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PAS Test Kit Client Test Demo.postman_collection.json
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PAS Test Kit Client Test Demo.postman_collection.json
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{
"info": {
"_postman_id": "f8ec51f4-bf56-461f-b610-fbf15503f860",
"name": "PAS Test Kit Client Test Demo",
"schema": "https://schema.getpostman.com/json/collection/v2.1.0/collection.json",
"_exporter_id": "2481890"
},
"item": [
{
"name": "mock token",
"request": {
"method": "POST",
"header": [],
"body": {
"mode": "urlencoded",
"urlencoded": [
{
"key": "grant_type",
"value": "client_credentials",
"type": "text"
},
{
"key": "client_id",
"value": "6849f18bde7ddfe01a2af7cfb32c5ad2",
"type": "text"
}
]
},
"url": {
"raw": "{{base_url}}/custom/davinci_pas_client_suite_v201/mock_auth/token",
"host": [
"{{base_url}}"
],
"path": [
"custom",
"davinci_pas_client_suite_v201",
"mock_auth",
"token"
]
}
},
"response": []
},
{
"name": "Referral Prior Authorization Request",
"request": {
"method": "POST",
"header": [
{
"key": "Authorization",
"value": "Bearer: {{access_token}}",
"type": "text"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"id\": \"ReferralAuthorizationBundleExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle\"\n ]\n },\n \"identifier\": {\n \"system\": \"http://notreal.com/SUBMITTER_TRANSACTION_IDENTIFIER\",\n \"value\": \"A12345\"\n },\n \"type\": \"collection\",\n \"timestamp\": \"2005-05-02T11:01:00+05:00\",\n \"entry\": [\n {\n \"fullUrl\": \"http://notreal.com/fhir/Claim/ReferralAuthorizationExample\",\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"id\": \"ReferralAuthorizationExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim\"\n ]\n },\n \"text\": {\n \"status\": \"extensions\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Claim</b><a name=\\\"ReferralAuthorizationExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Claim "ReferralAuthorizationExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-claim.html\\\">PAS Claim</a></p></div><p><b>LevelOfServiceCode</b>: Urgent <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1338#U)</span></p><p><b>identifier</b>: id:\\u00a0111099</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-claim-type.html\\\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: Patient/SubscriberExample</p><p><b>created</b>: 2005-05-02 11:01:00+0500</p><p><b>insurer</b>: Organization/InsurerExample</p><p><b>provider</b>: Organization/UMOExample</p><p><b>priority</b>: Normal <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-processpriority.html\\\">Process Priority Codes</a>#normal)</span></p><h3>CareTeams</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td/><td>1</td><td>PractitionerRole/ReferralPractitionerRoleExample</td></tr></table><h3>Diagnoses</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td/><td>1</td><td>G89.4 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-icd10CM.html\\\">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a>#G89.4)</span></td></tr></table><h3>Insurances</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td>1</td><td>true</td><td>Coverage/InsuranceExample</td></tr></table><h3>Items</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>DiagnosisSequence</b></td><td><b>Category</b></td><td><b>ProductOrService</b></td><td><b>Location[x]</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td>, , , , , , , , , </td><td>1</td><td>1</td><td>1</td><td>Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></td><td>Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></td><td>11 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-CMSPlaceofServiceCodes.html\\\">CMS Place of Service Codes (POS)</a>#11)</span></td></tr></table></div>\"\n },\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-levelOfServiceCode\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1338\",\n \"code\": \"U\",\n \"display\": \"Urgent\"\n }\n ]\n }\n }\n ],\n \"identifier\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://www.usps.com/\",\n \"code\": \"MA\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment\",\n \"valueString\": \"223412\"\n }\n ],\n \"system\": \"http://notreal.com/PATIENT_EVENT_TRACE_NUMBER\",\n \"value\": \"111099\",\n \"assigner\": {\n \"identifier\": {\n \"system\": \"http://notreal.com/USER_ASSIGNED\",\n \"value\": \"9012345678\"\n }\n }\n }\n ],\n \"status\": \"active\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n \"code\": \"professional\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"patient\": {\n \"reference\": \"Patient/SubscriberExample\"\n },\n \"created\": \"2005-05-02T11:01:00+05:00\",\n \"insurer\": {\n \"reference\": \"Organization/InsurerExample\"\n },\n \"provider\": {\n \"reference\": \"Organization/UMOExample\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/processpriority\",\n \"code\": \"normal\"\n }\n ]\n },\n \"careTeam\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope\",\n \"valueBoolean\": true\n }\n ],\n \"sequence\": 1,\n \"provider\": {\n \"reference\": \"PractitionerRole/ReferralPractitionerRoleExample\"\n }\n }\n ],\n \"diagnosis\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate\",\n \"valueDate\": \"2021-05-10\"\n }\n ],\n \"sequence\": 1,\n \"diagnosisCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n \"code\": \"G89.4\"\n }\n ]\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/InsuranceExample\"\n }\n }\n ],\n \"item\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n \"valueIdentifier\": {\n \"system\": \"http://notreal.com/ITEM_TRACE_NUMBER\",\n \"value\": \"1122334\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n \"valueString\": \"1122445\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n \"valueString\": \"9988311\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1525\",\n \"code\": \"SC\",\n \"display\": \"Specialty Care Review\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1322\",\n \"code\": \"I\",\n \"display\": \"Initial\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService\",\n \"valueReference\": {\n \"reference\": \"ServiceRequest/ReferralRequestExample\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator\",\n \"valueBoolean\": false\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1345\",\n \"code\": \"2\",\n \"display\": \"Newly Admitted\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1337\",\n \"code\": \"2\",\n \"display\": \"Intermediate Care Facility (ICF)\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit\",\n \"valueDecimal\": 100\n }\n ],\n \"sequence\": 1,\n \"careTeamSequence\": [\n 1\n ],\n \"diagnosisSequence\": [\n 1\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"3\",\n \"display\": \"Consultation\"\n }\n ]\n },\n \"productOrService\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"3\",\n \"display\": \"Consultation\"\n }\n ]\n },\n \"locationCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set\",\n \"code\": \"11\"\n }\n ]\n }\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Organization/UMOExample\",\n \"resource\": {\n \"resourceType\": \"Organization\",\n \"id\": \"UMOExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"UMOExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Organization "UMOExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-requestor.html\\\">PAS Requestor Organization</a></p></div><p><b>identifier</b>: id:\\u00a0<a href="http://terminology.hl7.org/5.0.0/NamingSystem-npi.html">NPI</a>#8189991234</p><p><b>active</b>: true</p><p><b>type</b>: X3 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#X3)</span></p><p><b>name</b>: DR. JOE SMITH CORPORATION</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"8189991234\"\n }\n ],\n \"active\": true,\n \"type\": [\n {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/98\",\n \"code\": \"X3\"\n }\n ]\n }\n ],\n \"name\": \"DR. JOE SMITH CORPORATION\",\n \"address\": [\n {\n \"line\": [\n \"111 1ST STREET\"\n ],\n \"city\": \"SAN DIEGO\",\n \"state\": \"CA\",\n \"postalCode\": \"92101\",\n \"country\": \"US\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Organization/InsurerExample\",\n \"resource\": {\n \"resourceType\": \"Organization\",\n \"id\": \"InsurerExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"InsurerExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Organization "InsurerExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-insurer.html\\\">PAS Insurer Organization</a></p></div><p><b>identifier</b>: id:\\u00a0<a href="http://terminology.hl7.org/5.0.0/NamingSystem-npi.html">NPI</a>#789312</p><p><b>active</b>: true</p><p><b>type</b>: PR <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#PR)</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"789312\"\n }\n ],\n \"active\": true,\n \"type\": [\n {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/98\",\n \"code\": \"PR\"\n }\n ]\n }\n ],\n \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\"\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Coverage/InsuranceExample\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"InsuranceExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Coverage</b><a name=\\\"InsuranceExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Coverage "InsuranceExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-coverage.html\\\">PAS Coverage</a></p></div><p><b>status</b>: active</p><p><b>beneficiary</b>: Patient/SubscriberExample</p><p><b>payor</b>: Organization/InsurerExample</p></div>\"\n },\n \"status\": \"active\",\n \"beneficiary\": {\n \"reference\": \"Patient/SubscriberExample\"\n },\n \"payor\": [\n {\n \"reference\": \"Organization/InsurerExample\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Patient/SubscriberExample\",\n \"resource\": {\n \"resourceType\": \"Patient\",\n \"id\": \"SubscriberExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber\"\n ]\n },\n \"text\": {\n \"status\": \"extensions\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Patient</b><a name=\\\"SubscriberExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Patient "SubscriberExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-subscriber.html\\\">PAS Subscriber Patient</a></p></div><p><b>MilitaryStatus</b>: RU <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (584#RU)</span></p><p><b>identifier</b>: id:\\u00a012345678901</p><p><b>name</b>: JOE SMITH </p><p><b>gender</b>: male</p></div>\"\n },\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/584\",\n \"code\": \"RU\"\n }\n ]\n }\n }\n ],\n \"identifier\": [\n {\n \"system\": \"http://notreal.com/MIN\",\n \"value\": \"12345678901\"\n }\n ],\n \"name\": [\n {\n \"family\": \"SMITH\",\n \"given\": [\n \"JOE\"\n ]\n }\n ],\n \"gender\": \"male\"\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/ServiceRequest/ReferralRequestExample\",\n \"resource\": {\n \"resourceType\": \"ServiceRequest\",\n \"id\": \"ReferralRequestExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: ServiceRequest</b><a name=\\\"ReferralRequestExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource ServiceRequest "ReferralRequestExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-servicerequest.html\\\">PAS Service Request</a></p></div><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>code</b>: Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></p><p><b>quantity</b>: 1 visit<span style=\\\"background: LightGoldenRodYellow\\\"> (Details: UCUM code 1 = '1')</span></p><p><b>subject</b>: Patient/SubscriberExample</p></div>\"\n },\n \"status\": \"active\",\n \"intent\": \"order\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"3\",\n \"display\": \"Consultation\"\n }\n ]\n },\n \"quantityQuantity\": {\n \"value\": 1,\n \"unit\": \"visit\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"1\"\n },\n \"subject\": {\n \"reference\": \"Patient/SubscriberExample\"\n }\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/PractitionerRole/ReferralPractitionerRoleExample\",\n \"resource\": {\n \"resourceType\": \"PractitionerRole\",\n \"id\": \"ReferralPractitionerRoleExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: PractitionerRole</b><a name=\\\"ReferralPractitionerRoleExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource PractitionerRole "ReferralPractitionerRoleExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-practitionerrole.html\\\">PAS PractitionerRole</a></p></div><p><b>practitioner</b>: Practitioner/ReferralPractitionerExample</p><p><b>location</b>: Location/ReferralLocationExample</p></div>\"\n },\n \"practitioner\": {\n \"reference\": \"Practitioner/ReferralPractitionerExample\"\n },\n \"location\": [\n {\n \"reference\": \"Location/ReferralLocationExample\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Practitioner/ReferralPractitionerExample\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"ReferralPractitionerExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Practitioner</b><a