Address 111 1ST STREET SAN DIEGO CA 92101 US
Entry 3 - fullUrl = http://example.org/fhir/Organization/InsurerExample
Resource Organization:
Generated Narrative: Organization
ResourceOrganization "InsurerExample"
Profile: PAS Insurer Organization
identifier: NPI/789312
active: true
type: PR (98#PR)
name: MARYLAND CAPITAL INSURANCE COMPANY
Entry 4 - fullUrl = http://example.org/fhir/Coverage/InsuranceExample
Resource Coverage:
ResourceCoverage "InsuranceExample"
Profile: PAS Coverage
status: ACTIVE
beneficiary: See on this page: Patient/SubscriberExample
Entry 5 - fullUrl = http://example.org/fhir/Patient/SubscriberExample
Resource Patient:
Anonymous Patient Male, DoB: ( http://example.org/MIN#12345678901)
Entry 6 - fullUrl = http://example.org/fhir/ServiceRequest/ReferralRequestExample
Resource ServiceRequest:
Generated Narrative: ServiceRequest
ResourceServiceRequest "ReferralRequestExample"
Profile: PAS Service Request
status: ACTIVE
intent: ORDER
code: Consultation (1365#3)
quantity: 1 visit (Details: UCUM code1 = '1')
Entry 7 - fullUrl = http://example.org/fhir/PractitionerRole/ReferralPractitionerRoleExample
Resource PractitionerRole:
Generated Narrative: PractitionerRole
ResourcePractitionerRole "ReferralPractitionerRoleExample"
Profile: PAS PractitionerRole
practitioner: See on this page: Practitioner/ReferralPractitionerExample
location: See on this page: Location/ReferralLocationExample
Entry 8 - fullUrl = http://example.org/fhir/Practitioner/ReferralPractitionerExample
Resource Practitioner:
Generated Narrative: Practitioner
ResourcePractitioner "ReferralPractitionerExample"
Profile: PAS Practitioner
identifier: NPI/987654321
name: SUSAN WATSON
telecom: ph: 4029993456
Entry 9 - fullUrl = http://example.org/fhir/Location/ReferralLocationExample
Resource Location:
ResourceLocation "ReferralLocationExample"
Profile: PAS Location Profile
name: REFERRAL CLINIC
address: 111 1ST STREET SAN DIEGO CA 92101 US