PAS Subscriber Patient - Da Vinci Prior Authorization Support (PAS) FHIR IG v2.2.0-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

Resource Profile: PAS Subscriber Patient

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber		Version: 2.2.0-ballot
Standards status: Trial-use	Maturity Level: 3	Computable Name: PASSubscriber
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.73

A patient who is the subscriber of an insurance plan.

Usages:

Refer to this Profile: PAS Coverage
Examples for this Profile: Patient/SubscriberExample

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

Key Elements Table
Differential Table
Snapshot Table
Statistics/References
All

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Patient		0..*	USCorePatientProfile(7.0.0)	Information about an individual or animal receiving health care services This profile also complies with the profiles US Core Patient Profile (3.1.1) and US Core Patient Profile (6.1.0)
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:race	C	0..1	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Race Extension. (multiple races are supported in the extension) URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-race Constraints: us-core-23
extension:ethnicity		0..1	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core ethnicity Extension (multiple ethnicities are supported in the extension) URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity
extension:tribalAffiliation		0..*	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Tribal Affiliation Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation
extension:birthsex		0..1	code	Birth Sex Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex Binding: Birth Sex (required): Code for sex assigned at birth
extension:sex		0..1	code	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Sex Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex Binding: Sex (extensible): Concepts used for general documentation of sex representation
extension:genderIdentity		0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: The individual's gender identity URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity Binding: Gender Identity (extensible)
extension:militaryStatus		0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus Binding: https://valueset.x12.org/x217/005010/request/2010C/INS/1/08/00/584 (required): Codes showing the general employment status of an employee/claimant. 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.
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	1..*	Identifier	An identifier for this patient Slice: Unordered, Open by value:type
identifier:All Slices				Content/Rules for all slices
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
identifier:memberIdentifier	SΣ	1..1	Identifier	An identifier for this patient
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique within the system. Example General: 123456
active	?!Σ	0..1	boolean	Whether this patient's record is in active use
name	SΣC	1..*	HumanName	A name associated with the patient Constraints: us-core-6
use	?!Σ	0..1	code	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: usual \| official \| temp \| nickname \| anonymous \| old \| maiden Binding: NameUse (required): The use of a human name.
family	SΣC	0..1	string	Family name (often called 'Surname')
given	SΣC	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix	SΣ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	SΣ	0..*	string	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
telecom	Σ	0..*	ContactPoint	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: A contact detail for the individual
system	SΣC	1..1	code	phone \| fax \| email \| pager \| url \| sms \| other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	1..1	string	The actual contact point details
use	?!SΣ	0..1	code	home \| work \| temp \| old \| mobile - purpose of this contact point Binding: ContactPointUse (required)
gender	SΣ	1..1	code	male \| female \| other \| unknown Binding: AdministrativeGender (required)
birthDate	SΣC	0..1	date	The date of birth for the individual Constraints: FullDateRule
deceased[x]	?!Σ	0..1		𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Indicates if the individual is deceased or not
deceasedBoolean			boolean
deceasedDateTime			dateTime
address	SΣ	0..*	Address	An address for the individual
use	?!Σ	0..1	code	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: home \| work \| temp \| old \| billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home
line	SΣ	0..*	string	Street 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 Example General: 49 MEADOW ST
city	SΣ	0..1	string	Name of city, town etc. Example General: Erewhon Example General: EVERYTOWN
district	SΣ	0..1	string	District name (aka county) Example General: Madison
state	SΣ	0..1	string	Sub-unit of country (abbreviations ok) Binding: UspsTwoLetterAlphabeticCodes (7.0.0) (extensible): Two Letter USPS alphabetic codes. Example General: OK
postalCode	SΣ	0..1	string	US Zip Codes Example General: 9132 Example General: 74047
country	SΣ	0..1	string	Country (e.g. can be ISO 3166 2 or 3 letter code)
communication		0..*	BackboneElement	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: A language which may be used to communicate with the patient about his or her health
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
language	S	1..1	CodeableConcept	The language which can be used to communicate with the patient about his or her health Binding: LanguageCodesWithLanguageAndOptionallyARegionModifier (7.0.0) (extensible)
link	?!Σ	0..*	BackboneElement	Link to another patient resource that concerns the same actual person
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
other	Σ	1..1	Reference(Patient \| RelatedPerson)	The other patient or related person resource that the link refers to
type	Σ	1..1	code	replaced-by \| replaces \| refer \| seealso Binding: LinkType (required): The type of link between this patient resource and another patient resource.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Patient.identifier.use	required	IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1` From the FHIR Standard
Patient.identifier:memberIdentifier.use	required	IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1` From the FHIR Standard
Patient.identifier:memberIdentifier.type	extensible	Pattern Value: MB `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
Patient.name.use	required	NameUse `http://hl7.org/fhir/ValueSet/name-use\|4.0.1` From the FHIR Standard
Patient.telecom.system	required	ContactPointSystem `http://hl7.org/fhir/ValueSet/contact-point-system` From the FHIR Standard
Patient.telecom.use	required	ContactPointUse `http://hl7.org/fhir/ValueSet/contact-point-use` From the FHIR Standard
Patient.gender	required	AdministrativeGender `http://hl7.org/fhir/ValueSet/administrative-gender` From the FHIR Standard
Patient.address.use	required	AddressUse `http://hl7.org/fhir/ValueSet/address-use\|4.0.1` From the FHIR Standard
Patient.address.state	extensible	UspsTwoLetterAlphabeticCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state\|7.0.0`
Patient.communication.language	extensible	LanguageCodesWithLanguageAndOptionallyARegionModifier `http://hl7.org/fhir/us/core/ValueSet/simple-language\|7.0.0`
Patient.link.type	required	LinkType `http://hl7.org/fhir/ValueSet/link-type\|4.0.1` From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
FullDateRule	error	Patient.birthDate	Dates need to be a full date - YYYY-MM-DD : $this.toString().length() = 10
dom-2	error	Patient	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Patient	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Patient	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Patient	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Patient	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
us-core-6	error	Patient.name	At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present. : (family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()
us-core-23	error	Patient.extension:race	If "ASKU" or "UNK" are present, then no other OMB race categories can be present. : extension.where(url = 'ombCategory').value.where(code in 'ASKU'\|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1

