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

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

Example Parameters: $member-match payer example request

This sample shows the three parameter values passed into the $member-match operation. At minimum, the Patient must have an identifier, name, and gender. The identifier will be the member number as known by the requesting organization. Both the old and new coverage identify the Patient as the beneficiary via a local reference. In both coverages, the organization information is conveyed as a 'contained' resource - indicating that it is maintained as part of the coverage.

Generated Narrative: Parameters member-match-in

Parameters

MemberPatient

Patient/1

Generated Narrative: Patient 1

Patricia Ann Person (official) Female, DoB: 1974-12-25

CoverageToMatch

Coverage/9876B1

Generated Narrative: Coverage 9876B1

identifier: Member Number/DH10001235

status: Draft

beneficiary: ??

relationship: Unknown

period: 2011-05-23 --> 2012-05-23

payor: Old Health Plan (Identifier: NPI/9876543210)

class

type: Group

value: CB135

class

type: Plan

value: B37FC

class

type: SubPlan

value: P7

class

type: Class

value: SILVER

CoverageToLink

Coverage/AA87654

Generated Narrative: Coverage AA87654

identifier: Member Number/234567

status: Active

beneficiary: ??

relationship: Unknown

payor: New Health Plan (Identifier: NPI/0123456789)

Consent

Consent/null

Generated Narrative: Consent

status: Active

scope: Privacy Consent

category: information disclosure

patient: ??

performer: ??

source: ??

Policies

-Uri
*http://hl7.org/fhir/us/davinci-hrex/StructureDefinition-hrex-consent.html#regular

provision

type: Opt In

period: 2022-01-01 --> 2022-01-31

actor

role: Performer

reference: Old Health Plan (Identifier: NPI/9876543210)

actor

role: information recipient

reference: New Health Plan (Identifier: NPI/0123456789)

action: Disclose