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

## Example Bundle: Homecare Authorization Update Bundle Example

Profile: PAS Request Bundle

Bundle HomecareAuthorizationUpdateBundleExample of type collection

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

Resource Claim:

> Profile: PAS Claim Update

> identifier: `http://example.org/PATIENT_EVENT_TRACE_NUMBER`/111099-UPDATE

> status: Active

> type: Professional

> use: Preauthorization

> patient: JOE SMITH Male, DoB Unknown ( Member Number)

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

> insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY

> provider: Organization DR. JOE SMITH CORPORATION

> priority: Normal

> ### Relateds

> - | Claim | Relationship
> * | Claim: extension = ; identifier = http://example.org/PATIENT_EVENT_TRACE_NUMBER#111099; status = active; type = Professional; use = preauthorization; created = 2019-07-20 11:01:00+0500; priority = Normal | Prior Claim

> ### Insurances

> - | Sequence | Focal | Coverage
> * | 1 | true | Coverage: status = active; subscriberId = 1122334455; relationship = Self

> > item

> > ServiceItemRequestType: Health Services Review

> > CertificationType: Initial

> > sequence: 1

> > category: Home Health Care

> > productOrService: G0154

> > location: Office

> > item

> > ServiceItemRequestType: Health Services Review

> > CertificationType: Cancel

> > InfoCancelledFlag: true

> > sequence: 2

> > category: Home Health Care

> > productOrService: B4184

> > location: Office

> > item

> > ServiceItemRequestType: Health Services Review

> > CertificationType: Initial

> > InfoChanged: added

> > sequence: 3

> > category: Home Health Care

> > productOrService: B4185

> > location: Office

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

Resource Organization:

> Profile: PAS Requestor Organization

> identifier: United States National Provider Identifier/8189991234

> active: true

> type: X3

> name: DR. JOE SMITH CORPORATION

> ### Contacts

> - | Address
> * | 111 1ST STREET SAN DIEGO CA 92101 US

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

Resource Organization:

> Profile: PAS Insurer Organization

> identifier: United States National Provider Identifier/1234567893

> active: true

> type: PR

> name: MARYLAND CAPITAL INSURANCE COMPANY

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

Resource Coverage:

> Profile: PAS Coverage

> status: Active

> subscriberId: 1122334455

> beneficiary: JOE SMITH Male, DoB Unknown ( Member Number)

> relationship: Self

Entry 5 - fullUrl = http://example.org/fhir/Patient/SubscriberExample

Resource Patient:

> Profile: PAS Subscriber Patient

> JOE SMITH Male, DoB Unknown ( Member Number)

> | RU

Entry 6 - fullUrl = http://example.org/fhir/Claim/HomecareAuthorizationExample

Resource Claim:

> Profile: PAS Claim

> > HomeHealthCareInformation

> > - prognosis: 1
> > - date: 2005-05-02

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

> status: Active

> type: Professional

> use: Preauthorization

> patient: JOE SMITH Male, DoB Unknown ( Member Number)

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

> insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY

> provider: Organization DR. JOE SMITH CORPORATION

> priority: Normal

> ### Insurances

> - | Sequence | Focal | Coverage
> * | 1 | true | Coverage: status = active; subscriberId = 1122334455; relationship = Self

> > item

> > ServiceItemRequestType: Health Services Review

> > CertificationType: Initial

> > sequence: 1

> > category: Home Health Care

> > productOrService: G0154

> > location: Office

> > item

> > ServiceItemRequestType: Health Services Review

> > CertificationType: Initial

> > sequence: 2

> > category: Home Health Care

> > productOrService: B4184

> > location: Office