Da Vinci Prior Authorization Support (PAS) FHIR IG
2.0.1 - STU 2 United States of America flag

Publication Build: This will be filled in by the publication tooling

Example ClaimResponse: PAS Claim Inquiry ResponseExample

Page standards status: Informative

Generated Narrative: ClaimResponse

Resource ClaimResponse "PASClaimInquiryResponseExample"

Profile: PAS Claim Inquiry Response

identifier: id: 111099

status: active

type: Professional (Claim Type Codes#professional)

use: preauthorization

patient: Patient/SubscriberExample " SMITH"

created: 2019-07-20 11:01:00+0500

insurer: Organization/InsurerExample "MARYLAND CAPITAL INSURANCE COMPANY"

outcome: complete

item

ItemRequestedServiceDate: 2005-05-02 --> 2005-06-02

itemSequence: 1

Adjudications

-ExtensionCategory
*Submitted Amount (Adjudication Value Codes#submitted)

Insurances

-SequenceFocalCoverage
*1trueCoverage/InsuranceExample