Da Vinci - Member Attribution (ATR) List
1.0.0 - STU 1 Publication

This page is part of the Risk Based Contracts Member Attribution List FHIR IG (v1.0.0: STU 1) based on FHIR 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

CapabilityStatement: DaVinci ATR Consumer

Raw OpenAPI-Swagger Definition file | Download

AtrConsumer

(Requirements Definition Capability Statement)

Canonical URL: http://hl7.org/fhir/us/davinci-atr/CapabilityStatement/atr-consumer

Published by: HL7 International - Financial Management

This profile defines the expected capabilities of the DaVinci ATR Consumer actor. This actor is responsible for consuming the member attribution list for Risk Based Contracts. Typically Payers are the Producers of the member attribution list and Provider organization are consumers.

General

FHIR Version: 4.0.1
Supported formats: json

REST behavior

The primary focus of the Consumer is to retrieve and use the member attribution list for implementing different DaVinci use cases such as CDex, PDex. The list can also be used for other purposes as needed by the Consumer.

Security:

Implementations must meet the general security requirements documented in FHIR Security guidance.

In addition the Consumer needs to meet the security requirements as outlined in the Formal Specification - Security Section.

Resource summary

Resource Search Read Read Version Instance History Resource History Create Update Delete
Coverage (Profile) SHALL
Group (Profile) SHALL SHALL SHOULD SHOULD
Location (Profile) SHALL
Organization (Profile) SHALL
Patient (Profile) SHALL
Practitioner (Profile) SHALL
PractitionerRole (Profile) SHALL
RelatedPerson (Profile) SHALL

FHIR Operations summary

The Consumer SHALL be capable of invoking the following FHIR operations.



Coverage

Profile: http://hl7.org/fhir/us/davinci-atr/StructureDefinition/atr-coverage

Interactions

Name Description
  read

Allows retrieval of a specific known Coverage Resource


Group

Profile: http://hl7.org/fhir/us/davinci-atr/StructureDefinition/atr-group

Interactions

Name Description
  search-type

Allows discovery of existing Groups corresponding to a Consumer using their own TAX and NPI Identifiers.
  read

Allows retrieval of a specific Group resource.
  vread

Allows retrieval of a historical version of a Group resource.
  history-instance

Allows review of changes to a Group over time

Search

Parameter Type Definition & Chaining
identifier token Search using identifiers which can be Consumer NPI, Consumer TIN, Settlement Entity Identifier, Contract Identifier. Combinations of AND/OR logic for the different identifiers are allowed according to the FHIR specification.
name string Search using Group name.
period date Search using contract validity period.


Location

Profile: http://hl7.org/fhir/us/davinci-atr/StructureDefinition/atr-location

Interactions

Name Description
  read

Allows retrieval of a specific known Location Resource


Organization

Profile: http://hl7.org/fhir/us/davinci-atr/StructureDefinition/atr-organization

Interactions

Name Description
  read

Allows retrieval of a specific known Organization Resource


Patient

Profile: http://hl7.org/fhir/us/davinci-atr/StructureDefinition/atr-patient

Interactions

Name Description
  read

Allows retrieval of a specific known Patient Resource


Practitioner

Profile: http://hl7.org/fhir/us/davinci-atr/StructureDefinition/atr-practitioner

Interactions

Name Description
  read

Allows retrieval of a specific known Practitioner Resource


PractitionerRole

Profile: http://hl7.org/fhir/us/davinci-atr/StructureDefinition/atr-practitionerrole

Interactions

Name Description
  read

Allows retrieval of a specific known PractitionerRole Resource


RelatedPerson

Profile: http://hl7.org/fhir/us/davinci-atr/StructureDefinition/atr-relatedperson

Interactions

Name Description
  read

Allows retrieval of a specific known RelatedPerson Resource