Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot United States of America flag

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-ballot 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

OperationDefinition: Submit a GFE resource for the creation of an AEOB

Official URL: http://hl7.org/fhir/us/davinci-pct/OperationDefinition/GFE-submit Version: 2.0.0-ballot
Standards status: Trial-use Computable Name: GFESubmit
Other Identifiers: OID:2.16.840.1.113883.4.642.40.4.33.2

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 output is a url in the Content-Location header for subsequent polling and optionally an OperationOutcome resource 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.

URL: [base]/Claim/$gfe-submit

Parameters

UseNameScopeCardinalityTypeBindingDocumentation
INresource1..1Bundle

A Bundle containing a single or multiple GFE resources plus referenced resources.

OUTreturn0..1OperationOutcome

When successful, this will return a Bundle of type batch-submit; When there is an error calling $gfe-submit (4xx, 5xx HTTP code) then an OperationOutcome must be returned per the async pattern.