Finance and Insurance Service (FAIS)
1.0.0-current - ci-build
Finance and Insurance Service (FAIS)
1.0.0-current - ci-build
Finance and Insurance Service (FAIS), published by IHE IT Infrastructure Technical Committee. This guide is not an authorized publication; it is the continuous build for version 1.0.0-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/ITI.Finance/ and changes regularly. See the Directory of published versions
| Active as of 2024-07-17 |
{
"resourceType" : "CapabilityStatement",
"id" : "IHE.FAIS.BeneficiaryRequestor",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CapabilityStatement IHE.FAIS.BeneficiaryRequestor</b></p><a name=\"IHE.FAIS.BeneficiaryRequestor\"> </a><a name=\"hcIHE.FAIS.BeneficiaryRequestor\"> </a><a name=\"IHE.FAIS.BeneficiaryRequestor-en-US\"> </a><h2 id=\"title\">IHE FAIS Beneficiary Requestor</h2><ul><li>Implementation Guide Version: 1.0.0-current </li><li>FHIR Version: 4.0.1 </li><li>Supported Formats: <code>application/fhir+xml</code>, <code>application/fhir+json</code></li><li>Supported Patch Formats: </li><li>Published on: 2024-07-17 </li><li>Published by: IHE IT Infrastructure Technical Committee </li></ul><blockquote class=\"impl-note\"><p><strong>Note to Implementers: FHIR Capabilities</strong></p><p>Any FHIR capability may be 'allowed' by the system unless explicitly marked as 'SHALL NOT'. A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.</p></blockquote><h2 id=\"rest\">FHIR RESTful Capabilities</h2><div class=\"panel panel-default\"><div class=\"panel-heading\"><h3 id=\"mode1\" class=\"panel-title\">Mode: <code>client</code></h3></div><div class=\"panel-body\"><div><p>FAIS Beneficiary Requestor provides capability to query insurance plans, submit enrollment requests, and query for enrollment responses.</p>\n</div><div class=\"lead\"><em>Security</em></div><blockquote><div><p>Recommend <a href=\"https://profiles.ihe.net/ITI/TF/Volume1/ch-9.html\">ATNA</a>, encouraged <a href=\"https://profiles.ihe.net/ITI/IUA/index.html\">IHE-IUA</a> or <a href=\"http://www.hl7.org/fhir/smart-app-launch/\">SMART-app-launch</a></p>\n</div></blockquote><div class=\"lead\"><em>Summary of System-wide Interactions</em></div><ul><li><strong>MAY </strong>support the <code>search-system</code>interaction.</li></ul></div></div><h3 id=\"resourcesCap1\">Capabilities by Resource/Profile</h3><h4 id=\"resourcesSummary1\">Summary</h4><p>The summary table lists the resources that are part of this configuration, and for each resource it lists:</p><ul><li>The relevant profiles (if any)</li><li>The interactions supported by each resource (<b><span class=\"bg-info\">R</span></b>ead, <b><span class=\"bg-info\">S</span></b>earch, <b><span class=\"bg-info\">U</span></b>pdate, and <b><span class=\"bg-info\">C</span></b>reate, are always shown, while <b><span class=\"bg-info\">VR</span></b>ead, <b><span class=\"bg-info\">P</span></b>atch, <b><span class=\"bg-info\">D</span></b>elete, <b><span class=\"bg-info\">H</span></b>istory on <b><span class=\"bg-info\">I</span></b>nstance, or <b><span class=\"bg-info\">H</span></b>istory on <b><span class=\"bg-info\">T</span></b>ype are only present if at least one of the resources has support for them.