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

Resource Profile: PAS Insurer Organization

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer Version: 1.2.0-ballot
Active as of 2022-02-17 Computable Name: PASInsurer

An organization who provides insurance and is the receiver of a prior authorization request.

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from PASOrganization

Summary

Must-Support: 1 element

This structure is derived from PASOrganization

NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization 0..*PASOrganizationA grouping of people or organizations with a common purpose
... type S0..*CodeableConceptKind of organization
Binding: https://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98 (required): Codes identifying an organizational entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization I0..*PASOrganizationA grouping of people or organizations with a common purpose
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣI0..*PASIdentifierAn identifier intended for computation
Slice: Unordered, Open by pattern:$this
.... identifier:NPI S0..1PASIdentifierAn identifier intended for computation

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:CLIA 0..1PASIdentifierAn identifier intended for computation

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.7
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
... active ?!SΣ1..1booleanWhether the organization's record is still in active use
... type SΣ0..*CodeableConceptKind of organization
Binding: https://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98 (required): Codes identifying an organizational entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


... name SΣI1..1stringName used for the organization
... alias 0..*stringA list of alternate names that the organization is known as, or was known as in the past
... telecom SI0..*ContactPointA contact detail for the organization
... address SI0..*AddressAn address for the organization
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codehome | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... type Σ0..1codepostal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).


Example General: both
.... text Σ0..1stringText representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣ0..4stringStreet name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city SΣ0..1stringName of city, town etc.
Example General: Erewhon
.... district Σ0..1stringDistrict name (aka county)
Example General: Madison
.... state SΣ0..1stringSub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.

.... postalCode SΣ0..1stringUS Zip Codes
Example General: 9132
.... country SΣ0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ0..1PeriodTime period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... partOf Σ0..1Reference(Organization)The organization of which this organization forms a part
... contact 0..*BackboneElementContact for the organization for a certain purpose
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... purpose 0..1CodeableConceptThe type of contact
Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party.

.... name 0..1HumanNameA name associated with the contact
.... telecom 0..*ContactPointContact details (telephone, email, etc.) for a contact
.... address 0..1AddressVisiting or postal addresses for the contact
... endpoint 0..*Reference(Endpoint)Technical endpoints providing access to services operated for the organization

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization I0..*PASOrganizationA grouping of people or organizations with a common purpose
... Slices for identifier ΣI0..*PASIdentifierAn identifier intended for computation
Slice: Unordered, Open by pattern:$this
.... identifier:NPI 0..1PASIdentifierAn identifier intended for computation

Required Pattern: At least the following
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
... active ?!Σ1..1booleanWhether the organization's record is still in active use
... type Σ0..*CodeableConceptKind of organization
Binding: https://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98 (required): Codes identifying an organizational entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


... telecom I0..*ContactPointA contact detail for the organization
... address I0..*AddressAn address for the organization
.... line Σ0..4stringStreet name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
.... city Σ0..1stringName of city, town etc.
.... state Σ0..1stringSub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.

.... postalCode Σ0..1stringUS Zip Codes
.... country Σ0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)

doco Documentation for this format

This structure is derived from PASOrganization

Summary

Must-Support: 1 element

Differential View

This structure is derived from PASOrganization

NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization 0..*PASOrganizationA grouping of people or organizations with a common purpose
... type S0..*CodeableConceptKind of organization
Binding: https://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98 (required): Codes identifying an organizational entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization I0..*PASOrganizationA grouping of people or organizations with a common purpose
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣI0..*PASIdentifierAn identifier intended for computation
Slice: Unordered, Open by pattern:$this
.... identifier:NPI S0..1PASIdentifierAn identifier intended for computation

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:CLIA 0..1PASIdentifierAn identifier intended for computation

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.4.7
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
... active ?!SΣ1..1booleanWhether the organization's record is still in active use
... type SΣ0..*CodeableConceptKind of organization
Binding: https://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98 (required): Codes identifying an organizational entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


... name SΣI1..1stringName used for the organization
... alias 0..*stringA list of alternate names that the organization is known as, or was known as in the past
... telecom SI0..*ContactPointA contact detail for the organization
... address SI0..*AddressAn address for the organization
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ0..1codehome | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


Example General: home
.... type Σ0..1codepostal | physical | both
Binding: AddressType (required): The type of an address (physical / postal).


Example General: both
.... text Σ0..1stringText representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣ0..4stringStreet name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city SΣ0..1stringName of city, town etc.
Example General: Erewhon
.... district Σ0..1stringDistrict name (aka county)
Example General: Madison
.... state SΣ0..1stringSub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.

.... postalCode SΣ0..1stringUS Zip Codes
Example General: 9132
.... country SΣ0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)
.... period Σ0..1PeriodTime period when address was/is in use
Example General: {"start":"2010-03-23","end":"2010-07-01"}
... partOf Σ0..1Reference(Organization)The organization of which this organization forms a part
... contact 0..*BackboneElementContact for the organization for a certain purpose
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... purpose 0..1CodeableConceptThe type of contact
Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party.

.... name 0..1HumanNameA name associated with the contact
.... telecom 0..*ContactPointContact details (telephone, email, etc.) for a contact
.... address 0..1AddressVisiting or postal addresses for the contact
... endpoint 0..*Reference(Endpoint)Technical endpoints providing access to services operated for the organization

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSet
Organization.languagepreferredCommonLanguages
Max Binding: AllLanguages
Organization.typerequiredhttps://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98
Organization.address.userequiredAddressUse
Organization.address.typerequiredAddressType
Organization.address.stateextensibleUspsTwoLetterAlphabeticCodes
Organization.contact.purposeextensibleContactEntityType