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 in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
@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:Bundle ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "PASSubscriptionNotification"] ; #
fhir:type [ fhir:v "history"] ; #
fhir:timestamp [ fhir:v "2020-05-29T11:44:33.188-05:00"^^xsd:dateTime] ; #
fhir:entry ( [
fhir:fullUrl [ fhir:v "http://example.org/Parameters/SubscriptionNotificationParameters"^^xsd:anyURI ] ;
( fhir:resource <http://example.org/Parameters/SubscriptionNotificationParameters> ) ;
fhir:request [
fhir:method [ fhir:v "GET" ] ;
fhir:url [ fhir:v "https://example.org/Subscription/PAS/$status"^^xsd:anyURI ] ] ;
fhir:response [
fhir:status [ fhir:v "200" ] ]
] [
fhir:fullUrl [ fhir:v "http://example.org/Bundle/ReferralAuthorizationResponseBundleExample"^^xsd:anyURI ] ;
( fhir:resource <http://example.org/Bundle/ReferralAuthorizationResponseBundleExample> ) ;
fhir:request [
fhir:method [ fhir:v "GET" ] ;
fhir:url [ fhir:v "https://example.org/Bundle/ReferralAuthorizationResponseBundleExample"^^xsd:anyURI ] ] ;
fhir:response [
fhir:status [ fhir:v "200" ] ]
] ) . #
<http://example.org/Parameters/SubscriptionNotificationParameters> a fhir:Parameters ;
fhir:id [ fhir:v "SubscriptionNotificationParameters"] ; #
fhir:parameter ( [
fhir:name [ fhir:v "subscription" ] ;
fhir:value [
a fhir:Reference ;
fhir:reference [ fhir:v "StructureDefinition/profile-subscription" ] ]
] [
fhir:name [ fhir:v "topic" ] ;
fhir:value [
fhir:v "http://hl7.org/fhir/us/davinci-pas/SubscriptionTopic/PASSubscriptionTopic|2.1.0"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/SubscriptionTopic/PASSubscriptionTopic|2.1.0> ]
] [
fhir:name [ fhir:v "type" ] ;
fhir:value [ fhir:v "event-notification" ]
] [
fhir:name [ fhir:v "notification-event" ] ;
( fhir:part [
fhir:name [ fhir:v "event-number" ] ;
fhir:value [ fhir:v "2" ] ] [
fhir:name [ fhir:v "timestamp" ] ;
fhir:value [ fhir:v "2020-05-29T11:44:33.188-05:00"^^xsd:dateTime ] ] [
fhir:name [ fhir:v "focus" ] ;
fhir:value [
a fhir:Reference ;
fhir:link <http://example.org/Bundle/ReferralAuthorizationResponseBundleExample> ;
fhir:reference [ fhir:v "http://example.org/Bundle/ReferralAuthorizationResponseBundleExample" ] ] ] )
] ) . #
<http://example.org/Bundle/ReferralAuthorizationResponseBundleExample> a fhir:Bundle ;
fhir:id [ fhir:v "ReferralAuthorizationResponseBundleExample"] ; #
fhir:meta [
( fhir:profile [
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:type [ fhir:v "collection"] ; #
fhir:timestamp [ fhir:v "2005-05-02T11:02:00+05:00"^^xsd:dateTime] ; #
fhir:entry ( [
fhir:fullUrl [ fhir:v "http://example.org/fhir/ClaimResponse/PractitionerRequestorResponseExample"^^xsd:anyURI ] ;
( fhir:resource <http://example.org/fhir/ClaimResponse/PractitionerRequestorResponseExample> )
] [
fhir:fullUrl [ fhir:v "http://example.org/fhir/Organization/UMOExample"^^xsd:anyURI ] ;
( fhir:resource <http://example.org/fhir/Organization/UMOExample> )
] [
fhir:fullUrl [ fhir:v "http://example.org/fhir/Organization/InsurerExample"^^xsd:anyURI ] ;
( fhir:resource <http://example.org/fhir/Organization/InsurerExample> )
] [
fhir:fullUrl [ fhir:v "http://example.org/fhir/Patient/SubscriberExample"^^xsd:anyURI ] ;
( fhir:resource <http://example.org/fhir/Patient/SubscriberExample> )
] [
fhir:fullUrl [ fhir:v "http://example.org/fhir/Practitioner/ReferralPractitionerExample"^^xsd:anyURI ] ;
( fhir:resource <http://example.org/fhir/Practitioner/ReferralPractitionerExample> )
] ) . #
<http://example.org/fhir/ClaimResponse/PractitionerRequestorResponseExample> a fhir:ClaimResponse ;
fhir:id [ fhir:v "PractitionerRequestorResponseExample"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse> ] )
] ; #
fhir:identifier ( [
fhir:system [ fhir:v "http://example.org/PATIENT_EVENT_TRACE_NUMBER"^^xsd:anyURI ] ;
fhir:value [ fhir:v "111099" ] ;
fhir:assigner [
fhir:identifier [
fhir:system [ fhir:v "http://example.org/USER_ASSIGNED"^^xsd:anyURI ] ;
fhir:value [ fhir:v "9012345678" ] ] ]
] ) ; #
fhir:status [ fhir:v "active"] ; #
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "professional" ] ] )
] ; #
fhir:use [ fhir:v "preauthorization"] ; #
fhir:patient [
fhir:reference [ fhir:v "Patient/SubscriberExample" ]
] ; #
fhir:created [ fhir:v "2005-05-02T11:02:00+05:00"^^xsd:dateTime] ; #
fhir:insurer [
fhir:reference [ fhir:v "Organization/InsurerExample" ]
] ; #
fhir:requestor [
fhir:reference [ fhir:v "PractitionerRole/ReferralPractitionerRoleExample" ]
