Da Vinci Health Record Exchange (HRex)
1.1.0-ballot - STU 1.1 Ballot United States of America flag

This page is part of the Da Vinci Health Record Exchange (v1.1.0-ballot: STU 1.1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

Example ClaimResponse: Unsolicited Prior Authorization example

Page standards status: Informative

Generated Narrative: ClaimResponse UnsolicitedReferralAuthorizationResponseExample

identifier: http://example.org/PATIENT_EVENT_TRACE_NUMBER/111099

status: Active

type: Professional

use: Preauthorization

patient: ??

created: 2005-05-02 11:02:00+0500

insurer: Organization New Health Plan

requestor: ??

outcome: Processing Complete

preAuthRef: A1B2C3D4

addItem

itemSequence: 1

productOrService: Consultation

location: 11

Adjudications

-Category
*Submitted Amount