Da Vinci Prior Authorization Support (PAS) FHIR IG
1.0.0 - STU 1

This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

Example Claim: Medical Services Authorization Example

Generated Narrative

identifier: id: 111099

status: active

type: Professional

use: preauthorization

patient: Generated Summary: id: 12345678901; JOE SMITH ; gender: male

created: May 2, 2005 6:01:00 AM

insurer: Generated Summary: id: 789312; active; PR; name: MARYLAND CAPITAL INSURANCE COMPANY

provider: Generated Summary: id: 8189991234; active; X3; name: DR. JOE SMITH CORPORATION

priority: Normal

Insurances

-SequenceFocalCoverage
*1trueGenerated Summary: status: active

Items

-ExtensionSequenceCareTeamSequenceDiagnosisSequenceProductOrServiceServiced[x]Location[x]
*, 111Established Office Visit2005-05-1011