This page is part of the Da Vinci Payer Data Exchange (v2.2.0: STU2.2) 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

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Example Consent: PDex Provider Access Consent Opt-Out Example

Participants

Role	Details
Patient	Johnny Appleseed Male, DoB: 1986-01-01 ( Member Number)
Party	Johnny Appleseed Male, DoB: 1986-01-01 ( Member Number)
Manager	Organization Payer 1

This consent is made under the regulation Common Rule Informed Consent .

Rule	Time Period	Who	What
permit
deny	Period: 2024-06-11 --> (ongoing)	Performer: My Health Plan (Identifier: United States National Provider Identifier/0123456789)	For action: Disclose
Documentation for this format