PCTGFESummary

PCT Good Faith Estimate Summary

activeDa Vinci PCT2.0.1resource40 key elements

PCT Good Faith Estimate Summary is a profile for summarizing costs associated with a set of Good Faith Estimate Claims for a single Period of Care.

Metadata

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

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

PathCard.TypeFlagsDescription
:gfeDisclaimer0..*
Extension
S
Disclaimers the patient should be made aware of regarding the estimate, e.g. application of sliding scale for self-pay/uninsured patients
:serviceDescription0..1
Extension
S
billablePeriod
S
The full Period of Care for all services or products included in the estimate from the first event to the last event.
insurer
Reference
S
provider.extension
1+
:dataAbsentReason1..1
Extension
1+
careTeam
S
careTeam.role
1+
:attending0..1
S
careTeam.qualification
1+
:operating0..2
S
:rendering0..1
S
:referring0..1
S
diagnosis
S
diagnosis.type
S
:principal0..1
S
Principal Diagnosis - Must Support means the information source SHALL be capable of populating and SHALL populate if available and permitted.
diagnosis.type1..1
1+
:admitting0..1
S
diagnosis.type1..1
1+
:patientReasonForVisit0..3
S
diagnosis.type1..1
1+
:externalcauseofinjury0..12
S
diagnosis.type1..1
1+
:other0..24
S
diagnosis.diagnosis[x]
CodeableConcept
S
diagnosis.type1..1
1+
procedure
S
procedure.extension
1+
:serviceDescription1..1
Extension
1+
procedure.type
S
:principal0..1
S
Principal clinical procedure performed
:serviceDescription1..1
Extension
1+
procedure.type1..1
1+
:anesthesiaRelated0..2
S
:serviceDescription1..1
Extension
1+
procedure.type1..1
1+
:other0..24
S
:serviceDescription1..1
Extension
1+
procedure.type1..1
1+
total
1+
Total GFE Charges