{
  "description": "The **$member-match** operation allows one health plan to retrieve a unique identifier for a member from another health plan using a member's demographic and coverage information.  This identifier can then be used to perform subsequent queries and operations.",
  "_filename": "OperationDefinition-member-match.json",
  "package_name": "hl7.fhir.us.davinci-hrex",
  "date": "2020-08-09T15:38:40+00:00",
  "system": false,
  "publisher": "HL7 International - Clinical Interoperability Council",
  "instance": false,
  "jurisdiction": [ {
    "coding": [ {
      "code": "US",
      "system": "urn:iso:std:iso:3166"
    } ]
  } ],
  "name": "MemberMatch",
  "type": "true",
  "experimental": null,
  "outputProfile": "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-parameters-member-match-out",
  "resourceType": "OperationDefinition",
  "title": "HRex Member Match Operation",
  "package_version": "0.2.0",
  "status": "draft",
  "id": "dbbdccd5-feb1-4cf2-885c-ee606b787744",
  "resource": [ "Patient" ],
  "kind": "operation",
  "url": "http://hl7.org/fhir/us/davinci-hrex/OperationDefinition/member-match",
  "code": "member-match",
  "version": "0.2.0",
  "contact": [ {
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/cic",
      "system": "url"
    } ]
  } ],
  "inputProfile": "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-parameters-member-match-in",
  "parameter": [ {
    "max": "1",
    "min": 1,
    "use": "in",
    "name": "MemberPatient",
    "type": "Resource",
    "documentation": "Parameter submitted by the new plan **SHALL** contain US Core Patient containing member demographics.",
    "referencedFrom": [ {
      "source": "OldCoverage",
      "sourceId": "beneficiary"
    }, {
      "source": "NewCoverage",
      "sourceId": "beneficiary"
    } ]
  }, {
    "max": "1",
    "min": 1,
    "use": "in",
    "name": "OldCoverage",
    "type": "Resource",
    "documentation": "Parameter submitted by the new plan **SHALL** contain Coverage details of prior health plan coverage provided by the member, typically from their health plan coverage card."
  }, {
    "max": "1",
    "min": 1,
    "use": "in",
    "name": "NewCoverage",
    "type": "Resource",
    "documentation": "Parameter submitted by the new plan **SHALL** contain Coverage details of new or prospective health plan coverage provided by the new health plan based upon the member's enrollment."
  }, {
    "max": "1",
    "min": 1,
    "use": "out",
    "name": "MemberPatient",
    "type": "Resource",
    "documentation": "Parameter returned by the old plan resource **SHALL** contain the MemberPatient resource received from new plan with the ADDITION of an identifier of type \"UMB\" representing the unique identifier identifying the member of the old health plan.",
    "referencedFrom": [ {
      "source": "NewCoverage",
      "sourceId": "beneficiary"
    } ]
  }, {
    "max": "1",
    "min": 1,
    "use": "out",
    "name": "NewCoverage",
    "type": "Resource",
    "documentation": "Parameter returned by the old plan resource **SHALL** contain the NewCoverage record received from the new plan."
  } ]
}