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: Referral 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

CareTeams

-SequenceProvider
*1Generated Summary: id: 987654321; SUSAN WATSON ; Phone: 4029993456

Diagnoses

-SequenceDiagnosis[x]
*1Chronic pain syndrome

Insurances

-SequenceFocalCoverage
*1trueGenerated Summary: status: active

Items

-ExtensionSequenceCareTeamSequenceDiagnosisSequenceProductOrServiceLocation[x]
*, , 111Consultation11