This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.1.0: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
Generated Narrative: Bundle PASSubscriptionNotification
Bundle PASSubscriptionNotification of type history
Entry 1 - fullUrl = http://example.org/Parameters/SubscriptionNotificationParameters
Resource Parameters:
Generated Narrative: Parameters SubscriptionNotificationParameters
Parameters
subscription StructureDefinition PAS Subscription topic http://hl7.org/fhir/us/davinci-pas/SubscriptionTopic/PASSubscriptionTopic|2.1.0 type event-notification notification-event event-number 2 timestamp 2020-05-29 11:44:33-0500 focus Bundle: type = history; timestamp = 2020-05-29 11:44:33-0500
Request:
GET https://example.org/Subscription/PAS/$status
Response:
200
Entry 2 - fullUrl = http://example.org/Bundle/ReferralAuthorizationResponseBundleExample
Resource Bundle:
Generated Narrative: Bundle ReferralAuthorizationResponseBundleExample
Bundle ReferralAuthorizationResponseBundleExample of type collection
Entry 1 - fullUrl = http://example.org/fhir/ClaimResponse/PractitionerRequestorResponseExample
Resource ClaimResponse:
Generated Narrative: ClaimResponse PractitionerRequestorResponseExample
identifier:
http://example.org/PATIENT_EVENT_TRACE_NUMBER
/111099status: Active
type: Professional
use: Preauthorization
patient: JOE SMITH Male, DoB Unknown ( Member Number)
created: 2005-05-02 11:02:00+0500
insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY
requestor: PractitionerRole
outcome: complete
item
ItemRequestedServiceDate: 2005-05-02 --> 2005-06-02
ItemPreAuthIssueDate: 2005-05-02
ItemPreAuthPeriod: 2005-05-02 --> 2005-06-02
ItemAuthorizedProvider
- provider: Practitioner SUSAN WATSON
ItemAuthorizedDetail
- productOrServiceCode: Consultation
- unitPrice: US$100.00 (USD)
- quantity: 1
itemSequence: 1
Adjudications
Extension Category Submitted Amount Entry 2 - fullUrl = http://example.org/fhir/Organization/UMOExample
Resource Organization:
Generated Narrative: Organization UMOExample
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:
Generated Narrative: Organization InsurerExample
identifier: United States National Provider Identifier/1234567893
active: true
type: PR
name: MARYLAND CAPITAL INSURANCE COMPANY
Entry 4 - fullUrl = http://example.org/fhir/Patient/SubscriberExample
Resource Patient:
Generated Narrative: Patient SubscriberExample
JOE SMITH Male, DoB Unknown ( Member Number)
RU Entry 5 - fullUrl = http://example.org/fhir/Practitioner/ReferralPractitionerExample
Resource Practitioner:
Generated Narrative: Practitioner ReferralPractitionerExample
identifier: United States National Provider Identifier/1234567893
name: SUSAN WATSON
telecom: ph: 4029993456
Request:
GET https://example.org/Bundle/ReferralAuthorizationResponseBundleExample
Response:
200