XIG: CapabilityStatement/IHE.FAIS.BeneficiaryManager

FHIR IG Statistics: CapabilityStatement/IHE.FAIS.BeneficiaryManager

Package	ihe.iti.fais
Type	CapabilityStatement
Id	IHE.FAIS.BeneficiaryManager
FHIR Version	R4
Source	https://profiles.ihe.net/ITI/FAIS/https://build.fhir.org/ig/IHE/ITI.Finance/CapabilityStatement-IHE.FAIS.BeneficiaryManager.html
URL	https://profiles.ihe.net/ITI/FAIS/CapabilityStatement/IHE.FAIS.BeneficiaryManager
Version	1.0.1-current
Status	active
Date	2024-07-17
Name	IHE_FAIS_BeneficiaryManager
Title	IHE FAIS Beneficiary Manager
Realm	uv
Authority	ihe
Description	CapabilityStatement for [Beneficiary Manager Actor](volume-1.html#beneficiary-manager). The Beneficiary Manager processes requests from the Beneficiary Requestor actor. It follows internal business processes to enroll beneficiaries from the Beneficiary Requestor that are beyond the scope of this profile and will return the result of the enrollment. It also responds to queries about insurance plans.
Kind	requirements

Resources that use this resource

No resources found

Resources that this resource uses

OperationDefinition
IHE.FAIS.EnrollmentRequest.Submit	FAIS Enrollment Request $submit

SearchParameter
InsurancePlan-benefitType	InsurancePlan_benefitType
InsurancePlan-coverageArea	InsurancePlan_coverageArea
InsurancePlan-network	InsurancePlan_network

StructureDefinition
IHE.FAIS.EnrollmentRequest	FAIS EnrollmentRequest Profile
IHE.FAIS.EnrollmentResponse	FAIS EnrollmentResponse Profile
IHE.FAIS.InsurancePlan	FAIS InsurancePlan Profile

Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: CapabilityStatement IHE.FAIS.BeneficiaryManager

IHE FAIS Beneficiary Manager

Implementation Guide Version: 1.0.1-current
FHIR Version: 4.0.1
Supported Formats: application/fhir+xml, application/fhir+json
Supported Patch Formats:
Published on: 2024-07-17
Published by: IHE IT Infrastructure Technical Committee

Note to Implementers: FHIR Capabilities
Any FHIR capability may be 'allowed' by the system unless explicitly marked as 'SHALL NOT'. A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.

FHIR RESTful Capabilities

Mode: `server`

FAIS Beneficiary Manager processes requests from the Beneficiary Requestor on Insurance Plans and Enrollment Responses and receives the Enrollment Request submission.

Security

Recommend ATNA, encouraged IHE-IUA or SMART-app-launch

Summary of System-wide Interactions

SHALL support the search-systeminteraction.

Capabilities by Resource/Profile

Summary

The summary table lists the resources that are part of this configuration, and for each resource it lists:

The relevant profiles (if any)
The interactions supported by each resource (Read, Search, Update, and Create, are always shown, while VRead, Patch, Delete, History on Instance, or History on Type are only present if at least one of the resources has support for them.
The required, recommended, and some optional search parameters (if any).
The linked resources enabled for _include
The other resources enabled for _revinclude
The operations on the resource (if any)

Resource Type	Profile	R	S	Searches	Operations
InsurancePlan	Supported Profiles FAIS InsurancePlan Profile	y	y	_lastUpdated, _id, status, type, name, identifier, administered-by, owned-by, network, coverage-area, benefit-type
EnrollmentRequest	Supported Profiles FAIS EnrollmentRequest Profile				`$submit`
EnrollmentResponse	Supported Profiles FAIS EnrollmentResponse Profile	y	y	_lastUpdated, _id, status, request

Resource Conformance: SHALL InsurancePlan

Core FHIR Resource
InsurancePlan

Reference Policy

Interaction summary

SHALL support read, search-type.