] ; #
fhir:request [
fhir:reference [ fhir:v "Claim/ReferralAuthorizationExample" ]
] ; #
fhir:outcome [ fhir:v "complete"] ; #
fhir:item ( [
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemRequestedServiceDate"^^xsd:anyURI ] ;
fhir:value [
a fhir:Period ;
fhir:start [ fhir:v "2005-05-02"^^xsd:date ] ;
fhir:end [ fhir:v "2005-06-02"^^xsd:date ] ] ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate"^^xsd:anyURI ] ;
fhir:value [ fhir:v "2005-05-02"^^xsd:date ] ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod"^^xsd:anyURI ] ;
fhir:value [
a fhir:Period ;
fhir:start [ fhir:v "2005-05-02"^^xsd:date ] ;
fhir:end [ fhir:v "2005-06-02"^^xsd:date ] ] ] [
( fhir:extension [
fhir:url [ fhir:v "provider"^^xsd:anyURI ] ;
fhir:value [
a fhir:Reference ;
fhir:reference [ fhir:v "Practitioner/ReferralPractitionerExample" ] ] ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider"^^xsd:anyURI ] ] [
( fhir:extension [
fhir:url [ fhir:v "productOrServiceCode"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/1365"^^xsd:anyURI ] ;
fhir:code [ fhir:v "3" ] ;
fhir:display [ fhir:v "Consultation" ] ] ) ] ] [
fhir:url [ fhir:v "unitPrice"^^xsd:anyURI ] ;
fhir:value [
a fhir:Money ;
fhir:value [ fhir:v "100"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ] ] ] [
fhir:url [ fhir:v "quantity"^^xsd:anyURI ] ;
fhir:value [
a fhir:Quantity ;
fhir:value [ fhir:v "1"^^xsd:decimal ] ] ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail"^^xsd:anyURI ] ] ) ;
fhir:itemSequence [ fhir:v "1"^^xsd:positiveInteger ] ;
( fhir:adjudication [
( fhir:extension [
( fhir:extension [
fhir:url [ fhir:v "number"^^xsd:anyURI ] ;
fhir:value [ fhir:v "AUTH0001" ] ] [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/306"^^xsd:anyURI ] ;
fhir:code [ fhir:v "A1" ] ;
fhir:display [ fhir:v "Certified in total" ] ] ) ] ] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction"^^xsd:anyURI ] ] ) ;
fhir:category [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ;
fhir:code [ fhir:v "submitted" ] ] ) ] ] )
] ) . #
<http://example.org/fhir/Organization/UMOExample> a fhir:Organization ;
fhir:id [ fhir:v "UMOExample"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor> ] )
] ; #
fhir:identifier ( [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "8189991234" ]
] ) ; #
fhir:active [ fhir:v "true"^^xsd:boolean] ; #
fhir:type ( [
( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/98"^^xsd:anyURI ] ;
fhir:code [ fhir:v "X3" ] ] )
] ) ; #
fhir:name [ fhir:v "DR. JOE SMITH CORPORATION"] ; #
fhir:address ( [
( fhir:line [ fhir:v "111 1ST STREET" ] ) ;
fhir:city [ fhir:v "SAN DIEGO" ] ;
fhir:state [ fhir:v "CA" ] ;
fhir:postalCode [ fhir:v "92101" ] ;
fhir:country [ fhir:v "US" ]
] ) . #
<http://example.org/fhir/Organization/InsurerExample> a fhir:Organization ;
fhir:id [ fhir:v "InsurerExample"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer> ] )
] ; #
fhir:identifier ( [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1234567893" ]
] ) ; #
fhir:active [ fhir:v "true"^^xsd:boolean] ; #
fhir:type ( [
( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/98"^^xsd:anyURI ] ;
fhir:code [ fhir:v "PR" ] ] )
] ) ; #
fhir:name [ fhir:v "MARYLAND CAPITAL INSURANCE COMPANY"] . #
<http://example.org/fhir/Patient/SubscriberExample> a fhir:Patient ;
fhir:id [ fhir:v "SubscriberExample"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber> ] )
] ; #
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/584"^^xsd:anyURI ] ;
fhir:code [ fhir:v "RU" ] ] ) ]
] ) ; #
fhir:identifier ( [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ] ] ) ] ;
fhir:system [ fhir:v "http://example.org/MIN"^^xsd:anyURI ] ;
fhir:value [ fhir:v "12345678901" ]
] ) ; #
fhir:name ( [
fhir:family [ fhir:v "SMITH" ] ;
( fhir:given [ fhir:v "JOE" ] )
] ) ; #
fhir:gender [ fhir:v "male"] . #
<http://example.org/fhir/Practitioner/ReferralPractitionerExample> a fhir:Practitioner ;
fhir:id [ fhir:v "ReferralPractitionerExample"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner> ] )
] ; #
fhir:identifier ( [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1234567893" ]
] ) ; #
fhir:name ( [
fhir:family [ fhir:v "WATSON" ] ;
( fhir:given [ fhir:v "SUSAN" ] )
] ) ; #
fhir:telecom ( [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "4029993456" ]
] ) . #
IG © 2020+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pas#2.1.0 based on FHIR 4.0.1. Generated 2024-12-20
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