description: A Group resource representing the treatment relationship between a specific member/patient and one or more healthcare providers. The Payer is the managing organization. The member is identified through a characteristic containing the Patient ID. The group members are the providers that have an active or confirmed treatment relationship with the member.
package_name: hl7.fhir.us.davinci-pdex
derivation: constraint
name: MemberProviderTreatmentRelationship
type: Group
elements:
  type:
    short: Type of group (practitioners with treatment relationship)
    mustSupport: true
    pattern: {type: Code, value: practitioner}
    index: 2
  member:
    short: Providers with treatment relationship to the member
    mustSupport: true
    index: 16
    elements:
      entity:
        type: Reference
        short: Provider entity
        mustSupport: true
        refers: ['http://hl7.org/fhir/StructureDefinition/Practitioner', 'http://hl7.org/fhir/StructureDefinition/PractitionerRole']
        index: 17
        extensions:
          treatmentDetails: {url: 'http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/treatment-relationship-details', min: 0, max: 1, type: Extension, short: Details of the treatment relationship, index: 18}
        elements:
          extension:
            type: Extension
            short: Details of the treatment relationship
            url: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/treatment-relationship-details
            index: 18
            slicing:
              slices:
                treatmentDetails:
                  match: {}
                  schema: {type: Extension, short: Details of the treatment relationship, url: 'http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/treatment-relationship-details', index: 18}
                  min: 0
                  max: 1
      inactive: {short: Whether the treatment relationship is currently active, index: 19}
  characteristic:
    short: Member/Patient identifier and other characteristics
    mustSupport: true
    index: 7
    elements:
      code:
        short: Identifies the member characteristic
        mustSupport: true
        pattern:
          type: CodeableConcept
          value:
            coding:
            - {code: pdex-member, system: 'http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMemberAttributionCS', display: PDex Member}
        index: 8
      value:
        mustSupport: true
        choices: []
        index: 10
        slicing:
          rules: open
          ordered: false
          discriminator:
          - {path: $this, type: type}
          min: null
          slices:
            valueReference:
              match: {}
              schema:
                short: Reference to the member/patient
                mustSupport: true
                choices: [valueReference]
                index: 12
              min: 0
              max: 1
      valueReference:
        short: Reference to the member/patient
        refers: ['http://hl7.org/fhir/StructureDefinition/Patient']
        type: Reference
        mustSupport: true
        choiceOf: value
        index: 13
        slicing:
          slices:
            valueReference:
              match: {}
              schema:
                short: Reference to the member/patient
                refers: ['http://hl7.org/fhir/StructureDefinition/Patient']
                type: Reference
                mustSupport: true
                choiceOf: value
                index: 13
              min: 0
              max: 1
      exclude:
        short: This is an include, not an exclude
        pattern: {type: Boolean, value: false}
        index: 14
      period: {short: Period during which this group is valid, mustSupport: true, index: 15}
  active:
    short: Treatment relationship group is active
    mustSupport: true
    pattern: {type: Boolean, value: true}
    index: 1
  code:
    short: Kind of treatment relationship
    binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS'}
    mustSupport: true
    index: 4
  identifier: {short: Unique identifier for the treatment relationship group, mustSupport: true, index: 0}
  quantity: {short: Number of providers in the group, mustSupport: true, index: 5}
  managingEntity:
    type: Reference
    short: The Payer managing this treatment relationship
    mustSupport: true
    refers: ['http://hl7.org/fhir/StructureDefinition/Organization']
    index: 6
  actual:
    short: This is an actual collection of providers
    mustSupport: true
    pattern: {type: Boolean, value: true}
    index: 3
package_version: 2.2.0
class: profile
kind: resource
url: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-treatment-relationship
base: http://hl7.org/fhir/StructureDefinition/Group
version: 2.2.0