Da Vinci Postable Remittance
1.0.0-ballot - STU 1 Ballot United States of America flag

This page is part of the DaVinci Postable Remittance FHIR Implementation Guide (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

: Search for Postable Remittance By Patient - XML Representation

Page standards status: Trial-use Maturity Level: 1

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<OperationDefinition xmlns="http://hl7.org/fhir">
  <id value="SearchByPatient"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: OperationDefinition SearchByPatient</b></p><a name="SearchByPatient"> </a><a name="hcSearchByPatient"> </a><a name="SearchByPatient-en-US"> </a><p>URL: [base]/$searchByPatient</p><p>Input parameters Profile:<a href="StructureDefinition-searchByPatientParameters.html">Search By Patient Incoming Parameters</a></p><p>Output parameters Profile:<a href="StructureDefinition-searchResultParameters.html">Search Result Outgoing Parameters</a></p><h3>Parameters</h3><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>TIN</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Medical Group / Billing Provider / Payee TIN</p>
</div></td></tr><tr><td>IN</td><td>DateOfService</td><td/><td>0..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#Period">Period</a></td><td/><td><div><p>Date of Service</p>
</div></td></tr><tr><td>IN</td><td>PayerID</td><td/><td>0..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Payer Identifer</p>
</div></td></tr><tr><td>IN</td><td>PayerName</td><td/><td>0..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Payer Name</p>
</div></td></tr><tr><td>IN</td><td>Patient</td><td/><td>1..1</td><td></td><td/><td><div><p>Information about the patient being searched for.</p>
</div></td></tr><tr><td>IN</td><td>Patient.PatientID</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Patient Member (or Subscriber) Insurance ID</p>
</div></td></tr><tr><td>IN</td><td>Patient.DateOfBirth</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#date">date</a></td><td/><td><div><p>Patient date of birth</p>
</div></td></tr><tr><td>IN</td><td>Patient.FirstName</td><td/><td>0..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Patient First Name</p>
</div></td></tr><tr><td>IN</td><td>Patient.LastName</td><td/><td>0..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Patient Last Name</p>
</div></td></tr><tr><td>OUT</td><td>TIN</td><td/><td>0..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Medical Group / Billing Provider / Payee TIN</p>
</div></td></tr><tr><td>OUT</td><td>Payer</td><td/><td>0..1</td><td></td><td/><td><div><p>Details of payer information.</p>
</div></td></tr><tr><td>OUT</td><td>Payer.PayerID</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Payer Identifier</p>
</div></td></tr><tr><td>OUT</td><td>Payer.PayerName</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Payer Name</p>
</div></td></tr><tr><td>OUT</td><td>Claim</td><td/><td>0..*</td><td></td><td/><td><div><p>Details to verify correct claim found.</p>
</div></td></tr><tr><td>OUT</td><td>Claim.PayerClaimID</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Payer Generated Claim ID (DCN or ICN)</p>
</div></td></tr><tr><td>OUT</td><td>Claim.ProviderClaimID</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Provider generated Claim ID</p>
</div></td></tr><tr><td>OUT</td><td>Claim.ClaimReceivedDate</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#date">date</a></td><td/><td><div><p>Claim Received Date</p>
</div></td></tr><tr><td>OUT</td><td>Claim.ProviderID</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>NPI or Payer Assigned Provider Identifier</p>
</div></td></tr><tr><td>OUT</td><td>Claim.PaymentInfo</td><td/><td>0..*</td><td></td><td/><td><div><p>Details of adjudicated payment.</p>
</div></td></tr><tr><td>OUT</td><td>Claim.PaymentInfo.PaymentDate</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#date">date</a></td><td/><td><div><p>Payment Date</p>
</div></td></tr><tr><td>OUT</td><td>Claim.PaymentInfo.PaymentNumber</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Payment Number</p>
</div></td></tr><tr><td>OUT</td><td>Claim.PaymentInfo.PaymentAmount</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#Money">Money</a></td><td/><td><div><p>Payment Amount</p>
</div></td></tr><tr><td>OUT</td><td>Claim.PaymentInfo.Remittance</td><td/><td>0..*</td><td></td><td/><td><div><p>Details of remittance advice.</p>
</div></td></tr><tr><td>OUT</td><td>Claim.PaymentInfo.Remittance.RemittanceAdviceIdentifier</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Remittance Advice Identifier</p>
</div></td></tr><tr><td>OUT</td><td>Claim.PaymentInfo.Remittance.RemittanceAdviceType</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></td><td><a href="ValueSet-RemittanceAdviceType.html">Remittance Advice Value Set</a> (Required)</td><td><div><p>Remittance Advice Type</p>
