description: PCT GFE Bundle that contains all resources for a Good faith estimate submitted by a single GFE contributing provider. Organizations for both the provider and payer MAY be included. This single contributing provider GFE Bundle may be included in a set of GFE bundles from other providers in a GFE Packet that can then be made available to the patient or sent to a payer for insurance estimation. The scope of this guide does not include coordination of benefits for more than one coverage. This does not serve as a replacement for eligibility, prior authorization or other financial and administrative use cases.
package_name: hl7.fhir.us.davinci-pct.r4b
derivation: constraint
name: PCTGFEBundle
type: Bundle
elements:
  identifier: {index: 0}
  type:
    pattern: {type: Code, value: collection}
    index: 1
  timestamp: {index: 2}
  entry:
    array: true
    min: 3
    index: 3
    elements:
      fullUrl: {index: 4}
      search: {index: 5}
      request: {index: 6}
      response: {index: 7}
    required: [fullUrl]
    slicing:
      rules: open
      description: Slice different resources included in the bundle
      discriminator:
      - {path: resource, type: type}
      min: 3
      slices:
        gfe:
          match: {}
          schema:
            short: SHALL have one or more PCTGFEProfessional or PCTGFEInstitutional resource(s)
            array: true
            min: 2
            index: 8
            elements:
              resource: {type: Claim, index: 9}
            required: [resource]
        patient:
          match: {}
          schema:
            short: SHALL have the patient subject of care and may have a separate subscriber
            array: true
            min: 1
            max: 2
            _required: true
            index: 10
            elements:
              resource: {type: Patient, index: 11}
            required: [resource]
        coverage:
          match: {}
          schema:
            short: MAY have one Coverage
            mustSupport: true
            index: 12
            elements:
              resource: {type: Coverage, index: 13}
            required: [resource]
        organization:
          match: {}
          schema:
            short: SHALL have a submitting provider or submitting organization, but not both. May also have a payer organization.
            mustSupport: true
            array: true
            index: 14
            elements:
              resource: {type: Organization, index: 15}
            required: [resource]
        practitioner:
          match: {}
          schema:
            short: SHALL have a submitting provider or submitting organization, but not both.
            mustSupport: true
            array: true
            index: 16
            elements:
              resource: {type: Practitioner, index: 17}
            required: [resource]
        attachment:
          match: {}
          schema:
            short: MAY have attachments as DocumentReference resource(s)
            mustSupport: true
            array: true
            index: 18
            elements:
              resource: {type: DocumentReference, index: 19}
            required: [resource]
package_version: 2.0.0
class: profile
kind: resource
url: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-bundle
base: http://hl7.org/fhir/StructureDefinition/Bundle
version: 2.0.0
required: [timestamp, identifier]