Da Vinci Prior Authorization Support (PAS) FHIR IG
1.2.0-ballot - STU 1.2 US

This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v1.2.0-ballot: STU 1.2 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

Example Claim: Homecare Authorizaion Update Example

Generated Narrative

Resource "HomecareAuthorizationUpdateExample"

Profile: PAS Claim Update

identifier: id: 111099

status: active

type: Professional (Claim Type Codes#professional)

use: preauthorization

patient: Patient/SubscriberExample " SMITH"

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

insurer: Organization/InsurerExample "MARYLAND CAPITAL INSURANCE COMPANY"

provider: Organization/UMOExample "DR. JOE SMITH CORPORATION"

priority: Normal (Process Priority Codes#normal)

Insurances

-SequenceFocalCoverage
*1trueCoverage/InsuranceExample

item

ServiceItemRequestType: Health Services Review (1525#HS)

CertificationType: Initial (1322#I)

sequence: 1

productOrService: G0154 (Current Procedural Terminology (CPT®)#G0154)

item

ServiceItemRequestType: Health Services Review (1525#HS)

CertificationType: Cancel (1322#3)

sequence: 2

productOrService: B4184 (Current Procedural Terminology (CPT®)#B4184)

item

InfoChanged: added

ServiceItemRequestType: Health Services Review (1525#HS)

CertificationType: Initial (1322#I)

sequence: 3

productOrService: B4185 (Current Procedural Terminology (CPT®)#B4185)