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PriorAuth.postman_collection.json
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PriorAuth.postman_collection.json
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{
"info": {
"_postman_id": "8fedac1d-110e-4fa6-8258-8f308c4805ac",
"name": "PriorAuth",
"schema": "https://schema.getpostman.com/json/collection/v2.1.0/collection.json"
},
"item": [
{
"name": "ClaimResponse",
"item": [
{
"name": "ClaimResponse: Get All",
"request": {
"method": "GET",
"header": [
{
"key": "Accept",
"value": "application/fhir+json",
"type": "text"
}
],
"url": {
"raw": "{{rest-root}}/fhir/ClaimResponse?patient.identifier=98765400001AZ",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"ClaimResponse"
],
"query": [
{
"key": "patient.identifier",
"value": "98765400001AZ"
}
]
},
"description": "http://localhost:9000/fhir/ClaimResponse"
},
"response": []
},
{
"name": "ClaimResponse: Get by ID",
"request": {
"method": "GET",
"header": [
{
"key": "Accept",
"value": "application/fhir+json",
"type": "text"
}
],
"url": {
"raw": "{{rest-root}}/fhir/ClaimResponse?identifier=5b4f23a5-bbc0-48ad-becf-49b45770c0cd&patient.identifier=98765400001AZ&status=active",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"ClaimResponse"
],
"query": [
{
"key": "identifier",
"value": "5b4f23a5-bbc0-48ad-becf-49b45770c0cd"
},
{
"key": "patient.identifier",
"value": "98765400001AZ"
},
{
"key": "status",
"value": "active"
}
]
},
"description": "http://localhost:9000/fhir/ClaimResponse/30c0ef95-f047-40c8-89b5-6005cdf54d96"
},
"response": []
},
{
"name": "ClaimResponse: Delete",
"request": {
"method": "DELETE",
"header": [
{
"key": "Accept",
"value": "application/fhir+json",
"type": "text"
}
],
"url": {
"raw": "{{rest-root}}/fhir/ClaimResponse?identifier=&patient.identifier=98765400001AZ",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"ClaimResponse"
],
"query": [
{
"key": "identifier",
"value": ""
},
{
"key": "patient.identifier",
"value": "98765400001AZ"
}
]
},
"description": "http://localhost:9000/fhir/ClaimResponse/c7ea09d0-49af-4ea8-8813-0f4a2653e1f8"
},
"response": []
}
]
},
{
"name": "Claim/$submit",
"item": [
{
"name": "Claims w/o Items",
"item": [
{
"name": "Claim: Post new $submit",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Accept",
"value": "application/fhir+json",
"type": "text"
},
{
"key": "Content-Type",
"name": "Content-Type",
"value": "application/json",
"type": "text"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"type\": \"collection\",\n \"entry\": [\n {\n \"fullUrl\": \"1234567890\",\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"id\": \"1234567890\",\n \"status\": \"active\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n \"code\": \"professional\",\n \"display\": \"Professional\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"patient\": {\n \"reference\": \"Patient/pat013\"\n },\n \"created\": \"2019-08-06\",\n \"provider\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"code\": \"normal\"\n }\n ]\n },\n \"prescription\": {\n \"reference\": \"DeviceRequest/devreq013\"\n },\n \"supportingInfo\": [\n {\n \"sequence\": 1,\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claiminformationcategory\",\n \"code\": \"info\",\n \"display\": \"Information\"\n }\n ]\n },\n \"valueReference\": {\n \"reference\": \"QuestionnaireResponse/response1\"\n }\n }\n ],\n \"diagnosis\": [\n {\n \"sequence\": 1,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013a\"\n }\n },\n {\n \"sequence\": 2,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013b\"\n }\n },\n {\n \"sequence\": 3,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013c\"\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/cov1234\"\n }\n }\n ]\n }\n },\n {\n \"fullUrl\": \"response1\",\n \"resource\": {\n \"resourceType\": \"QuestionnaireResponse\",\n \"id\": \"response1\",\n \"authored\": \"2019-08-06\",\n \"status\": \"completed\",\n \"item\": [\n {\n \"linkId\": \"1\",\n \"text\": \"Patient Information\",\n \"item\": [\n {\n \"linkId\": \"1.1\",\n \"text\": \"Last Name but Different This Time\",\n \"answer\": [\n {\n \"valueString\": \"Quinton\"\n }\n ]\n },\n {\n \"linkId\": \"1.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Vlad\"\n }\n ]\n },\n {\n \"linkId\": \"1.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"A, N\"\n }\n ]\n },\n {\n \"linkId\": \"1.4\",\n \"text\": \"Date Of Birth\",\n \"answer\": [\n {\n \"valueDate\": \"1956-12-01\"\n }\n ]\n },\n {\n \"linkId\": \"1.5\",\n \"text\": \"Gender\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"male\",\n \"display\": \"Male\"\n }\n }\n ]\n },\n {\n \"linkId\": \"1.6\",\n \"text\": \"Medicare ID\",\n \"answer\": [\n {\n \"valueString\": \"10A3D58WH22\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"2\",\n \"text\": \"Provider who is performing face-to-face evaluation\",\n \"item\": [\n {\n \"linkId\": \"2.1\",\n \"text\": \"Last Name\",\n \"answer\": [\n {\n \"valueString\": \"Doe\"\n }\n ]\n },\n {\n \"linkId\": \"2.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Jane\"\n }\n ]\n },\n {\n \"linkId\": \"2.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"B\"\n }\n ]\n },\n {\n \"linkId\": \"2.4\",\n \"text\": \"NPI\",\n \"answer\": [\n {\n \"valueString\": \"1122334455\"\n }\n ]\n },\n {\n \"linkId\": \"2.5\",\n \"text\": \"Date of Face-To-Face Evaluation\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"3\",\n \"text\": \"Coverage Requirements\",\n \"item\": [\n {\n \"linkId\": \"3.1\",\n \"text\": \"Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"COPD\",\n \"display\": \"COPD\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Hypoxemia\",\n \"display\": \"Hypoxemia\"\n }\n }\n ]\n },\n {\n \"linkId\": \"3.2\",\n \"text\": \"Arterial oxygen saturation (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.3\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.4\",\n \"text\": \"Arterial oxygen saturation (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.5\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.6\",\n \"text\": \"Is there a documented improvement of hypoxemia during exercise with oxygen?\"\n }\n ]\n },\n {\n \"linkId\": \"4\",\n \"text\": \"Prescribed Use\",\n \"item\": [\n {\n \"linkId\": \"4.1\",\n \"text\": \"Start date\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n },\n {\n \"linkId\": \"4.2\",\n \"text\": \"Length of need: (months) (99 = lifetime)\"\n },\n {\n \"linkId\": \"4.4\",\n \"text\": \"Peak Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.4.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 2\n }\n ]\n },\n {\n \"linkId\": \"4.4.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 95\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.5\",\n \"text\": \"Average Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.5.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 3\n }\n ]\n },\n {\n \"linkId\": \"4.5.