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 Claim Referral Request Example

Page standards status: Informative

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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:ServiceRequest ;
      fhir:nodeRole fhir:treeRoot ;
      fhir:id [ fhir:v "ReferralRequestExample"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest>     ] )
      ] ; #
      fhir:language [ fhir:v "en"] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest ReferralRequestExample</b></p><a name=\"ReferralRequestExample\"> </a><a name=\"hcReferralRequestExample\"> </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\">Language: en</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-servicerequest.html\">PAS Service Request</a></p></div><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>code</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/1365 3}\">Consultation</span></p><p><b>quantity</b>: 1 visit<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code1 = '1')</span></p><p><b>subject</b>: <a href=\"Patient-SubscriberExample.html\">JOE SMITH  Male, DoB Unknown ( Member Number)</a></p></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:status [ fhir:v "active"] ; #
      fhir:intent [ fhir:v "order"] ; #
      fhir:code [
        ( fhir:coding [
    fhir:system [
    fhir:v "https://codesystem.x12.org/005010/1365"^^xsd:anyURI ;
    fhir:l <https://codesystem.x12.org/005010/1365>       ] ;
    fhir:code [ fhir:v "3" ] ;
    fhir:display [ fhir:v "Consultation" ]     ] )
      ] ; #
      fhir:quantity [
    a fhir:Quantity ;
    fhir:value [ fhir:v "1"^^xsd:decimal ] ;
    fhir:unit [ fhir:v "visit" ] ;
    fhir:system [
    fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ;
    fhir:l <http://unitsofmeasure.org>     ] ;
    fhir:code [ fhir:v "1" ]
      ] ; #
      fhir:subject [
    fhir:l fhir:Patient/SubscriberExample ;
    fhir:reference [ fhir:v "Patient/SubscriberExample" ]
      ] . #