Patient Cost Transparency Implementation Guide, published by HL7 International - Financial Management Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• XML
• JSON
• TTL

Resource Profile: PCT GFE Bundle

PCT GFE Bundle that contains necessary resources as a GFE Submission for obtaining an AEOB. Organizations for both the provider and payer SHALL be included. The scope of this guide does not include coordination of benefits or more than one coverage. This does not serve as a replacement for eligibility, prior authorization or other financial and administrative use cases.

Usage:

• Use this Resource Profile: PCT AEOB Bundle
• Refer to this Resource Profile: GFE Reference
• Examples for this Resource Profile: Bundle/PCT-GFE-Bundle-Inst-1 and Bundle/PCT-GFE-Bundle-Prof-1

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Bundle

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources pct-gfe-bundle-1: All GFEs must have the same GFE submitter pct-gfe-bundle-2: SHALL have at least one entry for a payer organization. pct-gfe-bundle-3: All references resources SHALL be contained within the Bundle
identifier		1..1	Identifier	Persistent identifier for the bundle
type		1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Fixed Value: collection
timestamp		1..1	instant	When the bundle was assembled
Slices for entry		4..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource
entry:All Slices				Content/Rules for all slices
fullUrl		1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
search		0..0
request		0..0
response		0..0
entry:gfe		1..*	BackboneElement	SHALL have one or more PCTGFEProfessional or PCTGFEInstitutional resource(s)
resource		1..1	PCTGFEProfessional, PCTGFEInstitutional	Claim, Pre-determination or Pre-authorization
entry:patient		1..2	BackboneElement	SHALL have the patient subject of care and may have a separate subscriber
resource		1..1	HRexPatientDemographics	Information about an individual or animal receiving health care services
entry:coverage		1..1	BackboneElement	SHALL have one Coverage
resource		1..1	PCTCoverage	Insurance or medical plan or a payment agreement
entry:organization		1..*	BackboneElement	SHALL have the payer organization and may have provider organization(s)
resource		1..1	PCTOrganization	A grouping of people or organizations with a common purpose
entry:practitioner	S	0..*	BackboneElement	MAY have the provider Practitioner(s)
resource		1..1	PCTPractitioner	A person with a formal responsibility in the provisioning of healthcare or related services
entry:attachment	S	0..*	BackboneElement	MAY have attachments as DocumentReference resource(s)
resource		1..1	DocumentReference	A resource in the bundle
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
pct-gfe-bundle-1	error	Bundle	All GFEs must have the same GFE submitter : (Bundle.entry.resource.ofType(Claim).extension.where(url='http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeSubmitter').valueReference.reference.distinct().count() = 1)
pct-gfe-bundle-2	error	Bundle	SHALL have at least one entry for a payer organization. : entry.resource.ofType(Organization).exists(type.coding.code='pay')
pct-gfe-bundle-3	error	Bundle	All references resources SHALL be contained within the Bundle : Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources pct-gfe-bundle-1: All GFEs must have the same GFE submitter pct-gfe-bundle-2: SHALL have at least one entry for a payer organization. pct-gfe-bundle-3: All references resources SHALL be contained within the Bundle
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
identifier	Σ	1..1	Identifier	Persistent identifier for the bundle
type	Σ	1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Fixed Value: collection
timestamp	Σ	1..1	instant	When the bundle was assembled
Slices for entry	ΣC	4..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
entry:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	Σ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
entry:gfe	ΣC	1..*	BackboneElement	SHALL have one or more PCTGFEProfessional or PCTGFEInstitutional resource(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource		1..1	PCTGFEProfessional, PCTGFEInstitutional	Claim, Pre-determination or Pre-authorization
entry:patient	ΣC	1..2	BackboneElement	SHALL have the patient subject of care and may have a separate subscriber This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	C	1..1	HRexPatientDemographics	Information about an individual or animal receiving health care services
entry:coverage	ΣC	1..1	BackboneElement	SHALL have one Coverage This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	C	1..1	PCTCoverage	Insurance or medical plan or a payment agreement
entry:organization	ΣC	1..*	BackboneElement	SHALL have the payer organization and may have provider organization(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	C	1..1	PCTOrganization	A grouping of people or organizations with a common purpose
entry:practitioner	SΣC	0..*	BackboneElement	MAY have the provider Practitioner(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource		1..1	PCTPractitioner	A person with a formal responsibility in the provisioning of healthcare or related services
entry:attachment	SΣC	0..*	BackboneElement	MAY have attachments as DocumentReference resource(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	Σ	1..1	DocumentReference	A resource in the bundle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Bundle.type	required	Fixed Value: collection
Bundle.entry.request.method	required	HTTPVerb

