Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-ballot - STU 2.2 - Ballot
Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-ballot - STU 2.2 - Ballot
This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.2.0-ballot: STU 2 Ballot) based on FHIR (HL7® FHIR® Standard) R4. This version is a pre-release. The current official version is 2.1.0. For a full list of available versions, see the Directory of published versions
Profile: PAS Request Bundle
Bundle HomecareAuthorizationUpdateBundleExample of type collection
Entry 1 - fullUrl = http://example.org/fhir/Claim/HomecareAuthorizationUpdateExample
Resource Claim:
Profile: PAS Claim Update
identifier:
http://example.org/PATIENT_EVENT_TRACE_NUMBER/111099-UPDATEstatus: Active
type: Professional
use: Preauthorization
patient: JOE SMITH Male, DoB Unknown ( Member Number)
created: 2019-07-20 11:01:00+0500
insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY
provider: Organization DR. JOE SMITH CORPORATION
priority: Normal
Relateds
Insurances
Sequence Focal Coverage 1 true Coverage: status = active; subscriberId = 1122334455; relationship = Self item
ServiceItemRequestType: Health Services Review
CertificationType: Initial
sequence: 1
category: Home Health Care
productOrService: G0154
location: Office
item
ServiceItemRequestType: Health Services Review
CertificationType: Cancel
InfoCancelledFlag: true
sequence: 2
category: Home Health Care
productOrService: B4184
location: Office
item
ServiceItemRequestType: Health Services Review
CertificationType: Initial
InfoChanged: added
sequence: 3
category: Home Health Care
productOrService: B4185
location: Office
Entry 2 - fullUrl = http://example.org/fhir/Organization/UMOExample
Resource Organization:
Profile: PAS Requestor Organization
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:
Profile: PAS Insurer Organization
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:
Profile: PAS Coverage
status: Active
subscriberId: 1122334455
beneficiary: JOE SMITH Male, DoB Unknown ( Member Number)
relationship: Self
Entry 5 - fullUrl = http://example.org/fhir/Patient/SubscriberExample
Resource Patient:
Profile: PAS Subscriber Patient
JOE SMITH Male, DoB Unknown ( Member Number)
RU
Entry 6 - fullUrl = http://example.org/fhir/Claim/HomecareAuthorizationExample
Resource Claim:
Profile: PAS Claim
HomeHealthCareInformation
- prognosis: 1
- date: 2005-05-02
identifier:
http://example.org/PATIENT_EVENT_TRACE_NUMBER/111099status: Active
type: Professional
use: Preauthorization
patient: JOE SMITH Male, DoB Unknown ( Member Number)
created: 2019-07-20 11:01:00+0500
insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY
provider: Organization DR. JOE SMITH CORPORATION
priority: Normal
Insurances
Sequence Focal Coverage 1 true Coverage: status = active; subscriberId = 1122334455; relationship = Self item
ServiceItemRequestType: Health Services Review
CertificationType: Initial
sequence: 1
category: Home Health Care
productOrService: G0154
location: Office
item
ServiceItemRequestType: Health Services Review
CertificationType: Initial
sequence: 2
category: Home Health Care
productOrService: B4184
location: Office
IG © 2020+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pas#2.2.0-ballot based on FHIR 4.0.1. Generated 2025-07-30
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