Patient Cost Transparency Implementation Guide
1.1.0 - STU 1
Patient Cost Transparency Implementation Guide
1.1.0 - STU 1
This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v1.1.0: STU 1) based on FHIR (HL7® FHIR® Standard) 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
| Page standards status: Trial-use |
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<div xmlns="http://www.w3.org/1999/xhtml"><h2 id="title">Patient Cost Transparency Implementation Guide Capability Statement</h2><ul><li>Implementation Guide Version: 1.1.0</li><li>FHIR Version: 4.0.1</li><li>Supported Formats: <strong>SHALL</strong> support <code>json</code>, <strong>SHOULD</strong> support <code>xml</code></li><li>Supported Patch Formats: </li><li>Published on: Tue Mar 28 19:21:32 UTC 2023</li><li>Published by: HL7 International / Financial Management</li></ul><blockquote class="impl-note"><p><strong>Note to Implementers: FHIR Capabilities</strong></p><p>Any FHIR capability may be 'allowed' by the system unless explicitly marked as "SHALL NOT". A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.</p></blockquote><h2 id="rest">FHIR RESTful Capabilities</h2><div class="panel panel-default"><div class="panel-heading"><h3 id="mode1" class="panel-title">Mode: <code>server</code></h3></div><div class="panel-body"><div class="lead"><em>Summary of System-wide Interactions</em></div></div></div><h3 id="resourcesCap1">Capabilities by Resource/Profile</h3><h4 id="resourcesSummary1">Summary</h4><p>The summary table lists the resources that are part of this configuration, and for each resource it lists:</p><ul><li>The relevant profiles (if any)</li><li>The interactions supported by each resource (<b><span class="bg-info">R</span></b>ead, <b><span class="bg-info">S</span></b>earch, <b><span class="bg-info">U</span></b>pdate, and <b><span class="bg-info">C</span></b>reate, are always shown, while <b><span class="bg-info">VR</span></b>ead, <b><span class="bg-info">P</span></b>atch, <b><span class="bg-info">D</span></b>elete, <b><span class="bg-info">H</span></b>istory on <b><span class="bg-info">I</span></b>nstance, or <b><span class="bg-info">H</span></b>istory on <b><span class="bg-info">T</span></b>ype are only present if at least one of the resources has support for them.</li><li><span>The required, recommended, and some optional search parameters (if any). </span></li><li>The linked resources enabled for <code>_include</code></li><li>The other resources enabled for <code>_revinclude</code></li><li>The operations on the resource (if any)</li></ul><div class="table-responsive"><table class="table table-condensed table-hover"><thead><tr><th><b>Resource Type</b></th><th><b>Profile</b></th><th class="text-center"><b title="GET a resource (read interaction)">R</b></th><th class="text-center"><b title="GET past versions of resources (vread interaction)">V-R</b></th><th class="text-center"><b title="GET all set of resources of the type (search interaction)">S</b></th><th class="text-center"><b title="PUT a new resource version (update interaction)">U</b></th><th class="text-center"><b title="PATCH a new resource version (patch interaction)">P</b></th><th class="text-center"><b title="POST a new resource (create interaction)">C</b></th><th class="text-center"><b title="DELETE a resource (delete interaction)">D</b></th><th class="text-center"><b title="GET changes to a resource (history interaction on instance)">H-I</b></th><th class="text-center"><b title="GET changes for all resources of the type (history interaction on type)">H-T</b></th><th><b title="Required and recommended search parameters">Searches</b></th><th><code><b>_include</b></code></th><th><code><b>_revinclude</b></code></th><th><b>Operations</b></th></tr></thead><tbody><tr><td><a href="#Bundle1-1">Bundle</a></td><td>Supported profiles:<br/> <a href="StructureDefinition-davinci-pct-aeob-bundle.html">PCT AEOB Bundle</a><br/> <a href="StructureDefinition-davinci-pct-gfe-bundle.html">PCT GFE Bundle</a></td><td>y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td></td><td/><td/><td><code>$GFESubmit</code></td></tr><tr><td><a href="#ExplanationOfBenefit1-2">ExplanationOfBenefit</a></td><td>Supported profiles:<br/> <a href="StructureDefinition-davinci-pct-aeob.html">PCT Advanced EOB</a></td><td>y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td></td><td/><td/><td/></tr><tr><td><a href="#Coverage1-3">Coverage</a></td><td>Supported profiles:<br/> <a href="StructureDefinition-davinci-pct-coverage.html">PCT Coverage</a></td><td>y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td></td><td/><td/><td/></tr><tr><td><a href="#Claim1-4">Claim</a></td><td>Supported profiles:<br/> <a href="StructureDefinition-davinci-pct-gfe-professional.html">PCT Good Faith Estimate Professional</a><br/> <a href="StructureDefinition-davinci-pct-gfe-institutional.html">PCT Good Faith Estimate Institutional</a></td><td>y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td></td><td/><td/><td/></tr><tr><td><a href="#Organization1-5">Organization</a></td><td>Supported profiles:<br/> <a href="StructureDefinition-davinci-pct-organization.html">PCT Organization</a></td><td>y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td></td><td/><td/><td/></tr><tr><td><a href="#Practitioner1-6">Practitioner</a></td><td>Supported profiles:<br/> <a href="StructureDefinition-davinci-pct-practitioner.html">PCT Practitioner</a></td><td>y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td class="text-center">y</td><td></td><td/><td/><td/></tr></tbody></table></div><hr/><div class="panel panel-default"><div class="panel-heading"><h4 id="Bundle1-1" class="panel-title"><span style="float: right;">Resource Conformance: SHALL</span>Bundle</h4></div><div class="panel-body"><div class="container"><div class="row"><div class="col-lg-4"><span class="lead">Core FHIR Resource</span><br/><a href="http://hl7.org/fhir/R4/bundle.html">Bundle</a></div><div class="col-lg-4"><span class="lead">Reference Policy</span><br/></div><div class="col-lg-4"><span class="lead">Interaction summary</span><br/><ul><li><strong>SHALL</strong> support <code>search-type</code>, <code>read</code>.