</li><li><span>The required, recommended, and some optional search parameters (if any). </span></li><li>The linked resources enabled for <code>_include</code></li><li>The other resources enabled for <code>_revinclude</code></li><li>The operations on the resource (if any)</li></ul><div class=\"table-responsive\"><table class=\"table table-condensed table-hover\"><thead><tr><th><b>Resource Type</b></th><th><b>Profile</b></th><th class=\"text-center\"><b title=\"GET a resource (read interaction)\">R</b></th><th class=\"text-center\"><b title=\"GET all set of resources of the type (search interaction)\">S</b></th><th class=\"text-center\"><b title=\"PUT a new resource version (update interaction)\">U</b></th><th class=\"text-center\"><b title=\"POST a new resource (create interaction)\">C</b></th><th><b title=\"Required and recommended search parameters\">Searches</b></th><th><code><b>_include</b></code></th><th><code><b>_revinclude</b></code></th><th><b>Operations</b></th></tr></thead><tbody><tr><td><a href=\"#InsurancePlan1-1\">InsurancePlan</a></td><td>Supported Profiles<br/>\u00a0\u00a0<a href=\"StructureDefinition-IHE.FAIS.InsurancePlan.html\">FAIS InsurancePlan Profile</a></td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\"></td><td class=\"text-center\"></td><td>_lastUpdated, _id, status, type, name, identifier, administered-by, owned-by, network, coverage-area, benefit-type</td><td/><td/><td/></tr><tr><td><a href=\"#EnrollmentRequest1-2\">EnrollmentRequest</a></td><td>Supported Profiles<br/>\u00a0\u00a0<a href=\"StructureDefinition-IHE.FAIS.EnrollmentRequest.html\">FAIS EnrollmentRequest Profile</a></td><td class=\"text-center\"></td><td class=\"text-center\"></td><td class=\"text-center\"></td><td class=\"text-center\"></td><td></td><td/><td/><td><code>$submit</code></td></tr><tr><td><a href=\"#EnrollmentResponse1-3\">EnrollmentResponse</a></td><td>Supported Profiles<br/>\u00a0\u00a0<a href=\"StructureDefinition-IHE.FAIS.EnrollmentResponse.html\">FAIS EnrollmentResponse Profile</a></td><td class=\"text-center\">y</td><td class=\"text-center\">y</td><td class=\"text-center\"></td><td class=\"text-center\"></td><td>_lastUpdated, _id, status, request</td><td/><td/><td/></tr></tbody></table></div><hr/><div class=\"panel panel-default\"><div class=\"panel-heading\"><h4 id=\"InsurancePlan1-1\" class=\"panel-title\"><span style=\"float: right;\">Resource Conformance: MAY </span>InsurancePlan</h4></div><div class=\"panel-body\"><div class=\"container\"><div class=\"row\"><div class=\"col-lg-4\"><span class=\"lead\">Core FHIR Resource</span><br/><a href=\"http://hl7.org/fhir/R4/insuranceplan.html\">InsurancePlan</a></div><div class=\"col-lg-4\"><span class=\"lead\">Reference Policy</span><br/></div><div class=\"col-lg-4\"><span class=\"lead\">Interaction summary</span><br/><ul><li><strong>MAY</strong> support <code>read</code>, <code>search-type</code>.</li></ul></div></div><p/><div class=\"row\"><div class=\"col-6\"><span class=\"lead\">Supported Profiles</span><p><a href=\"StructureDefinition-IHE.FAIS.InsurancePlan.html\">FAIS InsurancePlan Profile</a></p></div></div><p/><div class=\"row\"><div class=\"col-12\"><span class=\"lead\">Documentation</span><blockquote><div><p>FAIS Query Insurance Plan transaction <a href=\"ITI-121.html\">[ITI-121]</a></p>\n</div></blockquote></div></div><div class=\"row\"><div class=\"col-lg-7\"><span class=\"lead\">Search Parameters</span><table class=\"table table-condensed table-hover\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>Documentation</th></tr></thead><tbody><tr><td><b>MAY</b></td><td>_lastUpdated</td><td><code>date</code></td><td><div><p>When the resource version last changed. The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb.