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
: Submit a Claim resource for adjudication - TTL Representation
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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:OperationDefinition ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "Claim-submit"] ; #
fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>URL: [base]/Claim/$submit</p><p>Input parameters Profile: <a href=\"StructureDefinition-profile-pas-request-bundle.html\">PAS Request Bundle</a></p><p>Output parameters Profile: <a href=\"StructureDefinition-profile-pas-response-bundle.html\">PAS Response Bundle</a></p><p>Parameters</p><table class=\"grid\"><tr><td><b>Use</b></td><td><b>Name</b></td><td><b>Scope</b></td><td><b>Cardinality</b></td><td><b>Type</b></td><td><b>Binding</b></td><td><b>Documentation</b></td></tr><tr><td>IN</td><td>resource</td><td/><td>1..1</td><td><a href=\"http://hl7.org/fhir/R4/bundle.html\">Bundle</a></td><td/><td><div><p>A Bundle containing a single Claim plus referenced resources.</p>\n</div></td></tr><tr><td>OUT</td><td>return</td><td/><td>1..1</td><td><a href=\"http://hl7.org/fhir/R4/bundle.html\">Bundle</a></td><td/><td><div><p>A Bundle containing a single ClaimResponse plus referenced resources.</p>\n</div></td></tr></table></div>"
] ; #
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ] ;
fhir:value [ fhir:v "fm" ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"^^xsd:anyURI ] ;
fhir:value [
fhir:v "3"^^xsd:integer ;
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ] ;
fhir:value [
fhir:v "http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas> ] ] ) ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ] ;
fhir:value [
fhir:v "trial-use" ;
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ] ;
fhir:value [
fhir:v "http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/ImplementationGuide/hl7.fhir.us.davinci-pas> ] ] ) ]
] ) ; #
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/OperationDefinition/Claim-submit"^^xsd:anyURI] ; #
fhir:version [ fhir:v "2.0.1"] ; #
fhir:name [ fhir:v "ClaimSubmit"] ; #
fhir:title [ fhir:v "Submit a Claim resource for adjudication"] ; #
fhir:status [ fhir:v "draft"] ; #
fhir:kind [ fhir:v "operation"] ; #
fhir:date [ fhir:v "2023-12-01T21:19:45+00:00"^^xsd:dateTime] ; #
fhir:publisher [ fhir:v "HL7 International / Financial Management"] ; #
fhir:contact ( [
fhir:name [ fhir:v "HL7 International / Financial Management" ] ;
( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://hl7.org/Special/committees/fm" ] ] [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "fmlists@lists.hl7.org" ] ] )
] [
fhir:name [ fhir:v "Jean Duteau" ] ;
( fhir:telecom [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "mailto:jean@duteaudesign.com" ] ] )
] [
fhir:name [ fhir:v "HL7 International / Financial Management" ] ;
( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fm" ] ] )
] ) ; #
fhir:description [ fhir:v "This operation is used to submit a Pre-Authorization Claim Request for adjudication as a Bundle containing the PASClaimRequest and other referenced resources for processing. The only input parameter is the single Bundle resource with a PASClaimRequest instance (along with other referenced resources) and the only output is a single Bundle with a PASClaimResponse (and other referenced resources) or an OperationOutcome resource. This is a variant of the FHIR Core Claim $submit operation."] ; #
fhir:jurisdiction ( [
( fhir:coding [
fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ] ;
fhir:code [ fhir:v "US" ] ;
fhir:display [ fhir:v "United States of America" ] ] )
] ) ; #
fhir:code [ fhir:v "submit"] ; #
fhir:base [
fhir:v "http://hl7.org/fhir/OperationDefinition/Claim-submit"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/OperationDefinition/Claim-submit>
] ; #
fhir:resource ( [ fhir:v "Claim"] ) ; #
fhir:system [ fhir:v "false"^^xsd:boolean] ; #
fhir:type [ fhir:v "true"^^xsd:boolean] ; #
fhir:instance [ fhir:v "false"^^xsd:boolean] ; #
fhir:inputProfile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle>
] ; #
fhir:outputProfile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle>
] ; #
fhir:parameter ( [
fhir:name [ fhir:v "resource" ] ;
fhir:use [ fhir:v "in" ] ;
fhir:min [ fhir:v "1"^^xsd:integer ] ;
fhir:max [ fhir:v "1" ] ;
fhir:documentation [ fhir:v "A Bundle containing a single Claim plus referenced resources." ] ;
fhir:type [ fhir:v "Bundle" ]
] [
fhir:name [ fhir:v "return" ] ;
fhir:use [ fhir:v "out" ] ;
fhir:min [ fhir:v "1"^^xsd:integer ] ;
fhir:max [ fhir:v "1" ] ;
fhir:documentation [ fhir:v "A Bundle containing a single ClaimResponse plus referenced resources." ] ;
fhir:type [ fhir:v "Bundle" ]
] ) . #
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