description: PAS constraints on Claim resource mandating support for elements relevant to the response of an inquiry for details of previous authorizations.
package_name: hl7.fhir.us.davinci-pas
derivation: constraint
name: PASClaimInquiryResponse
type: ClaimResponse
elements:
  patient:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary']
    index: 3
  requestor:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor']
    index: 6
  request:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim']
    index: 7
  use:
    pattern: {type: Code, value: preauthorization}
    index: 2
  item:
    mustSupport: true
    index: 10
    extensions:
      reviewAction: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction', min: 0, max: 1, type: Extension, mustSupport: true, index: 12}
      preAuthIssueDate: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate', min: 0, max: 1, type: Extension, mustSupport: true, index: 13}
      preAuthPeriod: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod', min: 0, max: 1, type: Extension, mustSupport: true, index: 14}
      previousAuthorizationNumber: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber', min: 0, max: 1, type: Extension, mustSupport: true, index: 15}
      administrationReferenceNumber: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber', min: 0, max: 1, type: Extension, mustSupport: true, index: 16}
      authorizedDate: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDate', min: 0, max: 1, type: Extension, mustSupport: true, index: 17}
      authorizedItemDetail: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail', min: 0, max: 1, type: Extension, mustSupport: true, index: 18}
      authorizedProvider: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider', min: 0, max: 1, type: Extension, mustSupport: true, index: 19}
    elements:
      extension:
        index: 11
        slicing:
          rules: open
          ordered: false
          discriminator:
          - {path: url, type: value}
          min: null
          slices:
            reviewAction:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction', index: 12}
              min: 0
              max: 1
            preAuthIssueDate:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate', index: 13}
              min: 0
              max: 1
            preAuthPeriod:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod', index: 14}
              min: 0
              max: 1
            previousAuthorizationNumber:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber', index: 15}
              min: 0
              max: 1
            administrationReferenceNumber:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber', index: 16}
              min: 0
              max: 1
            authorizedDate:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDate', index: 17}
              min: 0
              max: 1
            authorizedItemDetail:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail', index: 18}
              min: 0
              max: 1
            authorizedProvider:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider', index: 19}
              min: 0
              max: 1
  created: {mustSupport: true, index: 4}
  preAuthPeriod: {mustSupport: true, index: 9}
  outcome: {mustSupport: true, index: 8}
  insurer:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer']
    index: 5
  status:
    pattern: {type: Code, value: active}
    mustSupport: true
    index: 1
  identifier: {mustSupport: true, index: 0}
  error:
    mustSupport: true
    index: 20
    extensions:
      followupAction: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorFollowupAction', min: 0, max: 1, type: Extension, mustSupport: true, index: 22}
      errorElement: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement', min: 1, max: 1, type: Extension, mustSupport: true, index: 23}
    elements:
      extension:
        index: 21
        slicing:
          rules: open
          ordered: false
          discriminator:
          - {path: url, type: value}
          min: 1
          slices:
            followupAction:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorFollowupAction', index: 22}
              min: 0
              max: 1
            errorElement:
              match: {url: null}
              schema: {type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement', index: 23}
              min: 1
              max: 1
      code:
        binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RejectReasonCodes'}
        mustSupport: true
        index: 24
    required: [extension]
package_version: 1.0.0
class: profile
kind: resource
url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claiminquiryresponse
base: http://hl7.org/fhir/StructureDefinition/ClaimResponse
version: 1.0.0