Constraints

Id	Grade	Path(s)	Details	Requirements
pct-gfe-bundle-1	error	Bundle	All GFEs must have the same GFE submitter : (Bundle.entry.resource.ofType(Claim).extension.where(url='http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeSubmitter').valueReference.reference.distinct().count() = 1)
pct-gfe-bundle-2	error	Bundle	SHALL have at least one entry for a payer organization. : entry.resource.ofType(Organization).exists(type.coding.code='pay')
pct-gfe-bundle-3	error	Bundle	All references resources SHALL be contained within the Bundle : Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources pct-gfe-bundle-1: All GFEs must have the same GFE submitter pct-gfe-bundle-2: SHALL have at least one entry for a payer organization. pct-gfe-bundle-3: All references resources SHALL be contained within the Bundle
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
identifier	Σ	1..1	Identifier	Persistent identifier for the bundle
type	Σ	1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Fixed Value: collection
timestamp	Σ	1..1	instant	When the bundle was assembled
total	ΣC	0..1	unsignedInt	If search, the total number of matches
link	Σ	0..*	BackboneElement	Links related to this Bundle
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
relation	Σ	1..1	string	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
url	Σ	1..1	uri	Reference details for the link
Slices for entry	ΣC	4..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
entry:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	Σ	0..1	Resource	A resource in the bundle
entry:gfe	ΣC	1..*	BackboneElement	SHALL have one or more PCTGFEProfessional or PCTGFEInstitutional resource(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource		1..1	PCTGFEProfessional, PCTGFEInstitutional	Claim, Pre-determination or Pre-authorization
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
entry:patient	ΣC	1..2	BackboneElement	SHALL have the patient subject of care and may have a separate subscriber This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	C	1..1	HRexPatientDemographics	Information about an individual or animal receiving health care services
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
entry:coverage	ΣC	1..1	BackboneElement	SHALL have one Coverage This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	C	1..1	PCTCoverage	Insurance or medical plan or a payment agreement
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
entry:organization	ΣC	1..*	BackboneElement	SHALL have the payer organization and may have provider organization(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	C	1..1	PCTOrganization	A grouping of people or organizations with a common purpose
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
entry:practitioner	SΣC	0..*	BackboneElement	MAY have the provider Practitioner(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource		1..1	PCTPractitioner	A person with a formal responsibility in the provisioning of healthcare or related services
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
entry:attachment	SΣC	0..*	BackboneElement	MAY have attachments as DocumentReference resource(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	Σ	1..1	DocumentReference	A resource in the bundle
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
signature	ΣTU	0..1	Signature	Digital Signature
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Bundle.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Bundle.type	required	Fixed Value: collection
Bundle.entry.search.mode	required	SearchEntryMode
Bundle.entry.request.method	required	HTTPVerb
Bundle.entry:gfe.search.mode	required	SearchEntryMode
Bundle.entry:gfe.request.method	required	HTTPVerb
Bundle.entry:patient.search.mode	required	SearchEntryMode
Bundle.entry:patient.request.method	required	HTTPVerb
Bundle.entry:coverage.search.mode	required	SearchEntryMode
Bundle.entry:coverage.request.method	required	HTTPVerb
Bundle.entry:organization.search.mode	required	SearchEntryMode
Bundle.entry:organization.request.method	required	HTTPVerb
Bundle.entry:practitioner.search.mode	required	SearchEntryMode
Bundle.entry:practitioner.request.method	required	HTTPVerb
Bundle.entry:attachment.search.mode	required	SearchEntryMode
Bundle.entry:attachment.request.method	required	HTTPVerb

