{ "description": "To support the request for cost information for specific services and items from the payer and return them in near real-time to allow effective decision making by the patient in consultation with the 'ordering' provider.", "_filename": "ImplementationGuide-hl7.fhir.us.davinci-pct.json", "package_name": "hl7.fhir.us.davinci-pct", "definition": { "page": { "page": [ { "title": "Patient Cost Transparency Implementation Guide Home Page", "nameUrl": "index.html", "generation": "markdown" }, { "title": "Use Cases and Overview", "nameUrl": "use_cases.html", "generation": "markdown" }, { "title": "Technical Background and Underlying Technologies", "nameUrl": "underlying_technologies.html", "generation": "markdown" }, { "title": "Formal Specification", "nameUrl": "formal_specification.html", "generation": "markdown" }, { "title": "Terminology Licensure", "nameUrl": "terminology_licensure.html", "generation": "markdown" }, { "title": "Credits", "nameUrl": "credits.html", "generation": "markdown" } ], "title": "Table of Contents", "nameUrl": "toc.html", "generation": "html" }, "resource": [ { "name": "PCT AEOB Bundle", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:resource" } ], "reference": { "reference": "StructureDefinition/davinci-pct-aeob-bundle" }, "description": "PCT AEOB Bundle that contains necessary resources for an AEOBs. Organizations for both the payer and provider SHALL be included.", "exampleBoolean": false }, { "name": "PCT Advanced EOB", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:resource" } ], "reference": { "reference": "StructureDefinition/davinci-pct-aeob" }, "description": "The No Surprises Act requires that group health plans and insurers provide advance cost estimates, called advanced explanations of benefits (advanced EOBs), for scheduled services. This profile is used for exchanging the Advanced EOB data.", "exampleBoolean": false }, { "name": "PCT Coverage", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:resource" } ], "reference": { "reference": "StructureDefinition/davinci-pct-coverage" }, "description": "PCT Coverage is a profile for capturing data that reflect a payer’s coverage that was effective as of the proposed date of service or the date of admission of the GFE.", "exampleBoolean": false }, { "name": "PCT GFE Bundle", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:resource" } ], "reference": { "reference": "StructureDefinition/davinci-pct-gfe-bundle" }, "description": "PCT GFE Bundle that contains necessary resources as a GFE Submission for obtaining an AEOB. Organizations for both the provider and payer SHALL be included.", "exampleBoolean": false }, { "name": "PCT Good Faith Estimate Institutional", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:resource" } ], "reference": { "reference": "StructureDefinition/pct-gfe-Institutional" }, "description": "PCT Good Faith Estimate Institutional is a profile for capturing submission data needed to be processed by a payer for the creation of an Advanced EOB. This profile is used for an institutional GFE submission.", "exampleBoolean": false }, { "name": "PCT Good Faith Estimate Professional", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:resource" } ], "reference": { "reference": "StructureDefinition/davinci-pct-gfe-professional" }, "description": "PCT Good Faith Estimate Professional is a profile for capturing submission data needed to be processed by a payer for the creation of an Advanced EOB. This profile is used for a professional GFE submission.", "exampleBoolean": false }, { "name": "PCT Location", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:resource" } ], "reference": { "reference": "StructureDefinition/davinci-pct-location" }, "description": "The PCT Location profile builds upon the US Core Location profile and is used with other PCT profile resources.", "exampleBoolean": false }, { "name": "PCT Organization", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:resource" } ], "reference": { "reference": "StructureDefinition/davinci-pct-organization" }, "description": "The PCT Organization profile builds upon the US Core Organization profile. It is used to convey a payer, provider, payee, or service facility organization.", "exampleBoolean": false }, { "name": "PCT Patient", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:resource" } ], "reference": { "reference": "StructureDefinition/davinci-pct-patient" }, "description": "The PCT Patient profile builds upon the US Core Patient profile. It is used to convey information about the patient who will be receiving the services as described on the GFE.", "exampleBoolean": false }, { "name": "PCT Practitioner", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:resource" } ], "reference": { "reference": "StructureDefinition/davinci-pct-practitioner" }, "description": "The PCT Practitioner profile builds upon the US Core Practitioner profile. It is used to convey information about the practitioner who will be providing services to the patient as described on the GFE.", "exampleBoolean": false }, { "name": "PCT PractitionerRole", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:resource" } ], "reference": { "reference": "StructureDefinition/davinci-pct-practitionerrole" }, "description": "The