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

Resource Profile: PAS Practitioner

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner Version: 2.1.0-preview
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(7.0.0) This profile also complies with the profiles US Core Practitioner Profile (3.1.1) and US Core Practitioner Profile (6.1.0)
... identifier 1..* PASIdentifier An identifier for the person as this agent
... Slices for identifier Content/Rules for all slices
.... identifier:NPI 0..* PASIdentifier An identifier intended for computation

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..* USCorePractitionerProfile(7.0.0) A person with a formal responsibility in the provisioning of healthcare or related services
This profile also complies with the profiles US Core Practitioner Profile (3.1.1) and US Core Practitioner Profile (6.1.0)
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* PASIdentifier An identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI SC 0..* PASIdentifier An identifier intended for computation
us-core-16: NPI must be 10 digits
us-core-17: NPI check digit must be valid (Luhn algorithm check)

Required Pattern: At least the following
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... family SΣ 1..1 string Family name (often called 'Surname')
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
.... system SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

.... value SΣ 0..1 string The actual contact point details
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

... address SΣ 0..* Address Address(es) of the practitioner
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example General: 49 MEADOW ST
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
Example General: EVERYTOWN
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.


Example General: OK
.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
Example General: 74047
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Practitioner.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Practitioner.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state
NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..* USCorePractitionerProfile(7.0.0) A person with a formal responsibility in the provisioning of healthcare or related services
This profile also complies with the profiles US Core Practitioner Profile (3.1.1) and US Core Practitioner Profile (6.1.0)
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* PASIdentifier An identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI SC 0..* PASIdentifier An identifier intended for computation
us-core-16: NPI must be 10 digits
us-core-17: NPI check digit must be valid (Luhn algorithm check)

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 0..1 CodeableConcept Description of identifier
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
... active Σ 0..1 boolean Whether this practitioner's record is in active use
... name SΣ 1..* HumanName The name(s) associated with the practitioner
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... text Σ 0..1 string Text representation of the full name
.... family SΣ 1..1 string Family name (often called 'Surname')
.... given Σ 0..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ 0..* string Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ 0..1 Period Time period when name was/is in use
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... system SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

.... value SΣ 0..1 string The actual contact point details
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

.... rank Σ 0..1 positiveInt Specify preferred order of use (1 = highest)
.... period Σ 0..1 Period Time period when the contact point was/is in use
... address SΣ 0..* Address Address(es) of the practitioner
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... type Σ 0..1 code postal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).


Example General: both
.... text Σ 0..1 string Text representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example General: 49 MEADOW ST
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
Example General: EVERYTOWN
.... district Σ 0..1 string District name (aka county)
Example General: Madison
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.


Example General: OK
.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
Example General: 74047
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ 0..1 Period Time period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... gender Σ 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate Σ 0..1 date The date on which the practitioner was born
... photo 0..* Attachment Image of the person
... qualification 0..* BackboneElement Certification, licenses, or training pertaining to the provision of care
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... identifier 0..* Identifier An identifier for this qualification for the practitioner
.... code 1..1 CodeableConcept Coded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.

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

Additional BindingsPurpose
AllLanguages Max Binding


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Practitioner.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Practitioner.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Practitioner.address.typerequiredAddressType
http://hl7.org/fhir/ValueSet/address-type|4.0.1
from the FHIR Standard
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state
Practitioner.genderrequiredAdministrativeGender
http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
from the FHIR Standard
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
http://terminology.hl7.org/ValueSet/v2-2.7-0360
from the FHIR Standard
Practitioner.communicationpreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard

This structure is derived from USCorePractitionerProfile

Summary

Structures

This structure refers to these other structures:

Maturity: 3

Differential View

This structure is derived from USCorePractitionerProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner USCorePractitionerProfile(7.0.0) This profile also complies with the profiles US Core Practitioner Profile (3.1.1) and US Core Practitioner Profile (6.1.0)
... identifier 1..* PASIdentifier An identifier for the person as this agent
... Slices for identifier Content/Rules for all slices
.... identifier:NPI 0..* PASIdentifier An identifier intended for computation

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..* USCorePractitionerProfile(7.0.0) A person with a formal responsibility in the provisioning of healthcare or related services
This profile also complies with the profiles US Core Practitioner Profile (3.1.1) and US Core Practitioner Profile (6.1.0)
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* PASIdentifier An identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI SC 0..* PASIdentifier An identifier intended for computation
us-core-16: NPI must be 10 digits
us-core-17: NPI check digit must be valid (Luhn algorithm check)

Required Pattern: At least the following
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... family SΣ 1..1 string Family name (often called 'Surname')
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
.... system SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

.... value SΣ 0..1 string The actual contact point details
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

... address SΣ 0..* Address Address(es) of the practitioner
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example General: 49 MEADOW ST
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
Example General: EVERYTOWN
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.