</div></td></tr><tr><td>OUT</td><td>Claim.PaymentInfo.Remittance.RemittanceAdviceDate</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#date">date</a></td><td/><td><div><p>Remittance Advice Date</p>
</div></td></tr><tr><td>OUT</td><td>Claim.PaymentInfo.Remittance.RemittanceAdviceFileSize</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#integer">integer</a></td><td/><td><div><p>Remittance Advice File Size</p>
</div></td></tr><tr><td>OUT</td><td>Patient</td><td/><td>1..1</td><td></td><td/><td><div><p>Details to verify correct patient found.</p>
</div></td></tr><tr><td>OUT</td><td>Patient.DateOfBirth</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#date">date</a></td><td/><td><div><p>Patient date of birth</p>
</div></td></tr><tr><td>OUT</td><td>Patient.PatientID</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Patient Member (or Subscriber) Insurance ID</p>
</div></td></tr><tr><td>OUT</td><td>Patient.PatientFirstName</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Patient First Name</p>
</div></td></tr><tr><td>OUT</td><td>Patient.PatientLastName</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td/><td><div><p>Patient Last Name</p>
</div></td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="claims"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/us/davinci-pr/ImplementationGuide/hl7.fhir.us.davinci-pr"/>
      </extension>
    </valueInteger>
  </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-pr/ImplementationGuide/hl7.fhir.us.davinci-pr"/>
      </extension>
    </valueCode>
  </extension>
  <url
       value="http://hl7.org/fhir/us/davinci-pr/OperationDefinition/SearchByPatient"/>
  <version value="1.0.0-ballot"/>
  <name value="SearchByPatient"/>
  <title value="Search for Postable Remittance By Patient"/>
  <status value="active"/>
  <kind value="operation"/>
  <date value="2024-12-16T18:43:35+00:00"/>
  <publisher
             value="HL7 International / Payer/Provider Information Exchange Work Group"/>
  <contact>
    <name
          value="HL7 International / Payer/Provider Information Exchange Work Group"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/claims"/>
    </telecom>
  </contact>
  <description
               value="This operation is used to search for a postable remittance by providing patient information."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <code value="searchByPatient"/>
  <system value="true"/>
  <type value="false"/>
  <instance value="false"/>
  <inputProfile
                value="http://hl7.org/fhir/us/davinci-pr/StructureDefinition/searchByPatientParameters"/>
  <outputProfile
                 value="http://hl7.org/fhir/us/davinci-pr/StructureDefinition/searchResultParameters"/>
  <parameter>
    <name value="TIN"/>
    <use value="in"/>
    <min value="1"/>
    <max value="1"/>
    <documentation value="Medical Group / Billing Provider / Payee TIN"/>
    <type value="string"/>
  </parameter>
  <parameter>
    <name value="DateOfService"/>
    <use value="in"/>
    <min value="0"/>
    <max value="1"/>
    <documentation value="Date of Service"/>
    <type value="Period"/>
  </parameter>
  <parameter>
    <name value="PayerID"/>
    <use value="in"/>
    <min value="0"/>
    <max value="1"/>
    <documentation value="Payer Identifer"/>
    <type value="string"/>
  </parameter>
  <parameter>
    <name value="PayerName"/>
    <use value="in"/>
    <min value="0"/>
    <max value="1"/>
    <documentation value="Payer Name"/>
    <type value="string"/>
  </parameter>
  <parameter>
    <name value="Patient"/>
    <use value="in"/>
    <min value="1"/>
    <max value="1"/>
    <documentation value="Information about the patient being searched for."/>
    <part>
      <name value="PatientID"/>
      <use value="in"/>
      <min value="1"/>
      <max value="1"/>
      <documentation value="Patient Member (or Subscriber) Insurance ID"/>
      <type value="string"/>
    </part>
    <part>
      <name value="DateOfBirth"/>
      <use value="in"/>
      <min value="1"/>
      <max value="1"/>
      <documentation value="Patient date of birth"/>
      <type value="date"/>
    </part>
    <part>
      <name value="FirstName"/>
      <use value="in"/>
      <min value="0"/>
      <max value="1"/>
      <documentation value="Patient First Name"/>
      <type value="string"/>
    </part>
    <part>
      <name value="LastName"/>
      <use value="in"/>
      <min value="0"/>
      <max value="1"/>
      <documentation value="Patient Last Name"/>
      <type value="string"/>
    </part>
  </parameter>
  <parameter>
    <name value="TIN"/>
    <use value="out"/>
    <min value="0"/>
    <max value="1"/>
    <documentation value="Medical Group / Billing Provider / Payee TIN"/>
    <type value="string"/>
  </parameter>
  <parameter>
    <name value="Payer"/>
    <use value="out"/>
    <min value="0"/>