PCT PractitionerRole profile builds upon the US Core PractitionerRole profile. It is used to convey information about the practitioner who will be providing services to the patient as described on the GFE.", "exampleBoolean": false }, { "name": "CompoundDrugLinkingNumber", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/compoundDrugLinkingNum" }, "description": "This extension is used to provide the Compound Drug Linking Number.", "exampleBoolean": false }, { "name": "CountrySubdivisionCode", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/countrySubdivisionCode" }, "description": "This extension is used to provide the Country Subdivision Code - from Part 2 of ISO 3166.", "exampleBoolean": false }, { "name": "Disclaimer", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/disclaimer" }, "description": "This extension allows the payer to declare a disclaimer concerning the estimated costs provided in the AEOB.", "exampleBoolean": false }, { "name": "EstimatedDateOfService", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/estimatedDateOfService" }, "description": "This extension is used to provide the estimated date or dates of service or product delivery", "exampleBoolean": false }, { "name": "Expiration Date", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/expirationDate" }, "description": "This extension is used to indicate a specific date after which the issued AEOB is considered obsolete.", "exampleBoolean": false }, { "name": "GFEBillingProviderLineItemCtrlNum", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/gfeBillingProviderLineItemCtrlNum" }, "description": "This extension is used to provide the GFE Billing Provider Line Item Control Number.", "exampleBoolean": false }, { "name": "GFEProviderAssignedIdentifier", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/gfeProviderAssignedIdentifier" }, "description": "This extension is used to indicate the GFE Provider Assigned Identifier.", "exampleBoolean": false }, { "name": "GFE Reference", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/gfeReference" }, "description": "This extension is used to reference the GFE submitted by an entity that started the process for obtaining an Advanced EOB.", "exampleBoolean": false }, { "name": "GFEServiceLinkingInfo", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/gfeServiceLinkingInfo" }, "description": "This extension is used to provide the GFE Service Linking Information.", "exampleBoolean": false }, { "name": "GFESubmitter", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/gfeSubmitter" }, "description": "This extension is used to indicate the scheduling entity that submits the GFE to provide a collection of services to a payer for the creation of an Advanced EOB.", "exampleBoolean": false }, { "name": "InterTransIdentifier", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/interTransIdentifier" }, "description": "This extension is used to provide the GFE Service Identifier for Transmission Intermediaries.", "exampleBoolean": false }, { "name": "Out Of Network Provider Info", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/outOfNetworkProviderInfo" }, "description": "This extension is used to provide a reference to a web site for finding information on the out-of-network provider.", "exampleBoolean": false }, { "name": "PCTEndpoint", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/endpoint" }, "description": "This extension is used to provide an endpoint.", "exampleBoolean": false }, { "name": "ProviderEventMethodology", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/providerEventMethodology" }, "description": "This extension is used for indicating how the provider determined the number of providers involved--through internal experience/analysis or an external methodology.", "exampleBoolean": false }, { "name": "ProviderTaxonomy", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/providerTaxonomy" }, "description": "This extension is used to indicate the taxonomy code of the provider.", "exampleBoolean": false }, { "name": "ReferralNumber", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/referralNumber" }, "description": "This extension is used to provide the Referral Number.", "exampleBoolean": false }, { "name": "Subject To Medical Management", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "StructureDefinition:extension" } ], "reference": { "reference": "StructureDefinition/subjectToMedicalMgmt" }, "description": "This extension is used to provide a reason to explain how the estimate may change subject to medical management.", "exampleBoolean": false }, { "name": "PCT Care Team Role Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTCareTeamRoleVS" }, "description": "Codes to specify the the functional roles of the care team members.", "exampleBoolean": false }, { "name": "PCT Coverage Copay Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/pct-coverage-copay-codes" }, "description": "Codes for the classification of insurance coverage copay types for patient. This is an extension of the CoverageCopayTypeCodes value set", "exampleBoolean": false }, { "name": "PCT Diagnosis Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTDiagnosisTypeVS" }, "description": "Codes to