Supported Profiles

FAIS InsurancePlan Profile

Documentation

FAIS Query Insurance Plan transaction [ITI-121]

Search Parameters

Conformance	Parameter	Type	Documentation
SHALL	_lastUpdated	`date`	When the resource version last changed. The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb.
SHALL	_id	`token`	Logical id of this artifact
SHALL	status	`token`	The status of the Insurance Plan
SHALL	type	`token`	The type of the Insurance Plan
SHALL	name	`string`	The name of the Insurance Plan
SHALL	identifier	`token`	The business identifiers of the Insurance Plan
SHALL	administered-by	`reference`	Who administers the Insurance Plan
SHALL	owned-by	`reference`	Who owns the Insurance Plan
SHOULD	network	`reference`	The Insurance Plan network
SHOULD	coverage-area	`reference`	The Insurance Plan coverage area
SHOULD	benefit-type	`token`	The Insurance Plan type of benefit

Resource Conformance: supported EnrollmentRequest

Core FHIR Resource
EnrollmentRequest

Reference Policy

Interaction summary

Supported Profiles

FAIS EnrollmentRequest Profile

Documentation

FAIS Enroll Beneficiary transaction [ITI-122]

Extended Operations

Conformance	Operation	Documentation
SHALL	$submit	Submits an enrollment request to enroll a new beneficiary with the request coverage. FAIS Enroll Beneficiary transaction [ITI-122]

Resource Conformance: SHALL EnrollmentResponse

Core FHIR Resource
EnrollmentResponse

Reference Policy

Interaction summary

SHALL support read, search-type.

Supported Profiles

FAIS EnrollmentResponse Profile

Documentation

FAIS Check Enrollment Status transaction [ITI-123]

Search Parameters

Conformance	Parameter	Type	Documentation
SHALL	_lastUpdated	`date`	When the resource version last changed. The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb.
SHALL	_id	`token`	Logical id of this artifact
SHALL	status	`token`	The status of the response
SHALL	request	`reference`	The enrollment request

