Da Vinci Health Record Exchange (HRex)
1.0.0 - STU R1 US

This page is part of the Da Vinci Health Record Exchange (v1.0.0: STU1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: $member-match payer example request - JSON Representation

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{
  "resourceType" : "Parameters",
  "id" : "member-match-in",
  "parameter" : [
    {
      "name" : "MemberPatient",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "1",
        "identifier" : [
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "MB"
                }
              ]
            },
            "system" : "http://example.org/old-payer/identifiers/member",
            "value" : "55678",
            "assigner" : {
              "display" : "Old Payer"
            }
          }
        ],
        "name" : [
          {
            "use" : "official",
            "family" : "Person",
            "given" : [
              "Patricia",
              "Ann"
            ]
          }
        ],
        "gender" : "female",
        "birthDate" : "1974-12-25"
      }
    },
    {
      "name" : "CoverageToMatch",
      "resource" : {
        "resourceType" : "Coverage",
        "id" : "9876B1",
        "identifier" : [
          {
            "system" : "http://example.org/old-payer",
            "value" : "DH10001235"
          }
        ],
        "status" : "draft",
        "beneficiary" : {
          "reference" : "Patient/1"
        },
        "period" : {
          "start" : "2011-05-23",
          "end" : "2012-05-23"
        },
        "payor" : [
          {
            "identifier" : {
              "system" : "http://hl7.org/fhir/sid/us-npi",
              "value" : "9876543210"
            },
            "display" : "Old Health Plan"
          }
        ],
        "class" : [
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "group"
                }
              ]
            },
            "value" : "CB135"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "plan"
                }
              ]
            },
            "value" : "B37FC"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "subplan"
                }
              ]
            },
            "value" : "P7"
          },
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code" : "class"
                }
              ]
            },
            "value" : "SILVER"
          }
        ]
      }
    },
    {
      "name" : "CoverageToLink",
      "resource" : {
        "resourceType" : "Coverage",
        "id" : "AA87654",
        "identifier" : [
          {
            "system" : "http://example.org/new-payer/identifiers/coverage",
            "value" : "234567"
          }
        ],
        "status" : "active",
        "beneficiary" : {
          "reference" : "Patient/1"
        },
        "payor" : [
          {
            "identifier" : {
              "system" : "http://hl7.org/fhir/sid/us-npi",
              "value" : "0123456789"
            },
            "display" : "New Health Plan"
          }
        ]
      }
    },
    {
      "name" : "Consent",
      "resource" : {
        "resourceType" : "Consent",
        "status" : "active",
        "scope" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/consentscope",
              "code" : "patient-privacy"
            }
          ]
        },
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                "code" : "IDSCL"
              }
            ]
          }
        ],
        "patient" : {
          "reference" : "Patient/1"
        },
        "performer" : [
          {
            "reference" : "Patient/1"
          }
        ],
        "sourceReference" : {
          "reference" : "http://example.org/DocumentReference/someconsent.pdf"
        },
        "policy" : [
          {
            "uri" : "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition-hrex-consent.html#regular"
          }
        ],
        "provision" : {
          "type" : "permit",
          "period" : {
            "start" : "2022-01-01",
            "end" : "2022-01-31"
          },
          "actor" : [
            {
              "role" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/provenance-participant-type",
                    "code" : "performer"
                  }
                ]
              },
              "reference" : {
                "identifier" : {
                  "system" : "http://hl7.org/fhir/sid/us-npi",
                  "value" : "9876543210"
                },
                "display" : "Old Health Plan"
              }
            },
            {
              "role" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/v3-ParticipationType",
                    "code" : "IRCP"
                  }
                ]
              },
              "reference" : {
                "identifier" : {
                  "system" : "http://hl7.org/fhir/sid/us-npi",
                  "value" : "0123456789"
                },
                "display" : "New Health Plan"
              }
            }
          ],
          "action" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/consentaction",
                  "code" : "disclose"
                }
              ]
            }
          ]
        }
      }
    }
  ]
}