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
Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/PASMetricData | Version: 2.1.0 | |||
Standards status: Informative | Maturity Level: 1 | Computable Name: PASMetricData | ||
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.1 |
A logical model describing the information that should be captured by PAS implementers about every PAS invocation to support measures evaluating PAS implementation
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Base
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
PASMetricData | 0..* | Base | PAS Metric Data Instances of this logical model are not marked to be the target of a Reference | |
source | 1..1 | code | provider | intermediary | payer Binding: Metric Data Source (required) | |
providerId | 1..1 | Identifier | User invoking hook | |
system | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi | |
value | 1..1 | string | The value that is unique | |
groupId | 1..1 | Identifier | Healthcare org of user | |
system | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi | |
value | 1..1 | string | The value that is unique | |
payerId | 1..1 | Identifier | Payer receiving hook | |
system | 1..1 | uri | The namespace for the identifier value | |
value | 1..1 | string | The value that is unique | |
exchange | 1..* | BackboneElement | Prior Authorization Exchanges | |
type | 1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer | |
with | 0..1 | code | provider | intermediary | payer | |
method | 1..1 | code | x12 | restful | ihe | direct | other | |
requestTime | 1..1 | instant | Time exchange initiated | |
responseTime | 0..1 | instant | Time of exchange response | |
httpResponse | 1..1 | code | e.g. 200 | |
issue | 0..* | BackboneElement | OperationOutcome info | |
code | 1..1 | code | Error code Binding: IssueType (required) | |
details | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example) | |
aaaCodes | 0..* | BackboneElement | AAA codes returned | |
loopID | 1..1 | code | see X12 loop IDs | |
aaaCode | 1..1 | code | approved | modified | denied | |
itemDetail | 0..* | BackboneElement | Service level item detail | |
trn | 0..1 | integer | Service Level TRN | |
item | 1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC | |
assertionId | 0..1 | string | Unique ID for order item | |
initialSubmissionTime | 0..1 | dateTime | Date/time of the initial submission of the item | |
finalResponseTime | 0..1 | dateTime | Date/time of final result | |
responsesRequired | 0..1 | integer | Number of responses | |
aaaCodes | 0..* | BackboneElement | AAA codes returned | |
loopID | 1..1 | code | see X12 loop IDs | |
aaaCode | 1..1 | code | approved | modified | deined | |
locationType | 0..1 | code | inpatient | outpatient | home | |
result | 0..1 | code | approved | modified | denied | pended | |
denialReason | 0..1 | code | Denial Reason | |
supportingDoc | 0..1 | url | Documentation submitted as part of PAS Bundle | |
requestedDoc | 0..* | BackboneElement | Documentation requested via 278 response | |
docRequest | 1..* | CodeableConcept | Coded requests for additional documentation | |
timeRequested | 1..1 | dateTime | Date/Time of initial request | |
timeSubmitted | 0..1 | dateTime | Date/Time of final result | |
submissionMethod | 0..1 | code | CDex | portal | fax | x12 | other | |
exceptionSubmission | 0..1 | boolean | True if exchange is based on the exception grant | |
businessLine | 0..1 | CodeableConcept | E.g. MedicareAdvantage | |
Documentation for this format |
Path | Conformance | ValueSet | URI |
PASMetricData.source | required | MetricDataSourcehttp://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource from this IG | |
PASMetricData.issue.code | required | IssueTypehttp://hl7.org/fhir/ValueSet/issue-type from the FHIR Standard | |
PASMetricData.issue.details | example | OperationOutcomeCodeshttp://hl7.org/fhir/ValueSet/operation-outcome from the FHIR Standard |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
PASMetricData | 0..* | Base | PAS Metric Data Instances of this logical model are not marked to be the target of a Reference | |
source | 1..1 | code | provider | intermediary | payer Binding: Metric Data Source (required) | |
providerId | 1..1 | Identifier | User invoking hook ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ele-1: All FHIR elements must have a @value or children |
system | Σ | 0..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Required Pattern: http://hl7.org/fhir/sid/us-npi |
value | Σ | 1..1 | string | The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use ele-1: All FHIR elements must have a @value or children |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) ele-1: All FHIR elements must have a @value or children |
groupId | 1..1 | Identifier | Healthcare org of user ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ele-1: All FHIR elements must have a @value or children |
system | Σ | 0..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Required Pattern: http://hl7.org/fhir/sid/us-npi |
value | Σ | 1..1 | string | The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use ele-1: All FHIR elements must have a @value or children |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) ele-1: All FHIR elements must have a @value or children |
