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 - XML Representation

Raw xml | Download



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