Da Vinci Prior Authorization Support (PAS) FHIR IG
1.0.0 - STU 1
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 
| Defining URL: | http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer |
| Version: | 1.0.0 |
| Name: | PASInsurer |
| Title: | PAS Insurer Organization |
| Status: | Active as of 2020-12-20T19:17:24+00:00 |
| Definition: | An organization who provides insurance and is the receiver of a prior authorization request. |
| Publisher: | HL7 International - Financial Management Work Group |
| Source Resource: | XML / JSON / Turtle |
The official URL for this profile is:
http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from USCoreOrganizationProfile
This structure is derived from USCoreOrganizationProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Organization | 0..* | USCoreOrganizationProfile | A grouping of people or organizations with a common purpose | |
  type | S | 0..* | CodeableConcept | Kind of organization Binding: https://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98 (required): Codes identifying an organizational entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Organization | I | 0..* | USCoreOrganizationProfile | A grouping of people or organizations with a common purpose |
  id | Σ | 0..1 | string | Logical id of this artifact |
 meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
| contained | 0..* | Resource | Contained, inline Resources | |
 extension | 0..* | Extension | Additional content defined by implementations | |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
  identifier | SΣI | 0..* | (Slice Definition) | Identifies this organization across multiple systems Slice: Unordered, Open by pattern:$this |
  identifier:All Slices | Content/Rules for all slices | |||
  id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | SΣ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
| value | SΣ | 0..1 | string | The value that is unique Example General: 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
  assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
 identifier:NPI | SΣI | 0..1 | Identifier | National Provider Identifier (NPI) Required Pattern: At least the following |
 id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| use | 0..1 | code | usual | official | temp | secondary | old (If known) | |
| type | 0..1 | CodeableConcept | Description of identifier | |
 system | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi | |
| value | 0..1 | string | The value that is unique | |
| period | 0..1 | Period | Time period when id is/was valid for use | |
 assigner | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | |
 identifier:CLIA | SΣI | 0..1 | Identifier | Clinical Laboratory Improvement Amendments (CLIA) Number for laboratories Required Pattern: At least the following |
 id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| use | 0..1 | code | usual | official | temp | secondary | old (If known) | |
| type | 0..1 | CodeableConcept | Description of identifier | |
| system | 1..1 | uri | The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.4.7 | |
| value | 0..1 | string | The value that is unique | |
| period | 0..1 | Period | Time period when id is/was valid for use | |
| assigner | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | |
| active | ?!SΣ | 1..1 | boolean | Whether the organization's record is still in active use |
| type | SΣ | 0..* | CodeableConcept | Kind of organization Binding: https://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98 (required): Codes identifying an organizational entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. |
| name | SΣI | 1..1 | string | Name used for the organization |
| alias | 0..* | string | A list of alternate names that the organization is known as, or was known as in the past | |
| telecom | SI | 0..* | ContactPoint | A contact detail for the organization |
| address | SI | 0..* | Address | An address for the organization |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home |
| type | Σ | 0..1 | code | postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both |
| text | Σ | 0..1 | string | Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132 |
| line | SΣ | 0..4 | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street |
| city | SΣ | 0..1 | string | Name of city, town etc. Example General: Erewhon |
| district | Σ | 0..1 | string | District name (aka county) Example General: Madison |
| state | SΣ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes. |
| postalCode | SΣ | 0..1 | string | US Zip Codes Example General: 9132 |
| country | SΣ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code) |
| period | Σ | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23T00:00:00+11:00","end":"2010-07-01T00:00:00+10:00"} |
| partOf | Σ | 0..1 | Reference(Organization) | The organization of which this organization forms a part |
| contact | 0..* | BackboneElement | Contact for the organization for a certain purpose | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| purpose | 0..1 | CodeableConcept | The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party. | |
| name | 0..1 | HumanName | A name associated with the contact | |
| telecom | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact | |
| address | 0..1 | Address | Visiting or postal addresses for the contact | |
| endpoint | 0..* | Reference(Endpoint) | Technical endpoints providing access to services operated for the organization | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Organization | I | 0..* | USCoreOrganizationProfile | A grouping of people or organizations with a common purpose |
| identifier | ΣI | 0..* | (Slice Definition) | Identifies this organization across multiple systems Slice: Unordered, Open by pattern:$this |
| identifier:All Slices | Content/Rules for all slices | |||
| system | Σ | 0..1 | uri | The namespace for the identifier value |
| value | Σ | 0..1 | string | The value that is unique |
| identifier:NPI | ΣI | 0..1 | Identifier | National Provider Identifier (NPI) Required Pattern: At least the following |
| system | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi | |
| identifier:CLIA | ΣI | 0..1 | Identifier | Clinical Laboratory Improvement Amendments (CLIA) Number for laboratories Required Pattern: At least the following |
| system | 1..1 | uri | The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.4.7 | |
| active | ?!Σ | 1..1 | boolean | Whether the organization's record is still in active use |
| type | Σ | 0..* | CodeableConcept | Kind of organization Binding: https://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98 (required): Codes identifying an organizational entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. |
