PCTGFEPacket

PCT GFE Packet

activeDa Vinci PCT2.0.1resource18 key elements

PCT GFE Packet that contains GFE Bundles from GFE contributors. This document type bundle of GFE Bundles from GFE contributors that can then be made available to the patient or sent to a payer for insurance estimation. 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.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-packet
ID
davinci-pct-gfe-packet
Type
Base Definition
Derivation
constraint
Mandatory and Must-Support Elements

Elements with cardinality > 0 or marked as Must Support (S)

PathCard.TypeFlagsDescription
identifier
1+
timestamp
1+
entry
1+
entry.fullUrl
1+
:composition1..1
S1+
SHALL have a PCTGFEComposition resource
entry.resource
Composition
1+
:patient1..2
1+
SHALL have the patient subject of care and may have a separate subscriber
entry.resource
Patient
1+
:coverage0..1
S
MAY have one Coverage. SHALL be present submitted to a payer in the $gfe-submit operation.
entry.resource
Coverage
1+
:organization0..2
S
SHALL have an initiating provider or initiating organization, but not both. May also have a payer organization. Payer Organization SHALL be present when being submitted to a payer in the $gfe-submit operation.
entry.resource
Organization
1+
:practitioner0..1
S
SHALL have a initiating provider or initiating organization, but not both.
entry.resource
Practitioner
1+
:gfeBundle0..*
S
MAY include GFE contributor specific GFE bundle or information about a unfulfilled GFE request (GFE Missing Bundle)
entry.resource
Bundle
1+
:attachment0..*
S
MAY have attachments as DocumentReference resource(s)
entry.resource
DocumentReference
1+