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 - XML Representation

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

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    <OperationDefinition xmlns="http://hl7.org/fhir">
      <id value="Claim-submit"/>
      <text>
        <status value="generated"/>
        <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>
    </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>
    </div></td></tr></table></div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
        <valueCode value="fm"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
        <valueInteger value="3">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
            <valueCanonical
                            value="http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"/>
          </extension>
        </valueInteger>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="trial-use">
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
            <valueCanonical
                            value="http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"/>
          </extension>
        </valueCode>
      </extension>
      <url
           value="http://hl7.org/fhir/us/davinci-pas/OperationDefinition/Claim-submit"/>
      <version value="2.2.0-ballot"/>
      <name value="ClaimSubmit"/>
      <title value="Submit a Prior Authorization Request for adjudication"/>
      <status value="draft"/>
      <kind value="operation"/>
      <date value="2025-07-29T17:39:14+00:00"/>
      <publisher value="HL7 International / Financial Management"/>
      <contact>
        <name value="HL7 International / Financial Management"/>
        <telecom>
          <system value="url"/>
          <value value="http://hl7.org/Special/committees/fm"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="fmlists@lists.hl7.org"/>
        </telecom>
      </contact>
      <contact>
        <name value="Jean Duteau"/>
        <telecom>
          <system value="email"/>
          <value value="mailto:jean@duteaudesign.com"/>
        </telecom>
      </contact>
      <contact>
        <name value="HL7 International / Financial Management"/>
        <telecom>
          <system value="url"/>
          <value value="http://www.hl7.org/Special/committees/fm"/>
        </telecom>
      </contact>
      <description
                   value="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 value="urn:iso:std:iso:3166"/>
          <code value="US"/>
          <display value="United States of America"/>
        </coding>
      </jurisdiction>
      <code value="submit"/>
      <base value="http://hl7.org/fhir/OperationDefinition/Claim-submit"/>
      <resource value="Claim"/>
      <system value="false"/>
      <type value="true"/>
      <instance value="false"/>
      <parameter>
        <name value="resource"/>
        <use value="in"/>
        <min value="1"/>
        <max value="1"/>
        <documentation
                       value="A Bundle containing a single Claim plus referenced resources."/>
        <type value="Bundle"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle"/>
      </parameter>
      <parameter>
        <name value="return"/>
        <use value="out"/>
        <min value="1"/>
        <max value="1"/>
        <documentation
                       value="A Bundle containing a single ClaimResponse plus referenced resources."/>
        <type value="Bundle"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle"/>
      </parameter>
    </OperationDefinition>