Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0-preview - STU 2 United States of America flag

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

Example Bundle: Surgical Admission Request Bundle Example

Generated Narrative: Bundle SurgicalRequestBundleExample

Bundle SurgicalRequestBundleExample of type collection


Entry 1 - fullUrl = http://example.org/fhir/Claim/SurgicalAuthorizationRequestExample

Resource Claim:

Generated Narrative: Claim SurgicalAuthorizationRequestExample

LevelOfServiceCode: Elective

Extension Definition for Claim.encounter for Version 5.0: Encounter: extension = Still a patient; status = planned; class = ambulatory (ActCode#AMB); type = 2; period = 2020-07-02 --> 2020-07-09

ConditionCode

  • category: 07
  • indicator: true
  • code: 09

identifier: http://example.org/PATIENT_EVENT_TRACE_NUMBER/16139462398

status: Active

type: Institutional

use: Preauthorization

patient: JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)

created: 2020-06-24 07:34:00+0500

insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY

provider: Organization DR. JOE SMITH CORPORATION

priority: Normal

CareTeams

-ExtensionSequenceProvider
*1PractitionerRole

SupportingInfos

-SequenceCategoryTiming[x]
*1Admission Dates2020-07-02 --> 2020-07-09

Diagnoses

-ExtensionSequenceDiagnosis[x]
*1Malignant neoplasm of colon, unspecified

Insurances

-SequenceFocalCoverage
*1trueCoverage: status = active; subscriberId = 1122334455; relationship = Self

item

ServiceItemRequestType: Admission Review

CertificationType: Initial

ItemTraceNumber: http://example.org/ITEM_TRACE_NUMBER/1122334

AuthorizationNumber: 1122445

AdministrationReferenceNumber: 9988311

sequence: 1

careTeamSequence: 1

diagnosisSequence: 1

category: Surgical

productOrService: Under Venous Grafting Only for Coronary Artery Bypass

location: 21


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

Contacts

-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/Coverage/InsuranceExample

Resource Coverage:

Generated Narrative: Coverage InsuranceExample

status: Active

subscriberId: 1122334455

beneficiary: JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)

relationship: Self


Entry 5 - 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 6 - fullUrl = http://example.org/fhir/Encounter/SurgicalEncounterExample

Resource Encounter:

Generated Narrative: Encounter SurgicalEncounterExample

Not done yet

Entry 7 - fullUrl = http://example.org/fhir/PractitionerRole/SurgicalPractitionerRoleExample

Resource PractitionerRole:

Generated Narrative: PractitionerRole SurgicalPractitionerRoleExample

practitioner: Practitioner SUSAN WATSON

location: Location REFERRAL CLINIC


Entry 8 - fullUrl = http://example.org/fhir/Practitioner/SurgicalPractitionerExample

Resource Practitioner:

Generated Narrative: Practitioner SurgicalPractitionerExample

identifier: United States National Provider Identifier/1234567893

name: SUSAN WATSON

telecom: ph: 4029993456


Entry 9 - fullUrl = http://example.org/fhir/Location/SurgicalLocationExample

Resource Location:

Generated Narrative: Location SurgicalLocationExample

name: REFERRAL CLINIC

address: 111 1ST STREET SAN DIEGO CA 92101 US