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 98\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.6\",\n \"text\": \"Frequency of use (choose all that apply)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"At rest and awake\",\n \"display\": \"At rest and awake\"\n }\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"5\",\n \"text\": \"Oxygen Supply Order Details\",\n \"item\": [\n {\n \"linkId\": \"5.1\",\n \"text\": \"Current Order Description\",\n \"answer\": [\n {\n \"valueString\": \"HCPCS E0424 - Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n {\n \"linkId\": \"5.1b\",\n \"text\": \"Current Order Is For A Portable Device\"\n },\n {\n \"linkId\": \"5.2\",\n \"text\": \"Type\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Compressed Gas\",\n \"display\": \"Compressed Gas\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.3\",\n \"text\": \"Means of oxygen delivery and accessories\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Nasal cannula\",\n \"display\": \"Nasal cannula\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Mask\",\n \"display\": \"Mask\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.4\",\n \"text\": \"Type of order\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Initial or original order for certification\",\n \"display\": \"Initial or original order for certification\"\n }\n }\n ]\n }\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"devreq013\",\n \"resource\": {\n \"resourceType\": \"DeviceRequest\",\n \"id\": \"devreq013\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-crd/STU3/StructureDefinition/profile-devicerequest-stu3\"\n ]\n },\n \"extension\": [\n {\n \"url\": \"http://build.fhir.org/ig/HL7/davinci-crd/STU3/ext-insurance.html\",\n \"valueReference\": {\n \"reference\": \"Coverage/cov013\"\n }\n }\n ],\n \"status\": \"draft\",\n \"codeCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://bluebutton.cms.gov/resources/codesystem/hcpcs\",\n \"code\": \"E0424\",\n \"display\": \"Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"performer\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"intent\": \"original-order\"\n }\n },\n {\n \"fullUrl\": \"pat013\",\n \"resource\": {\n \"resourceType\": \"Patient\",\n \"id\": \"pat013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.116-04:00\"\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><div class=\\\"hapiHeaderText\\\">Vlad Alan Nestor <b>QUINTON </b></div><table class=\\\"hapiPropertyTable\\\"><tbody><tr><td>Identifier</td><td>98765400001AZ</td></tr><tr><td>Date of birth</td><td><span>01 December 1956</span></td></tr></tbody></table></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-medicare\",\n \"value\": \"98765400001AZ\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Quinton\",\n \"given\": [\n \"Vlad\",\n \"Alan\",\n \"Nestor\"\n ]\n }\n ],\n \"gender\": \"male\",\n \"birthDate\": \"1956-12-01\"\n }\n },\n {\n \"fullUrl\": \"pra1234\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1234\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:47.101-04:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1122334455\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Doe\",\n \"given\": [\n \"Jane\",\n \"Betty\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"pra1255\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1255\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:52.089-04:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"348074389\"\n }\n ],\n \"name\": [\n {\n \"family\": \"Smythe\",\n \"given\": [\n \"Juliette\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"obs013\",\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.343-04:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"59408-5\",\n \"display\": \"Oxygen saturation in Arterial blood by Pulse oximetry\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"issued\": \"2019-03-20T15:30:10+01:00\",\n \"valueQuantity\": {\n \"value\": 85,\n \"unit\": \"%\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"%\"\n }\n }\n },\n {\n \"fullUrl\": \"obs013B\",\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013B\",\n \"meta\": {\n \"versionId\": \"2\",\n \"lastUpdated\": \"2019-06-13T09:55:51.583-04:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"31100-1\",\n \"display\": \"Hematocrit [Volume Fraction] of Blood by Impedance\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"issued\": \"2019-03-20T15:30:10+01:00\",\n \"valueQuantity\": {\n \"value\": 61,\n \"unit\": \"%\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"%\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013a\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013a\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.203-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"87837008\",\n \"display\": \"Chronic pulmonary heart disease (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013b\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013b\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.246-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"389087006\",\n \"display\": \"Hypoxemia (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013c\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013c\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.294-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"44054006\",\n \"display\": \"Diabetes mellitus type 2 (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov1234\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov1234\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:49.318-04:00\"\n },\n \"payor\": [\n {\n \"reference\": \"Organization/org1234\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov015\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov015\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.151-04:00\"\n },\n \"subscriberId\": \"10A3D58WH456\",\n \"payor\": [\n {\n \"reference\": \"Organization/org015\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov016\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov016\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.692-04:00\"\n },\n \"subscriberId\": \"64A3D58WH01\",\n \"payor\": [\n {\n \"reference\": \"Organization/org016\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov013\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov013\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.166-04:00\"\n },\n \"subscriberId\": \"10A3D58WH22\",\n \"payor\": [\n {\n \"reference\": \"Organization/org013\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov014\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov014\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.811-04:00\"\n },\n \"subscriberId\": \"10A3D58WH1600\",\n \"payor\": [\n {\n \"reference\": \"Organizarion/org014\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n }\n ]\n}\n"
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit?Content-Type=application/fhir+json",
"host": [
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],
"path": [
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"query": [
{
"key": "Content-Type",
"value": "application/fhir+json"
}
]
},
"description": "Post a new Claim to the Claim/$submit endpoint."
