| Name | Flags | Card. | Type |
Description & Constraints
|
|---|---|---|---|---|
PASMetricData
|
Base |
PAS Metric Data This logical model cannot be the target of a reference |
||
source
|
1..1 | code |
provider-src | intermediary-src | payer-src Binding: Metric Data Source ( required ) |
|
providerId
|
1..1 | Identifier | User invoking hook | |
system
|
Required Pattern: http://hl7.org/fhir/sid/us-npi | |||
value
|
1.. | |||
|
groupId
|
1..1 | Identifier | Healthcare org of user | |
|
system
|
Required Pattern: http://hl7.org/fhir/sid/us-npi | |||
|
value
|
1.. | |||
|
payerId
|
1..1 | Identifier | Payer receiving hook | |
|
system
|
1.. | |||
|
value
|
1.. | |||
|
trackingId
|
1..1 | Identifier | Submission Tracking ID | |
|
system
|
1.. | |||
|
value
|
1.. | |||
|
exchanges
|
1..* | BackboneElement |
Prior Authorization Exchanges |
|
|
submissionType
|
1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer | |
|
exchangeWith
|
0..1 | code | provider | intermediary | payer | |
|
exchangeTYpe
|
1..1 | code | x12 | RESTful | IHE | Direct | Other | |
|
requestTime
|
1..1 | instant | Time exchange initiated | |
|
responseTime
|
0..1 | instant | Time of exchange response | |
|
exchangeResponse
|
0..1 | positiveInt | e.g. 200 | |
|
errorCode
|
1..1 | code |
Error code Binding: Issue Type ( required ) |
|
|
errorDetails
|
0..1 | CodeableConcept |
More detailed error code Binding: Operation Outcome Codes ( example ) |
|
|
AAACodes
|
0..* | BackboneElement |
AAA codes returned |
|
loopID
|
1..1 | string | Id of element where error occurred | |
|
code
|
1..1 | string | Specific AAA code returned | |
|
followupAction
|
0..1 | CodeableConcept |
What action must be taken Binding: X12 278 Follow Up Action Value Set ( required ) |
|
|
itemDetail
|
0..* | BackboneElement |
Service level item detail |
|
|
itemTraceNumber
|
0..1 | integer | Item Trace Number | |
|
item
|
1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC | |
|
assertionId
|
0..1 | string | Unique ID for order item | |
|
initialSubmissionTime
|
0..1 | dateTime | Date/time of the initial submission of the item | |
|
finalResponseTime
|
0..1 | dateTime | Date/time of final result | |
|
responsesRequired
|
0..1 | integer | Number of responses | |
|
AAACodes
|
0..* | BackboneElement |
AAA codes returned |
|
|
loopID
|
1..1 | string | Id of element where error occurred | |
|
code
|
1..1 | string | Specific AAA code returned | |
|
followupAction
|
0..1 | CodeableConcept |
What action must be taken Binding: X12 278 Follow Up Action Value Set ( required ) |
|
|
result
|
0..1 | code | approved | modified | denied | |
|
supportingDocumentation
|
0..1 | url | Documentation submitted as part of PAS Bundle | |
|
requestedDocumentation
|
0..* | BackboneElement |
Documentation requested via 278 response |
|
|
additionalDocumentationReq
|
1..* | CodeableConcept |
Coded requests for additional documentation |
|
|
timeRequested
|
1..1 | dateTime | Date/Time of initial request | |
|
timeSubmitted
|
0..1 | dateTime | Date/Time of final result | |
|
submissionMethod
|
0..1 | code | CDex | portal | fax | x12 | other | |
|
exceptionSubmission
|
0..1 | boolean | True if exchange is based on the exception grant | |
|
locationType
|
0..1 | CodeableConcept | Site of Service | |
|
businessLine
|
0..1 | CodeableConcept | E.g. MedicareAdvantage | |
|
Documentation for this format
|
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