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 Beneficiary Example

Page standards status: Informative

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    {
      "resourceType" : "Patient",
      "id" : "BeneficiaryExample",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary"
        ]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: Patient BeneficiaryExample</b></p><a name=\"BeneficiaryExample\"> </a><a name=\"hcBeneficiaryExample\"> </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-beneficiary.html\">PAS Beneficiary Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">JESSE SMITH  Female, DoB: 1947-01-18 ( Member Number)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Known multipleBirth status of Patient\">Multiple Birth:</td><td colspan=\"3\">1</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">US </td></tr></table></div>"
      },
      "identifier" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                "code" : "MB"
              }
            ]
          },
          "system" : "http://example.org/MIN",
          "value" : "12345678902"
        }
      ],
      "name" : [
        {
          "family" : "SMITH",
          "given" : [
            "JESSE"
          ]
        }
      ],
      "gender" : "female",
      "birthDate" : "1947-01-18",
      "address" : [
        {
          "country" : "US"
        }
      ],
      "multipleBirthInteger" : 1
    }