    <max value="1"/>
    <documentation value="Details of payer information."/>
    <part>
      <name value="PayerID"/>
      <use value="out"/>
      <min value="1"/>
      <max value="1"/>
      <documentation value="Payer Identifier"/>
      <type value="string"/>
    </part>
    <part>
      <name value="PayerName"/>
      <use value="out"/>
      <min value="1"/>
      <max value="1"/>
      <documentation value="Payer Name"/>
      <type value="string"/>
    </part>
  </parameter>
  <parameter>
    <name value="Claim"/>
    <use value="out"/>
    <min value="0"/>
    <max value="*"/>
    <documentation value="Details to verify correct claim found."/>
    <part>
      <name value="PayerClaimID"/>
      <use value="out"/>
      <min value="1"/>
      <max value="1"/>
      <documentation value="Payer Generated Claim ID (DCN or ICN)"/>
      <type value="string"/>
    </part>
    <part>
      <name value="ProviderClaimID"/>
      <use value="out"/>
      <min value="1"/>
      <max value="1"/>
      <documentation value="Provider generated Claim ID"/>
      <type value="string"/>
    </part>
    <part>
      <name value="ClaimReceivedDate"/>
      <use value="out"/>
      <min value="1"/>
      <max value="1"/>
      <documentation value="Claim Received Date"/>
      <type value="date"/>
    </part>
    <part>
      <name value="ProviderID"/>
      <use value="out"/>
      <min value="1"/>
      <max value="1"/>
      <documentation value="NPI or Payer Assigned Provider Identifier"/>
      <type value="string"/>
    </part>
    <part>
      <name value="PaymentInfo"/>
      <use value="out"/>
      <min value="0"/>
      <max value="*"/>
      <documentation value="Details of adjudicated payment."/>
      <part>
        <name value="PaymentDate"/>
        <use value="out"/>
        <min value="1"/>
        <max value="1"/>
        <documentation value="Payment Date"/>
        <type value="date"/>
      </part>
      <part>
        <name value="PaymentNumber"/>
        <use value="out"/>
        <min value="1"/>
        <max value="1"/>
        <documentation value="Payment Number"/>
        <type value="string"/>
      </part>
      <part>
        <name value="PaymentAmount"/>
        <use value="out"/>
        <min value="1"/>
        <max value="1"/>
        <documentation value="Payment Amount"/>
        <type value="Money"/>
      </part>
      <part>
        <name value="Remittance"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <documentation value="Details of remittance advice."/>
        <part>
          <name value="RemittanceAdviceIdentifier"/>
          <use value="out"/>
          <min value="1"/>
          <max value="1"/>
          <documentation value="Remittance Advice Identifier"/>
          <type value="string"/>
        </part>
        <part>
          <name value="RemittanceAdviceType"/>
          <use value="out"/>
          <min value="1"/>
          <max value="1"/>
          <documentation value="Remittance Advice Type"/>
          <type value="code"/>
          <binding>
            <strength value="required"/>
            <valueSet
                      value="http://hl7.org/fhir/us/davinci-pr/ValueSet/RemittanceAdviceType"/>
          </binding>
        </part>
        <part>
          <name value="RemittanceAdviceDate"/>
          <use value="out"/>
          <min value="1"/>
          <max value="1"/>
          <documentation value="Remittance Advice Date"/>
          <type value="date"/>
        </part>
        <part>
          <name value="RemittanceAdviceFileSize"/>
          <use value="out"/>
          <min value="1"/>
          <max value="1"/>
          <documentation value="Remittance Advice File Size"/>
          <type value="integer"/>
        </part>
      </part>
    </part>
  </parameter>
  <parameter>
    <name value="Patient"/>
    <use value="out"/>
    <min value="1"/>
    <max value="1"/>
    <documentation value="Details to verify correct patient found."/>
    <part>
      <name value="DateOfBirth"/>
      <use value="out"/>
      <min value="1"/>
      <max value="1"/>
      <documentation value="Patient date of birth"/>
      <type value="date"/>
    </part>
    <part>
      <name value="PatientID"/>
      <use value="out"/>
      <min value="1"/>
      <max value="1"/>
      <documentation value="Patient Member (or Subscriber) Insurance ID"/>
      <type value="string"/>
    </part>
    <part>
      <name value="PatientFirstName"/>
      <use value="out"/>
      <min value="1"/>
      <max value="1"/>
      <documentation value="Patient First Name"/>
      <type value="string"/>
    </part>
    <part>
      <name value="PatientLastName"/>
      <use value="out"/>
      <min value="1"/>
      <max value="1"/>
      <documentation value="Patient Last Name"/>
      <type value="string"/>
    </part>
  </parameter>
</OperationDefinition>