| name | ΣI | 1..1 | string | Name used for the organization |
| telecom | I | 0..* | ContactPoint | A contact detail for the organization |
 address | I | 0..* | Address | An address for the organization |
| line | Σ | 0..4 | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label |
| city | Σ | 0..1 | string | Name of city, town etc. |
| state | Σ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes. |
| postalCode | Σ | 0..1 | string | US Zip Codes |
| country | Σ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code) |
| Documentation for this format | ||||
This structure is derived from USCoreOrganizationProfile
Differential View
This structure is derived from USCoreOrganizationProfile
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Organization | 0..* | USCoreOrganizationProfile | A grouping of people or organizations with a common purpose | |
| type | S | 0..* | CodeableConcept | Kind of organization Binding: https://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98 (required): Codes identifying an organizational entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. |
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Organization | I | 0..* | USCoreOrganizationProfile | A grouping of people or organizations with a common purpose |
| id | Σ | 0..1 | string | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
| contained | 0..* | Resource | Contained, inline Resources | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | SΣI | 0..* | (Slice Definition) | Identifies this organization across multiple systems Slice: Unordered, Open by pattern:$this |
| identifier:All Slices | Content/Rules for all slices | |||
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | SΣ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
| value | SΣ | 0..1 | string | The value that is unique Example General: 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| identifier:NPI | SΣI | 0..1 | Identifier | National Provider Identifier (NPI) Required Pattern: At least the following |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| use | 0..1 | code | usual | official | temp | secondary | old (If known) | |
| type | 0..1 | CodeableConcept | Description of identifier | |
| system | 1..1 | uri | The namespace for the identifier value Fixed Value: http://hl7.org/fhir/sid/us-npi | |
| value | 0..1 | string | The value that is unique | |
| period | 0..1 | Period | Time period when id is/was valid for use | |
| assigner | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | |
| identifier:CLIA | SΣI | 0..1 | Identifier | Clinical Laboratory Improvement Amendments (CLIA) Number for laboratories Required Pattern: At least the following |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| use | 0..1 | code | usual | official | temp | secondary | old (If known) | |
| type | 0..1 | CodeableConcept | Description of identifier | |
| system | 1..1 | uri | The namespace for the identifier value Fixed Value: urn:oid:2.16.840.1.113883.4.7 | |
| value | 0..1 | string | The value that is unique | |
| period | 0..1 | Period | Time period when id is/was valid for use | |
| assigner | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | |
| active | ?!SΣ | 1..1 | boolean | Whether the organization's record is still in active use |
| type | SΣ | 0..* | CodeableConcept | Kind of organization Binding: https://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98 (required): Codes identifying an organizational entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. |
| name | SΣI | 1..1 | string | Name used for the organization |
| alias | 0..* | string | A list of alternate names that the organization is known as, or was known as in the past | |
| telecom | SI | 0..* | ContactPoint | A contact detail for the organization |
| address | SI | 0..* | Address | An address for the organization |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | home | work | temp | old | billing - purpose of this address Binding: AddressUse (required): The use of an address. Example General: home |
| type | Σ | 0..1 | code | postal | physical | both Binding: AddressType (required): The type of an address (physical / postal). Example General: both |
| text | Σ | 0..1 | string | Text representation of the address Example General: 137 Nowhere Street, Erewhon 9132 |
| line | SΣ | 0..4 | string | Street name, number, direction & P.O. Box etc. This repeating element order: The order in which lines should appear in an address label Example General: 137 Nowhere Street |
| city | SΣ | 0..1 | string | Name of city, town etc. Example General: Erewhon |
| district | Σ | 0..1 | string | District name (aka county) Example General: Madison |
| state | SΣ | 0..1 | string | Sub-unit of country (abbreviations ok) Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes. |
| postalCode | SΣ | 0..1 | string | US Zip Codes Example General: 9132 |
| country | SΣ | 0..1 | string | Country (e.g. can be ISO 3166 2 or 3 letter code) |
| period | Σ | 0..1 | Period | Time period when address was/is in use Example General: {"start":"2010-03-23T00:00:00+11:00","end":"2010-07-01T00:00:00+10:00"} |
| partOf | Σ | 0..1 | Reference(Organization) | The organization of which this organization forms a part |
| contact | 0..* | BackboneElement | Contact for the organization for a certain purpose | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| purpose | 0..1 | CodeableConcept | The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party. | |
| name | 0..1 | HumanName | A name associated with the contact | |
| telecom | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact | |
| address | 0..1 | Address | Visiting or postal addresses for the contact | |
| endpoint | 0..* | Reference(Endpoint) | Technical endpoints providing access to services operated for the organization | |
| Documentation for this format | ||||
Other representations of profile: Schematron
| Path | Conformance | ValueSet |
| Organization.language | preferred | CommonLanguages Max Binding: AllLanguages |
| Organization.identifier.use | required | IdentifierUse |
| Organization.identifier.type | extensible | Identifier Type Codes |
| Organization.type | required | https://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98 |
| Organization.address.use | required | AddressUse |
| Organization.address.type | required | AddressType |
| Organization.address.state | extensible | UspsTwoLetterAlphabeticCodes |
| Organization.contact.purpose | extensible | ContactEntityType |
IG © 2020+ HL7 International - Financial Management Work Group. Package hl7.fhir.us.davinci-pas#1.0.0 based on FHIR 4.0.1. Generated 2020-12-20
Links: Table of Contents |
QA Report
| Version History |
Search |
|
Propose a change