Source | hl7.fhir.us.davinci-pct#current:Patient Cost Transparency Implementation Guide (v4.0.1) |
resourceType | StructureDefinition |
id | davinci-pct-gfe-bundle |
canonical | http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-bundle |
version | 1.0.0 |
status | active |
publisher | HL7 International - Financial Management Work Group |
name | PCTGFEBundle |
title | PCT GFE Bundle |
date | 2023-03-29T20:18:58+00:00 |
description | PCT GFE Bundle that contains necessary resources as a GFE Submission for obtaining an AEOB. Organizations for both the provider and payer SHALL be included. The scope of this guide does not include coordination of benefits or more than one coverage. This does not serve as a replacement for eligibility, prior authorization or other financial and administrative use cases. |
jurisdictions | us |
fhirVersion | 4.0.1 |
kind | resource |
abstract | false |
sdTtype | Bundle |
derivation | constraint |
base | http://hl7.org/fhir/StructureDefinition/Bundle |
Usages |
|
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Bundle | C | Bundle |
pct-gfe-bundle-1:
All GFEs must have the same GFE submitter pct-gfe-bundle-2: SHALL have at least one entry for a payer organization. pct-gfe-bundle-3: All references resources SHALL be contained within the Bundle |
|
identifier | 1.. | |||
type | Fixed Value: collection | |||
timestamp | 1.. | |||
Slices for entry | 4 .. | Slice: Unordered, Open by type:resource | ||
entry:All Slices | Content/Rules for all slices | |||
fullUrl | 1.. | |||
search | .. 0 | |||
request | .. 0 | |||
response | .. 0 | |||
entry:gfe | 1..* |
SHALL have one or more PCTGFEProfessional or PCTGFEInstitutional resource(s) |
||
resource | 1.. | Claim , Claim | ||
entry:patient | 1..2 | SHALL have the patient subject of care and may have a separate subscriber | ||
resource | 1.. | Patient | ||
entry:coverage | 1..1 | SHALL have one Coverage | ||
resource | 1.. | Coverage | ||
entry:organization | 1..* |
SHALL have the payer organization and may have provider organization(s) |
||
resource | 1.. | Organization | ||
entry:practitioner | S | 0..* |
MAY have the provider Practitioner(s) |
|
resource | 1.. | Practitioner | ||
entry:attachment | S | 0..* |
MAY have attachments as DocumentReference resource(s) |
|
resource | 1.. | DocumentReference | ||
Documentation for this format |
Produced 06 Apr 2023