Patient Cost Transparency Implementation Guide
2.0.0 - STU 2
Patient Cost Transparency Implementation Guide
2.0.0 - STU 2
Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/fhir/us/davinci-pct/CapabilityStatement/davinci-pct | Version: 2.0.0 | |||
| Standards status: Trial-use | Maturity Level: 2 | Computable Name: PatientCostTransparencyCapabilityStatement | ||
| Other Identifiers: OID:2.16.840.1.113883.4.642.40.4.13.1 | ||||
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License |
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Payer capability statement for the Da Vinci Patient Cost Transparency Implementation Guide
Raw OpenAPI-Swagger Definition file | Download
version: 1; Last updated: 2023-03-28 19:21:32+0000
json, SHOULD support xmlNote to Implementers: FHIR Capabilities
Any FHIR capability may be 'allowed' by the system unless explicitly marked as 'SHALL NOT'. A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.
This CapabilityStatement imports the CapabilityStatement US Core Server CapabilityStatementversion: 7.0.0)
serverThe summary table lists the resources that are part of this configuration, and for each resource it lists:
_include_revinclude| Resource Type | Profile | R | V-R | S | U | P | C | D | H-I | H-T | Searches | _include | _revinclude | Operations |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DocumentReference | Supported Profiles PCT AEOB Packet Document Reference PCT GFE Bundle PCT GFE Packet | Y | y? | Y | y? | y? | y?y? | y?y? | category, status, doc-status, type, date, patient, estimate-initiation-time, estimate-service, estimate-condition, linking-identifier, planned-period, author, relatesto | $GFESubmit | ||||
| ExplanationOfBenefit | Supported Profiles PCT Advanced EOB | Y | y? | Y | y? | y? | y? | y? | y? | y? | ||||
| Coverage | Supported Profiles PCT Coverage | Y | y? | Y | y? | y? | y? | y? | y? | y? | ||||
| Claim | Supported Profiles PCT Good Faith Estimate Professional PCT Good Faith Estimate Institutional | Y | y? | Y | y? | y? | y? | y? | y? | y? | ||||
| Organization | Supported Profiles PCT Organization | Y | y? | Y | y? | y? | y? | y? | y? | y? | ||||
| Practitioner | Supported Profiles PCT Practitioner | Y | y? | Y | y? | y? | y? | y? | y? | y? |
search-type, read.vread, history-instance, history-type, patch, delete, history-instance, history-type.PCT AEOB Packet Document Reference
PCT GFE Bundle
PCT GFE Packet
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | category | token | Categorization of document. |
| SHALL | status | token | current | superseded | entered-in-error |
| SHALL | doc-status | token | preliminary | final | amended | entered-in-error |
| SHALL | type | token | Kind of document |
| SHALL | date | date | Kind of document |
| SHALL | patient | reference | Who/what is the subject of the document |
| SHOULD | estimate-initiation-time | date | Instant from which the request originating request was being initiated. |
| SHOULD | estimate-service | token | Significant Procedures and/or products involved in an estimate in the packet. |
| SHOULD | estimate-condition | token | Significant condition involved in an estimate in the packet. |
| SHOULD | linking-identifier | token | An identifier assigned to a particular service or series of services to enabling linking. |
| SHOULD | planned-period | date | Planned date(s) of a particular admission/service or a series of admissions/services. |
| SHOULD | author | reference | All involved authoring parties, including payer all Good Faith Estimate (GFE) providers. |
| SHOULD | relatesto | reference | Target of the relationship. |
| Conformance | Operation | Documentation |
|---|---|---|
| SHALL | $GFESubmit | This operation is used by an entity to submit one or multiple GFEs as a Bundle containing the GFE(s) and other referenced resources for processing. The only input parameter is the single Bundle resource with one or multiple GFE(s) - each of which is based on the Claim resource (along with other referenced resources). The only output is a url for subsequent polling per async pattern. If after polling the response is complete, then the result will either be a single Bundle with the AEOB - which is based on the ExplanationOfBenefit resource, (and other referenced resources) or an OperationOutcome resource indicating the AEOB will be sent directly to the patient. |
search-type, read.create, vread, update, patch, delete, history-instance, history-type.search-type, read.create, vread, update, patch, delete, history-instance, history-type.search-type, read.create, vread, update, patch, delete, history-instance, history-type.search-type, read.create, vread, update, patch, delete, history-instance, history-type.search-type, read.create, vread, update, patch, delete, history-instance, history-type.
IG © 2025+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pct#2.0.0 based on FHIR 4.0.1. Generated 2025-10-08
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