This structure is derived from Bundle

Summary

Mandatory: 11 elements (2 nested mandatory elements)
Must-Support: 2 elements
Fixed Value: 1 element
Prohibited: 3 elements

Structures

This structure refers to these other structures:

• PCT Good Faith Estimate Professional (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional)
• HRex Patient Demographics (http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-patient-demographics)
• PCT Coverage (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage)
• PCT Organization (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization)
• PCT Practitioner (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner)

Slices

This structure defines the following Slices:

• The element Bundle.entry is sliced based on the value of type:resource

Differential View

This structure is derived from Bundle

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources pct-gfe-bundle-1: All GFEs must have the same GFE submitter pct-gfe-bundle-2: SHALL have at least one entry for a payer organization. pct-gfe-bundle-3: All references resources SHALL be contained within the Bundle
identifier		1..1	Identifier	Persistent identifier for the bundle
type		1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Fixed Value: collection
timestamp		1..1	instant	When the bundle was assembled
Slices for entry		4..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource
entry:All Slices				Content/Rules for all slices
fullUrl		1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
search		0..0
request		0..0
response		0..0
entry:gfe		1..*	BackboneElement	SHALL have one or more PCTGFEProfessional or PCTGFEInstitutional resource(s)
resource		1..1	PCTGFEProfessional, PCTGFEInstitutional	Claim, Pre-determination or Pre-authorization
entry:patient		1..2	BackboneElement	SHALL have the patient subject of care and may have a separate subscriber
resource		1..1	HRexPatientDemographics	Information about an individual or animal receiving health care services
entry:coverage		1..1	BackboneElement	SHALL have one Coverage
resource		1..1	PCTCoverage	Insurance or medical plan or a payment agreement
entry:organization		1..*	BackboneElement	SHALL have the payer organization and may have provider organization(s)
resource		1..1	PCTOrganization	A grouping of people or organizations with a common purpose
entry:practitioner	S	0..*	BackboneElement	MAY have the provider Practitioner(s)
resource		1..1	PCTPractitioner	A person with a formal responsibility in the provisioning of healthcare or related services
entry:attachment	S	0..*	BackboneElement	MAY have attachments as DocumentReference resource(s)
resource		1..1	DocumentReference	A resource in the bundle
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
pct-gfe-bundle-1	error	Bundle	All GFEs must have the same GFE submitter : (Bundle.entry.resource.ofType(Claim).extension.where(url='http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeSubmitter').valueReference.reference.distinct().count() = 1)
pct-gfe-bundle-2	error	Bundle	SHALL have at least one entry for a payer organization. : entry.resource.ofType(Organization).exists(type.coding.code='pay')
pct-gfe-bundle-3	error	Bundle	All references resources SHALL be contained within the Bundle : Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources pct-gfe-bundle-1: All GFEs must have the same GFE submitter pct-gfe-bundle-2: SHALL have at least one entry for a payer organization. pct-gfe-bundle-3: All references resources SHALL be contained within the Bundle
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
identifier	Σ	1..1	Identifier	Persistent identifier for the bundle
type	Σ	1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Fixed Value: collection
timestamp	Σ	1..1	instant	When the bundle was assembled
Slices for entry	ΣC	4..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
entry:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
fullUrl	Σ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
entry:gfe	ΣC	1..*	BackboneElement	SHALL have one or more PCTGFEProfessional or PCTGFEInstitutional resource(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource		1..1	PCTGFEProfessional, PCTGFEInstitutional	Claim, Pre-determination or Pre-authorization
entry:patient	ΣC	1..2	BackboneElement	SHALL have the patient subject of care and may have a separate subscriber This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	C	1..1	HRexPatientDemographics	Information about an individual or animal receiving health care services
entry:coverage	ΣC	1..1	BackboneElement	SHALL have one Coverage This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	C	1..1	PCTCoverage	Insurance or medical plan or a payment agreement
entry:organization	ΣC	1..*	BackboneElement	SHALL have the payer organization and may have provider organization(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	C	1..1	PCTOrganization	A grouping of people or organizations with a common purpose
entry:practitioner	SΣC	0..*	BackboneElement	MAY have the provider Practitioner(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource		1..1	PCTPractitioner	A person with a formal responsibility in the provisioning of healthcare or related services
entry:attachment	SΣC	0..*	BackboneElement	MAY have attachments as DocumentReference resource(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
resource	Σ	1..1	DocumentReference	A resource in the bundle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Bundle.type	required	Fixed Value: collection
Bundle.entry.request.method	required	HTTPVerb