payerId | 1..1 | Identifier | Payer receiving hook ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ele-1: All FHIR elements must have a @value or children |
system | Σ | 1..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient |
value | Σ | 1..1 | string | The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use ele-1: All FHIR elements must have a @value or children |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) ele-1: All FHIR elements must have a @value or children |
exchange | 1..* | BackboneElement | Prior Authorization Exchanges ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
type | 1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer | |
with | 0..1 | code | provider | intermediary | payer | |
method | 1..1 | code | x12 | restful | ihe | direct | other | |
requestTime | 1..1 | instant | Time exchange initiated | |
responseTime | 0..1 | instant | Time of exchange response | |
httpResponse | 1..1 | code | e.g. 200 | |
issue | 0..* | BackboneElement | OperationOutcome info ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
code | 1..1 | code | Error code Binding: IssueType (required) | |
details | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example) | |
aaaCodes | 0..* | BackboneElement | AAA codes returned ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
loopID | 1..1 | code | see X12 loop IDs | |
aaaCode | 1..1 | code | approved | modified | denied | |
itemDetail | 0..* | BackboneElement | Service level item detail ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
trn | 0..1 | integer | Service Level TRN | |
item | 1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC | |
assertionId | 0..1 | string | Unique ID for order item | |
initialSubmissionTime | 0..1 | dateTime | Date/time of the initial submission of the item | |
finalResponseTime | 0..1 | dateTime | Date/time of final result | |
responsesRequired | 0..1 | integer | Number of responses | |
aaaCodes | 0..* | BackboneElement | AAA codes returned ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
loopID | 1..1 | code | see X12 loop IDs | |
aaaCode | 1..1 | code | approved | modified | deined | |
locationType | 0..1 | code | inpatient | outpatient | home | |
result | 0..1 | code | approved | modified | denied | pended | |
denialReason | 0..1 | code | Denial Reason | |
supportingDoc | 0..1 | url | Documentation submitted as part of PAS Bundle | |
requestedDoc | 0..* | BackboneElement | Documentation requested via 278 response ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
docRequest | 1..* | CodeableConcept | Coded requests for additional documentation | |
timeRequested | 1..1 | dateTime | Date/Time of initial request | |
timeSubmitted | 0..1 | dateTime | Date/Time of final result | |
submissionMethod | 0..1 | code | CDex | portal | fax | x12 | other | |
exceptionSubmission | 0..1 | boolean | True if exchange is based on the exception grant | |
businessLine | 0..1 | CodeableConcept | E.g. MedicareAdvantage | |
Documentation for this format |
Path | Conformance | ValueSet | URI |
PASMetricData.source | required | MetricDataSourcehttp://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource from this IG | |
PASMetricData.providerId.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard | |
PASMetricData.providerId.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard | |
PASMetricData.groupId.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard | |
PASMetricData.groupId.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard | |
PASMetricData.payerId.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard | |
PASMetricData.payerId.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard | |
PASMetricData.issue.code | required | IssueTypehttp://hl7.org/fhir/ValueSet/issue-type from the FHIR Standard | |
PASMetricData.issue.details | example | OperationOutcomeCodeshttp://hl7.org/fhir/ValueSet/operation-outcome from the FHIR Standard |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
PASMetricData | 0..* | Base | PAS Metric Data Instances of this logical model are not marked to be the target of a Reference | |
source | 1..1 | code | provider | intermediary | payer Binding: Metric Data Source (required) | |
providerId | 1..1 | Identifier | User invoking hook | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
groupId | 1..1 | Identifier | Healthcare org of user | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
payerId | 1..1 | Identifier | Payer receiving hook | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
exchange | 1..* | BackboneElement | Prior Authorization Exchanges | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | 1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer | |
with | 0..1 | code | provider | intermediary | payer | |
method | 1..1 | code | x12 | restful | ihe | direct | other | |
requestTime | 1..1 | instant | Time exchange initiated | |
responseTime | 0..1 | instant | Time of exchange response | |
httpResponse | 1..1 | code | e.g. 200 | |
issue | 0..* | BackboneElement | OperationOutcome info | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | 1..1 | code | Error code Binding: IssueType (required) | |
details | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example) | |
