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

: Submit Claim Insurance Example - JSON Representation

Raw json | Download


{
  "resourceType" : "Coverage",
  "id" : "InsuranceExample",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage"
    ]
  },
  "text" : {
    "status" : "generated",
    "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 \"InsuranceExample\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-coverage.html\">PAS Coverage</a></p></div><p><b>status</b>: active</p><p><b>beneficiary</b>: <a href=\"Patient-SubscriberExample.html\">Patient/SubscriberExample</a> \" SMITH\"</p><p><b>payor</b>: <a href=\"Organization-InsurerExample.html\">Organization/InsurerExample</a> \"MARYLAND CAPITAL INSURANCE COMPANY\"</p></div>"
  },
  "status" : "active",
  "beneficiary" : {
    "reference" : "Patient/SubscriberExample"
  },
  "payor" : [
    {
      "reference" : "Organization/InsurerExample"
    }
  ]
}