Patient Cost Transparency Implementation Guide
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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 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

: Submit a GFE resource for the creation of an AEOB - XML Representation

Page standards status: Trial-use

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<OperationDefinition xmlns="http://hl7.org/fhir">
  <id value="GFE-submit"/>
  <text>
    <status value="extensions"/>
    <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>
</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>
</div></td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct"/>
      </extension>
    </valueCode>
  </extension>
  <url
       value="http://hl7.org/fhir/us/davinci-pct/OperationDefinition/GFE-submit"/>
  <version value="1.1.0"/>
  <name value="GFESubmit"/>
  <title value="Submit a GFE resource for the creation of an AEOB"/>
  <status value="active"/>
  <kind value="operation"/>
  <date value="2024-01-03T18:19:28+00:00"/>
  <publisher value="HL7 International / Financial Management"/>
  <contact>
    <name value="HL7 International / Financial Management"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="fmlists@lists.hl7.org"/>
    </telecom>
  </contact>
  <description
               value="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 value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <code value="gfe-submit"/>
  <base
        value="http://hl7.org/fhir/us/davinci-pct/OperationDefinition/GFE-submit"/>
  <resource value="Claim"/>
  <system value="false"/>
  <type value="true"/>
  <instance value="false"/>
  <parameter>
    <name value="resource"/>
    <use value="in"/>
    <min value="1"/>
    <max value="1"/>
    <documentation
                   value="A Bundle containing a single or multiple GFE resources plus referenced resources."/>
    <type value="Bundle"/>
  </parameter>
  <parameter>
    <name value="return"/>
    <use value="out"/>
    <min value="0"/>
    <max value="1"/>
    <documentation
                   value="An optional OperationOutcome per the [async pattern](https://hl7.org/fhir/R5/async-bundle.html)."/>
    <type value="OperationOutcome"/>
  </parameter>
</OperationDefinition>