},
"response": []
},
{
"name": "Claim: Post update $submit",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Accept",
"value": "application/fhir+json",
"type": "text"
},
{
"key": "Content-Type",
"name": "Content-Type",
"value": "application/json",
"type": "text"
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],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"type\": \"collection\",\n \"entry\": [\n {\n \"fullUrl\": \"1234567890\",\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"id\": \"1234567890\",\n \"status\": \"active\",\n \"related\": [\n \t{\n \t\t\"id\": \"0000000000\",\n \t\t\"relationship\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n \t\t\t\t\t\"code\": \"replaces\",\n \t\t\t\t\t\"display\": \"replaces\"\n \t\t\t\t}\t\n \t\t\t]\n \t\t}\n \t}\n ],\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n \"code\": \"professional\",\n \"display\": \"Professional\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"patient\": {\n \"reference\": \"Patient/pat013\"\n },\n \"created\": \"2019-08-06\",\n \"provider\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"code\": \"normal\"\n }\n ]\n },\n \"prescription\": {\n \"reference\": \"DeviceRequest/devreq013\"\n },\n \"supportingInfo\": [\n {\n \"sequence\": 1,\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claiminformationcategory\",\n \"code\": \"info\",\n \"display\": \"Information\"\n }\n ]\n },\n \"valueReference\": {\n \"reference\": \"QuestionnaireResponse/response1\"\n }\n }\n ],\n \"diagnosis\": [\n {\n \"sequence\": 1,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013a\"\n }\n },\n {\n \"sequence\": 2,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013b\"\n }\n },\n {\n \"sequence\": 3,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013c\"\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/cov1234\"\n }\n }\n ]\n }\n },\n {\n \"fullUrl\": \"response1\",\n \"resource\": {\n \"resourceType\": \"QuestionnaireResponse\",\n \"id\": \"response1\",\n \"authored\": \"2019-08-06\",\n \"status\": \"completed\",\n \"item\": [\n {\n \"linkId\": \"1\",\n \"text\": \"Patient Information\",\n \"item\": [\n {\n \"linkId\": \"1.1\",\n \"text\": \"Last Name but Different This Time\",\n \"answer\": [\n {\n \"valueString\": \"Quinton\"\n }\n ]\n },\n {\n \"linkId\": \"1.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Vlad\"\n }\n ]\n },\n {\n \"linkId\": \"1.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"A, N\"\n }\n ]\n },\n {\n \"linkId\": \"1.4\",\n \"text\": \"Date Of Birth\",\n \"answer\": [\n {\n \"valueDate\": \"1956-12-01\"\n }\n ]\n },\n {\n \"linkId\": \"1.5\",\n \"text\": \"Gender\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"male\",\n \"display\": \"Male\"\n }\n }\n ]\n },\n {\n \"linkId\": \"1.6\",\n \"text\": \"Medicare ID\",\n \"answer\": [\n {\n \"valueString\": \"10A3D58WH22\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"2\",\n \"text\": \"Provider who is performing face-to-face evaluation\",\n \"item\": [\n {\n \"linkId\": \"2.1\",\n \"text\": \"Last Name\",\n \"answer\": [\n {\n \"valueString\": \"Doe\"\n }\n ]\n },\n {\n \"linkId\": \"2.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Jane\"\n }\n ]\n },\n {\n \"linkId\": \"2.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"B\"\n }\n ]\n },\n {\n \"linkId\": \"2.4\",\n \"text\": \"NPI\",\n \"answer\": [\n {\n \"valueString\": \"1122334455\"\n }\n ]\n },\n {\n \"linkId\": \"2.5\",\n \"text\": \"Date of Face-To-Face Evaluation\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"3\",\n \"text\": \"Coverage Requirements\",\n \"item\": [\n {\n \"linkId\": \"3.1\",\n \"text\": \"Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"COPD\",\n \"display\": \"COPD\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Hypoxemia\",\n \"display\": \"Hypoxemia\"\n }\n }\n ]\n },\n {\n \"linkId\": \"3.2\",\n \"text\": \"Arterial oxygen saturation (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.3\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.4\",\n \"text\": \"Arterial oxygen saturation (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.5\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.6\",\n \"text\": \"Is there a documented improvement of hypoxemia during exercise with oxygen?\"\n }\n ]\n },\n {\n \"linkId\": \"4\",\n \"text\": \"Prescribed Use\",\n \"item\": [\n {\n \"linkId\": \"4.1\",\n \"text\": \"Start date\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n },\n {\n \"linkId\": \"4.2\",\n \"text\": \"Length of need: (months) (99 = lifetime)\"\n },\n {\n \"linkId\": \"4.4\",\n \"text\": \"Peak Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.4.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 2\n }\n ]\n },\n {\n \"linkId\": \"4.4.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 95\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.5\",\n \"text\": \"Average Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.5.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 3\n }\n ]\n },\n {\n \"linkId\": \"4.5.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 98\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.6\",\n \"text\": \"Frequency of use (choose all that apply)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"At rest and awake\",\n \"display\": \"At rest and awake\"\n }\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"5\",\n \"text\": \"Oxygen Supply Order Details\",\n \"item\": [\n {\n \"linkId\": \"5.1\",\n \"text\": \"Current Order Description\",\n \"answer\": [\n {\n \"valueString\": \"HCPCS E0424 - Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n {\n \"linkId\": \"5.1b\",\n \"text\": \"Current Order Is For A Portable Device\"\n },\n {\n \"linkId\": \"5.2\",\n \"text\": \"Type\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Compressed Gas\",\n \"display\": \"Compressed Gas\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.3\",\n \"text\": \"Means of oxygen delivery and accessories\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Nasal cannula\",\n \"display\": \"Nasal cannula\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Mask\",\n \"display\": \"Mask\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.4\",\n \"text\": \"Type of order\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Initial or original order for certification\",\n \"display\": \"Initial or original order for certification\"\n }\n }\n ]\n }\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"devreq013\",\n \"resource\": {\n \"resourceType\": \"DeviceRequest\",\n \"id\": \"devreq013\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-crd/STU3/StructureDefinition/profile-devicerequest-stu3\"\n ]\n },\n \"extension\": [\n {\n \"url\": \"http://build.fhir.org/ig/HL7/davinci-crd/STU3/ext-insurance.html\",\n \"valueReference\": {\n \"reference\": \"Coverage/cov013\"\n }\n }\n ],\n \"status\": \"draft\",\n \"codeCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://bluebutton.cms.gov/resources/codesystem/hcpcs\",\n \"code\": \"E0424\",\n \"display\": \"Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"performer\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"intent\": \"original-order\"\n }\n },\n {\n \"fullUrl\": \"pat013\",\n \"resource\": {\n \"resourceType\": \"Patient\",\n \"id\": \"pat013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.116-04:00\"\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><div class=\\\"hapiHeaderText\\\">Vlad Alan Nestor <b>QUINTON </b></div><table class=\\\"hapiPropertyTable\\\"><tbody><tr><td>Identifier</td><td>98765400001AZ</td></tr><tr><td>Date of birth</td><td><span>01 December 1956</span></td></tr></tbody></table></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-medicare\",\n \"value\": \"98765400001AZ\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Quinton\",\n \"given\": [\n \"Vlad\",\n \"Alan\",\n \"Nestor\"\n ]\n }\n ],\n \"gender\": \"male\",\n \"birthDate\": \"1956-12-01\"\n }\n },\n {\n \"fullUrl\": \"pra1234\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1234\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:47.101-04:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1122334455\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Doe\",\n \"given\": [\n \"Jane\",\n \"Betty\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"pra1255\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1255\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:52.089-04:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"348074389\"\n }\n ],\n \"name\": [\n {\n \"family\": \"Smythe\",\n \"given\": [\n \"Juliette\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"obs013\",\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.343-04:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"59408-5\",\n \"display\": \"Oxygen saturation in Arterial blood by Pulse oximetry\"\n }\n ]\n },\n \"subject\": {\n \"reference\": 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\"lastUpdated\": \"2019-06-13T09:55:51.203-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"87837008\",\n \"display\": \"Chronic pulmonary heart disease (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013b\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013b\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.246-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"389087006\",\n \"display\": \"Hypoxemia (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013c\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013c\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.294-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"44054006\",\n \"display\": \"Diabetes mellitus type 2 (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov1234\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov1234\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:49.318-04:00\"\n },\n \"payor\": [\n {\n \"reference\": \"Organization/org1234\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov015\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov015\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.151-04:00\"\n },\n \"subscriberId\": \"10A3D58WH456\",\n \"payor\": [\n {\n \"reference\": \"Organization/org015\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov016\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov016\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.692-04:00\"\n },\n \"subscriberId\": \"64A3D58WH01\",\n \"payor\": [\n {\n \"reference\": \"Organization/org016\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov013\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov013\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.166-04:00\"\n },\n \"subscriberId\": \"10A3D58WH22\",\n \"payor\": [\n {\n \"reference\": \"Organization/org013\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov014\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov014\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.811-04:00\"\n },\n \"subscriberId\": \"10A3D58WH1600\",\n \"payor\": [\n {\n \"reference\": \"Organizarion/org014\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n }\n ]\n}\n"
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit?Content-Type=application/fhir+json",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
],
"query": [
{
"key": "Content-Type",
"value": "application/fhir+json"
}
]
},
"description": "Post an update to a Claim to the Claim/$submit endpoint."
