Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0 - STU 2.1
Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0 - STU 2.1
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
| Page standards status: Trial-use | Maturity Level: 3 |
Mappings for the profile-claim-inquiry resource profile.
| PASClaimInquiry | ||
| Claim | Request | |
| status | Request.status | |
| patient | Request.subject | |
| created | Request.authoredOn | |
| insurer | Request.performer | |
| provider | Request.requester | |
| priority | Request.priority | |
| related | ||
| claim | Request.replaces | |
| supportingInfo | Request.supportingInfo | |
| supportingInfo (PatientEvent) | Request.supportingInfo | |
| supportingInfo (AdmissionDates) | Request.supportingInfo | |
| supportingInfo (DischargeDates) | Request.supportingInfo | |
| diagnosis | Request.reasonReference | |
| insurance | ||
| identifier | Request.identifier | |
| item | ||
| encounter | Request.context | |
| PASClaimInquiry | ||
| Claim | ||
| status | FiveWs.status | |
| type | FiveWs.class | |
| subType | FiveWs.class | |
| use | FiveWs.class | |
| patient | FiveWs.subject[x], FiveWs.subject | |
| billablePeriod | FiveWs.done[x] | |
| created | FiveWs.recorded | |
| enterer | FiveWs.author | |
| provider | FiveWs.source | |
| referral | FiveWs.cause | |
| facility | FiveWs.where[x] | |
| careTeam | ||
| provider | FiveWs.actor | |
| careTeam (OverallClaimMember) | ||
| provider | FiveWs.actor | |
| careTeam (ItemClaimMember) | ||
| provider | FiveWs.actor | |
| insurance | ||
| identifier | FiveWs.identifier | |
| item | ||
| serviced[x] | FiveWs.done[x] | |
| serviced[x] (servicedDate) | FiveWs.done[x] | |
| serviced[x] (servicedPeriod) | FiveWs.done[x] | |
| location[x] | FiveWs.where[x] | |
| PASClaimInquiry | ||
| Claim | Entity. Role, or Act | |
| text | Act.text? | |
| contained | N/A | |
| modifierExtension | N/A | |
| identifier | n/a, II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] | |
| id | n/a | |
| extension | n/a | |
| use | Role.code or implied by context | |
| type | Role.code or implied by context | |
| system | II.root or Role.id.root | |
| value | II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) | |
| period | Role.effectiveTime or implied by context | |
| assigner | II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper | |
| related | ||
| id | n/a | |
| extension | n/a | |
| modifierExtension | N/A | |
| payee | ||
| id | n/a | |
| extension | n/a | |
| modifierExtension | N/A | |
| careTeam | ||
| id | n/a | |
| extension | ||
| extension (careTeamClaimScope) | ||
| modifierExtension | N/A | |
| careTeam (OverallClaimMember) | ||
| id | n/a | |
| extension | ||
| extension (careTeamClaimScope) | ||
| id | n/a | |
| url | N/A | |
| value[x] | N/A | |
| modifierExtension | N/A | |
| careTeam (ItemClaimMember) | ||
| id | n/a | |
| extension | ||
| extension (careTeamClaimScope) | ||
| id | n/a | |
| url | N/A | |
| value[x] | N/A | |
| modifierExtension | N/A | |
| supportingInfo | ||
| id | n/a | |
| extension | n/a | |
| modifierExtension | N/A | |
| timing[x] | ||
| supportingInfo (PatientEvent) | ||
| id | n/a | |
| extension | n/a | |
| modifierExtension | N/A | |
| timing[x] | ||
| timing[x] (timingDate) | ||
| timing[x] (timingPeriod) | ||
| id | n/a | |
| extension | n/a | |
| start | ./low | |
| end | ./high | |
| supportingInfo (AdmissionDates) | ||
| id | n/a | |
| extension | n/a | |
| modifierExtension | N/A | |
| timing[x] | ||
| timing[x] (timingDate) | ||
| timing[x] (timingPeriod) | ||
| id | n/a | |
| extension | n/a | |
| start | ./low | |
| end | ./high | |
| supportingInfo (DischargeDates) | ||
| id | n/a | |
| extension | n/a | |
| modifierExtension | N/A | |
| timing[x] | ||
| timing[x] (timingDate) | ||
| timing[x] (timingPeriod) | ||
| id | n/a | |
| extension | n/a | |
| start | ./low | |
| end | ./high | |
| diagnosis | ||
| id | n/a | |
| extension | n/a | |
| modifierExtension | N/A | |
| procedure | ||
| id | n/a | |
| extension | n/a | |
| modifierExtension | N/A | |
| insurance | Coverage | |
| id | n/a | |
| extension | n/a | |
| modifierExtension | N/A | |
| accident | ||
| id | n/a | |
| extension | n/a | |
| modifierExtension | N/A | |
| item | ||
| id | n/a | |
| modifierExtension | N/A | |
| serviced[x] | ||
| serviced[x] (servicedDate) | ||
| serviced[x] (servicedPeriod) | ||
| id | n/a | |
| extension | n/a | |
| start | ./low | |
| end | ./high | |
| quantity | n/a, PQ, IVL<PQ>, MO, CO, depending on the values | |
| detail | ||
| id | n/a | |
| extension | n/a | |
| modifierExtension | N/A | |
| subDetail | ||
| id | n/a | |
| extension | n/a | |
| modifierExtension | N/A | |
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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