Da Vinci Payer Data Exchange
2.1.0 - STU 2.1 United States of America flag

Publication Build: This will be filled in by the publication tooling

Example Consent: PDex Provider Access Consent Example

Page standards status: Informative

status: Active

scope: Privacy Consent

category: information disclosure

patient: Johnny Appleseed Male, DoB: 1986-01-01 ( Member Number)

performer: Johnny Appleseed Male, DoB: 1986-01-01 ( Member Number)

organization: Organization Payer 1

policyRule: Common Rule Informed Consent

provision

type: Opt Out

period: 2024-06-11 --> (ongoing)

Actors

-RoleReference
*PerformerMy Health Plan (Identifier: NPI/0123456789)

action: Disclose