This page is part of the Da Vinci Payer Data Exchange (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

1-2 Conventions

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Conventions

This implementation guide (IG) uses specific terminology to flag statements that have relevance for the evaluation of conformance with the guide:

SHALL indicates requirements that must be met to be conformant with the specification.

SHOULD indicates behaviors that are strongly recommended (and which may result in interoperability issues or sub-optimal behavior if not adhered to) but which do not, for this version of the specification, affect the determination of specification conformance.

MAY describes optional behaviors that are free to consider but where there is no recommendation for, or against, adoption.

It is important to differentiate in the Implementation Guide between identifiers used by the Provider/EMR and those used by the Payer/Health Plan to identify the patient/subject/member.

For the purposes of this IG we will use the following terms:

patient or subject id will be used to express the identifier used by the provider to identify a patient/subject.
subscriber or member id will be used to express the identifier used by the payer/health plan to identify an individual member. Health Plans may historically have referred to these individual members as:
Member
Subscriber
Beneficiary
Dependent
Group Member
Plan Member
Covered Party
Subject of Care