Da Vinci Prior Authorization Support (PAS) FHIR IG
2.0.1 - 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 2.0.1 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

Resource Profile: PASClaimInquiry - Mappings

Page standards status: Trial-use Maturity Level: 3

Mappings for the profile-claim-inquiry resource profile.

Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

PASClaimInquiry
ClaimRequest
   statusRequest.status
   patientRequest.subject
   createdRequest.authoredOn
   insurerRequest.performer
   providerRequest.requester
   priorityRequest.priority
   related
      claimRequest.replaces
   supportingInfoRequest.supportingInfo
   supportingInfo (PatientEvent)Request.supportingInfo
   supportingInfo (AdmissionDates)Request.supportingInfo
   supportingInfo (DischargeDates)Request.supportingInfo
   diagnosisRequest.reasonReference
   insurance
      identifierRequest.identifier
   item
      encounterRequest.context

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

PASClaimInquiry
Claim
   statusFiveWs.status
   typeFiveWs.class
   subTypeFiveWs.class
   useFiveWs.class
   patientFiveWs.subject[x], FiveWs.subject
   billablePeriodFiveWs.done[x]
   createdFiveWs.recorded
   entererFiveWs.author
   providerFiveWs.source
   referralFiveWs.cause
   facilityFiveWs.where[x]
   careTeam
      providerFiveWs.actor
   careTeam (OverallClaimMember)
      providerFiveWs.actor
   careTeam (ItemClaimMember)
      providerFiveWs.actor
   insurance
      identifierFiveWs.identifier
   item
      serviced[x]FiveWs.done[x]
      location[x]FiveWs.where[x]

Mappings for RIM Mapping (http://hl7.org/v3)

PASClaimInquiry
ClaimEntity. Role, or Act
   textAct.text?
   containedN/A
   modifierExtensionN/A
   identifiern/a, II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
   related
      idn/a
      extensionn/a
      modifierExtensionN/A
   payee
      idn/a
      extensionn/a
      modifierExtensionN/A
   careTeam
      idn/a
      extension
      extension (careTeamClaimScope)
      modifierExtensionN/A
   careTeam (OverallClaimMember)
      idn/a
      extension
      extension (careTeamClaimScope)
         idn/a
         urlN/A
         value[x]N/A
      modifierExtensionN/A
   careTeam (ItemClaimMember)
      idn/a
      extension
      extension (careTeamClaimScope)
         idn/a
         urlN/A
         value[x]N/A
      modifierExtensionN/A
   supportingInfo
      idn/a
      extensionn/a
      modifierExtensionN/A
      timing[x]
   supportingInfo (PatientEvent)
      idn/a
      extensionn/a
      modifierExtensionN/A
      timing[x]
      timing[x] (timingDate)
      timing[x] (timingPeriod)
         idn/a
         extensionn/a
         start./low
         end./high
   supportingInfo (AdmissionDates)
      idn/a
      extensionn/a
      modifierExtensionN/A
      timing[x]
      timing[x] (timingDate)
      timing[x] (timingPeriod)
         idn/a
         extensionn/a
         start./low
         end./high
   supportingInfo (DischargeDates)
      idn/a
      extensionn/a
      modifierExtensionN/A
      timing[x]
      timing[x] (timingDate)
      timing[x] (timingPeriod)
         idn/a
         extensionn/a
         start./low
         end./high
   diagnosis
      idn/a
      extensionn/a
      modifierExtensionN/A
   procedure
      idn/a
      extensionn/a
      modifierExtensionN/A
   insuranceCoverage
      idn/a
      extensionn/a
      modifierExtensionN/A
   accident
      idn/a
      extensionn/a
      modifierExtensionN/A
   item
      idn/a
      modifierExtensionN/A
      detail
         idn/a
         extensionn/a
         modifierExtensionN/A
         subDetail
            idn/a
            extensionn/a
            modifierExtensionN/A