Patient Cost Transparency Implementation Guide
2.0.2 - STU 2 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 2.0.2 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

Example Bundle: PCT-GFE-Missing-Bundle-1

Language: en

Profile: PCT GFE Missing Bundle

Bundle PCT-GFE-Missing-Bundle-1 of type collection

Entry 1 - fullUrl = http://example.org/fhir/Organization/org1002

Resource Organization:

Language: en

Profile: PCT Organization

Boston Radiology Center (Healthcare Provider) (http://hl7.org/fhir/sid/us-npi#United States National Provider Identifier#9941339100)

Active:true
Type:Healthcare Provider
Other Id:Tax ID number/TAX-3211001
Contact Detail
  • ph: 781-232-3200(Work)
  • 32 Fruit Street Boston MA 02114 US

Entry 2 - fullUrl = http://example.org/fhir/Patient/patient1001

Resource Patient:

Eve Betterhalf female, DoB: 1955-07-23 ( http://example.com/identifiers/patient/1001)

Marital Status:unmarried
Contact Details:
  • ph: 781-949-4949(MOBILE)
  • 222 Burlington Road, Bedford MA 01730
Language:English (United States) (preferred)

Entry 3 - fullUrl = http://example.org/fhir/Coverage/coverage1001

Resource Coverage:

Language: en

Profile: PCT Coverage

R5: insurance | self-pay | other (new): insurance

status: Active

subscriberId: PFP123450000

beneficiary: Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)

relationship: Self

period: 2021-01-01 --> 2022-01-01

Classes

-TypeValueName
*PlanPremim Family PlusPremim Family Plus Plan

CostToBeneficiaries

-TypeValue[x]
*Copay Percentage20

Entry 4 - fullUrl = http://example.org/fhir/Organization/org1001

Resource Organization:

Language: en

Profile: PCT Organization

Umbrella Insurance Company (Payer) (Electronic Transmitter Identification Number: ETIN-3200002)

Active:true
Type:Payer
Contact Detail
  • ph: 860-547-5001(Work)
  • 680 Asylum Street Hartford CT 06155 US

Entry 5 - fullUrl = http://example.org/fhir/DeviceRequest/PCT-DeviceRequest-1

Resource DeviceRequest:

Language: en

Profile: PCT GFE DeviceRequest

status: Active

intent: Proposal

subject: Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)