Da Vinci Prior Authorization Support (PAS) FHIR IG
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This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.2.0-ballot: STU 2 Ballot) based on FHIR (HL7® FHIR® Standard) R4. This version is a pre-release. The current official version is 2.1.0. For a full list of available versions, see the Directory of published versions

: Submit Claim Insurer Example - XML Representation

Page standards status: Informative

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<Organization xmlns="http://hl7.org/fhir">
  <id value="InsurerExample"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Organization InsurerExample</b></p><a name="InsurerExample"> </a><a name="hcInsurerExample"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-profile-insurer.html">PAS Insurer Organization</a></p></div><p><b>identifier</b>: <a href="http://terminology.hl7.org/6.2.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/1234567893</p><p><b>active</b>: true</p><p><b>type</b>: <span title="Codes:{https://codesystem.x12.org/005010/98 PR}">PR</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>
  </text>
  <identifier>
    <system value="http://hl7.org/fhir/sid/us-npi"/>
    <value value="1234567893"/>
  </identifier>
  <active value="true"/>
  <type>
    <coding>
      <system value="https://codesystem.x12.org/005010/98"/>
      <code value="PR"/>
    </coding>
  </type>
  <name value="MARYLAND CAPITAL INSURANCE COMPANY"/>
</Organization>