Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0-preview - STU 2 United States of America flag

This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.1.0-preview: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.1. For a full list of available versions, see the Directory of published versions

Example Bundle: Homecare Authorization Bundle Example

Generated Narrative: Bundle HomecareAuthorizationBundleExample

Bundle HomecareAuthorizationBundleExample of type collection

Entry 1 - fullUrl = http://example.org/fhir/Claim/HomecareAuthorizationExample

Resource Claim:

Generated Narrative: Claim HomecareAuthorizationExample

HomeHealthCareInformation

  • prognosis: 1
  • date: 2005-05-02

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

status: Active

type: Professional

use: Preauthorization

patient: JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)

created: 2019-07-20 11:01:00+0500

insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY

provider: Organization DR. JOE SMITH CORPORATION

priority: Normal

Insurances

-SequenceFocalCoverage
*1trueCoverage: status = active; subscriberId = 1122334455; relationship = Self

item

ServiceItemRequestType: Health Services Review

CertificationType: Initial

sequence: 1

category: Home Health Care

productOrService: G0154

location: 11

item

ServiceItemRequestType: Health Services Review

CertificationType: Initial

sequence: 2

category: Home Health Care

productOrService: B4184

location: 11

Entry 2 - fullUrl = http://example.org/fhir/Organization/UMOExample

Resource Organization:

Generated Narrative: Organization UMOExample

identifier: United States National Provider Identifier/8189991234

active: true

type: X3

name: DR. JOE SMITH CORPORATION

Contacts

-Address
*111 1ST STREET SAN DIEGO CA 92101 US

Entry 3 - fullUrl = http://example.org/fhir/Organization/InsurerExample

Resource Organization:

Generated Narrative: Organization InsurerExample

identifier: United States National Provider Identifier/1234567893

active: true

type: PR

name: MARYLAND CAPITAL INSURANCE COMPANY

Entry 4 - fullUrl = http://example.org/fhir/Coverage/InsuranceExample

Resource Coverage:

Generated Narrative: Coverage InsuranceExample

status: Active

subscriberId: 1122334455

beneficiary: JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)

relationship: Self

Entry 5 - fullUrl = http://example.org/fhir/Patient/SubscriberExample

Resource Patient:

Generated Narrative: Patient SubscriberExample

JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)

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