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: PAS Subscription Notification example

Language: en

Bundle PASSubscriptionNotification of type history

Entry 1 - fullUrl = http://example.org/Parameters/SubscriptionNotificationParameters

Resource Parameters:

> Language: en

> ## Parameters

> subscription | StructureDefinition PAS Subscription
> topic | http://hl7.org/fhir/us/davinci-pas/SubscriptionTopic/PASSubscriptionTopic|2.1.0
> type | event-notification
> notification-event |
> event-number | 2
> timestamp | 2020-05-29 11:44:33-0500
> focus | Bundle: identifier = http://example.org/SUBMITTER_TRANSACTION_IDENTIFIER#A12345; type = collection; timestamp = 2005-05-02 11:02:00+0500

Request:

    GET https://example.org/Subscription/PAS/$status

Response:

    200

Entry 2 - fullUrl = http://example.org/Bundle/ReferralAuthorizationResponseBundleExample

Resource Bundle:

> Language: en

> Profile: PAS Response Bundle

> Bundle ReferralAuthorizationResponseBundleExample of type collection

> Entry 1 - fullUrl = http://example.org/fhir/ClaimResponse/PractitionerRequestorResponseExample

> Resource ClaimResponse:

> > Language: en

> > Profile: PAS Claim Response

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

> > status: Active

> > type: Professional

> > use: Preauthorization

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

> > created: 2005-05-02 11:02:00+0500

> > insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY

> > requestor: PractitionerRole: telecom = ph: 4029993456

> > request: Claim: extension = Urgent; identifier = urn:trnorg:9012345678#111099; status = active; type = Professional; use = preauthorization; created = 2005-05-02 11:01:00+0500; priority = Normal

> > outcome: complete

> > > item

> > > ItemRequestedServiceDate: 2005-05-02 --> 2005-06-02

> > > ItemPreAuthIssueDate: 2005-05-02

> > > ItemPreAuthPeriod: 2005-05-02 --> 2005-06-02

> > > > ItemAuthorizedProvider

> > > > - provider: Practitioner SUSAN WATSON

> > > > ItemAuthorizedDetail

> > > > - productOrServiceCode: Consultation
> > > > - unitPrice: $100.00 (USD)
> > > > - quantity: 1

> > > itemSequence: 1

> > > ### Adjudications

> > > - | Extension | Category
> > > * |  | Submitted Amount

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

> Resource Organization:

> > Language: en

> > 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:

> > Language: en

> > 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/Patient/SubscriberExample

> Resource Patient:

> > Language: en

> > Profile: PAS Subscriber Patient

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

> > | RU

> Entry 5 - fullUrl = http://example.org/fhir/Practitioner/ReferralPractitionerExample

> Resource Practitioner:

> > Language: en

> > Profile: PAS Practitioner

> > identifier: United States National Provider Identifier/1234567893

> > name: SUSAN WATSON

Request:

    GET https://example.org/Bundle/ReferralAuthorizationResponseBundleExample

Response:

    200