Da Vinci Prior Authorization Support (PAS) FHIR IG
1.1.0 - STU 1
Da Vinci Prior Authorization Support (PAS) FHIR IG
1.1.0 - STU 1
This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v1.1.0: STU 1.1) 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 
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:Bundle;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "ReferralAuthorizationResponseBundleExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle> ]
];
fhir:Bundle.type [ fhir:value "collection"];
fhir:Bundle.timestamp [ fhir:value "2005-05-02T11:02:00+05:00"^^xsd:dateTime];
fhir:Bundle.entry [
fhir:index 0;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/ClaimResponse/ReferralAuthorizationResponseExample" ];
fhir:Bundle.entry.resource <http://example.org/fhir/ClaimResponse/ReferralAuthorizationResponseExample>
], [
fhir:index 1;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Organization/UMOExample" ];
fhir:Bundle.entry.resource <http://example.org/fhir/Organization/UMOExample>
], [
fhir:index 2;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Organization/InsurerExample" ];
fhir:Bundle.entry.resource <http://example.org/fhir/Organization/InsurerExample>
], [
fhir:index 3;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Patient/SubscriberExample" ];
fhir:Bundle.entry.resource <http://example.org/fhir/Patient/SubscriberExample>
].
<http://example.org/fhir/ClaimResponse/ReferralAuthorizationResponseExample> a fhir:ClaimResponse;
fhir:Resource.id [ fhir:value "ReferralAuthorizationResponseExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "extensions" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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\">Resource \"ReferralAuthorizationResponseExample\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-claimresponse.html\">PAS Claim Response</a></p></div><p><b>identifier</b>: id: 111099</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\"#Patient_SubscriberExample\">See above (Patient/SubscriberExample)</a></p><p><b>created</b>: 2005-05-02T11:02:00+05:00</p><p><b>insurer</b>: <a href=\"#Organization_InsurerExample\">See above (Organization/InsurerExample)</a></p><p><b>requestor</b>: <a href=\"#Organization_UMOExample\">See above (Organization/UMOExample)</a></p><p><b>outcome</b>: complete</p><blockquote><p><b>item</b></p><p><b>ItemAuthorizedDate</b>: 2005-05-02 --> 2005-06-02</p><p><b>ItemPreAuthIssueDate</b>: 2005-05-02</p><p><b>ItemPreAuthPeriod</b>: 2005-05-02 --> 2005-06-02</p><blockquote><p><b>ItemAuthorizedProvider</b></p><p><b>value</b>: <a href=\"Practitioner-ReferralPractitionerExample.html\">Practitioner/ReferralPractitionerExample</a> \" WATSON\"</p></blockquote><blockquote><p><b>ItemAuthorizedDetail</b></p><p><b>value</b>: Consultation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (1365#3)</span></p><p><b>value</b>: <span title=\"US Dollar\">$100.00</span> (USD)</p><p><b>value</b>: 1</p></blockquote><p><b>itemSequence</b>: 1</p><h3>Adjudications</h3><table class=\"grid\"><tr><td>-</td><td><b>Extension</b></td><td><b>Category</b></td></tr><tr><td>*</td><td></td><td>Submitted Amount <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-adjudication.html\">Adjudication Value Codes</a>#submitted)</span></td></tr></table></blockquote></div>"
];
fhir:ClaimResponse.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://example.org/PATIENT_EVENT_TRACE_NUMBER" ];
fhir:Identifier.value [ fhir:value "111099" ];
fhir:Identifier.assigner [
fhir:Reference.identifier [
fhir:Identifier.system [ fhir:value "http://example.org/USER_ASSIGNED" ];
fhir:Identifier.value [ fhir:value "9012345678" ] ] ]
];
fhir:ClaimResponse.status [ fhir:value "active"];
fhir:ClaimResponse.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ];
fhir:Coding.code [ fhir:value "professional" ] ]
];
fhir:ClaimResponse.use [ fhir:value "preauthorization"];
fhir:ClaimResponse.patient [
fhir:Reference.reference [ fhir:value "Patient/SubscriberExample" ]
];
fhir:ClaimResponse.created [ fhir:value "2005-05-02T11:02:00+05:00"^^xsd:dateTime];
fhir:ClaimResponse.insurer [
fhir:Reference.reference [ fhir:value "Organization/InsurerExample" ]
];
fhir:ClaimResponse.requestor [
fhir:Reference.reference [ fhir:value "Organization/UMOExample" ]
];
fhir:ClaimResponse.outcome [ fhir:value "complete"];
fhir:ClaimResponse.item [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDate" ];
fhir:Extension.valuePeriod [
fhir:Period.start [ fhir:value "2005-05-02"^^xsd:date ];
fhir:Period.end [ fhir:value "2005-06-02"^^xsd:date ] ] ], [
fhir:index 1;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate" ];
fhir:Extension.valueDate [ fhir:value "2005-05-02"^^xsd:date ] ], [
fhir:index 2;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod" ];
fhir:Extension.valuePeriod [
fhir:Period.start [ fhir:value "2005-05-02"^^xsd:date ];
fhir:Period.end [ fhir:value "2005-06-02"^^xsd:date ] ] ], [
fhir:index 3;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "provider" ];
fhir:Extension.valueReference [