},
"response": []
},
{
"name": "Claim: DTR 1/20",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"name": "Content-Type",
"value": "application/json",
"type": "text"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"type\": \"collection\",\n \"entry\": [\n {\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"status\": \"active\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n \"code\": \"professional\",\n \"display\": \"Professional\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"patient\": {\n \"reference\": \"Patient/pat013\"\n },\n \"created\": \"2020-01-07\",\n \"provider\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"code\": \"normal\"\n }\n ]\n },\n \"prescription\": {\n \"reference\": \"DeviceRequest/devreq013\"\n },\n \"supportingInfo\": [\n {\n \"sequence\": 1,\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claiminformationcategory\",\n \"code\": \"info\",\n \"display\": \"Information\"\n }\n ]\n },\n \"valueReference\": {\n \"reference\": \"QuestionnaireResponse/response1\"\n }\n }\n ],\n \"diagnosis\": [\n {\n \"sequence\": 1,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013a\"\n }\n },\n {\n \"sequence\": 2,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013b\"\n }\n },\n {\n \"sequence\": 3,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013c\"\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/NotFound\"\n }\n }\n ]\n }\n },\n {\n \"resource\": {\n \"resourceType\": \"QuestionnaireResponse\",\n \"id\": \"response1\",\n \"authored\": \"2020-01-07\",\n \"status\": \"completed\",\n \"item\": [\n {\n \"linkId\": \"1\",\n \"text\": \"Patient Information\",\n \"item\": [\n {\n \"linkId\": \"1.1\",\n \"text\": \"Last Name but Different This Time\",\n \"answer\": [\n {\n \"valueString\": \"Quinton\"\n }\n ]\n },\n {\n \"linkId\": \"1.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Vlad\"\n }\n ]\n },\n {\n \"linkId\": \"1.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"A, N\"\n }\n ]\n },\n {\n \"linkId\": \"1.4\",\n \"text\": \"Date Of Birth\",\n \"answer\": [\n {\n \"valueDate\": \"1956-12-01\"\n }\n ]\n },\n {\n \"linkId\": \"1.5\",\n \"text\": \"Gender\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"male\",\n \"display\": \"Male\"\n }\n }\n ]\n },\n {\n \"linkId\": \"1.6\",\n \"text\": \"Medicare ID\",\n \"answer\": [\n {\n \"valueString\": \"10A3D58WH22\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"2\",\n \"text\": \"Provider who is performing face-to-face evaluation\",\n \"item\": [\n {\n \"linkId\": \"2.1\",\n \"text\": \"Last Name\",\n \"answer\": [\n {\n \"valueString\": \"Doe\"\n }\n ]\n },\n {\n \"linkId\": \"2.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Jane\"\n }\n ]\n },\n {\n \"linkId\": \"2.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"B\"\n }\n ]\n },\n {\n \"linkId\": \"2.4\",\n \"text\": \"NPI\",\n \"answer\": [\n {\n \"valueString\": \"1122334455\"\n }\n ]\n },\n {\n \"linkId\": \"2.5\",\n \"text\": \"Date of Face-To-Face Evaluation\",\n \"answer\": [\n {\n \"valueDate\": \"2020-01-07\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"3\",\n \"text\": \"Coverage Requirements\",\n \"item\": [\n {\n \"linkId\": \"3.1\",\n \"text\": \"Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"COPD\",\n \"display\": \"COPD\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Hypoxemia\",\n \"display\": \"Hypoxemia\"\n }\n }\n ]\n },\n {\n \"linkId\": \"3.2\",\n \"text\": \"Arterial oxygen saturation (Patient on room air while at rest and awake when tested)\",\n \"answer\": [\n {\n \"valueQuantity\": {\n \"value\": 85,\n \"unit\": \"%\"\n }\n }\n ]\n },\n {\n \"linkId\": \"3.3\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.4\",\n \"text\": \"Arterial oxygen saturation (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.5\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.6\",\n \"text\": \"Is there a documented improvement of hypoxemia during exercise with oxygen?\"\n }\n ]\n },\n {\n \"linkId\": \"4\",\n \"text\": \"Prescribed Use\",\n \"item\": [\n {\n \"linkId\": \"4.1\",\n \"text\": \"Start date\",\n \"answer\": [\n {\n \"valueDate\": \"2020-01-07\"\n }\n ]\n },\n {\n \"linkId\": \"4.2\",\n \"text\": \"Length of need: (months) (99 = lifetime)\"\n },\n {\n \"linkId\": \"4.4\",\n \"text\": \"Peak Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.4.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"integer\": \"1\"\n }\n ]\n },\n {\n \"linkId\": \"4.4.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"integer\": \"1\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.5\",\n \"text\": \"Average Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.5.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"integer\": \"1\"\n }\n ]\n },\n {\n \"linkId\": \"4.5.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"integer\": \"1\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.6\",\n \"text\": \"Frequency of use (choose all that apply)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"At rest and awake\",\n \"display\": \"At rest and awake\"\n }\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"5\",\n \"text\": \"Oxygen Supply Order Details\",\n \"item\": [\n {\n \"linkId\": \"5.1\",\n \"text\": \"Current Order Description\",\n \"answer\": [\n {\n \"valueString\": \"HCPCS E0424 - Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n {\n \"linkId\": \"5.1b\",\n \"text\": \"Current Order Is For A Portable Device\"\n },\n {\n \"linkId\": \"5.2\",\n \"text\": \"Type\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Liquid\",\n \"display\": \"Liquid\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.3\",\n \"text\": \"Means of oxygen delivery and accessories\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Nasal cannula\",\n \"display\": \"Nasal cannula\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.4\",\n \"text\": \"Type of order\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Initial or original order for certification\",\n \"display\": \"Initial or original order for certification\"\n }\n }\n ]\n }\n ]\n }\n ]\n }\n },\n {\n \"resource\": {\n \"resourceType\": \"DeviceRequest\",\n \"id\": \"devreq013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-12-06T17:18:21.189-05:00\",\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-crd/R4/StructureDefinition/profile-devicerequest-r4\"\n ]\n },\n \"extension\": [\n {\n \"url\": \"http://build.fhir.org/ig/HL7/davinci-crd/R4/ext-insurance.html\",\n \"valueReference\": {\n \"reference\": \"Coverage/cov013\"\n }\n }\n ],\n \"status\": \"draft\",\n \"codeCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://bluebutton.cms.gov/resources/codesystem/hcpcs\",\n \"code\": \"E0424\",\n \"display\": \"Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"performer\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"insurance\": [\n {\n \"reference\": \"Coverage/cov013\"\n }\n ]\n }\n },\n {\n \"resource\": {\n \"resourceType\": \"Patient\",\n \"id\": \"pat013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-12-10T07:36:28.533-05:00\"\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><div class=\\\"hapiHeaderText\\\">Vlad Alan Nestor <b>QUINTON </b></div><table class=\\\"hapiPropertyTable\\\"><tbody><tr><td>Identifier</td><td>98765400001AZ</td></tr><tr><td>Address</td><td><span>NY </span></td></tr><tr><td>Date of birth</td><td><span>01 December 1956</span></td></tr></tbody></table></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-medicare\",\n \"value\": \"98765400001AZ\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Quinton\",\n \"given\": [\n \"Vlad\",\n \"Alan\",\n \"Nestor\"\n ]\n }\n ],\n \"gender\": \"male\",\n \"birthDate\": \"1956-12-01\",\n \"address\": [\n {\n \"use\": \"home\",\n \"type\": \"both\",\n \"state\": \"NY\"\n }\n ]\n }\n },\n {\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1234\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-12-06T17:18:12.976-05:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1122334455\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Doe\",\n \"given\": [\n \"Jane\",\n \"Betty\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013\",\n \"meta\": {\n \"versionId\": \"2\",\n \"lastUpdated\": \"2019-12-09T10:38:38.144-05:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"59408-5\",\n \"display\": \"Oxygen saturation in Arterial blood by Pulse oximetry\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"issued\": \"2019-11-20T15:30:10+01:00\",\n \"valueQuantity\": {\n \"value\": 85,\n \"unit\": \"%\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"%\"\n }\n }\n },\n {\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013B\",\n \"meta\": {\n \"versionId\": \"10\",\n \"lastUpdated\": \"2019-12-19T08:23:22.217-05:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"31100-1\",\n \"display\": \"Hematocrit [Volume Fraction] of Blood by Impedance\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"issued\": \"2019-03-20T15:30:10+01:00\",\n \"valueQuantity\": {\n \"value\": 61,\n \"unit\": \"%\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"%\"\n }\n }\n },\n {\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013a\",\n \"meta\": {\n \"versionId\": \"2\",\n \"lastUpdated\": \"2019-12-09T10:38:37.767-05:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n \"code\": \"J44.9\",\n \"display\": \"Chronic obstructive pulmonary disease, unspecified\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013b\",\n \"meta\": {\n \"versionId\": \"2\",\n \"lastUpdated\": \"2019-12-09T10:38:38.008-05:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n \"code\": \"R09.02\",\n \"display\": \"Hypoxemia\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013c\",\n \"meta\": {\n \"versionId\": \"2\",\n \"lastUpdated\": \"2019-12-09T10:38:38.074-05:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-10-cm\",\n \"code\": \"E11.21\",\n \"display\": \"Type 2 diabetes mellitus with diabetic nephropathy\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n }\n ]\n}",
"options": {
"raw": {
"language": "json"
}
}
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
]
}
},
"response": []
}
],
"_postman_isSubFolder": true
},
{
"name": "PAS IG Examples",
"item": [
{
"name": "Claim: JSON PA Referral Request Example",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"name": "Content-Type",
"type": "text",
"value": "application/fhir+json"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"id\": \"pa-request-example-referral\",\n \"identifier\": {\n \"system\": \"http://example.org/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://example.org/fhir/Claim/1\",\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: 111099</p><p><b>status</b>: active</p><p><b>type</b>: Specialty Care Review <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/UM_REQUEST_CATEGORY_CODE code 'SC' = 'SC', given as 'Specialty Care Review'})</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\\\"Patient/1\\\">Patient/1</a></p><p><b>created</b>: Jul 20, 2019, 12:00:00 AM</p><p><b>insurer</b>: <a href=\\\"Organization/1\\\">Organization/1</a></p><p><b>provider</b>: <a href=\\\"PractitionerRole/1\\\">PractitionerRole/1</a></p><p><b>priority</b>: Normal <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://terminology/hl7.org/CodeSystem/processpriority code 'normal' = 'normal', given as 'Normal'})</span></p><p><b>prescription</b>: see requested service extension</p><p><b>facility</b>: <a href=\\\"Location/1\\\">Location/1</a></p><h3>Diagnoses</h3><table class=\\\"grid\\\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td>*</td><td>1</td><td><a href=\\\"Condition/1\\\">Condition/1</a></td></tr></table><h3>Insurances</h3><table class=\\\"grid\\\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td><a href=\\\"Coverage/1\\\">Coverage/1</a></td></tr></table></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://example.org/PATIENT_EVENT_TRACE_NUMBER\",\n \"value\": \"111099\",\n \"assigner\": {\n \"reference\": \"Organization/3\"\n }\n }\n ],\n \"status\": \"active\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://example.org/UM_REQUEST_CATEGORY_CODE\",\n \"code\": \"SC\",\n \"display\": \"Specialty Care Review\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"_use\": {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n \"valueCode\": \"I\"\n }\n ]\n },\n \"patient\": {\n \"reference\": \"Patient/1\"\n },\n \"created\": \"2019-07-20\",\n \"insurer\": {\n \"reference\": \"Organization/1\"\n },\n \"provider\": {\n \"reference\": \"PractitionerRole/1\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"system\": \"http://terminology/hl7.org/CodeSystem/processpriority\",\n \"code\": \"normal\",\n \"display\": \"Normal\"\n }\n ]\n },\n \"prescription\": {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService\",\n \"valueReference\": {\n \"reference\": \"ServiceRequest/1\"\n }\n }\n ],\n \"display\": \"see requested service extension\"\n },\n \"facility\": {\n \"reference\": \"Location/1\"\n },\n \"diagnosis\": [\n {\n \"sequence\": 1,\n \"diagnosisReference\": {\n \"reference\": \"Condition/1\"\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/1\"\n }\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Organization/1\",\n \"resource\": {\n \"resourceType\": \"Organization\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: ETIN = 789312</p><p><b>type</b>: Utilization Management Organization <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/ENTITY_IDENTIFIER_CODE code 'X3' = 'X3', given as 'Utilization Management Organization'})</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>\"\n },\n \"identifier\": [\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://example.org/IDENTIFICATION_CODE_QUALIFIER\",\n \"code\": \"46\",\n \"display\": \"ETIN\"\n }\n ]\n },\n \"system\": \"http://example.org/ETIN\",\n \"value\": \"789312\"\n }\n ],\n \"type\": [\n {\n \"coding\": [\n {\n \"system\": \"http://example.org/ENTITY_IDENTIFIER_CODE\",\n \"code\": \"X3\",\n \"display\": \"Utilization Management Organization\"\n }\n ]\n }\n ],\n \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\"\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/PractitionerRole/1\",\n \"resource\": {\n \"resourceType\": \"PractitionerRole\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>practitioner</b>: <a href=\\\"Practitioner/1\\\">Practitioner/1</a></p><p><b>code</b>: Provider <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/ENTITY_IDENTIFIER_CODE code '1P' = '1P', given as 'Provider'})</span></p></div>\"\n },\n \"practitioner\": {\n \"reference\": \"Practitioner/1\"\n },\n \"code\": [\n {\n \"coding\": [\n {\n \"system\": \"http://example.org/ENTITY_IDENTIFIER_CODE\",\n \"code\": \"1P\",\n \"display\": \"Provider\"\n }\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Practitioner/1\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: ETIN = 8189991234</p><p><b>name</b>: JAMES GARDENER </p></div>\"\n },\n \"identifier\": [\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://example.org/IDENTIFICATION_CODE_QUALIFIER\",\n \"code\": \"46\",\n \"display\": \"ETIN\"\n }\n ]\n },\n \"system\": \"http://example.org/ETIN\",\n \"value\": \"8189991234\"\n }\n ],\n \"name\": [\n {\n \"family\": \"GARDENER\",\n \"given\": [\n \"JAMES\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Coverage/1\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>status</b>: active</p><p><b>beneficiary</b>: <a href=\\\"Patient/1\\\">Patient/1</a></p><p><b>payor</b>: <a href=\\\"Organization/1\\\">Organization/1</a></p></div>\"\n },\n \"status\": \"active\",\n \"beneficiary\": {\n \"reference\": \"Patient/1\"\n },\n \"payor\": [\n {\n \"reference\": \"Organization/1\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Patient/1\",\n \"resource\": {\n \"resourceType\": \"Patient\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: Member Identification Number = 12345678901</p><p><b>name</b>: JOE SMITH </p></div>\"\n },\n \"identifier\": [\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://example.org/IDENTIFICATION_CODE_QUALIFIER\",\n \"code\": \"MI\",\n \"display\": \"Member Identification Number\"\n }\n ]\n },\n \"system\": \"http://example.org/MIN\",\n \"value\": \"12345678901\"\n }\n ],\n \"name\": [\n {\n \"family\": \"SMITH\",\n \"given\": [\n \"JOE\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Organization/3\",\n \"resource\": {\n \"resourceType\": \"Organization\",\n \"id\": \"3\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 3</p><p><b>identifier</b>: 9012345678</p></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://example.org/USER_ASSIGNED\",\n \"value\": \"9012345678\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/ServiceRequest/1\",\n \"resource\": {\n \"resourceType\": \"ServiceRequest\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>code</b>: Consultation <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/SERVICE_TYPE_CODE code '3' = '3', given as 'Consultation'})</span></p><p><b>quantity</b>: 1 VS</p><p><b>subject</b>: <a href=\\\"Patient/1\\\">Patient/1</a></p><p><b>performer</b>: <a href=\\\"PractitionerRole/2\\\">PractitionerRole/2</a></p></div>\"\n },\n \"status\": \"active\",\n \"intent\": \"plan\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://example.org/SERVICE_TYPE_CODE\",\n \"code\": \"3\",\n \"display\": \"Consultation\"\n }\n ]\n },\n \"quantityQuantity\": {\n \"value\": 1,\n \"unit\": \"VS\"\n },\n \"subject\": {\n \"reference\": \"Patient/1\"\n },\n \"performer\": [\n {\n \"reference\": \"PractitionerRole/2\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Location/1\",\n \"resource\": {\n \"resourceType\": \"Location\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>type</b>: 11 <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/Place-of-Service-Codes code '11' = '11)</span></p></div>\"\n },\n \"type\": [\n {\n \"coding\": [\n {\n \"system\": \"http://example.org/Place-of-Service-Codes\",\n \"code\": \"11\"\n }\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Condition/1\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>code</b>: 410.90 <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://hl7.org/fhir/sid/icd-9-cm code '410.90' = '410.90)</span></p><p><b>subject</b>: <a href=\\\"Patient/1\\\">Patient/1</a></p><p><b>recordedDate</b>: Apr 30, 2005, 12:00:00 AM</p></div>\"\n },\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-9-cm\",\n \"code\": \"410.90\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/1\"\n },\n \"recordedDate\": \"2005-04-30\"\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/PractitionerRole/2\",\n \"resource\": {\n \"resourceType\": \"PractitionerRole\",\n \"id\": \"2\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 2</p><p><b>practitioner</b>: <a href=\\\"Practitioner/2\\\">Practitioner/2</a></p><p><b>code</b>: Service Provider <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/ENTITY_IDENTIFIER_CODE code 'SJ' = 'SJ', given as 'Service Provider'})</span></p></div>\"\n },\n \"practitioner\": {\n \"reference\": \"Practitioner/2\"\n },\n \"code\": [\n {\n \"coding\": [\n {\n \"system\": \"http://example.org/ENTITY_IDENTIFIER_CODE\",\n \"code\": \"SJ\",\n \"display\": \"Service Provider\"\n }\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Practitioner/2\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"2\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 2</p><p><b>identifier</b>: SSN = 987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>\"\n },\n \"identifier\": [\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://example.org/IDENTIFICATION_CODE_QUALIFIER\",\n \"code\": \"34\",\n \"display\": \"SSN\"\n }\n ]\n },\n \"system\": \"http://example.org/SSN\",\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}"
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
]
},
"description": "Post the JSON PA Referral Request Example form the IG to the Claim/$submit endpoint."
