This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

Submit Claim - JSON Representation

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Raw json

{
  "resourceType" : "OperationDefinition",
  "id" : "Claim-submit",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>ClaimSubmit</h2><p>OPERATION: ClaimSubmit</p><p>The official URL for this operation definition is: </p><pre>http://hl7.org/fhir/us/davinci-pas/OperationDefinition/Claim-submit</pre><div><p>Da Vinci Prior Authorization Support This operation is used to submit a Claim, Pre-Authorization or Pre-Determination (all instances of Claim resources) for adjudication either as a single Claim resource instance or as a Bundle containing the Claim and other referenced resources, or Bundle containing a batch of Claim resources, either as single Claims resources or Bundle resources, for processing. The only input parameter is the single Claim or Bundle resource and the only output is a single ClaimResponse, Bundle of ClaimResponses or an OperationOutcome resource.</p>\n</div><p>URL: [base]/Claim/$submit</p><p>Parameters</p><table class=\"grid\"><tr><td><b>Use</b></td><td><b>Name</b></td><td><b>Cardinality</b></td><td><b>Type</b></td><td><b>Binding</b></td><td><b>Documentation</b></td></tr><tr><td>IN</td><td>resource</td><td>1..1</td><td><a href=\"http://hl7.org/fhir/R4/bundle.html\">Bundle</a></td><td/><td><div><p>A Claim resource or Bundle of claims, either as individual Claim resources or as Bundles each containing a single Claim plus referenced resources.</p>\n</div></td></tr><tr><td>OUT</td><td>return</td><td>1..1</td><td><a href=\"http://hl7.org/fhir/R4/bundle.html\">Bundle</a></td><td/><td><div><p>A ClaimResponse resource or Bundle of claim responses, either as individual ClaimResponse resources or as Bundles each containing a single ClaimResponse plus referenced resources.</p>\n</div></td></tr></table></div>"
  },
  "url" : "http://hl7.org/fhir/us/davinci-pas/OperationDefinition/Claim-submit",
  "version" : "0.1.0",
  "name" : "ClaimSubmit",
  "title" : "Submit a Claim resource for adjudication",
  "status" : "draft",
  "kind" : "operation",
  "date" : "2019-08-05T11:50:42-04:00",
  "description" : "Da Vinci Prior Authorization Support This operation is used to submit a Claim, Pre-Authorization or Pre-Determination (all instances of Claim resources) for adjudication either as a single Claim resource instance or as a Bundle containing the Claim and other referenced resources, or Bundle containing a batch of Claim resources, either as single Claims resources or Bundle resources, for processing. The only input parameter is the single Claim or Bundle resource and the only output is a single ClaimResponse, Bundle of ClaimResponses or an OperationOutcome resource.",
  "code" : "submit",
  "base" : "http://hl7.org/fhir/OperationDefinition/Claim-submit",
  "resource" : [
    "Claim"
  ],
  "system" : false,
  "type" : true,
  "instance" : false,
  "parameter" : [
    {
      "name" : "resource",
      "use" : "in",
      "min" : 1,
      "max" : "1",
      "documentation" : "A Claim resource or Bundle of claims, either as individual Claim resources or as Bundles each containing a single Claim plus referenced resources.",
      "type" : "Bundle"
    },
    {
      "name" : "return",
      "use" : "out",
      "min" : 1,
      "max" : "1",
      "documentation" : "A ClaimResponse resource or Bundle of claim responses, either as individual ClaimResponse resources or as Bundles each containing a single ClaimResponse plus referenced resources.",
      "type" : "Bundle"
    }
  ]
}