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

: Error Response Example

Page standards status: Informative

Raw ttl | Download


@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/ClaimResponse/ErrorResponseExample> a fhir:ClaimResponse ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "ErrorResponseExample"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse" ;
       fhir:index -1 ;
       fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse>
     ]
  ] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "extensions" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse ErrorResponseExample</b></p><a name=\"ErrorResponseExample\"> </a><a name=\"hcErrorResponseExample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-claimresponse.html\">PAS Claim Response</a></p></div><blockquote><p><b>Transmission Identifiers</b></p><ul><li>applicationSenderCode: PAYERAPP</li><li>applicationReceiverCode: PROVIDERAPP</li><li>interchangeSenderID: PAYERID</li><li>interchangeReceiverID: PROVIDERID</li></ul></blockquote><p><b>identifier</b>: <code>http://example.org/PATIENT_EVENT_TRACE_NUMBER</code>/111099</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}\">Professional</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"Patient-SubscriberExample.html\">JOE SMITH  Male, DoB Unknown ( http://example.org/MIN#12345678901)</a></p><p><b>created</b>: 2005-05-02 11:02:00+0500</p><p><b>insurer</b>: <a href=\"Organization-InsurerExample.html\">Organization MARYLAND CAPITAL INSURANCE COMPANY</a></p><p><b>requestor</b>: <a href=\"Organization-UMOExample.html\">Organization DR. JOE SMITH CORPORATION</a></p><p><b>request</b>: <a href=\"Claim-ReferralAuthorizationExample.html\">Claim: extension = Urgent,; identifier = urn:trnorg:9012345678#111099; status = active; type = Professional; use = preauthorization; created = 2005-05-02 11:01:00+0500; priority = Normal</a></p><p><b>outcome</b>: Error</p><blockquote><p><b>error</b></p><p><b>code</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/901 04}\">04</span></p></blockquote><blockquote><p><b>error</b></p><blockquote><p><b>Error Element</b></p><ul><li>error: 2010A-NM103</li></ul></blockquote><p><b>Error Path</b>: Bundle.entry[1].Organization.name</p><p><b>Error Follow-up Action</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/889 C}\">C</span></p><p><b>code</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/901 T4}\">T4</span></p></blockquote></div>"
  ] ;
  fhir:DomainResource.extension [
     fhir:index -1 ;
     fhir:Element.extension [
       fhir:index -1 ;
       fhir:Extension.url [ fhir:value "applicationSenderCode" ] ;
       fhir:Extension.valueString [ fhir:value "PAYERAPP" ]
     ], [
       fhir:index -1 ;
       fhir:Extension.url [ fhir:value "applicationReceiverCode" ] ;
       fhir:Extension.valueString [ fhir:value "PROVIDERAPP" ]
     ], [
       fhir:index -1 ;
       fhir:Extension.url [ fhir:value "interchangeSenderID" ] ;
       fhir:Extension.valueString [ fhir:value "PAYERID" ]
     ], [
       fhir:index -1 ;
       fhir:Extension.url [ fhir:value "interchangeReceiverID" ] ;
       fhir:Extension.valueString [ fhir:value "PROVIDERID" ]
     ] ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers" ]
  ] ;
  fhir:ClaimResponse.identifier [
     fhir:index -1 ;
     fhir:Identifier.system [ fhir:value "http://example.org/PATIENT_EVENT_TRACE_NUMBER" ] ;
     fhir:Identifier.value [ fhir:value "111099" ] ;
     fhir:Identifier.assigner [
       fhir:Reference.identifier [
         fhir:Identifier.system [ fhir:value "http://example.org/USER_ASSIGNED" ] ;
         fhir:Identifier.value [ fhir:value "9012345678" ]
       ]
     ]
  ] ;
  fhir:ClaimResponse.status [ fhir:value "active"] ;
  fhir:ClaimResponse.type [
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ] ;
       fhir:Coding.code [ fhir:value "professional" ]
     ]
  ] ;
  fhir:ClaimResponse.use [ fhir:value "preauthorization"] ;
  fhir:ClaimResponse.patient [
     fhir:link <http://hl7.org/fhir/Patient/SubscriberExample> ;
     fhir:Reference.reference [ fhir:value "Patient/SubscriberExample" ]
  ] ;
  fhir:ClaimResponse.created [ fhir:value "2005-05-02T11:02:00+05:00"^^xsd:dateTime] ;
  fhir:ClaimResponse.insurer [
     fhir:link <http://hl7.org/fhir/Organization/InsurerExample> ;
     fhir:Reference.reference [ fhir:value "Organization/InsurerExample" ]
  ] ;
  fhir:ClaimResponse.requestor [
     fhir:link <http://hl7.org/fhir/Organization/UMOExample> ;
     fhir:Reference.reference [ fhir:value "Organization/UMOExample" ]
  ] ;
  fhir:ClaimResponse.request [
     fhir:link <http://hl7.org/fhir/Claim/ReferralAuthorizationExample> ;
     fhir:Reference.reference [ fhir:value "Claim/ReferralAuthorizationExample" ]
  ] ;
  fhir:ClaimResponse.outcome [ fhir:value "error"] ;
  fhir:ClaimResponse.error [
     fhir:index -1 ;
     fhir:ClaimResponse.error.code [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/901" ] ;
         fhir:Coding.code [ fhir:value "04" ]
       ]
     ]
  ], [
     fhir:index -1 ;
     fhir:Element.extension [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "error" ] ;
         fhir:Extension.valueString [ fhir:value "2010A-NM103" ]
       ] ;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement" ]
     ], [
       fhir:index -1 ;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorPath" ] ;
       fhir:Extension.valueString [ fhir:value "Bundle.entry[1].Organization.name" ]
     ], [
       fhir:index -1 ;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorFollowupAction" ] ;
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index -1 ;
           fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/889" ] ;
           fhir:Coding.code [ fhir:value "C" ]
         ]
       ]
     ] ;
     fhir:ClaimResponse.error.code [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/901" ] ;
         fhir:Coding.code [ fhir:value "T4" ]
       ]
     ]
  ] .

<http://hl7.org/fhir/Patient/SubscriberExample> a fhir:Patient .

<http://hl7.org/fhir/Organization/InsurerExample> a fhir:Organization .

<http://hl7.org/fhir/Organization/UMOExample> a fhir:Organization .

<http://hl7.org/fhir/Claim/ReferralAuthorizationExample> a fhir:Claim .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/ClaimResponse/ErrorResponseExample.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/ClaimResponse/ErrorResponseExample.ttl> .