</li><li><strong>MAY</strong> support <code>create</code>, <code>vread</code>, <code>update</code>, <code>patch</code>, <code>delete</code>, <code>history-instance</code>, <code>history-type</code>.</li></ul></div></div><p/><div class="row"><div class="col-6"><span class="lead">Supported Profiles</span><p><a href="StructureDefinition-davinci-pct-aeob-bundle.html">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob-bundle</a><br/><a href="StructureDefinition-davinci-pct-gfe-bundle.html">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-bundle</a></p></div></div><p/><div class="row"><div class="col-12"><span class="lead">Extended Operations</span><table class="table table-condensed table-hover"><thead><tr><th>Conformance</th><th>Operation</th><th>Documentation</th></tr></thead><tbody><tr><td><b>SHALL</b></td><td><a href="OperationDefinition-GFE-submit.html">$GFESubmit</a></td><td><div><p>This operation is used by an entity to submit one or multiple GFEs as a Bundle containing the GFE(s) and other referenced resources for processing. The only input parameter is the single Bundle resource with one or multiple GFE(s) - each of which is based on the Claim resource (along with other referenced resources). The only output is a url for subsequent polling per <a href="https://hl7.org/fhir/R5/async-bundle.html">async pattern</a>. If after polling the response is complete, then the result will either be a single Bundle with the AEOB - which is based on the ExplanationOfBenefit resource, (and other referenced resources) or an OperationOutcome resource indicating the AEOB will be sent directly to the patient.</p>
</div></td></tr></tbody></table></div></div></div></div></div><div class="panel panel-default"><div class="panel-heading"><h4 id="ExplanationOfBenefit1-2" class="panel-title"><span style="float: right;">Resource Conformance: SHALL</span>ExplanationOfBenefit</h4></div><div class="panel-body"><div class="container"><div class="row"><div class="col-lg-4"><span class="lead">Core FHIR Resource</span><br/><a href="http://hl7.org/fhir/R4/explanationofbenefit.html">ExplanationOfBenefit</a></div><div class="col-lg-4"><span class="lead">Reference Policy</span><br/></div><div class="col-lg-4"><span class="lead">Interaction summary</span><br/><ul><li><strong>SHALL</strong> support <code>search-type</code>, <code>read</code>.</li><li><strong>MAY</strong> support <code>create</code>, <code>vread</code>, <code>update</code>, <code>patch</code>, <code>delete</code>, <code>history-instance</code>, <code>history-type</code>.</li></ul></div></div><p/><div class="row"><div class="col-6"><span class="lead">Supported Profiles</span><p><a href="StructureDefinition-davinci-pct-aeob.html">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob</a></p></div></div><p/></div></div></div><div class="panel panel-default"><div class="panel-heading"><h4 id="Coverage1-3" class="panel-title"><span style="float: right;">Resource Conformance: SHALL</span>Coverage</h4></div><div class="panel-body"><div class="container"><div class="row"><div class="col-lg-4"><span class="lead">Core FHIR Resource</span><br/><a href="http://hl7.org/fhir/R4/coverage.html">Coverage</a></div><div class="col-lg-4"><span class="lead">Reference Policy</span><br/></div><div class="col-lg-4"><span class="lead">Interaction summary</span><br/><ul><li><strong>SHALL</strong> support <code>search-type</code>, <code>read</code>.</li><li><strong>MAY</strong> support <code>create</code>, <code>vread</code>, <code>update</code>, <code>patch</code>, <code>delete</code>, <code>history-instance</code>, <code>history-type</code>.</li></ul></div></div><p/><div class="row"><div class="col-6"><span class="lead">Supported Profiles</span><p><a href="StructureDefinition-davinci-pct-coverage.html">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage</a></p></div></div><p/></div></div></div><div class="panel panel-default"><div class="panel-heading"><h4 id="Claim1-4" class="panel-title"><span style="float: right;">Resource Conformance: SHALL</span>Claim</h4></div><div class="panel-body"><div class="container"><div class="row"><div class="col-lg-4"><span class="lead">Core FHIR Resource</span><br/><a href="http://hl7.org/fhir/R4/claim.html">Claim</a></div><div class="col-lg-4"><span class="lead">Reference Policy</span><br/></div><div class="col-lg-4"><span class="lead">Interaction summary</span><br/><ul><li><strong>SHALL</strong> support <code>search-type</code>, <code>read</code>.</li><li><strong>MAY</strong> support <code>create</code>, <code>vread</code>, <code>update</code>, <code>patch</code>, <code>delete</code>, <code>history-instance</code>, <code>history-type</code>.