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 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

• Narrative Content
• XML
• JSON
• TTL

: Submit Claim Insurance Example - XML Representation

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<Coverage xmlns="http://hl7.org/fhir">
  <id value="InsuranceExample"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Coverage InsuranceExample</b></p><a name="InsuranceExample"> </a><a name="hcInsuranceExample"> </a><a name="InsuranceExample-en-US"> </a><p><b>status</b>: Active</p><p><b>subscriberId</b>: 1122334455</p><p><b>beneficiary</b>: <a href="Patient-SubscriberExample.html">JOE SMITH  Male, DoB Unknown ( Member Number)</a></p><p><b>relationship</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}, {https://codesystem.x12.org/005010/1069 18}">Self</span></p><p><b>payor</b>: <a href="Organization-InsurerExample.html">Organization MARYLAND CAPITAL INSURANCE COMPANY</a></p></div>
  </text>
  <status value="active"/>
  <subscriberId value="1122334455"/>
  <beneficiary>🔗 
    <reference value="Patient/SubscriberExample"/>
  </beneficiary>
  <relationship>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
      <code value="self"/>
    </coding>
    <coding>
      <system value="https://codesystem.x12.org/005010/1069"/>
      <code value="18"/>
    </coding>
  </relationship>
  <payor>🔗 
    <reference value="Organization/InsurerExample"/>
  </payor>
</Coverage>