specify the type of diagnosis", "exampleBoolean": false }, { "name": "PCT ICD-10 Diagnostic Codes", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTDiagnosticCodes" }, "description": "ICD-10 Codes to specify the type of diagnosis", "exampleBoolean": false }, { "name": "PCT GFE CMS Place of Service Value Set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTGFECMSPOS" }, "description": "CMS Place of Service codes", "exampleBoolean": false }, { "name": "PCT GFE Item Adjudication Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTGFEItemAdjudicationVS" }, "description": "Sample Adjudication codes to indicate the amounts eligible under the plan, the amount of benefit, copays etc.", "exampleBoolean": false }, { "name": "PCT GFE Item CPT - HCPCS - HIPPS Value Set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTGFEItemCptHcpcsHippsVS" }, "description": "CPT - HCPCS - HIPPS codes to report medical procedures and services under public and private health insurance programs", "exampleBoolean": false }, { "name": "PCT GFE Item CPT - HCPCS Value Set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTGFEItemCptHcpcsVS" }, "description": "CPT - HCPCS codes to report medical procedures and services under public and private health insurance programs", "exampleBoolean": false }, { "name": "PCT GFE Item NDC Value Set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTGFEItemNDCVS" }, "description": "The FDA published list of NDC codes for finished drug products", "exampleBoolean": false }, { "name": "PCT GFE NUBC Revenue Value Set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTGFEItemRevenueVS" }, "description": "NUBC UB-04 Revenue codes", "exampleBoolean": false }, { "name": "PCT GFE NUBC Uniform Billing (UB-04) Type of Bill Value Set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTGFETypeOfBillVS" }, "description": "NUBC Uniform Billing (UB-04) codes to indicate the specific Type of Bill (TOB), e.g., hospital inpatient, outpatient, replacements, voids, etc. The first digit is a leading zero*. The fourth digit defines the frequency of the bill for the institutional and electronic professional claim.", "exampleBoolean": false }, { "name": "PCT Organization Contact Purpose Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTOrgContactPurposeTypeVS" }, "description": "Codes for the classification of organization contact purposes", "exampleBoolean": false }, { "name": "PCT Organization Identifier Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTOrgIdentifierTypeVS" }, "description": "Codes to specify the type of identifiers for organizations to indicate usage for a specific purpose", "exampleBoolean": false }, { "name": "PCT Organization Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTOrganizationTypeVS" }, "description": "Codes to specify the type of entity involved in the PCT GFE process", "exampleBoolean": false }, { "name": "PCT CMS HCPCS and AMA CPT Procedure Surgical Codes", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTProcedureSurgicalCodes" }, "description": "Combination of CMS HCPCS and AMA CPT codes to specify the type of surgical procedure", "exampleBoolean": false }, { "name": "PCT Procedure Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTProcedureTypeVS" }, "description": "Codes to specify the type of procedure", "exampleBoolean": false }, { "name": "PCT Subject-To-Medical-Management Reason Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTSubjectToMedicalMgmtReasonVS" }, "description": "Codes for the classification of subject-to-medical-management reasons", "exampleBoolean": false }, { "name": "PCT Supporting Info Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ValueSet" } ], "reference": { "reference": "ValueSet/PCTSupportingInfoTypeVS" }, "description": "Codes to specify the type of the supplied supporting information", "exampleBoolean": false }, { "name": "PCT Adjudication Category Type", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTAdjudicationCategoryType" }, "description": "Describes the various amount fields used when payers receive and adjudicate a claim. It complements the values defined in http://terminology.hl7.org/CodeSystem/adjudication.", "exampleBoolean": false }, { "name": "PCT Care Team Role", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTCareTeamRole" }, "description": "PCT code system for defining the functional roles of the care team members.", "exampleBoolean": false }, { "name": "PCT Coverage Copay Type Code System", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTCoverageCopayTypeCS" }, "description": "Defining codes for the classification of insurance coverage copay types for patient", "exampleBoolean": false }, { "name": "PCT Diagnosis Type", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTDiagnosisType" }, "description": "Defining codes for the classification of diagnosis types", "exampleBoolean": false }, { "name": "PCT GFE Item Procedure Code System", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTGFEItemProcedureCodes" }, "description": "Defining codes to report medical procedures and services under public and private health insurance programs", "exampleBoolean": false }, { "name": "PCT GFE Item Revenue Code System", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTGFEItemRevenueCS" }, "description": "Defining codes to report medical procedures and services under public and private health insurance programs", "exampleBoolean": false }, { "name": "PCT GFE Type Of Bill Code System", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTGFETypeOfBillCS" }, "description": "Defining codes to indicate the specific Type of Bill (TOB)", "exampleBoolean": false }, { "name": "PCT Organization Contact Purpose Type Code System", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTOrgContactPurposeType" }, "description": "Organization Contact Purpose Type Code System", "exampleBoolean": false }, { "name": "PCT Organization Identifier Type Code System", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTOrgIdentifierTypeCS" }, "description": "Identifier Type codes for defining the type of identifier payers and providers assign to organizations", "exampleBoolean": false }, { "name": "PCT Organization Type Code System", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTOrganizationTypeCS" }, "description": "Organization Type codes for describing the type of organizations involved in the PCT GFE process", "exampleBoolean": false }, { "name": "PCT Procedure Surgical Code System", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTProcedureSurgicalCS" }, "description": "Defining codes for the classification of surgical procedure types", "exampleBoolean": false }, { "name": "PCT Procedure Type", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTProcedureType" }, "description": "Defining codes for the classification of procedure types", "exampleBoolean": false }, { "name": "PCT Subject-To-Medical-Management Reason Code System", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTSubjectToMedicalMgmtReasonCS" }, "description": "Defining codes for the classification of subject-to-medical-management reason types", "exampleBoolean": false }, { "name": "PCT GFE Supporting Info Type Code System", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "CodeSystem" } ], "reference": { "reference": "CodeSystem/PCTSupportingInfoType" }, "description": "Defining codes for the classification of the supplied supporting information", "exampleBoolean": false }, { "name": "GFESubmitOperation", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "OperationDefinition" } ], "reference": { "reference": "OperationDefinition/GFE-submit" }, "description": "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) and the only output is a single Bundle with the AEOB - which is based on the ExplanationOfBenefit resource, (and other referenced resources) or an OperationOutcome resource.", "exampleBoolean": false }, { "name": "PCT-AEOB-1", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "ExplanationOfBenefit" } ], "reference": { "reference": "ExplanationOfBenefit/PCT-AEOB-1" }, "description": "An instance of the PCTAdvancedEOB Profile", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob" }, { "name": "PCT-AEOB-Bundle-1", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Bundle" } ], "reference": { "reference": "Bundle/PCT-AEOB-Bundle-1" }, "description": "PCT AEOB Bundle Example 1", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob-bundle" }, { "name": "PCT-GFE-Bundle-Inst-1", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Bundle" } ], "reference": { "reference": "Bundle/PCT-GFE-Bundle-Inst-1" }, "description": "PCT GFE Bundle Institutional Example 1", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-bundle" }, { "name": "PCT-GFE-Bundle-Prof-1", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Bundle" } ], "reference": { "reference": "Bundle/PCT-GFE-Bundle-Prof-1" }, "description": "PCT GFE Bundle Professional Example 1", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-bundle" }, { "name": "PCT-GFE-Institutional-1", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Claim" } ], "reference": { "reference": "Claim/PCT-GFE-Institutional-1" }, "description": "PCT Institutional GFE Example 1", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/pct-gfe-Institutional" }, { "name": "PCT-GFE-Professional-1", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Claim" } ], "reference": { "reference": "Claim/PCT-GFE-Professional-1" }, "description": "PCT Professional GFE Example 1", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-professional" }, { "name": "Provider-Org-Loc-2", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Location" } ], "reference": { "reference": "Location/Provider-Org-Loc-2" }, "description": "An instance of PCTLocation", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-location" }, { "name": "Submitter-Org-1", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Organization" } ], "reference": { "reference": "Organization/Submitter-Org-1" }, "description": "Institutional GFE Submitter 1", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization" }, { "name": "Submitter-Practitioner-1", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Practitioner" } ], "reference": { "reference": "Practitioner/Submitter-Practitioner-1" }, "description": "Professional GFE Submitter 1", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner" }, { "name": "contract1001", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Contract" } ], "reference": { "reference": "Contract/contract1001" }, "description": "An