</li></ul></div></div><p/><div class="row"><div class="col-6"><span class="lead">Supported Profiles</span><p><a href="StructureDefinition-davinci-pct-gfe-professional.html">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional</a><br/><a href="StructureDefinition-davinci-pct-gfe-institutional.html">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-institutional</a></p></div></div><p/></div></div></div><div class="panel panel-default"><div class="panel-heading"><h4 id="Organization1-5" class="panel-title"><span style="float: right;">Resource Conformance: SHALL</span>Organization</h4></div><div class="panel-body"><div class="container"><div class="row"><div class="col-lg-4"><span class="lead">Core FHIR Resource</span><br/><a href="http://hl7.org/fhir/R4/organization.html">Organization</a></div><div class="col-lg-4"><span class="lead">Reference Policy</span><br/></div><div class="col-lg-4"><span class="lead">Interaction summary</span><br/><ul><li><strong>SHALL</strong> support <code>search-type</code>, <code>read</code>.</li><li><strong>MAY</strong> support <code>create</code>, <code>vread</code>, <code>update</code>, <code>patch</code>, <code>delete</code>, <code>history-instance</code>, <code>history-type</code>.</li></ul></div></div><p/><div class="row"><div class="col-6"><span class="lead">Supported Profiles</span><p><a href="StructureDefinition-davinci-pct-organization.html">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization</a></p></div></div><p/></div></div></div><div class="panel panel-default"><div class="panel-heading"><h4 id="Practitioner1-6" class="panel-title"><span style="float: right;">Resource Conformance: SHALL</span>Practitioner</h4></div><div class="panel-body"><div class="container"><div class="row"><div class="col-lg-4"><span class="lead">Core FHIR Resource</span><br/><a href="http://hl7.org/fhir/R4/practitioner.html">Practitioner</a></div><div class="col-lg-4"><span class="lead">Reference Policy</span><br/></div><div class="col-lg-4"><span class="lead">Interaction summary</span><br/><ul><li><strong>SHALL</strong> support <code>search-type</code>, <code>read</code>.</li><li><strong>MAY</strong> support <code>create</code>, <code>vread</code>, <code>update</code>, <code>patch</code>, <code>delete</code>, <code>history-instance</code>, <code>history-type</code>.</li></ul></div></div><p/><div class="row"><div class="col-6"><span class="lead">Supported Profiles</span><p><a href="StructureDefinition-davinci-pct-practitioner.html">http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner</a></p></div></div><p/></div></div></div></div>
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<valueCode value="MAY"/>
</extension>
<code value="history-instance"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-type"/>
</interaction>
</resource>
<resource>
<type value="Claim">
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
</type>
<supportedProfile
value="http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional">🔗
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<supportedProfile
value="http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-institutional">🔗
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="create"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="read"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="vread"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="update"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="patch"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="delete"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-instance"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-type"/>
</interaction>
</resource>
<resource>
<type value="Organization">
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
</type>
<supportedProfile
value="http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization">🔗
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="create"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="read"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="vread"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="update"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="patch"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="delete"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-instance"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-type"/>
</interaction>
</resource>
<resource>
<type value="Practitioner">
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
</type>
<supportedProfile
value="http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner">🔗
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
</supportedProfile>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="create"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="read"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="vread"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="update"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="patch"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="delete"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-instance"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="MAY"/>
</extension>
<code value="history-type"/>
</interaction>
</resource>
</rest>
</CapabilityStatement>
IG © 2023+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pct#1.1.0 based on FHIR 4.0.1. Generated 2024-01-03
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