name=\\\"ReferralPractitionerExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Practitioner "ReferralPractitionerExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-practitioner.html\\\">PAS Practitioner</a></p></div><p><b>identifier</b>: id:\\u00a0<a href="http://terminology.hl7.org/5.0.0/NamingSystem-npi.html">NPI</a>#987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"987654321\"\n }\n ],\n \"name\": [\n {\n \"family\": \"WATSON\",\n \"given\": [\n \"SUSAN\"\n ]\n }\n ],\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"4029993456\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Location/ReferralLocationExample\",\n \"resource\": {\n \"resourceType\": \"Location\",\n \"id\": \"ReferralLocationExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-location\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Location</b><a name=\\\"ReferralLocationExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Location "ReferralLocationExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-location.html\\\">PAS Location Profile</a></p></div><p><b>name</b>: REFERRAL CLINIC</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n },\n \"name\": \"REFERRAL CLINIC\",\n \"address\": {\n \"line\": [\n \"111 1ST STREET\"\n ],\n \"city\": \"SAN DIEGO\",\n \"state\": \"CA\",\n \"postalCode\": \"92101\",\n \"country\": \"US\"\n }\n }\n }\n ]\n }",
"options": {
"raw": {
"language": "json"
}
}
},
"url": {
"raw": "{{base_url}}/custom/davinci_pas_client_suite_v201/fhir/Claim/$submit",
"host": [
"{{base_url}}"
],
"path": [
"custom",
"davinci_pas_client_suite_v201",
"fhir",
"Claim",
"$submit"
]
}
},
"response": [
{
"name": "Approve Response",
"originalRequest": {
"method": "POST",
"header": [
{
"key": "Authorization",
"value": "Bearer: 716f4a71546e64d28639bb578f2c7702",
"type": "text"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"id\": \"ReferralAuthorizationBundleExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle\"\n ]\n },\n \"identifier\": {\n \"system\": \"http://notreal.com/SUBMITTER_TRANSACTION_IDENTIFIER\",\n \"value\": \"A12345\"\n },\n \"type\": \"collection\",\n \"timestamp\": \"2005-05-02T11:01:00+05:00\",\n \"entry\": [\n {\n \"fullUrl\": \"http://notreal.com/fhir/Claim/ReferralAuthorizationExample\",\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"id\": \"ReferralAuthorizationExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim\"\n ]\n },\n \"text\": {\n \"status\": \"extensions\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Claim</b><a name=\\\"ReferralAuthorizationExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Claim "ReferralAuthorizationExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-claim.html\\\">PAS Claim</a></p></div><p><b>LevelOfServiceCode</b>: Urgent <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1338#U)</span></p><p><b>identifier</b>: id:\\u00a0111099</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-claim-type.html\\\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: Patient/SubscriberExample</p><p><b>created</b>: 2005-05-02 11:01:00+0500</p><p><b>insurer</b>: Organization/InsurerExample</p><p><b>provider</b>: Organization/UMOExample</p><p><b>priority</b>: Normal <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-processpriority.html\\\">Process Priority Codes</a>#normal)</span></p><h3>CareTeams</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td/><td>1</td><td>PractitionerRole/ReferralPractitionerRoleExample</td></tr></table><h3>Diagnoses</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td/><td>1</td><td>G89.4 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-icd10CM.html\\\">International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)</a>#G89.4)</span></td></tr></table><h3>Insurances</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td>1</td><td>true</td><td>Coverage/InsuranceExample</td></tr></table><h3>Items</h3><table class=\\\"grid\\\"><tr><td style=\\\"display: none\\\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>DiagnosisSequence</b></td><td><b>Category</b></td><td><b>ProductOrService</b></td><td><b>Location[x]</b></td></tr><tr><td style=\\\"display: none\\\">*</td><td>, , , , , , , , , </td><td>1</td><td>1</td><td>1</td><td>Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></td><td>Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></td><td>11 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (<a href=\\\"http://terminology.hl7.org/5.0.0/CodeSystem-CMSPlaceofServiceCodes.html\\\">CMS Place of Service Codes (POS)</a>#11)</span></td></tr></table></div>\"\n },\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-levelOfServiceCode\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1338\",\n \"code\": \"U\",\n \"display\": \"Urgent\"\n }\n ]\n }\n }\n ],\n \"identifier\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://www.usps.com/\",\n \"code\": \"MA\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment\",\n \"valueString\": \"223412\"\n }\n ],\n \"system\": \"http://notreal.com/PATIENT_EVENT_TRACE_NUMBER\",\n \"value\": \"111099\",\n \"assigner\": {\n \"identifier\": {\n \"system\": \"http://notreal.com/USER_ASSIGNED\",\n \"value\": \"9012345678\"\n }\n }\n }\n ],\n \"status\": \"active\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n \"code\": \"professional\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"patient\": {\n \"reference\": \"Patient/SubscriberExample\"\n },\n \"created\": \"2005-05-02T11:01:00+05:00\",\n \"insurer\": {\n \"reference\": \"Organization/InsurerExample\"\n },\n \"provider\": {\n \"reference\": \"Organization/UMOExample\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/processpriority\",\n \"code\": \"normal\"\n }\n ]\n },\n \"careTeam\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope\",\n \"valueBoolean\": true\n }\n ],\n \"sequence\": 1,\n \"provider\": {\n \"reference\": \"PractitionerRole/ReferralPractitionerRoleExample\"\n }\n }\n ],\n \"diagnosis\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate\",\n \"valueDate\": \"2021-05-10\"\n }\n ],\n \"sequence\": 1,\n \"diagnosisCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n \"code\": \"G89.4\"\n }\n ]\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/InsuranceExample\"\n }\n }\n ],\n \"item\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber\",\n \"valueIdentifier\": {\n \"system\": \"http://notreal.com/ITEM_TRACE_NUMBER\",\n \"value\": \"1122334\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber\",\n \"valueString\": \"1122445\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber\",\n \"valueString\": \"9988311\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1525\",\n \"code\": \"SC\",\n \"display\": \"Specialty Care Review\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1322\",\n \"code\": \"I\",\n \"display\": \"Initial\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService\",\n \"valueReference\": {\n \"reference\": \"ServiceRequest/ReferralRequestExample\"\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator\",\n \"valueBoolean\": false\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1345\",\n \"code\": \"2\",\n \"display\": \"Newly Admitted\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1337\",\n \"code\": \"2\",\n \"display\": \"Intermediate Care Facility (ICF)\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit\",\n \"valueDecimal\": 100\n }\n ],\n \"sequence\": 1,\n \"careTeamSequence\": [\n 1\n ],\n \"diagnosisSequence\": [\n 1\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"3\",\n \"display\": \"Consultation\"\n }\n ]\n },\n \"productOrService\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"3\",\n \"display\": \"Consultation\"\n }\n ]\n },\n \"locationCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set\",\n \"code\": \"11\"\n }\n ]\n }\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Organization/UMOExample\",\n \"resource\": {\n \"resourceType\": \"Organization\",\n \"id\": \"UMOExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"UMOExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Organization "UMOExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-requestor.html\\\">PAS Requestor Organization</a></p></div><p><b>identifier</b>: id:\\u00a0<a href="http://terminology.hl7.org/5.0.0/NamingSystem-npi.html">NPI</a>#8189991234</p><p><b>active</b>: true</p><p><b>type</b>: X3 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#X3)</span></p><p><b>name</b>: DR. JOE SMITH