</p>\n</div></td></tr><tr><td><b>MAY</b></td><td>_id</td><td><code>token</code></td><td><div><p>Logical id of this artifact</p>\n</div></td></tr><tr><td><b>MAY</b></td><td>status</td><td><code>token</code></td><td><div><p>The status of the Insurance Plan</p>\n</div></td></tr><tr><td><b>MAY</b></td><td>type</td><td><code>token</code></td><td><div><p>The type of the Insurance Plan</p>\n</div></td></tr><tr><td><b>MAY</b></td><td>name</td><td><code>string</code></td><td><div><p>The name of the Insurance Plan</p>\n</div></td></tr><tr><td><b>MAY</b></td><td>identifier</td><td><code>token</code></td><td><div><p>The business identifiers of the Insurance Plan</p>\n</div></td></tr><tr><td><b>MAY</b></td><td>administered-by</td><td><code>reference</code></td><td><div><p>Who administers the Insurance Plan</p>\n</div></td></tr><tr><td><b>MAY</b></td><td>owned-by</td><td><code>reference</code></td><td><div><p>Who owns the Insurance Plan</p>\n</div></td></tr><tr><td><b>MAY</b></td><td><a href=\"SearchParameter-InsurancePlan-network.html\">network</a></td><td><code>reference</code></td><td><div><p>The Insurance Plan network</p>\n</div></td></tr><tr><td><b>MAY</b></td><td><a href=\"SearchParameter-InsurancePlan-coverageArea.html\">coverage-area</a></td><td><code>reference</code></td><td><div><p>The Insurance Plan coverage area</p>\n</div></td></tr><tr><td><b>MAY</b></td><td><a href=\"SearchParameter-InsurancePlan-benefitType.html\">benefit-type</a></td><td><code>token</code></td><td><div><p>The Insurance Plan type of benefit</p>\n</div></td></tr></tbody></table></div><div class=\"col-lg-5\">\u00a0</div></div></div></div></div><div class=\"panel panel-default\"><div class=\"panel-heading\"><h4 id=\"EnrollmentRequest1-2\" class=\"panel-title\"><span style=\"float: right;\">Resource Conformance: supported </span>EnrollmentRequest</h4></div><div class=\"panel-body\"><div class=\"container\"><div class=\"row\"><div class=\"col-lg-4\"><span class=\"lead\">Core FHIR Resource</span><br/><a href=\"http://hl7.org/fhir/R4/enrollmentrequest.html\">EnrollmentRequest</a></div><div class=\"col-lg-4\"><span class=\"lead\">Reference Policy</span><br/></div><div class=\"col-lg-4\"><span class=\"lead\">Interaction summary</span><br/><ul/></div></div><p/><div class=\"row\"><div class=\"col-6\"><span class=\"lead\">Supported Profiles</span><p><a href=\"StructureDefinition-IHE.FAIS.EnrollmentRequest.html\">FAIS EnrollmentRequest Profile</a></p></div></div><p/><div class=\"row\"><div class=\"col-12\"><span class=\"lead\">Documentation</span><blockquote><div><p>FAIS Enroll Beneficiary transaction <a href=\"ITI-122.html\">[ITI-122]</a></p>\n</div></blockquote></div></div><div class=\"row\"><div class=\"col-12\"><span class=\"lead\">Extended Operations</span><table class=\"table table-condensed table-hover\"><thead><tr><th>Conformance</th><th>Operation</th><th>Documentation</th></tr></thead><tbody><tr><td><b>SHALL</b></td><td><a href=\"OperationDefinition-IHE.FAIS.EnrollmentRequest.Submit.html\">$submit</a></td><td><div><p>Submits an enrollment request to enroll a new beneficiary with the request coverage. FAIS Enroll Beneficiary transaction <a href=\"ITI-122.html\">[ITI-122]</a></p>\n</div></td></tr></tbody></table></div></div></div></div></div><div class=\"panel panel-default\"><div class=\"panel-heading\"><h4 id=\"EnrollmentResponse1-3\" class=\"panel-title\"><span style=\"float: right;\">Resource Conformance: MAY </span>EnrollmentResponse</h4></div><div class=\"panel-body\"><div class=\"container\"><div class=\"row\"><div class=\"col-lg-4\"><span class=\"lead\">Core FHIR Resource</span><br/><a href=\"http://hl7.org/fhir/R4/enrollmentresponse.html\">EnrollmentResponse</a></div><div class=\"col-lg-4\"><span class=\"lead\">Reference Policy</span><br/></div><div class=\"col-lg-4\"><span class=\"lead\">Interaction summary</span><br/><ul><li><strong>MAY</strong> support <code>read</code>, <code>search-type</code>.