aaaCodes | 0..* | BackboneElement | AAA codes returned | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
loopID | 1..1 | code | see X12 loop IDs | |
aaaCode | 1..1 | code | approved | modified | denied | |
itemDetail | 0..* | BackboneElement | Service level item detail | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
trn | 0..1 | integer | Service Level TRN | |
item | 1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC | |
assertionId | 0..1 | string | Unique ID for order item | |
initialSubmissionTime | 0..1 | dateTime | Date/time of the initial submission of the item | |
finalResponseTime | 0..1 | dateTime | Date/time of final result | |
responsesRequired | 0..1 | integer | Number of responses | |
aaaCodes | 0..* | BackboneElement | AAA codes returned | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
loopID | 1..1 | code | see X12 loop IDs | |
aaaCode | 1..1 | code | approved | modified | deined | |
locationType | 0..1 | code | inpatient | outpatient | home | |
result | 0..1 | code | approved | modified | denied | pended | |
denialReason | 0..1 | code | Denial Reason | |
supportingDoc | 0..1 | url | Documentation submitted as part of PAS Bundle | |
requestedDoc | 0..* | BackboneElement | Documentation requested via 278 response | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
docRequest | 1..* | CodeableConcept | Coded requests for additional documentation | |
timeRequested | 1..1 | dateTime | Date/Time of initial request | |
timeSubmitted | 0..1 | dateTime | Date/Time of final result | |
submissionMethod | 0..1 | code | CDex | portal | fax | x12 | other | |
exceptionSubmission | 0..1 | boolean | True if exchange is based on the exception grant | |
businessLine | 0..1 | CodeableConcept | E.g. MedicareAdvantage | |
Documentation for this format |
Path | Conformance | ValueSet | URI |
PASMetricData.source | required | MetricDataSourcehttp://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource from this IG | |
PASMetricData.providerId.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard | |
PASMetricData.providerId.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard | |
PASMetricData.groupId.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard | |
PASMetricData.groupId.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard | |
PASMetricData.payerId.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard | |
PASMetricData.payerId.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard | |
PASMetricData.issue.code | required | IssueTypehttp://hl7.org/fhir/ValueSet/issue-type from the FHIR Standard | |
PASMetricData.issue.details | example | OperationOutcomeCodeshttp://hl7.org/fhir/ValueSet/operation-outcome from the FHIR Standard |
Differential View
This structure is derived from Base
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
PASMetricData | 0..* | Base | PAS Metric Data Instances of this logical model are not marked to be the target of a Reference | |
source | 1..1 | code | provider | intermediary | payer Binding: Metric Data Source (required) | |
providerId | 1..1 | Identifier | User invoking hook | |
system | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi | |
value | 1..1 | string | The value that is unique | |
groupId | 1..1 | Identifier | Healthcare org of user | |
system | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi | |
value | 1..1 | string | The value that is unique | |
payerId | 1..1 | Identifier | Payer receiving hook | |
system | 1..1 | uri | The namespace for the identifier value | |
value | 1..1 | string | The value that is unique | |
exchange | 1..* | BackboneElement | Prior Authorization Exchanges | |
type | 1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer | |
with | 0..1 | code | provider | intermediary | payer | |
method | 1..1 | code | x12 | restful | ihe | direct | other | |
requestTime | 1..1 | instant | Time exchange initiated | |
responseTime | 0..1 | instant | Time of exchange response | |
httpResponse | 1..1 | code | e.g. 200 | |
issue | 0..* | BackboneElement | OperationOutcome info | |
code | 1..1 | code | Error code Binding: IssueType (required) | |
details | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example) | |
aaaCodes | 0..* | BackboneElement | AAA codes returned | |
loopID | 1..1 | code | see X12 loop IDs | |
aaaCode | 1..1 | code | approved | modified | denied | |
itemDetail | 0..* | BackboneElement | Service level item detail | |
trn | 0..1 | integer | Service Level TRN | |
item | 1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC | |
assertionId | 0..1 | string | Unique ID for order item | |
initialSubmissionTime | 0..1 | dateTime | Date/time of the initial submission of the item | |
finalResponseTime | 0..1 | dateTime | Date/time of final result | |
responsesRequired | 0..1 | integer | Number of responses | |
aaaCodes | 0..* | BackboneElement | AAA codes returned | |
loopID | 1..1 | code | see X12 loop IDs | |
aaaCode | 1..1 | code | approved | modified | deined | |
locationType | 0..1 | code | inpatient | outpatient | home | |
result | 0..1 | code | approved | modified | denied | pended | |
denialReason | 0..1 | code | Denial Reason | |
supportingDoc | 0..1 | url | Documentation submitted as part of PAS Bundle | |