fhir:Reference.reference [ fhir:value "Practitioner/ReferralPractitionerExample" ] ] ];
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider" ] ], [
fhir:index 4;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "productOrServiceCode" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://codesystem.x12.org/005010/1365" ];
fhir:Coding.code [ fhir:value "3" ];
fhir:Coding.display [ fhir:value "Consultation" ] ] ] ], [
fhir:index 1;
fhir:Extension.url [ fhir:value "unitPrice" ];
fhir:Extension.valueMoney [
fhir:Money.value [ fhir:value "100"^^xsd:decimal ];
fhir:Money.currency [ fhir:value "USD" ] ] ], [
fhir:index 2;
fhir:Extension.url [ fhir:value "quantity" ];
fhir:Extension.valueQuantity [
fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ] ] ];
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail" ] ];
fhir:ClaimResponse.item.itemSequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:ClaimResponse.item.adjudication [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "number" ];
fhir:Extension.valueString [ fhir:value "AUTH0001" ] ], [
fhir:index 1;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://codesystem.x12.org/005010/306" ];
fhir:Coding.code [ fhir:value "A1" ];
fhir:Coding.display [ fhir:value "Certified in total" ] ] ] ];
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction" ] ];
fhir:ClaimResponse.item.adjudication.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ];
fhir:Coding.code [ fhir:value "submitted" ] ] ] ]
].
<http://example.org/fhir/Organization/UMOExample> a fhir:Organization;
fhir:Resource.id [ fhir:value "UMOExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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\">Resource \"UMOExample\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-requestor.html\">PAS Requestor Organization</a></p></div><p><b>identifier</b>: id: 8189991234</p><p><b>active</b>: true</p><p><b>type</b>: X3 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (98#X3)</span></p><p><b>name</b>: DR. JOE SMITH CORPORATION</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>"
];
fhir:Organization.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ];
fhir:Identifier.value [ fhir:value "8189991234" ]
];
fhir:Organization.active [ fhir:value "true"^^xsd:boolean];
fhir:Organization.type [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/98" ];
fhir:Coding.code [ fhir:value "X3" ] ]
];
fhir:Organization.name [ fhir:value "DR. JOE SMITH CORPORATION"];
fhir:Organization.address [
fhir:index 0;
fhir:Address.line [
fhir:value "111 1ST STREET";
fhir:index 0 ];
fhir:Address.city [ fhir:value "SAN DIEGO" ];
fhir:Address.state [ fhir:value "CA" ];
fhir:Address.postalCode [ fhir:value "92101" ];
fhir:Address.country [ fhir:value "US" ]
].
<http://example.org/fhir/Organization/InsurerExample> a fhir:Organization;
fhir:Resource.id [ fhir:value "InsurerExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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\">Resource \"InsurerExample\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-insurer.html\">PAS Insurer Organization</a></p></div><p><b>identifier</b>: id: 789312</p><p><b>active</b>: true</p><p><b>type</b>: PR <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (98#PR)</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>"
];
fhir:Organization.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ];
fhir:Identifier.value [ fhir:value "789312" ]
];
fhir:Organization.active [ fhir:value "true"^^xsd:boolean];
fhir:Organization.type [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/98" ];
fhir:Coding.code [ fhir:value "PR" ] ]
];
fhir:Organization.name [ fhir:value "MARYLAND CAPITAL INSURANCE COMPANY"].
<http://example.org/fhir/Patient/SubscriberExample> a fhir:Patient;
fhir:Resource.id [ fhir:value "SubscriberExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "extensions" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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\">Resource \"SubscriberExample\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-subscriber.html\">PAS Subscriber Patient</a></p></div><p><b>MilitaryStatus</b>: RU <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (584#RU)</span></p><p><b>identifier</b>: id: 12345678901</p><p><b>name</b>: JOE SMITH </p><p><b>gender</b>: male</p></div>"
];
fhir:DomainResource.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/584" ];
fhir:Coding.code [ fhir:value "RU" ] ] ]
];
fhir:Patient.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://example.org/MIN" ];
fhir:Identifier.value [ fhir:value "12345678901" ]
];
fhir:Patient.name [
fhir:index 0;
fhir:HumanName.family [ fhir:value "SMITH" ];
fhir:HumanName.given [
fhir:value "JOE";
fhir:index 0 ]
];
fhir:Patient.gender [ fhir:value "male"].
# - ontology header ------------------------------------------------------------
a owl:Ontology;
owl:imports fhir:fhir.ttl.
IG © 2020+ HL7 International - Financial Management Work Group. Package hl7.fhir.us.davinci-pas#1.1.0 based on FHIR 4.0.1. Generated 2021-12-20
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