CORPORATION</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"8189991234\"\n }\n ],\n \"active\": true,\n \"type\": [\n {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/98\",\n \"code\": \"X3\"\n }\n ]\n }\n ],\n \"name\": \"DR. JOE SMITH CORPORATION\",\n \"address\": [\n {\n \"line\": [\n \"111 1ST STREET\"\n ],\n \"city\": \"SAN DIEGO\",\n \"state\": \"CA\",\n \"postalCode\": \"92101\",\n \"country\": \"US\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Organization/InsurerExample\",\n \"resource\": {\n \"resourceType\": \"Organization\",\n \"id\": \"InsurerExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"InsurerExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Organization "InsurerExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-insurer.html\\\">PAS Insurer Organization</a></p></div><p><b>identifier</b>: id:\\u00a0<a href="http://terminology.hl7.org/5.0.0/NamingSystem-npi.html">NPI</a>#789312</p><p><b>active</b>: true</p><p><b>type</b>: PR <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#PR)</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"789312\"\n }\n ],\n \"active\": true,\n \"type\": [\n {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/98\",\n \"code\": \"PR\"\n }\n ]\n }\n ],\n \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\"\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Coverage/InsuranceExample\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"InsuranceExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Coverage</b><a name=\\\"InsuranceExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Coverage "InsuranceExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-coverage.html\\\">PAS Coverage</a></p></div><p><b>status</b>: active</p><p><b>beneficiary</b>: Patient/SubscriberExample</p><p><b>payor</b>: Organization/InsurerExample</p></div>\"\n },\n \"status\": \"active\",\n \"beneficiary\": {\n \"reference\": \"Patient/SubscriberExample\"\n },\n \"payor\": [\n {\n \"reference\": \"Organization/InsurerExample\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Patient/SubscriberExample\",\n \"resource\": {\n \"resourceType\": \"Patient\",\n \"id\": \"SubscriberExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber\"\n ]\n },\n \"text\": {\n \"status\": \"extensions\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Patient</b><a name=\\\"SubscriberExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Patient "SubscriberExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-subscriber.html\\\">PAS Subscriber Patient</a></p></div><p><b>MilitaryStatus</b>: RU <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (584#RU)</span></p><p><b>identifier</b>: id:\\u00a012345678901</p><p><b>name</b>: JOE SMITH </p><p><b>gender</b>: male</p></div>\"\n },\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/584\",\n \"code\": \"RU\"\n }\n ]\n }\n }\n ],\n \"identifier\": [\n {\n \"system\": \"http://notreal.com/MIN\",\n \"value\": \"12345678901\"\n }\n ],\n \"name\": [\n {\n \"family\": \"SMITH\",\n \"given\": [\n \"JOE\"\n ]\n }\n ],\n \"gender\": \"male\"\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/ServiceRequest/ReferralRequestExample\",\n \"resource\": {\n \"resourceType\": \"ServiceRequest\",\n \"id\": \"ReferralRequestExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: ServiceRequest</b><a name=\\\"ReferralRequestExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource ServiceRequest "ReferralRequestExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-servicerequest.html\\\">PAS Service Request</a></p></div><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>code</b>: Consultation <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (1365#3)</span></p><p><b>quantity</b>: 1 visit<span style=\\\"background: LightGoldenRodYellow\\\"> (Details: UCUM code 1 = '1')</span></p><p><b>subject</b>: Patient/SubscriberExample</p></div>\"\n },\n \"status\": \"active\",\n \"intent\": \"order\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/1365\",\n \"code\": \"3\",\n \"display\": \"Consultation\"\n }\n ]\n },\n \"quantityQuantity\": {\n \"value\": 1,\n \"unit\": \"visit\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"1\"\n },\n \"subject\": {\n \"reference\": \"Patient/SubscriberExample\"\n }\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/PractitionerRole/ReferralPractitionerRoleExample\",\n \"resource\": {\n \"resourceType\": \"PractitionerRole\",\n \"id\": \"ReferralPractitionerRoleExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: PractitionerRole</b><a name=\\\"ReferralPractitionerRoleExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource PractitionerRole "ReferralPractitionerRoleExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-practitionerrole.html\\\">PAS PractitionerRole</a></p></div><p><b>practitioner</b>: Practitioner/ReferralPractitionerExample</p><p><b>location</b>: Location/ReferralLocationExample</p></div>\"\n },\n \"practitioner\": {\n \"reference\": \"Practitioner/ReferralPractitionerExample\"\n },\n \"location\": [\n {\n \"reference\": \"Location/ReferralLocationExample\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Practitioner/ReferralPractitionerExample\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"ReferralPractitionerExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitioner\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Practitioner</b><a name=\\\"ReferralPractitionerExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Practitioner "ReferralPractitionerExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-practitioner.html\\\">PAS Practitioner</a></p></div><p><b>identifier</b>: id:\\u00a0<a href="http://terminology.hl7.org/5.0.0/NamingSystem-npi.html">NPI</a>#987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"987654321\"\n }\n ],\n \"name\": [\n {\n \"family\": \"WATSON\",\n \"given\": [\n \"SUSAN\"\n ]\n }\n ],\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"4029993456\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Location/ReferralLocationExample\",\n \"resource\": {\n \"resourceType\": \"Location\",\n \"id\": \"ReferralLocationExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-location\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Location</b><a name=\\\"ReferralLocationExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Location "ReferralLocationExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-location.html\\\">PAS Location Profile</a></p></div><p><b>name</b>: REFERRAL CLINIC</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n },\n \"name\": \"REFERRAL CLINIC\",\n \"address\": {\n \"line\": [\n \"111 1ST STREET\"\n ],\n \"city\": \"SAN DIEGO\",\n \"state\": \"CA\",\n \"postalCode\": \"92101\",\n \"country\": \"US\"\n }\n }\n }\n ]\n }",
"options": {
"raw": {
"language": "json"
}
}
},
"url": {
"raw": "{{base_url}}/custom/davinci_pas_client_suite_v201/fhir/Claim/$submit",
"host": [
"{{base_url}}"
],
"path": [
"custom",
"davinci_pas_client_suite_v201",
"fhir",
"Claim",
"$submit"
]
}
},
"status": "OK",
"code": 200,
"_postman_previewlanguage": "json",
"header": [
{
"key": "Content-Type",
"value": "application/json"
},
{
"key": "Content-Length",
"value": "9540"
}
],
"cookie": [],
"body": "{\n \"id\": \"3ed46b59-b75d-4c3e-8d00-da47c1044b21\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle\"\n ]\n },\n \"type\": \"collection\",\n \"timestamp\": \"2024-01-30T12:56:35Z\",\n \"entry\": [\n {\n \"fullUrl\": \"urn:uuid:cb0e2c8a-9280-4dae-83b9-fab1b4efc5d1\",\n \"resource\": {\n \"id\": \"cb0e2c8a-9280-4dae-83b9-fab1b4efc5d1\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse\"\n ]\n },\n \"identifier\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://www.usps.com/\",\n \"code\": \"MA\"\n }\n ]\n }\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment\",\n \"valueString\": \"223412\"\n }\n ],\n \"system\": \"http://notreal.com/PATIENT_EVENT_TRACE_NUMBER\",\n \"value\": \"111099\",\n \"assigner\": {\n \"identifier\": {\n \"system\": \"http://notreal.com/USER_ASSIGNED\",\n \"value\": \"9012345678\"\n }\n }\n }\n ],\n \"status\": \"active\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n \"code\": \"professional\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"patient\": {\n \"reference\": \"http://notreal.com/fhir/Patient/SubscriberExample\"\n },\n \"created\": \"2024-01-30T12:56:35Z\",\n \"insurer\": {\n \"reference\": \"http://notreal.com/fhir/Organization/InsurerExample\"\n },\n \"requestor\": {\n \"reference\": \"http://notreal.com/fhir/Organization/UMOExample\"\n },\n \"outcome\": \"complete\",\n \"item\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate\",\n \"valueDate\": \"2024-01-30\"\n },\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod\",\n \"valuePeriod\": {\n \"start\": \"2024-01-30\",\n \"end\": \"2024-02-29\"\n }\n }\n ],\n \"itemSequence\": 1,\n \"adjudication\": [\n {\n \"extension\": [\n {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/306\",\n \"code\": \"A1\",\n \"display\": \"Certified in total\"\n }\n ]\n }\n }\n ],\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\"\n }\n ],\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\n \"code\": \"submitted\"\n }\n ]\n }\n }\n ]\n }\n ],\n \"resourceType\": \"ClaimResponse\"\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Patient/SubscriberExample\",\n \"resource\": {\n \"id\": \"SubscriberExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber\"\n ]\n },\n \"text\": {\n \"status\": \"extensions\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Patient</b><a name=\\\"SubscriberExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Patient "SubscriberExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-subscriber.html\\\">PAS Subscriber Patient</a></p></div><p><b>MilitaryStatus</b>: RU <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (584#RU)</span></p><p><b>identifier</b>: id: 12345678901</p><p><b>name</b>: JOE SMITH </p><p><b>gender</b>: male</p></div>\"\n },\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/584\",\n \"code\": \"RU\"\n }\n ]\n }\n }\n ],\n \"identifier\": [\n {\n \"system\": \"http://notreal.com/MIN\",\n \"value\": \"12345678901\"\n }\n ],\n \"name\": [\n {\n \"family\": \"SMITH\",\n \"given\": [\n \"JOE\"\n ]\n }\n ],\n \"gender\": \"male\",\n \"resourceType\": \"Patient\"\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Organization/InsurerExample\",\n \"resource\": {\n \"id\": \"InsurerExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"InsurerExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Organization "InsurerExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-insurer.html\\\">PAS Insurer Organization</a></p></div><p><b>identifier</b>: id: <a href="http://terminology.hl7.org/5.0.0/NamingSystem-npi.html">NPI</a>#789312</p><p><b>active</b>: true</p><p><b>type</b>: PR <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#PR)</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"789312\"\n }\n ],\n \"active\": true,\n \"type\": [\n {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/98\",\n \"code\": \"PR\"\n }\n ]\n }\n ],\n \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\",\n \"resourceType\": \"Organization\"\n }\n },\n {\n \"fullUrl\": \"http://notreal.com/fhir/Organization/UMOExample\",\n \"resource\": {\n \"id\": \"UMOExample\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor\"\n ]\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative: Organization</b><a name=\\\"UMOExample\\\"> </a></p><div style=\\\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\\\"><p style=\\\"margin-bottom: 0px\\\">Resource Organization "UMOExample" </p><p style=\\\"margin-bottom: 0px\\\">Profile: <a href=\\\"StructureDefinition-profile-requestor.html\\\">PAS Requestor Organization</a></p></div><p><b>identifier</b>: id: <a href="http://terminology.hl7.org/5.0.0/NamingSystem-npi.html">NPI</a>#8189991234</p><p><b>active</b>: true</p><p><b>type</b>: X3 <span style=\\\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\\\"> (98#X3)</span></p><p><b>name</b>: DR. JOE SMITH CORPORATION</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"8189991234\"\n }\n ],\n \"active\": true,\n \"type\": [\n {\n \"coding\": [\n {\n \"system\": \"https://codesystem.x12.org/005010/98\",\n \"code\": \"X3\"\n }\n ]\n }\n ],\n \"name\": \"DR. JOE SMITH CORPORATION\",\n \"address\": [\n {\n \"line\": [\n \"111 1ST STREET\"\n ],\n \"city\": \"SAN DIEGO\",\n \"state\": \"CA\",\n \"postalCode\": \"92101\",\n \"country\": \"US\"\n }\n ],\n \"resourceType\": \"Organization\"\n }\n }\n ],\n \"resourceType\": \"Bundle\"\n}"
}
]
},
{
"name": "HomeCare Prior Authorization Request",
"request": {
"method": "POST",
"header": [
{
"key": "Authorization",
"value": "Bearer: {{access_token}}",
"type": "text"
}
],
"body": {
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