requestedDoc | 0..* | BackboneElement | Documentation requested via 278 response | |
docRequest | 1..* | CodeableConcept | Coded requests for additional documentation | |
timeRequested | 1..1 | dateTime | Date/Time of initial request | |
timeSubmitted | 0..1 | dateTime | Date/Time of final result | |
submissionMethod | 0..1 | code | CDex | portal | fax | x12 | other | |
exceptionSubmission | 0..1 | boolean | True if exchange is based on the exception grant | |
businessLine | 0..1 | CodeableConcept | E.g. MedicareAdvantage | |
Documentation for this format |
Path | Conformance | ValueSet | URI |
PASMetricData.source | required | MetricDataSourcehttp://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource from this IG | |
PASMetricData.issue.code | required | IssueTypehttp://hl7.org/fhir/ValueSet/issue-type from the FHIR Standard | |
PASMetricData.issue.details | example | OperationOutcomeCodeshttp://hl7.org/fhir/ValueSet/operation-outcome from the FHIR Standard |
Key Elements View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
PASMetricData | 0..* | Base | PAS Metric Data Instances of this logical model are not marked to be the target of a Reference | |
source | 1..1 | code | provider | intermediary | payer Binding: Metric Data Source (required) | |
providerId | 1..1 | Identifier | User invoking hook ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ele-1: All FHIR elements must have a @value or children |
system | Σ | 0..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Required Pattern: http://hl7.org/fhir/sid/us-npi |
value | Σ | 1..1 | string | The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use ele-1: All FHIR elements must have a @value or children |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) ele-1: All FHIR elements must have a @value or children |
groupId | 1..1 | Identifier | Healthcare org of user ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ele-1: All FHIR elements must have a @value or children |
system | Σ | 0..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Required Pattern: http://hl7.org/fhir/sid/us-npi |
value | Σ | 1..1 | string | The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use ele-1: All FHIR elements must have a @value or children |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) ele-1: All FHIR elements must have a @value or children |
payerId | 1..1 | Identifier | Payer receiving hook ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ele-1: All FHIR elements must have a @value or children |
system | Σ | 1..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient |
value | Σ | 1..1 | string | The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use ele-1: All FHIR elements must have a @value or children |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) ele-1: All FHIR elements must have a @value or children |
exchange | 1..* | BackboneElement | Prior Authorization Exchanges ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
type | 1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer | |
with | 0..1 | code | provider | intermediary | payer | |
method | 1..1 | code | x12 | restful | ihe | direct | other | |
requestTime | 1..1 | instant | Time exchange initiated | |
responseTime | 0..1 | instant | Time of exchange response | |
httpResponse | 1..1 | code | e.g. 200 | |
issue | 0..* | BackboneElement | OperationOutcome info ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
code | 1..1 | code | Error code Binding: IssueType (required) | |
details | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example) | |
aaaCodes | 0..* | BackboneElement | AAA codes returned ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
loopID | 1..1 | code | see X12 loop IDs | |
aaaCode | 1..1 | code | approved | modified | denied | |
itemDetail | 0..* | BackboneElement | Service level item detail ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
trn | 0..1 | integer | Service Level TRN | |
item | 1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC | |
assertionId | 0..1 | string | Unique ID for order item | |
initialSubmissionTime | 0..1 | dateTime | Date/time of the initial submission of the item | |
finalResponseTime | 0..1 | dateTime | Date/time of final result | |
responsesRequired | 0..1 | integer | Number of responses | |
aaaCodes | 0..* | BackboneElement | AAA codes returned ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
loopID | 1..1 | code | see X12 loop IDs | |
aaaCode | 1..1 | code | approved | modified | deined | |
locationType | 0..1 | code | inpatient | outpatient | home | |
result | 0..1 | code | approved | modified | denied | pended | |
denialReason | 0..1 | code | Denial Reason | |
supportingDoc | 0..1 | url | Documentation submitted as part of PAS Bundle | |
requestedDoc | 0..* | BackboneElement | Documentation requested via 278 response ele-1: All FHIR elements must have a @value or children | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
docRequest | 1..* | CodeableConcept | Coded requests for additional documentation | |
timeRequested | 1..1 | dateTime | Date/Time of initial request | |
timeSubmitted | 0..1 | dateTime | Date/Time of final result | |
submissionMethod | 0..1 | code | CDex | portal | fax | x12 | other | |