Constraints

Id	Grade	Path(s)	Details	Requirements
pct-gfe-bundle-1	error	Bundle	All GFEs must have the same GFE submitter : (Bundle.entry.resource.ofType(Claim).extension.where(url='http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeSubmitter').valueReference.reference.distinct().count() = 1)
pct-gfe-bundle-2	error	Bundle	SHALL have at least one entry for a payer organization. : entry.resource.ofType(Organization).exists(type.coding.code='pay')
pct-gfe-bundle-3	error	Bundle	All references resources SHALL be contained within the Bundle : Bundle.entry.resource.descendants().reference.where($this.startsWith('#').not()).all((%resource.entry.fullUrl.join('|')&'|').contains(($this&'|')))

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Bundle	C	0..*	Bundle	Contains a collection of resources pct-gfe-bundle-1: All GFEs must have the same GFE submitter pct-gfe-bundle-2: SHALL have at least one entry for a payer organization. pct-gfe-bundle-3: All references resources SHALL be contained within the Bundle
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
identifier	Σ	1..1	Identifier	Persistent identifier for the bundle
type	Σ	1..1	code	document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used. Fixed Value: collection
timestamp	Σ	1..1	instant	When the bundle was assembled
total	ΣC	0..1	unsignedInt	If search, the total number of matches
link	Σ	0..*	BackboneElement	Links related to this Bundle
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
relation	Σ	1..1	string	See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
url	Σ	1..1	uri	Reference details for the link
Slices for entry	ΣC	4..*	BackboneElement	Entry in the bundle - will have a resource or information Slice: Unordered, Open by type:resource This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
entry:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	1..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	Σ	0..1	Resource	A resource in the bundle
entry:gfe	ΣC	1..*	BackboneElement	SHALL have one or more PCTGFEProfessional or PCTGFEInstitutional resource(s) This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource		1..1	PCTGFEProfessional, PCTGFEInstitutional	Claim, Pre-determination or Pre-authorization
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
entry:patient	ΣC	1..2	BackboneElement	SHALL have the patient subject of care and may have a separate subscriber This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	C	1..1	HRexPatientDemographics	Information about an individual or animal receiving health care services
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request	ΣC	0..1	BackboneElement	Additional execution information (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
method	Σ	1..1	code	GET | HEAD | POST | PUT | DELETE | PATCH Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.
url	Σ	1..1	uri	URL for HTTP equivalent of this entry
ifNoneMatch	Σ	0..1	string	For managing cache currency
ifModifiedSince	Σ	0..1	instant	For managing cache currency
ifMatch	Σ	0..1	string	For managing update contention
ifNoneExist	Σ	0..1	string	For conditional creates
response	ΣC	0..1	BackboneElement	Results of execution (transaction/batch/history)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status	Σ	1..1	string	Status response code (text optional)
location	Σ	0..1	uri	The location (if the operation returns a location)
etag	Σ	0..1	string	The Etag for the resource (if relevant)
lastModified	Σ	0..1	instant	Server's date time modified
outcome	Σ	0..1	Resource	OperationOutcome with hints and warnings (for batch/transaction)
entry:coverage	ΣC	1..1	BackboneElement	SHALL have one Coverage This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
link	Σ	0..*	See link (Bundle)	Links related to this entry
fullUrl	Σ	0..1	uri	URI for resource (Absolute URL server address or URI for UUID/OID)
resource	C	1..1	PCTCoverage	Insurance or medical plan or a payment agreement
search	ΣC	0..1	BackboneElement	Search related information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	Σ	0..1	code	match | include | outcome - why this is in the result set Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.
score	Σ	0..1	decimal	Search ranking (between 0 and 1)
request