Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.1 - STU 2.2 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 2.2.1 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

Example Bundle: PAS Inquiry Request Bundle Example

Language: en

Profile: PAS Inquiry Request Bundle

Bundle PASClaimInquiryBundleExample of type collection

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

Resource Claim:

Language: en

Profile: PAS Claim Inquiry

identifier: http://example.org/PATIENT_EVENT_TRACE_NUMBER/111099

status: Active

type: Professional

use: Preauthorization

created: 2019-07-20 11:01:00+0500

insurer: MARYLAND CAPITAL INSURANCE COMPANY (PR) (http://hl7.org/fhir/sid/us-npi#United States National Provider Identifier#1234567893)

provider: DR. JOE SMITH CORPORATION (X3) (http://hl7.org/fhir/sid/us-npi#United States National Provider Identifier#8189991234)

priority: Normal

Insurances

-SequenceFocalCoverage
*1trueCoverage: identifier = Member Number: ?ngen-9?; status = active; subscriberId = 1122334455; relationship = Self

item

Service Item Request Type: Health Services Review

Certification Type: Initial

sequence: 1

productOrService: Hhcp-svs of rn,ea 15 min

item

Service Item Request Type: Health Services Review

Certification Type: Initial

Certification Issue Date: 2019-07-01

Certification Effective Date: 2019-07-01

Certification Expiration Date: 2019-07-31

Review Action Code: Certified in total

Product or Service Code End: B4190

sequence: 2

productOrService: B4184

Entry 2 - fullUrl = http://example.org/fhir/Organization/UMOExample

Resource Organization:

Language: en

Profile: PAS Requestor Organization

DR. JOE SMITH CORPORATION (X3) (http://hl7.org/fhir/sid/us-npi#United States National Provider Identifier#8189991234)

Active:true
Type:X3
Contact Detail
  • 111 1ST STREET SAN DIEGO CA 92101 US

Entry 3 - fullUrl = http://example.org/fhir/Organization/InsurerExample

Resource Organization:

Language: en

Profile: PAS Insurer Organization

MARYLAND CAPITAL INSURANCE COMPANY (PR) (http://hl7.org/fhir/sid/us-npi#United States National Provider Identifier#1234567893)

Active:true
Type:PR

Entry 4 - fullUrl = http://example.org/fhir/Coverage/InsuranceExample

Resource Coverage:

Language: en

Profile: PAS Coverage

identifier: Member Number/?ngen-9?

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:

Language: en

Profile: PAS Subscriber Patient

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

Military StatusRU