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: Medical Services Authorization Example

Generated Narrative

Resource "MedicalServicesAuthorizationExample"

Profile: PAS Claim

identifier: id: 111099

status: active

type: Professional (Claim Type Codes#professional)

use: preauthorization

patient: Patient/SubscriberExample " SMITH"

created: 2005-05-02T11:01:00+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

Items

-ExtensionSequenceProductOrServiceServiced[x]Location[x]
*, , , 1Established Office Visit (Current Procedural Terminology (CPT®)#99212)2005-05-1011 (CMS Place of Service Codes (POS)#11)