Da Vinci Health Record Exchange (HRex)
1.0.0 - STU R1 US

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Example Parameters: $member-match payer example request

This sample shows the three parameter values passed into the $member-match operation. At minimum, the Patient must have an identifier, name, and gender. The identifier will be the member number as known by the requesting organization. Both the old and new coverage identify the Patient as the beneficiary via a local reference. In both coverages, the organization information is conveyed as a ‘contained’ resource - indicating that it is maintained as part of the coverage.

Parameters

MemberPatient

Patient/1

Generated Narrative

Resource "1"

identifier: Member Number: 55678

name: Patricia Ann Person (OFFICIAL)

gender: female

birthDate: 1974-12-25

CoverageToMatch

Coverage/9876B1

Generated Narrative

Resource "9876B1"

identifier: id: DH10001235

status: draft

beneficiary: See above (Patient/1)

period: 2011-05-23 --> 2012-05-23

payor: : Old Health Plan

class

type: Group (Coverage Class Codes#group)

value: CB135

class

type: Plan (Coverage Class Codes#plan)

value: B37FC

class

type: SubPlan (Coverage Class Codes#subplan)

value: P7

class

type: Class (Coverage Class Codes#class)

value: SILVER

CoverageToLink

Coverage/AA87654

Generated Narrative

Resource "AA87654"

identifier: id: 234567

status: active

beneficiary: See above (Patient/1)

payor: : New Health Plan

Consent

Consent/null

Generated Narrative

status: active

scope: Privacy Consent (Consent Scope Codes#patient-privacy)

category: information disclosure (ActCode#IDSCL)

patient: See above (Patient/1)

performer: See above (Patient/1)

source: http://example.org/DocumentReference/someconsent.pdf

Policies

-Uri
*http://hl7.org/fhir/us/davinci-hrex/StructureDefinition-hrex-consent.html#regular

provision

type: permit

period: 2022-01-01 --> 2022-01-31

actor

role: Performer (Provenance participant type#performer)

reference: : Old Health Plan

actor

role: information recipient (ParticipationType#IRCP)

reference: : New Health Plan

action: Disclose (Consent Action Codes#disclose)