exceptionSubmission | 0..1 | boolean | True if exchange is based on the exception grant | |
businessLine | 0..1 | CodeableConcept | E.g. MedicareAdvantage | |
Documentation for this format |
Path | Conformance | ValueSet | URI |
PASMetricData.source | required | MetricDataSourcehttp://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource from this IG | |
PASMetricData.providerId.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard | |
PASMetricData.providerId.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard | |
PASMetricData.groupId.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard | |
PASMetricData.groupId.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard | |
PASMetricData.payerId.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard | |
PASMetricData.payerId.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard | |
PASMetricData.issue.code | required | IssueTypehttp://hl7.org/fhir/ValueSet/issue-type from the FHIR Standard | |
PASMetricData.issue.details | example | OperationOutcomeCodeshttp://hl7.org/fhir/ValueSet/operation-outcome from the FHIR Standard |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
PASMetricData | 0..* | Base | PAS Metric Data Instances of this logical model are not marked to be the target of a Reference | |
source | 1..1 | code | provider | intermediary | payer Binding: Metric Data Source (required) | |
providerId | 1..1 | Identifier | User invoking hook | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
groupId | 1..1 | Identifier | Healthcare org of user | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
payerId | 1..1 | Identifier | Payer receiving hook | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
period | Σ | 0..1 | Period | Time period when id is/was valid for use |
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
exchange | 1..* | BackboneElement | Prior Authorization Exchanges | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | 1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer | |
with | 0..1 | code | provider | intermediary | payer | |
method | 1..1 | code | x12 | restful | ihe | direct | other | |
requestTime | 1..1 | instant | Time exchange initiated | |
responseTime | 0..1 | instant | Time of exchange response | |
httpResponse | 1..1 | code | e.g. 200 | |
issue | 0..* | BackboneElement | OperationOutcome info | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | 1..1 | code | Error code Binding: IssueType (required) | |
details | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example) | |
aaaCodes | 0..* | BackboneElement | AAA codes returned | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
loopID | 1..1 | code | see X12 loop IDs | |
aaaCode | 1..1 | code | approved | modified | denied | |
itemDetail | 0..* | BackboneElement | Service level item detail | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
trn | 0..1 | integer | Service Level TRN | |
item | 1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC | |
assertionId | 0..1 | string | Unique ID for order item | |
initialSubmissionTime | 0..1 | dateTime | Date/time of the initial submission of the item | |
finalResponseTime | 0..1 | dateTime | Date/time of final result | |
responsesRequired | 0..1 | integer | Number of responses | |
aaaCodes | 0..* | BackboneElement | AAA codes returned | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
loopID | 1..1 | code | see X12 loop IDs | |
aaaCode | 1..1 | code | approved | modified | deined | |
locationType | 0..1 | code | inpatient | outpatient | home | |
result | 0..1 | code | approved | modified | denied | pended | |
denialReason | 0..1 | code | Denial Reason | |
supportingDoc | 0..1 | url | Documentation submitted as part of PAS Bundle | |
requestedDoc | 0..* | BackboneElement | Documentation requested via 278 response | |
@id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
docRequest | 1..* | CodeableConcept | Coded requests for additional documentation | |
timeRequested | 1..1 | dateTime | Date/Time of initial request | |
timeSubmitted | 0..1 | dateTime | Date/Time of final result | |
submissionMethod | 0..1 | code | CDex | portal | fax | x12 | other | |
exceptionSubmission | 0..1 | boolean | True if exchange is based on the exception grant | |
businessLine | 0..1 | CodeableConcept | E.g. MedicareAdvantage | |
Documentation for this format |
Path | Conformance | ValueSet | URI |
PASMetricData.source | required | MetricDataSourcehttp://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource from this IG | |
PASMetricData.providerId.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard | |
PASMetricData.providerId.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard | |
PASMetricData.groupId.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard | |
PASMetricData.groupId.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard | |
PASMetricData.payerId.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard | |
PASMetricData.payerId.type | extensible | Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard | |
PASMetricData.issue.code | required | IssueTypehttp://hl7.org/fhir/ValueSet/issue-type from the FHIR Standard | |
PASMetricData.issue.details | example | OperationOutcomeCodeshttp://hl7.org/fhir/ValueSet/operation-outcome from the FHIR Standard |