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

Example Claim: Homecare Authorization Example

Generated Narrative

Resource "HomecareAuthorizationExample"

Profile: PAS Claim

identifier: id: 111099

status: active

type: Professional (Claim Type Codes#professional)

use: preauthorization

patient: Patient/SubscriberExample " SMITH"

created: 2019-07-20T11:01:00+05:00

insurer: Organization/InsurerExample "MARYLAND CAPITAL INSURANCE COMPANY"

provider: Organization/UMOExample "DR. JOE SMITH CORPORATION"

priority: Normal (Process Priority Codes#normal)

Insurances

-SequenceFocalCoverage
*1trueCoverage/InsuranceExample

item

ServiceItemRequestType: Health Services Review (1525#HS)

CertificationType: Initial (1322#I)

sequence: 1

productOrService: G0154 (Current Procedural Terminology (CPT®)#G0154)

item

ServiceItemRequestType: Health Services Review (1525#HS)

CertificationType: Initial (1322#I)

sequence: 2

productOrService: B4184 (Current Procedural Terminology (CPT®)#B4184)