This structure is derived from USCorePatientProfile

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Patient			USCorePatientProfile(7.0.0)	This profile also complies with the profiles US Core Patient Profile (3.1.1) and US Core Patient Profile (6.1.0)
Slices for extension				Content/Rules for all slices
extension:militaryStatus		0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus Binding: https://valueset.x12.org/x217/005010/request/2010C/INS/1/08/00/584 (required): Codes showing the general employment status of an employee/claimant. 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.
Slices for identifier		1..*	Identifier	An identifier for this patient Slice: Unordered, Open by value:type
identifier:memberIdentifier	S	1..1	Identifier	An identifier for this patient
type		1..1	CodeableConcept	Description of identifier Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
name
prefix	S	0..*	string	Parts that come before the name
suffix	S	0..*	string	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Parts that come after the name
birthDate	C	0..1	date	The date of birth for the individual Constraints: FullDateRule
address
district	S	0..1	string	District name (aka county)
country	S	0..1	string	Country (e.g. can be ISO 3166 2 or 3 letter code)
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
FullDateRule	error	Patient.birthDate	Dates need to be a full date - YYYY-MM-DD : $this.toString().length() = 10

Description & Constraints Filter: Filters

Patient

0..*

USCorePatientProfile(7.0.0)

Information about an individual or animal receiving health care services
This profile also complies with the profiles US Core Patient Profile (3.1.1) and US Core Patient Profile (6.1.0)

0..1

Logical id of this artifact