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

: Submit a GFE resource for the creation of an AEOB - TTL Representation

Page standards status: Trial-use

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:OperationDefinition ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "GFE-submit"] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>URL: [base]/Claim/$gfe-submit</p><p>Parameters</p><table class=\"grid\"><tr><td><b>Use</b></td><td><b>Name</b></td><td><b>Scope</b></td><td><b>Cardinality</b></td><td><b>Type</b></td><td><b>Binding</b></td><td><b>Documentation</b></td></tr><tr><td>IN</td><td>resource</td><td/><td>1..1</td><td><a href=\"http://hl7.org/fhir/R4/bundle.html\">Bundle</a></td><td/><td><div><p>A Bundle containing a single or multiple GFE resources plus referenced resources.</p>\n</div></td></tr><tr><td>OUT</td><td>return</td><td/><td>0..1</td><td><a href=\"http://hl7.org/fhir/R4/operationoutcome.html\">OperationOutcome</a></td><td/><td><div><p>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 <a href=\"https://hl7.org/fhir/R5/async-bundle.html\">async pattern</a>.</p>\n</div></td></tr></table></div>"
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ] ;
fhir:value [ fhir:v "fm" ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ] ;
fhir:value [
fhir:v "trial-use" ;
      ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ] ;
fhir:value [
fhir:v "http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct>         ]       ] )     ]
  ] ) ; # 
  fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pct/OperationDefinition/GFE-submit"^^xsd:anyURI] ; # 
  fhir:version [ fhir:v "2.0.0-ballot"] ; # 
  fhir:name [ fhir:v "GFESubmit"] ; # 
  fhir:title [ fhir:v "Submit a GFE resource for the creation of an AEOB"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:kind [ fhir:v "operation"] ; # 
  fhir:date [ fhir:v "2024-04-08T16:35:46+00:00"^^xsd:dateTime] ; # 
  fhir:publisher [ fhir:v "HL7 International / Financial Management"] ; # 
  fhir:contact ( [
fhir:name [ fhir:v "HL7 International / Financial Management" ] ;
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fm" ]     ] [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "fmlists@lists.hl7.org" ]     ] )
  ] ) ; # 
  fhir:description [ fhir:v "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](https://hl7.org/fhir/R5/async-bundle.html). 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."] ; # 
  fhir:jurisdiction ( [
    ( fhir:coding [
fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ] ;
fhir:code [ fhir:v "US" ]     ] )
  ] ) ; # 
  fhir:code [ fhir:v "gfe-submit"] ; # 
  fhir:base [
fhir:v "http://hl7.org/fhir/us/davinci-pct/OperationDefinition/GFE-submit"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pct/OperationDefinition/GFE-submit>
  ] ; # 
  fhir:resource ( [ fhir:v "Claim"] ) ; # 
  fhir:system [ fhir:v "false"^^xsd:boolean] ; # 
  fhir:type [ fhir:v "true"^^xsd:boolean] ; # 
  fhir:instance [ fhir:v "false"^^xsd:boolean] ; # 
  fhir:parameter ( [
fhir:name [ fhir:v "resource" ] ;
fhir:use [ fhir:v "in" ] ;
fhir:min [ fhir:v "1"^^xsd:integer ] ;
fhir:max [ fhir:v "1" ] ;
fhir:documentation [ fhir:v "A Bundle containing a single or multiple GFE resources plus referenced resources." ] ;
fhir:type [ fhir:v "Bundle" ]
  ] [
fhir:name [ fhir:v "return" ] ;
fhir:use [ fhir:v "out" ] ;
fhir:min [ fhir:v "0"^^xsd:integer ] ;
fhir:max [ fhir:v "1" ] ;
fhir:documentation [ fhir:v "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](https://hl7.org/fhir/R5/async-bundle.html)." ] ;
fhir:type [ fhir:v "OperationOutcome" ]
  ] ) . #