Example General: OK
.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
Example General: 74047
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Practitioner.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Practitioner.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Practitioner 0..* USCorePractitionerProfile(7.0.0) A person with a formal responsibility in the provisioning of healthcare or related services
This profile also complies with the profiles US Core Practitioner Profile (3.1.1) and US Core Practitioner Profile (6.1.0)
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 1..* PASIdentifier An identifier for the person as this agent
Slice: Unordered, Open by pattern:$this
.... identifier:NPI SC 0..* PASIdentifier An identifier intended for computation
us-core-16: NPI must be 10 digits
us-core-17: NPI check digit must be valid (Luhn algorithm check)

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... use 0..1 code usual | official | temp | secondary | old (If known)
..... type 0..1 CodeableConcept Description of identifier
..... system 1..1 uri The namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value 0..1 string The value that is unique
..... period 0..1 Period Time period when id is/was valid for use
..... assigner 0..1 Reference(Organization) Organization that issued id (may be just text)
... active Σ 0..1 boolean Whether this practitioner's record is in active use
... name SΣ 1..* HumanName The name(s) associated with the practitioner
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required): The use of a human name.

.... text Σ 0..1 string Text representation of the full name
.... family SΣ 1..1 string Family name (often called 'Surname')
.... given Σ 0..* string Given names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
.... prefix Σ 0..* string Parts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
.... suffix Σ 0..* string Parts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
.... period Σ 0..1 Period Time period when name was/is in use
... telecom SΣ 0..* ContactPoint A contact detail for the practitioner (that apply to all roles)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... system SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.

.... value SΣ 0..1 string The actual contact point details
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.

.... rank Σ 0..1 positiveInt Specify preferred order of use (1 = highest)
.... period Σ 0..1 Period Time period when the contact point was/is in use
... address SΣ 0..* Address Address(es) of the practitioner
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... type Σ 0..1 code postal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).


Example General: both
.... text Σ 0..1 string Text representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
Example General: 49 MEADOW ST
.... city SΣ 0..1 string Name of city, town etc.
Example General: Erewhon
Example General: EVERYTOWN
.... district Σ 0..1 string District name (aka county)
Example General: Madison
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.


Example General: OK
.... postalCode SΣ 0..1 string US Zip Codes
Example General: 9132
Example General: 74047
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ 0..1 Period Time period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... gender Σ 0..1 code male | female | other | unknown
Binding: AdministrativeGender (required): The gender of a person used for administrative purposes.

... birthDate Σ 0..1 date The date on which the practitioner was born
... photo 0..* Attachment Image of the person
... qualification 0..* BackboneElement Certification, licenses, or training pertaining to the provision of care
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... identifier 0..* Identifier An identifier for this qualification for the practitioner
.... code 1..1 CodeableConcept Coded representation of the qualification
Binding: v2 table 0360, Version 2.7 (example): Specific qualification the practitioner has to provide a service.

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

Additional BindingsPurpose
AllLanguages Max Binding


doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Practitioner.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Practitioner.name.userequiredNameUse
http://hl7.org/fhir/ValueSet/name-use|4.0.1
from the FHIR Standard
Practitioner.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Practitioner.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Practitioner.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Practitioner.address.typerequiredAddressType
http://hl7.org/fhir/ValueSet/address-type|4.0.1
from the FHIR Standard
Practitioner.address.stateextensibleUspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state
Practitioner.genderrequiredAdministrativeGender
http://hl7.org/fhir/ValueSet/administrative-gender|4.0.1
from the FHIR Standard
Practitioner.qualification.codeexamplev2.0360.2.7 (a valid code from http://terminology.hl7.org/CodeSystem/v2-0360|2.7)
http://terminology.hl7.org/ValueSet/v2-2.7-0360
from the FHIR Standard
Practitioner.communicationpreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard

This structure is derived from USCorePractitionerProfile

Summary

Structures

This structure refers to these other structures:

Maturity: 3

 

Other representations of profile: CSV, Excel, Schematron