Source

{
  "resourceType": "CapabilityStatement",
  "id": "IHE.FAIS.BeneficiaryManager",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "url": "https://profiles.ihe.net/ITI/FAIS/CapabilityStatement/IHE.FAIS.BeneficiaryManager",
  "version": "1.0.1-current",
  "name": "IHE_FAIS_BeneficiaryManager",
  "title": "IHE FAIS Beneficiary Manager",
  "status": "active",
  "experimental": false,
  "date": "2024-07-17",
  "publisher": "IHE IT Infrastructure Technical Committee",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "https://www.ihe.net/ihe_domains/it_infrastructure/"
        }
      ]
    },
    {
      "telecom": [
        {
          "system": "email",
          "value": "iti@ihe.net"
        }
      ]
    },
    {
      "name": "IHE IT Infrastructure Technical Committee",
      "telecom": [
        {
          "system": "email",
          "value": "iti@ihe.net"
        }
      ]
    }
  ],
  "description": "CapabilityStatement for [Beneficiary Manager Actor](volume-1.html#beneficiary-manager).\n\nThe Beneficiary Manager processes requests from the Beneficiary Requestor actor. It follows internal business processes to enroll beneficiaries from the Beneficiary Requestor that are beyond the scope of this profile and will return the result of the enrollment. It also responds to queries about insurance plans.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001"
        }
      ]
    }
  ],
  "kind": "requirements",
  "fhirVersion": "4.0.1",
  "format": [
    "application/fhir+xml",
    "application/fhir+json"
  ],
  "rest": [
    {
      "mode": "server",
      "documentation": "FAIS Beneficiary Manager processes requests from the Beneficiary Requestor on Insurance Plans and Enrollment Responses and receives the Enrollment Request submission.",
      "security": {
        "description": "Recommend [ATNA](https://profiles.ihe.net/ITI/TF/Volume1/ch-9.html), encouraged [IHE-IUA](https://profiles.ihe.net/ITI/IUA/index.html) or [SMART-app-launch](http://www.hl7.org/fhir/smart-app-launch/)"
      },
      "resource": [
        {
          "type": "InsurancePlan",
          "supportedProfile": [
            "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.InsurancePlan"
          ],
          "documentation": "FAIS Query Insurance Plan transaction [[ITI-121]](ITI-121.html)",
          "interaction": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "code": "read"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "code": "search-type"
            }
          ],
          "searchParam": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "_lastUpdated",
              "type": "date",
              "documentation": "When the resource version last changed.  The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb."
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "_id",
              "type": "token",
              "documentation": "Logical id of this artifact"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "status",
              "type": "token",
              "documentation": "The status of the Insurance Plan"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "type",
              "type": "token",
              "documentation": "The type of the Insurance Plan"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "name",
              "type": "string",
              "documentation": "The name of the Insurance Plan"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "identifier",
              "type": "token",
              "documentation": "The business identifiers of the Insurance Plan"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "administered-by",
              "type": "reference",
              "documentation": "Who administers the Insurance Plan"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "owned-by",
              "type": "reference",
              "documentation": "Who owns the Insurance Plan"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHOULD"
                }
              ],
              "name": "network",
              "definition": "https://profiles.ihe.net/ITI/FAIS/SearchParameter/InsurancePlan-network",
              "type": "reference",
              "documentation": "The Insurance Plan network"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHOULD"
                }
              ],
              "name": "coverage-area",
              "definition": "https://profiles.ihe.net/ITI/FAIS/SearchParameter/InsurancePlan-coverageArea",
              "type": "reference",
              "documentation": "The Insurance Plan coverage area"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHOULD"
                }
              ],
              "name": "benefit-type",
              "definition": "https://profiles.ihe.net/ITI/FAIS/SearchParameter/InsurancePlan-benefitType",
              "type": "token",
              "documentation": "The Insurance Plan type of benefit"
            }
          ]
        },
        {
          "type": "EnrollmentRequest",
          "supportedProfile": [
            "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.EnrollmentRequest"
          ],
          "documentation": "FAIS Enroll Beneficiary transaction [[ITI-122]](ITI-122.html)",
          "operation": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "submit",
              "definition": "https://profiles.ihe.net/ITI/FAIS/OperationDefinition/IHE.FAIS.EnrollmentRequest.Submit",
              "documentation": "Submits an enrollment request to enroll a new beneficiary with the request coverage.  FAIS Enroll Beneficiary transaction [[ITI-122]](ITI-122.html)"
            }
          ]
        },
        {
          "type": "EnrollmentResponse",
          "supportedProfile": [
            "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.EnrollmentResponse"
          ],
          "documentation": "FAIS Check Enrollment Status transaction [[ITI-123]](ITI-123.html)",
          "interaction": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "code": "read"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "code": "search-type"
            }
          ],
          "searchParam": [
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "_lastUpdated",
              "type": "date",
              "documentation": "When the resource version last changed.  The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb."
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "_id",
              "type": "token",
              "documentation": "Logical id of this artifact"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "status",
              "type": "token",
              "documentation": "The status of the response"
            },
            {
              "extension": [
                {
                  "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
                  "valueCode": "SHALL"
                }
              ],
              "name": "request",
              "type": "reference",
              "documentation": "The enrollment request"
            }
          ]
        }
      ],
      "interaction": [
        {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
              "valueCode": "SHALL"
            }
          ],
          "code": "search-system"
        }
      ]
    }
  ]
}

FHIR IG Statistics: CapabilityStatement/IHE.FAIS.BeneficiaryManager

Resources that use this resource

Resources that this resource uses

Narrative

IHE FAIS Beneficiary Manager

FHIR RESTful Capabilities

Mode: server

Capabilities by Resource/Profile

Summary

Resource Conformance: SHALL InsurancePlan

Resource Conformance: supported EnrollmentRequest

Resource Conformance: SHALL EnrollmentResponse

Source

Mode: `server`