FHIR IG analytics| Package | hl7.fhir.us.davinci-pdex |
| Resource Type | Parameters |
| Id | Parameters-provider-member-match-response-001.json |
| FHIR Version | R4 |
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FHIR
FHIRsmith{
"resourceType": "Parameters",
"id": "provider-member-match-response-001",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/provider-parameters-multi-member-match-bundle-out"
]
},
"parameter": [
{
"name": "MatchedMembers",
"resource": {
"resourceType": "Group",
"id": "matched-treatment-relationship-group-001",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Matched Members with Treatment Relationships</h2><p>Members with confirmed treatment relationships who are authorized for provider data access</p></div>"
},
"identifier": [
{
"system": "http://example.org/payer/match-groups",
"value": "MTG-2024-12-16-001",
"assigner": {
"display": "Example Payer"
}
},
{
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1982947230",
"assigner": {
"display": "Provider Organization"
}
}
],
"active": true,
"type": "person",
"actual": true,
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS",
"code": "match",
"display": "Matched"
}
]
},
"quantity": 2,
"managingEntity": {
"identifier": {
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "5555555555"
},
"display": "Current Payer"
},
"characteristic": [
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS",
"code": "match",
"display": "Matched"
}
]
},
"valueReference": {
"identifier": {
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1982947230"
},
"display": "Provider Organization"
},
"exclude": false,
"period": {
"start": "2024-12-16"
}
}
],
"member": [
{
"entity": {
"reference": "Patient/payer-member-001",
"display": "Robert Michael Johnson - Payer Member"
},
"inactive": false
},
{
"entity": {
"reference": "Patient/payer-member-002",
"display": "Sarah Elizabeth Williams - Payer Member"
},
"inactive": false
}
]
}
},
{
"name": "NonMatchedMembers",
"resource": {
"resourceType": "Group",
"id": "nomatch-group-001",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Non-Matched Members</h2><p>Members submitted by provider that were not found in payer system</p></div>"
},
"identifier": [
{
"system": "http://example.org/payer/match-groups",
"value": "NMG-2024-12-16-001",
"assigner": {
"display": "Example Payer"
}
},
{
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1982947230",
"assigner": {
"display": "Provider Organization"
}
}
],
"active": true,
"type": "person",
"actual": true,
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS",
"code": "nomatch",
"display": "Not Matched"
}
]
},
"quantity": 1,
"managingEntity": {
"identifier": {
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "5555555555"
},
"display": "Current Payer"
},
"characteristic": [
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS",
"code": "nomatch",
"display": "Not Matched"
}
]
},
"valueBoolean": true,
"exclude": false,
"period": {
"start": "2024-12-16"
}
}
],
"member": [
{
"entity": {
"reference": "Patient/patient-prov-002",
"display": "Jane Smith (submitted demographics - no match found)"
},
"inactive": false
}
]
}
},
{
"name": "ConsentConstrainedMembers",
"resource": {
"resourceType": "Group",
"id": "consent-constrained-group-001",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Consent-Constrained Members</h2><p>Members found but who have exercised their right to opt out of Provider Access data sharing</p></div>"
},
"identifier": [
{
"system": "http://example.org/payer/match-groups",
"value": "CCG-2024-12-16-001",
"assigner": {
"display": "Example Payer"
}
},
{
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1982947230",
"assigner": {
"display": "Provider Organization"
}
}
],
"active": true,
"type": "person",
"actual": true,
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS",
"code": "consentconstraint",
"display": "Consent Constraint"
}
]
},
"quantity": 1,
"managingEntity": {
"identifier": {
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "5555555555"
},
"display": "Current Payer"
},
"characteristic": [
{
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PdexMultiMemberMatchResultCS",
"code": "consentconstraint",
"display": "Consent Constraint"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/opt-out-scope",
"code": "provider-specific",
"display": "Provider-Specific Opt-Out"
}
]
},
"exclude": false,
"period": {
"start": "2024-12-16"
}
}
],
"member": [
{
"entity": {
"reference": "Patient/payer-member-002",
"display": "Sarah Elizabeth Williams (matched but opted out of Provider Access)"
},
"inactive": false
}
]
}
}
]
}