</li></ul></div></div><p/><div class=\"row\"><div class=\"col-6\"><span class=\"lead\">Supported Profiles</span><p><a href=\"StructureDefinition-IHE.FAIS.EnrollmentResponse.html\">FAIS EnrollmentResponse Profile</a></p></div></div><p/><div class=\"row\"><div class=\"col-12\"><span class=\"lead\">Documentation</span><blockquote><div><p>FAIS Check Enrollment Status transaction <a href=\"ITI-123.html\">[ITI-123]</a></p>\n</div></blockquote></div></div><div class=\"row\"><div class=\"col-lg-7\"><span class=\"lead\">Search Parameters</span><table class=\"table table-condensed table-hover\"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>Documentation</th></tr></thead><tbody><tr><td><b>MAY</b></td><td>_lastUpdated</td><td><code>date</code></td><td><div><p>When the resource version last changed. The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb.</p>\n</div></td></tr><tr><td><b>MAY</b></td><td>_id</td><td><code>token</code></td><td><div><p>Logical id of this artifact</p>\n</div></td></tr><tr><td><b>MAY</b></td><td>status</td><td><code>token</code></td><td><div><p>The status of the response</p>\n</div></td></tr><tr><td><b>MAY</b></td><td>request</td><td><code>reference</code></td><td><div><p>The enrollment request</p>\n</div></td></tr></tbody></table></div><div class=\"col-lg-5\">\u00a0</div></div></div></div></div></div>"
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"title" : "IHE FAIS Beneficiary Requestor",
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"date" : "2024-07-17",
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"fhirVersion" : "4.0.1",
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"documentation" : "FAIS Beneficiary Requestor provides capability to query insurance plans, submit enrollment requests, and query for enrollment responses.",
"security" : {
"description" : "Recommend [ATNA](https://profiles.ihe.net/ITI/TF/Volume1/ch-9.html), encouraged [IHE-IUA](https://profiles.ihe.net/ITI/IUA/index.html) or [SMART-app-launch](http://www.hl7.org/fhir/smart-app-launch/)"
},
"resource" : [
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🔗 "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.InsurancePlan"
],
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"documentation" : "Who administers the Insurance Plan"
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"name" : "network",
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],
"name" : "benefit-type",
"definition" : "https://profiles.ihe.net/ITI/FAIS/SearchParameter/InsurancePlan-benefitType",
"type" : "token",
"documentation" : "The Insurance Plan type of benefit"
}
]
},
{
"type" : "EnrollmentRequest",
"supportedProfile" : [
🔗 "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.EnrollmentRequest"
],
"documentation" : "FAIS Enroll Beneficiary transaction [[ITI-122]](ITI-122.html)",
"operation" : [
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"name" : "submit",
"definition" : "https://profiles.ihe.net/ITI/FAIS/OperationDefinition/IHE.FAIS.EnrollmentRequest.Submit",
"documentation" : "Submits an enrollment request to enroll a new beneficiary with the request coverage. FAIS Enroll Beneficiary transaction [[ITI-122]](ITI-122.html)"
}
]
},
{
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"supportedProfile" : [
🔗 "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.EnrollmentResponse"
],
"documentation" : "FAIS Check Enrollment Status transaction [[ITI-123]](ITI-123.html)",
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}
IG © 2024+ IHE IT Infrastructure Technical Committee. Package ihe.iti.fais#1.0.0-current based on FHIR 4.0.1. Generated 2024-10-24
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