{
  "description": "CapabilityStatement for [Claims Requestor Actor](volume-1.html#claims-requestor).\\n\\nThe Claims Requestor files a pre-determination, pre-authorization, or claim for a patient, as well as cancel and re-process claims, and can query for responses when the result is queued.",
  "_filename": "CapabilityStatement-IHE.FAIS.ClaimsRequestor.json",
  "package_name": "ihe.iti.fais",
  "format": [ "application/fhir+xml", "application/fhir+json" ],
  "date": "2024-07-17",
  "publisher": "IHE IT Infrastructure Technical Committee",
  "fhirVersion": "4.0.1",
  "jurisdiction": [ {
    "coding": [ {
      "code": "001",
      "system": "http://unstats.un.org/unsd/methods/m49/m49.htm"
    } ]
  } ],
  "name": "IHE_FAIS_ClaimsRequestor",
  "type": null,
  "experimental": "false",
  "resourceType": "CapabilityStatement",
  "title": "IHE FAIS Claims Requestor",
  "package_version": "1.0.0-comment",
  "status": "active",
  "id": "fa4322f6-7e68-4015-8b97-4fe47e1e8db0",
  "kind": "requirements",
  "url": "https://profiles.ihe.net/ITI/FAIS/CapabilityStatement/IHE.FAIS.ClaimsRequestor",
  "version": "1.0.0-comment",
  "contact": [ {
    "telecom": [ {
      "value": "https://www.ihe.net/ihe_domains/it_infrastructure/",
      "system": "url"
    } ]
  }, {
    "telecom": [ {
      "value": "iti@ihe.net",
      "system": "email"
    } ]
  }, {
    "name": "IHE IT Infrastructure Technical Committee",
    "telecom": [ {
      "value": "iti@ihe.net",
      "system": "email"
    } ]
  } ],
  "rest": [ {
    "mode": "client",
    "resource": [ {
      "type": "Claim",
      "operation": [ {
        "name": "submit",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
          "valueCode": "SHALL"
        } ],
        "definition": "https://profiles.ihe.net/ITI/FAIS/OperationDefinition/IHE.FAIS.Claim.Submit",
        "documentation": "Submits a claim.  FAIS Submit Claim transaction [[ITI-YY5]](ITI-YY5.html)."
      }, {
        "name": "cancel",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
          "valueCode": "SHALL"
        } ],
        "definition": "https://profiles.ihe.net/ITI/FAIS/OperationDefinition/IHE.FAIS.Claim.Cancel",
        "documentation": "Cancels a claim.  FAIS Cancel Claim transaction [[ITI-YY8]](ITI-YY8.html)."
      }, {
        "name": "reprocess",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
          "valueCode": "SHALL"
        } ],
        "definition": "https://profiles.ihe.net/ITI/FAIS/OperationDefinition/IHE.FAIS.Claim.Reprocess",
        "documentation": "Re-processes a claim.  FAIS Re-process Claim transaction [[ITI-YY9]](ITI-YY9.html)."
      } ],
      "documentation": "Supports these transactions:\n* [Submit Claim [ITI-YY5]](ITI-YY5.html)\n* [Cancel Claim [ITI-YY8]](ITI-YY8.html)\n* [Re-process Claim [ITI-YY9]](ITI-YY9.html)",
      "supportedProfile": [ "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.Claim" ]
    }, {
      "type": "ClaimResponse",
      "interaction": [ {
        "code": "read",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
          "valueCode": "MAY"
        } ]
      }, {
        "code": "search-type",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
          "valueCode": "MAY"
        } ]
      } ],
      "searchParam": [ {
        "name": "_lastUpdated",
        "type": "date",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
          "valueCode": "MAY"
        } ],
        "documentation": "When the resource version last changed.  The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb."
      }, {
        "name": "_id",
        "type": "token",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
          "valueCode": "MAY"
        } ],
        "documentation": "Logical id of this artifact"
      }, {
        "name": "status",
        "type": "token",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
          "valueCode": "MAY"
        } ],
        "documentation": "The status of the response"
      }, {
        "name": "request",
        "type": "reference",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
          "valueCode": "MAY"
        } ],
        "documentation": "The coverage eligiblity request"
      }, {
        "name": "patient",
        "type": "reference",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
          "valueCode": "MAY"
        } ],
        "documentation": "The beneficiary"
      } ],
      "documentation": "FAIS Track Claim transaction [[ITI-YY6]](ITI-YY6.html)",
      "supportedProfile": [ "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.ClaimResponse" ]
    } ],
    "security": {
      "description": "Recommend [ATNA](https://profiles.ihe.net/ITI/TF/Volume1/ch-9.html), encouraged [IHE-IUA](https://profiles.ihe.net/ITI/IUA/index.html) or [SMART-app-launch](http://www.hl7.org/fhir/smart-app-launch/)"
    },
    "interaction": [ {
      "code": "search-system",
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
        "valueCode": "MAY"
      } ]
    } ],
    "documentation": "FAIS Claims Requestor provides capability to submit claim requests and query for claim responses."
  } ]
}