Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-ballot - STU 2.2 - Ballot

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 2.2.0-ballot 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

## : Submit a Prior Authorization Request for adjudication - JSON Representation

Page standards status: Trial-use | Maturity Level: 3

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    {
      "resourceType" : "OperationDefinition",
      "id" : "Claim-submit",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: OperationDefinition Claim-submit</b></p><a name=\"Claim-submit\"> </a><a name=\"hcClaim-submit\"> </a><p>URL: [base]/Claim/$submit</p><h3>Parameters</h3><table class=\"grid\"><tr><td><b>Use</b></td><td><b>Name</b></td><td><b>Scope</b></td><td><b>Cardinality</b></td><td><b>Type</b></td><td><b>Binding</b></td><td><b>Documentation</b></td></tr><tr><td>IN</td><td>resource</td><td/><td>1..1</td><td><a href=\"http://hl7.org/fhir/R4/bundle.html\">Bundle</a> (<a href=\"StructureDefinition-profile-pas-request-bundle.html\" title=\"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle\">PAS Request Bundle</a>)</td><td/><td><div><p>A Bundle containing a single Claim plus referenced resources.</p>\n</div></td></tr><tr><td>OUT</td><td>return</td><td/><td>1..1</td><td><a href=\"http://hl7.org/fhir/R4/bundle.html\">Bundle</a> (<a href=\"StructureDefinition-profile-pas-response-bundle.html\" title=\"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle\">PAS Response Bundle</a>)</td><td/><td><div><p>A Bundle containing a single ClaimResponse plus referenced resources.</p>\n</div></td></tr></table></div>"
      },
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
          "valueCode" : "fm"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
          "valueInteger" : 3,
          "_valueInteger" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
                "valueCanonical" : "http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"
              }
            ]
          }
        },
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          "valueCode" : "trial-use",
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        }
      ],
      "url" : "http://hl7.org/fhir/us/davinci-pas/OperationDefinition/Claim-submit",
      "version" : "2.2.0-ballot",
      "name" : "ClaimSubmit",
      "title" : "Submit a Prior Authorization Request for adjudication",
      "status" : "draft",
      "kind" : "operation",
      "date" : "2025-07-29T17:39:14+00:00",
      "publisher" : "HL7 International / Financial Management",
      "contact" : [
        {
          "name" : "HL7 International / Financial Management",
          "telecom" : [
            {
              "system" : "url",
              "value" : "http://hl7.org/Special/committees/fm"
            },
            {
              "system" : "email",
              "value" : "fmlists@lists.hl7.org"
            }
          ]
        },
        {
          "name" : "Jean Duteau",
          "telecom" : [
            {
              "system" : "email",
              "value" : "mailto:jean@duteaudesign.com"
            }
          ]
        },
        {
          "name" : "HL7 International / Financial Management",
          "telecom" : [
            {
              "system" : "url",
              "value" : "http://www.hl7.org/Special/committees/fm"
            }
          ]
        }
      ],
      "description" : "This operation is used to submit a PreAuthorization Claim Request for adjudication as a Bundle containing the PASClaimRequest and other referenced resources for processing. The only input parameter is the single Bundle resource with a PASClaimRequest instance (along with other referenced resources) and the only output is a single Bundle with a PASClaimResponse (and other referenced resources) or an OperationOutcome resource.  This is a variant of the FHIR Core Claim $submit operation.",
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "urn:iso:std:iso:3166",
              "code" : "US",
              "display" : "United States of America"
            }
          ]
        }
      ],
      "code" : "submit",
      "base" : "http://hl7.org/fhir/OperationDefinition/Claim-submit",
      "resource" : [
        "Claim"
      ],
      "system" : false,
      "type" : true,
      "instance" : false,
      "parameter" : [
        {
          "name" : "resource",
          "use" : "in",
          "min" : 1,
          "max" : "1",
          "documentation" : "A Bundle containing a single Claim plus referenced resources.",
          "type" : "Bundle",
          "targetProfile" : [
            🔗 "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle"
          ]
        },
        {
          "name" : "return",
          "use" : "out",
          "min" : 1,
          "max" : "1",
          "documentation" : "A Bundle containing a single ClaimResponse plus referenced resources.",
          "type" : "Bundle",
          "targetProfile" : [
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        }
      ]
    }