Patient Cost Transparency Implementation Guide
2.0.1 - 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 2.0.1 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

## Resource Profile: PCT AEOB Complete

Official URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob-complete | Version: 2.0.1
Standards status: Trial-use | Maturity Level: 2 | Computable Name: AEOBComplete
Other Identifiers: OID:2.16.840.1.113883.4.642.40.4.42.4

OperationOutcome returned from the gfeSubmit operation when the AEOB process is complete but no AEOB will be returned to the submitter (i.e. it was sent only to the patient)

Usages:

- Examples for this Profile: OperationOutcome/PCT-AEOB-Complete-Example-1

You can also check for usages in the FHIR IG Statistics

Changes since version 1.1.0:

- No changes

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
OperationOutcome |  | 0..* | OperationOutcome | Information about the success/failure of an action
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
issue | Σ | 1..* | BackboneElement | A single issue associated with the action
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
severity | Σ | 1..1 | code | fatal | error | warning | information Binding: IssueSeverity (required): How the issue affects the success of the action. Required Pattern: information
code | Σ | 1..1 | code | Error or warning code Binding: IssueType (required): A code that describes the type of issue. Required Pattern: processing
diagnostics | Σ | 0..1 | string | Additional diagnostic information about the issue Required Pattern: AEOB processing is complete, the AEOB will be sent directly to the patient. No AEOB will be returned to the submitter.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
OperationOutcome.issue.​severity | Base | required | IssueSeverity | 📍4.0.1 | FHIR Std.
OperationOutcome.issue.​code | Base | required | IssueType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | OperationOutcome | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | OperationOutcome | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | OperationOutcome | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | OperationOutcome | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | OperationOutcome | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from OperationOutcome

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
OperationOutcome |  | 0..* | OperationOutcome | Information about the success/failure of an action
issue |  |  |  |
severity |  | 1..1 | code | fatal | error | warning | information Required Pattern: information
code |  | 1..1 | code | Error or warning code Required Pattern: processing
diagnostics |  | 0..1 | string | Additional diagnostic information about the issue Required Pattern: AEOB processing is complete, the AEOB will be sent directly to the patient. No AEOB will be returned to the submitter.
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
OperationOutcome |  | 0..* | OperationOutcome | Information about the success/failure of an action
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
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
issue | Σ | 1..* | BackboneElement | A single issue associated with the action
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
severity | Σ | 1..1 | code | fatal | error | warning | information Binding: IssueSeverity (required): How the issue affects the success of the action. Required Pattern: information
code | Σ | 1..1 | code | Error or warning code Binding: IssueType (required): A code that describes the type of issue. Required Pattern: processing
details | Σ | 0..1 | CodeableConcept | Additional details about the error Binding: OperationOutcomeCodes (example): A code that provides details as the exact issue.
diagnostics | Σ | 0..1 | string | Additional diagnostic information about the issue Required Pattern: AEOB processing is complete, the AEOB will be sent directly to the patient. No AEOB will be returned to the submitter.
location | Σ | 0..* | string | Deprecated: Path of element(s) related to issue
expression | Σ | 0..* | string | FHIRPath of element(s) related to issue
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
OperationOutcome.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
OperationOutcome.issue.​severity | Base | required | IssueSeverity | 📍4.0.1 | FHIR Std.
OperationOutcome.issue.​code | Base | required | IssueType | 📍4.0.1 | FHIR Std.
OperationOutcome.issue.​details | Base | example | Operation Outcome Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | OperationOutcome | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | OperationOutcome | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | OperationOutcome | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | OperationOutcome | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | OperationOutcome | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from OperationOutcome

Summary

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
OperationOutcome |  | 0..* | OperationOutcome | Information about the success/failure of an action
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
issue | Σ | 1..* | BackboneElement | A single issue associated with the action
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
severity | Σ | 1..1 | code | fatal | error | warning | information Binding: IssueSeverity (required): How the issue affects the success of the action. Required Pattern: information
code | Σ | 1..1 | code | Error or warning code Binding: IssueType (required): A code that describes the type of issue. Required Pattern: processing
diagnostics | Σ | 0..1 | string | Additional diagnostic information about the issue Required Pattern: AEOB processing is complete, the AEOB will be sent directly to the patient. No AEOB will be returned to the submitter.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
OperationOutcome.issue.​severity | Base | required | IssueSeverity | 📍4.0.1 | FHIR Std.
OperationOutcome.issue.​code | Base | required | IssueType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | OperationOutcome | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | OperationOutcome | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | OperationOutcome | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | OperationOutcome | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | OperationOutcome | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from OperationOutcome

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
OperationOutcome |  | 0..* | OperationOutcome | Information about the success/failure of an action
issue |  |  |  |
severity |  | 1..1 | code | fatal | error | warning | information Required Pattern: information
code |  | 1..1 | code | Error or warning code Required Pattern: processing
diagnostics |  | 0..1 | string | Additional diagnostic information about the issue Required Pattern: AEOB processing is complete, the AEOB will be sent directly to the patient. No AEOB will be returned to the submitter.
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
OperationOutcome |  | 0..* | OperationOutcome | Information about the success/failure of an action
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
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
issue | Σ | 1..* | BackboneElement | A single issue associated with the action
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
severity | Σ | 1..1 | code | fatal | error | warning | information Binding: IssueSeverity (required): How the issue affects the success of the action. Required Pattern: information
code | Σ | 1..1 | code | Error or warning code Binding: IssueType (required): A code that describes the type of issue. Required Pattern: processing
details | Σ | 0..1 | CodeableConcept | Additional details about the error Binding: OperationOutcomeCodes (example): A code that provides details as the exact issue.
diagnostics | Σ | 0..1 | string | Additional diagnostic information about the issue Required Pattern: AEOB processing is complete, the AEOB will be sent directly to the patient. No AEOB will be returned to the submitter.
location | Σ | 0..* | string | Deprecated: Path of element(s) related to issue
expression | Σ | 0..* | string | FHIRPath of element(s) related to issue
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
OperationOutcome.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
OperationOutcome.issue.​severity | Base | required | IssueSeverity | 📍4.0.1 | FHIR Std.
OperationOutcome.issue.​code | Base | required | IssueType | 📍4.0.1 | FHIR Std.
OperationOutcome.issue.​details | Base | example | Operation Outcome Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | OperationOutcome | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | OperationOutcome | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | OperationOutcome | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | OperationOutcome | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | OperationOutcome | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from OperationOutcome

Summary

Maturity: 2

Other representations of profile: CSV, Excel, Schematron