description: 'A Group List created by the Payer to provide information back to a requesting provider about failed matches. Based on the Group resource. An Extension is added to capture the submitted patient demographics from the provider''s request. The match may have failed for one of two reasons: a) No match on member (member not found in payer''s system), or b) Matched but unable to comply due to member''s opt-out of Provider Access API.'
package_name: hl7.fhir.us.davinci-pdex
derivation: constraint
name: ProviderMemberNoMatchGroup
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
  member:
    short: Non-matched or consent-constrained members
    mustSupport: true
    index: 6
    elements:
      entity:
        short: Reference to submitted patient demographics
        mustSupport: true
        index: 7
        extensions:
          nonMatchedMember: {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: 8}
        elements:
          extension:
            short: Submitted member demographics
            type: Extension
            mustSupport: true
            url: http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters
            index: 8
            slicing:
              slices:
                nonMatchedMember:
                  match: {}
                  schema: {short: Submitted member demographics, type: Extension, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/base-ext-match-parameters', index: 8}
                  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-no-match
base: http://hl7.org/fhir/StructureDefinition/Group
version: 2.2.0
required: [member, managingEntity, code]