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 - TTL Representation

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

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    @prefix fhir: <http://hl7.org/fhir/> .
    @prefix owl: <http://www.w3.org/2002/07/owl#> .
    @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
    @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
    @prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

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

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