instance of Contract", "exampleBoolean": true }, { "name": "coverage1001", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Coverage" } ], "reference": { "reference": "Coverage/coverage1001" }, "description": "An instance of PCTCoverage", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage" }, { "name": "endpoint001", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Endpoint" } ], "reference": { "reference": "Endpoint/endpoint001" }, "description": "An instance of Endpoint", "exampleBoolean": true }, { "name": "org1001", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Organization" } ], "reference": { "reference": "Organization/org1001" }, "description": "An instance of PCTOrganization as a payer", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization" }, { "name": "org1002", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Organization" } ], "reference": { "reference": "Organization/org1002" }, "description": "An instance of PCTOrganization as a healthcare provider", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization" }, { "name": "patient1001", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Patient" } ], "reference": { "reference": "Patient/patient1001" }, "description": "An instance of Patient", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-patient" }, { "name": "prac001", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Practitioner" } ], "reference": { "reference": "Practitioner/prac001" }, "description": "An instance of PCTPractitioner", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner" }, { "name": "prac002", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "Practitioner" } ], "reference": { "reference": "Practitioner/prac002" }, "description": "An instance of PCTPractitioner", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner" }, { "name": "pracRole002", "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information", "valueString": "PractitionerRole" } ], "reference": { "reference": "PractitionerRole/pracRole002" }, "description": "An instance of PCTPractitionerRole", "exampleCanonical": "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitionerrole" } ], "extension": [ { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "copyrightyear" }, { "url": "value", "valueString": "2021+" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "releaselabel" }, { "url": "value", "valueString": "STU 1 Ballot" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "path-history" }, { "url": "value", "valueString": "http://hl7.org/fhir/us/davinci-pct/history.html" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "path-liquid" }, { "url": "value", "valueString": "template/liquid" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "path-liquid" }, { "url": "value", "valueString": "input/liquid" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "path-qa" }, { "url": "value", "valueString": "temp/qa" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "path-temp" }, { "url": "value", "valueString": "temp/pages" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "path-output" }, { "url": "value", "valueString": "output" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "path-suppressed-warnings" }, { "url": "value", "valueString": "input/ignoreWarnings.txt" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "template-html" }, { "url": "value", "valueString": "template-page.html" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "template-md" }, { "url": "value", "valueString": "template-page-md.html" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "apply-contact" }, { "url": "value", "valueString": "true" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "apply-context" }, { "url": "value", "valueString": "true" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "apply-copyright" }, { "url": "value", "valueString": "true" } ] }, { "url": "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter", "extension": [ { "url": "code", "valueString": "apply-jurisdiction" }, { "url": "value", "valueString": "true" } ] }, { "url": 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"value": "input/operations" }, { "code": "path-resource", "value": "input/profiles" }, { "code": "path-resource", "value": "input/resources" }, { "code": "path-resource", "value": "input/vocabulary" }, { "code": "path-resource", "value": "input/maps" }, { "code": "path-resource", "value": "input/testing" }, { "code": "path-resource", "value": "input/history" }, { "code": "path-resource", "value": "fsh-generated/resources" }, { "code": "path-pages", "value": "template/config" }, { "code": "path-pages", "value": "input/images" }, { "code": "path-tx-cache", "value": "input-cache/txcache" } ] }, "date": "2021-12-04T21:54:35+00:00", "publisher": "HL7 International - Financial Management Work Group", "fhirVersion": [ "4.0.1" ], "license": "CC0-1.0", "jurisdiction": [ { "coding": [ { "code": "US", "system": "urn:iso:std:iso:3166" } ] } ], "dependsOn": [ { "id": "hl7_fhir_us_core", "uri": "http://hl7.org/fhir/us/core/ImplementationGuide/hl7.fhir.us.core", "version": "4.0.0", "packageId": 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