description: A Group List created by the Payer to enable Provider Access API access by providers to retrieve member information. Based on the Group resource. An Extension is added to capture the submitted parameters from the provider's match request.
package_name: hl7.fhir.us.davinci-pdex
derivation: constraint
name: ProviderMemberMatchGroup
type: Group
elements:
  contained: {short: Submitted member demographics from provider, index: 0}
  identifier: {short: Provider organization identifier, mustSupport: true, index: 1}
  type:
    short: Group of persons (patients)
    pattern: {type: Code, value: person}
    index: 2
  actual:
    short: Actual group (not definitional)
    pattern: {type: Boolean, value: true}
    index: 3
  code:
    short: Match result code
    binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS'}
    mustSupport: true
    index: 4
  managingEntity:
    type: Reference
    short: Payer managing this group
    mustSupport: true
    refers: ['http://hl7.org/fhir/StructureDefinition/Organization']
    index: 5
  characteristic:
    short: Match characteristics
    mustSupport: true
    index: 6
    elements:
      code:
        mustSupport: true
        index: 7
        elements:
          coding:
            binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexMultiMemberMatchResultVS'}
            index: 8
            elements:
              code:
                pattern: {type: Code, value: match}
                index: 9
      value:
        choices: []
        index: 11
        slicing:
          rules: open
          ordered: false
          discriminator:
          - {path: $this, type: type}
          min: null
          slices:
            valueReference:
              match: {}
              schema:
                short: Provider organization reference
                mustSupport: true
                choices: [valueReference]
                index: 13
              min: 0
              max: 1
      valueReference:
        short: Provider organization reference
        type: Reference
        mustSupport: true
        choiceOf: value
        index: 14
        slicing:
          slices:
            valueReference:
              match: {}
              schema: {short: Provider organization reference, type: Reference, mustSupport: true, choiceOf: value, index: 14}
              min: 0
              max: 1
      exclude:
        short: Include these characteristics
        pattern: {type: Boolean, value: false}
        index: 15
      period: {short: Period when match was performed, mustSupport: true, index: 16}
  member:
    short: Matched members
    mustSupport: true
    index: 17
    elements:
      entity:
        short: Reference to matched patient
        mustSupport: true
        index: 18
        extensions:
          matchedMember: {url: 'http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters', min: 0, max: 1, short: Submitted member demographics, type: Extension, mustSupport: true, index: 19}
        elements:
          extension:
            short: Submitted member demographics
            type: Extension
            mustSupport: true
            url: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters
            index: 19
            slicing:
              slices:
                matchedMember:
                  match: {}
                  schema: {short: Submitted member demographics, type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters', index: 19}
                  min: 0
                  max: 1
package_version: 2.2.0
class: profile
kind: resource
url: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-provider-member-match
base: http://hl7.org/fhir/StructureDefinition/Group
version: 2.2.0
required: [member, managingEntity, code]