Da Vinci Prior Authorization Support (PAS) FHIR IG
2.0.1 - STU 2
Da Vinci Prior Authorization Support (PAS) FHIR IG
2.0.1 - STU 2
This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.0.1: 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
| Page standards status: Informative |
Resource Claim "ReferralAuthorizationExample"
Profile: PAS Claim
LevelOfServiceCode: Urgent (1338#U)
identifier: id: 111099
status: active
type: Professional (Claim Type Codes#professional)
use: preauthorization
patient: Patient/SubscriberExample " SMITH"
created: 2005-05-02 11:01:00+0500
insurer: Organization/InsurerExample "MARYLAND CAPITAL INSURANCE COMPANY"
provider: Organization/UMOExample "DR. JOE SMITH CORPORATION"
priority: Normal (Process Priority Codes#normal)
| Extension | Sequence | Provider |
| 1 | PractitionerRole/ReferralPractitionerRoleExample |
| Extension | Sequence | Diagnosis[x] |
| 1 | G89.4 (International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)#G89.4) |
| Sequence | Focal | Coverage |
| 1 | true | Coverage/InsuranceExample |
| Extension | Sequence | CareTeamSequence | DiagnosisSequence | Category | ProductOrService | Location[x] |
| , , , , , , , , , | 1 | 1 | 1 | Consultation (1365#3) | Consultation (1365#3) | 11 (CMS Place of Service Codes (POS)#11) |
IG © 2020+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pas#2.0.1 based on FHIR 4.0.1. Generated 2023-12-01
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