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: PAS Practitioner

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner Version: 2.0.1
Standards status: Trial-use Maturity Level: 3 Computable Name: PASPractitioner

PAS constraints on Practitioner resource mandating support for elements relevant to the care team involved in a prior authorization request

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCorePractitionerProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner USCorePractitionerProfile
... identifier 1..*PASIdentifierAn identifier for the person as this agent
... identifier:NPI 0..1PASIdentifierAn identifier intended for computation
... telecom S0..*ContactPointA contact detail for the practitioner (that apply to all roles)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*USCorePractitionerProfileA person with a formal responsibility in the provisioning of healthcare or related services
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣ1..*PASIdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI S0..1PASIdentifierAn identifier intended for computation

Required Pattern: At least the following
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
.... use ?!Σ0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... family SΣ1..1stringFamily name (often called 'Surname')
... telecom SΣ0..*ContactPointA contact detail for the practitioner (that apply to all roles)
... address SΣ0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Practitioner.name.userequiredNameUse
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*USCorePractitionerProfileA person with a formal responsibility in the provisioning of healthcare or related services
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣ1..*PASIdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI S0..1PASIdentifierAn identifier intended for computation

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
... active Σ0..1booleanWhether this practitioner's record is in active use
... name SΣ1..*HumanNameThe name(s) associated with the practitioner
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... text Σ0..1stringText representation of the full name
.... family SΣ1..1stringFamily name (often called 'Surname')
.... given Σ0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ0..1PeriodTime period when name was/is in use
... telecom SΣ0..*ContactPointA contact detail for the practitioner (that apply to all roles)
... address SΣ0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)
... gender Σ0..1codemale | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate Σ0..1dateThe date on which the practitioner was born
... photo 0..*AttachmentImage of the person
... qualification 0..*BackboneElementCertification, licenses, or training pertaining to the provision of care
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier 0..*IdentifierAn identifier for this qualification for the practitioner
.... code 1..1CodeableConceptCoded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.

.... period 0..1PeriodPeriod during which the qualification is valid
.... issuer 0..1Reference(Organization)Organization that regulates and issues the qualification
... communication 0..*CodeableConceptA language the practitioner can use in patient communication
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Practitioner.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Practitioner.name.userequiredNameUse
Practitioner.genderrequiredAdministrativeGender
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
Practitioner.communicationpreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding

This structure is derived from USCorePractitionerProfile

Summary

Must-Support: 2 elements

Structures

This structure refers to these other structures:

Maturity: 3

Differential View

This structure is derived from USCorePractitionerProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner USCorePractitionerProfile
... identifier 1..*PASIdentifierAn identifier for the person as this agent
... identifier:NPI 0..1PASIdentifierAn identifier intended for computation
... telecom S0..*ContactPointA contact detail for the practitioner (that apply to all roles)

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*USCorePractitionerProfileA person with a formal responsibility in the provisioning of healthcare or related services
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣ1..*PASIdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI S0..1PASIdentifierAn identifier intended for computation

Required Pattern: At least the following
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
.... use ?!Σ0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... family SΣ1..1stringFamily name (often called 'Surname')
... telecom SΣ0..*ContactPointA contact detail for the practitioner (that apply to all roles)
... address SΣ0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Practitioner.name.userequiredNameUse

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..*USCorePractitionerProfileA person with a formal responsibility in the provisioning of healthcare or related services
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣ1..*PASIdentifierAn identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI S0..1PASIdentifierAn identifier intended for computation

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
... active Σ0..1booleanWhether this practitioner's record is in active use
... name SΣ1..*HumanNameThe name(s) associated with the practitioner
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... text Σ0..1stringText representation of the full name
.... family SΣ1..1stringFamily name (often called 'Surname')
.... given Σ0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ0..1PeriodTime period when name was/is in use
... telecom SΣ0..*ContactPointA contact detail for the practitioner (that apply to all roles)
... address SΣ0..*AddressAddress(es) of the practitioner that are not role specific (typically home address)
... gender Σ0..1codemale | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate Σ0..1dateThe date on which the practitioner was born
... photo 0..*AttachmentImage of the person
... qualification 0..*BackboneElementCertification, licenses, or training pertaining to the provision of care
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier 0..*IdentifierAn identifier for this qualification for the practitioner
.... code 1..1CodeableConceptCoded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.

.... period 0..1PeriodPeriod during which the qualification is valid
.... issuer 0..1Reference(Organization)Organization that regulates and issues the qualification
... communication 0..*CodeableConceptA language the practitioner can use in patient communication
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Practitioner.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Practitioner.name.userequiredNameUse
Practitioner.genderrequiredAdministrativeGender
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
Practitioner.communicationpreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding

This structure is derived from USCorePractitionerProfile

Summary

Must-Support: 2 elements

Structures

This structure refers to these other structures:

Maturity: 3

 

Other representations of profile: CSV, Excel, Schematron