Patient Cost Transparency Implementation Guide
1.1.0 - STU 1 United States of America flag

This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v1.1.0: STU 1) 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 GFE resource for the creation of an AEOB - JSON Representation

Page standards status: Trial-use

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{
  "resourceType" : "OperationDefinition",
  "id" : "GFE-submit",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>URL: [base]/Claim/$gfe-submit</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 or multiple GFE resources plus referenced resources.</p>\n</div></td></tr><tr><td>OUT</td><td>return</td><td/><td>0..1</td><td><a href=\"http://hl7.org/fhir/R4/operationoutcome.html\">OperationOutcome</a></td><td/><td><div><p>An optional OperationOutcome per the <a href=\"https://hl7.org/fhir/R5/async-bundle.html\">async pattern</a>.</p>\n</div></td></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-pct/OperationDefinition/GFE-submit",
  "version" : "1.1.0",
  "name" : "GFESubmit",
  "title" : "Submit a GFE resource for the creation of an AEOB",
  "status" : "active",
  "kind" : "operation",
  "date" : "2024-01-03T18:32:02+00:00",
  "publisher" : "HL7 International / Financial Management",
  "contact" : [
    {
      "name" : "HL7 International / Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        },
        {
          "system" : "email",
          "value" : "fmlists@lists.hl7.org"
        }
      ]
    }
  ],
  "description" : "This operation is used by an entity to submit one or multiple GFEs as a Bundle containing the GFE(s) and other referenced resources for processing. The only input parameter is the single Bundle resource with one or multiple GFE(s) - each of which is based on the Claim resource (along with other referenced resources). The output is a url in the Content-Location header for subsequent polling and optionally an OperationOutcome resource per [async pattern](http://build.fhir.org/async-bundle.html). If after polling the response is complete, then the result will either be a single Bundle with the AEOB - which is based on the ExplanationOfBenefit resource, (and other referenced resources) or an OperationOutcome resource indicating the AEOB will be sent directly to the patient.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "code" : "gfe-submit",
  "base" : "http://hl7.org/fhir/us/davinci-pct/OperationDefinition/GFE-submit",
  "resource" : [
    "Claim"
  ],
  "system" : false,
  "type" : true,
  "instance" : false,
  "parameter" : [
    {
      "name" : "resource",
      "use" : "in",
      "min" : 1,
      "max" : "1",
      "documentation" : "A Bundle containing a single or multiple GFE resources plus referenced resources.",
      "type" : "Bundle"
    },
    {
      "name" : "return",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "documentation" : "An optional OperationOutcome per the [async pattern](https://hl7.org/fhir/R5/async-bundle.html).",
      "type" : "OperationOutcome"
    }
  ]
}