OperationDefinition-member-match

Sourcehl7.fhir.us.davinci-hrex#current:Da Vinci Health Record Exchange (HRex) (v4.0.1)
resourceTypeOperationDefinition
idmember-match
canonicalhttp://hl7.org/fhir/us/davinci-hrex/OperationDefinition/member-match
version1.0.0
statusdraft
publisherHL7 International - Clinical Interoperability Council
nameMemberMatch
titleHRex Member Match Operation
date2022-03-23T18:22:39+00:00
descriptionThe **$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. Members implementing a deterministic match will require a match on member id or subscriber id at a minimum. (I.e. A pure demographic match will not be supported by such implementations.)
jurisdictionsus
affectsStatetrue
codemember-match
systemfalse
typetrue
instancefalse
resourcesPatient
Usages

URL: [base]/Patient/$member-match

Input parameters Profile: HRex Parameters - Member Match Request Profile

Output parameters Profile: HRex Parameters - Member Match Response Profile

Parameters

Use Name Scope Cardinality Type Binding Documentation
IN MemberPatient 1..1 Resource

Parameter submitted by the new plan SHALL contain US Core Patient containing member demographics.

IN Consent 1..1 Resource

Consent held by the system seeking the match that grants permission to access the patient information information on the system for whom a patient is sought.

IN CoverageToMatch 1..1 Resource

Parameter that identifies the coverage to be matched by the receiving payer. It contains the coverage details of health plan coverage provided by the member, typically from their health plan coverage card.

IN CoverageToLink 0..1 Resource

Parameter that identifies the coverage information of the member as they are known by the requesting payer. This information allows the matching payer to link their member coverage information to that of the requesting payer to ease subsequent exchanges, including evaluating authorization to share information in subsequent queries. This parameter is optional as this operation may be invoked by non-payer systems. However, it is considered 'mustSupport'. If the client invoking the operation is a payer, they SHALL include their coverage information for the member when invoking the operation.

OUT MemberIdentifier 1..1 Identifier

This is the member identifier information for the patient as known by the server that is the target of the operation.


Produced 06 Apr 2023