},
"response": []
},
{
"name": "Claim: XML PA Referral Request Example",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"type": "text",
"value": "application/fhir+xml"
}
],
"body": {
"mode": "raw",
"raw": "<Bundle xmlns=\"http://hl7.org/fhir\">\n <id value=\"pa-request-example-referral\"/>\n <identifier>\n <system value=\"http://example.org/SUBMITTER_TRANSACTION_IDENTIFIER\"/>\n <value value=\"A12345\"/>\n </identifier>\n <type value=\"collection\"/>\n <timestamp value=\"2005-05-02T11:01:00+05:00\"/>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Claim/1\"/>\n <resource>\n <Claim>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: 111099</p><p><b>status</b>: active</p><p><b>type</b>: Specialty Care Review <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/UM_REQUEST_CATEGORY_CODE code 'SC' = 'SC', given as 'Specialty Care Review'})</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\"Patient/1\">Patient/1</a></p><p><b>created</b>: Jul 20, 2019, 12:00:00 AM</p><p><b>insurer</b>: <a href=\"Organization/1\">Organization/1</a></p><p><b>provider</b>: <a href=\"PractitionerRole/1\">PractitionerRole/1</a></p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow\">(Details : {http://terminology/hl7.org/CodeSystem/processpriority code 'normal' = 'normal', given as 'Normal'})</span></p><p><b>prescription</b>: see requested service extension</p><p><b>facility</b>: <a href=\"Location/1\">Location/1</a></p><h3>Diagnoses</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td>*</td><td>1</td><td><a href=\"Condition/1\">Condition/1</a></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td><a href=\"Coverage/1\">Coverage/1</a></td></tr></table></div>\n </text>\n <identifier>\n <system value=\"http://example.org/PATIENT_EVENT_TRACE_NUMBER\"/>\n <value value=\"111099\"/>\n <assigner>\n <reference value=\"Organization/3\"/>\n </assigner>\n </identifier>\n <status value=\"active\"/>\n <type>\n <coding>\n <system value=\"http://example.org/UM_REQUEST_CATEGORY_CODE\"/>\n <code value=\"SC\"/>\n <display value=\"Specialty Care Review\"/>\n </coding>\n </type>\n <use value=\"preauthorization\">\n <extension\n url=\"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\">\n <valueCode value=\"I\"/>\n </extension>\n </use>\n <patient>\n <reference value=\"Patient/1\"/>\n </patient>\n <created value=\"2019-07-20\"/>\n <insurer>\n <reference value=\"Organization/1\"/>\n </insurer>\n <provider>\n <reference value=\"PractitionerRole/1\"/>\n </provider>\n <priority>\n <coding>\n <system\n value=\"http://terminology/hl7.org/CodeSystem/processpriority\"/>\n <code value=\"normal\"/>\n <display value=\"Normal\"/>\n </coding>\n </priority>\n <prescription>\n <extension\n url=\"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService\">\n <valueReference>\n <reference value=\"ServiceRequest/1\"/>\n </valueReference>\n </extension>\n <display value=\"see requested service extension\"/>\n </prescription>\n <facility>\n <reference value=\"Location/1\"/>\n </facility>\n <diagnosis>\n <sequence value=\"1\"/>\n <diagnosisReference>\n <reference value=\"Condition/1\"/>\n </diagnosisReference>\n </diagnosis>\n <insurance>\n <sequence value=\"1\"/>\n <focal value=\"true\"/>\n <coverage>\n <reference value=\"Coverage/1\"/>\n </coverage>\n </insurance>\n </Claim>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Organization/1\"/>\n <resource>\n <Organization>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: ETIN = 789312</p><p><b>type</b>: Utilization Management Organization <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/ENTITY_IDENTIFIER_CODE code 'X3' = 'X3', given as 'Utilization Management Organization'})</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>\n </text>\n <identifier>\n <type>\n <coding>\n <system value=\"http://example.org/IDENTIFICATION_CODE_QUALIFIER\"/>\n <code value=\"46\"/>\n <display value=\"ETIN\"/>\n </coding>\n </type>\n <system value=\"http://example.org/ETIN\"/>\n <value value=\"789312\"/>\n </identifier>\n <type>\n <coding>\n <system value=\"http://example.org/ENTITY_IDENTIFIER_CODE\"/>\n <code value=\"X3\"/>\n <display value=\"Utilization Management Organization\"/>\n </coding>\n </type>\n <name value=\"MARYLAND CAPITAL INSURANCE COMPANY\"/>\n </Organization>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/PractitionerRole/1\"/>\n <resource>\n <PractitionerRole>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>practitioner</b>: <a href=\"Practitioner/1\">Practitioner/1</a></p><p><b>code</b>: Provider <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/ENTITY_IDENTIFIER_CODE code '1P' = '1P', given as 'Provider'})</span></p></div>\n </text>\n <practitioner>\n <reference value=\"Practitioner/1\"/>\n </practitioner>\n <code>\n <coding>\n <system value=\"http://example.org/ENTITY_IDENTIFIER_CODE\"/>\n <code value=\"1P\"/>\n <display value=\"Provider\"/>\n </coding>\n </code>\n </PractitionerRole>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Practitioner/1\"/>\n <resource>\n <Practitioner>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: ETIN = 8189991234</p><p><b>name</b>: JAMES GARDENER </p></div>\n </text>\n <identifier>\n <type>\n <coding>\n <system value=\"http://example.org/IDENTIFICATION_CODE_QUALIFIER\"/>\n <code value=\"46\"/>\n <display value=\"ETIN\"/>\n </coding>\n </type>\n <system value=\"http://example.org/ETIN\"/>\n <value value=\"8189991234\"/>\n </identifier>\n <name>\n <family value=\"GARDENER\"/>\n <given value=\"JAMES\"/>\n </name>\n </Practitioner>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Coverage/1\"/>\n <resource>\n <Coverage>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>status</b>: active</p><p><b>beneficiary</b>: <a href=\"Patient/1\">Patient/1</a></p><p><b>payor</b>: <a href=\"Organization/1\">Organization/1</a></p></div>\n </text>\n <status value=\"active\"/>\n <!-- This is actual the subscriber but beneficiary is mandatory -->\n <beneficiary>\n <reference value=\"Patient/1\"/>\n </beneficiary>\n <!-- Payor is mandatory but we don't actually have one so the insurer organization is specified here -->\n <payor>\n <reference value=\"Organization/1\"/>\n </payor>\n </Coverage>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Patient/1\"/>\n <resource>\n <Patient>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: Member Identification Number = 12345678901</p><p><b>name</b>: JOE SMITH </p></div>\n </text>\n <identifier>\n <type>\n <coding>\n <system value=\"http://example.org/IDENTIFICATION_CODE_QUALIFIER\"/>\n <code value=\"MI\"/>\n <display value=\"Member Identification Number\"/>\n </coding>\n </type>\n <system value=\"http://example.org/MIN\"/>\n <value value=\"12345678901\"/>\n </identifier>\n <name>\n <family value=\"SMITH\"/>\n <given value=\"JOE\"/>\n </name>\n </Patient>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Organization/3\"/>\n <resource>\n <Organization>\n <id value=\"3\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 3</p><p><b>identifier</b>: 9012345678</p></div>\n </text>\n <identifier>\n <system value=\"http://example.org/USER_ASSIGNED\"/>\n <value value=\"9012345678\"/>\n </identifier>\n </Organization>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/ServiceRequest/1\"/>\n <resource>\n <ServiceRequest>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>code</b>: Consultation <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/SERVICE_TYPE_CODE code '3' = '3', given as 'Consultation'})</span></p><p><b>quantity</b>: 1 VS</p><p><b>subject</b>: <a href=\"Patient/1\">Patient/1</a></p><p><b>performer</b>: <a href=\"PractitionerRole/2\">PractitionerRole/2</a></p></div>\n </text>\n <status value=\"active\"/>\n <intent value=\"plan\"/>\n <code>\n <coding>\n <system value=\"http://example.org/SERVICE_TYPE_CODE\"/>\n <code value=\"3\"/>\n <display value=\"Consultation\"/>\n </coding>\n </code>\n <quantityQuantity>\n <value value=\"1\"/>\n <unit value=\"VS\"/>\n </quantityQuantity>\n <subject>\n <reference value=\"Patient/1\"/>\n </subject>\n <performer>\n <reference value=\"PractitionerRole/2\"/>\n </performer>\n </ServiceRequest>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Location/1\"/>\n <resource>\n <Location>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>type</b>: 11 <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/Place-of-Service-Codes code '11' = '11)</span></p></div>\n </text>\n <type>\n <coding>\n <system value=\"http://example.org/Place-of-Service-Codes\"/>\n <code value=\"11\"/>\n </coding>\n </type>\n </Location>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Condition/1\"/>\n <resource>\n <Condition>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>code</b>: 410.90 <span style=\"background: LightGoldenRodYellow\">(Details : {http://hl7.org/fhir/sid/icd-9-cm code '410.90' = '410.90)</span></p><p><b>subject</b>: <a href=\"Patient/1\">Patient/1</a></p><p><b>recordedDate</b>: Apr 30, 2005, 12:00:00 AM</p></div>\n </text>\n <code>\n <coding>\n <system value=\"http://hl7.org/fhir/sid/icd-9-cm\"/>\n <code value=\"410.90\"/>\n </coding>\n </code>\n <subject>\n <reference value=\"Patient/1\"/>\n </subject>\n <recordedDate value=\"2005-04-30\"/>\n </Condition>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/PractitionerRole/2\"/>\n <resource>\n <PractitionerRole>\n <id value=\"2\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 2</p><p><b>practitioner</b>: <a href=\"Practitioner/2\">Practitioner/2</a></p><p><b>code</b>: Service Provider <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/ENTITY_IDENTIFIER_CODE code 'SJ' = 'SJ', given as 'Service Provider'})</span></p></div>\n </text>\n <practitioner>\n <reference value=\"Practitioner/2\"/>\n </practitioner>\n <code>\n <coding>\n <system value=\"http://example.org/ENTITY_IDENTIFIER_CODE\"/>\n <code value=\"SJ\"/>\n <display value=\"Service Provider\"/>\n </coding>\n </code>\n </PractitionerRole>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Practitioner/2\"/>\n <resource>\n <Practitioner>\n <id value=\"2\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 2</p><p><b>identifier</b>: SSN = 987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>\n </text>\n <identifier>\n <type>\n <coding>\n <system value=\"http://example.org/IDENTIFICATION_CODE_QUALIFIER\"/>\n <code value=\"34\"/>\n <display value=\"SSN\"/>\n </coding>\n </type>\n <system value=\"http://example.org/SSN\"/>\n <value value=\"987654321\"/>\n </identifier>\n <name>\n <family value=\"WATSON\"/>\n <given value=\"SUSAN\"/>\n </name>\n <telecom>\n <system value=\"phone\"/>\n <value value=\"4029993456\"/>\n </telecom>\n </Practitioner>\n </resource>\n </entry>\n</Bundle>"
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
]
},
"description": "Post the JSON PA Referral Request Example form the IG to the Claim/$submit endpoint."
},
"response": []
},
{
"name": "Claim: JSON PA Home Healthcare Request Example",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"name": "Content-Type",
"type": "text",
"value": "application/fhir+json"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"id\": \"pa-request-example-homehealthcare\",\n \"identifier\": {\n \"system\": \"http://example.org/SUBMITTER_TRANSACTION_IDENTIFIER\",\n \"value\": \"B56789\"\n },\n \"type\": \"collection\",\n \"timestamp\": \"2005-05-02T14:30:00+05:00\",\n \"entry\": [\n {\n \"fullUrl\": \"http://example.org/fhir/Claim/1\",\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>status</b>: active</p><p><b>type</b>: Health Services Review <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/UM_REQUEST_CATEGORY_CODE code 'HS' = 'HS', given as 'Health Services Review'})</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\\\"Patient/1\\\">Patient/1</a></p><p><b>created</b>: Jul 20, 2019, 12:00:00 AM</p><p><b>insurer</b>: <a href=\\\"Organization/1\\\">Organization/1</a></p><p><b>provider</b>: <a href=\\\"PractitionerRole/1\\\">PractitionerRole/1</a></p><p><b>priority</b>: Normal <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://terminology/hl7.org/CodeSystem/processpriority code 'normal' = 'normal', given as 'Normal'})</span></p><p><b>prescription</b>: see requested service extension</p><p><b>facility</b>: <a href=\\\"Location/1\\\">Location/1</a></p><h3>SupportingInfos</h3><table class=\\\"grid\\\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>1</td><td>Release Of Information <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASSupportingInfoType code 'releaseOfInformation' = 'Release Of Information)</span></td><td>Y</td></tr></table><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 1</p><p><b>diagnosis</b>: <a href=\\\"Condition/1\\\">Condition/1</a></p></blockquote><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 2</p><p><b>diagnosis</b>: <a href=\\\"Condition/2\\\">Condition/2</a></p></blockquote><h3>Insurances</h3><table class=\\\"grid\\\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td><a href=\\\"Coverage/1\\\">Coverage/1</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: G0154 <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://www.ama-assn.org/go/cpt code 'G0154' = 'G0154)</span></p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>productOrService</b>: B4184 <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://www.ama-assn.org/go/cpt code 'B4184' = 'B4184)</span></p></blockquote></div>\"\n },\n \"status\": \"active\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://example.org/UM_REQUEST_CATEGORY_CODE\",\n \"code\": \"HS\",\n \"display\": \"Health Services Review\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"_use\": {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\",\n \"valueCode\": \"I\"\n }\n ]\n },\n \"patient\": {\n \"reference\": \"Patient/1\"\n },\n \"created\": \"2019-07-20\",\n \"insurer\": {\n \"reference\": \"Organization/1\"\n },\n \"provider\": {\n \"reference\": \"PractitionerRole/1\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"system\": \"http://terminology/hl7.org/CodeSystem/processpriority\",\n \"code\": \"normal\",\n \"display\": \"Normal\"\n }\n ]\n },\n \"prescription\": {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService\",\n \"valueReference\": {\n \"reference\": \"ServiceRequest/1\"\n }\n }\n ],\n \"display\": \"see requested service extension\"\n },\n \"facility\": {\n \"reference\": \"Location/1\"\n },\n \"supportingInfo\": [\n {\n \"sequence\": 1,\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASSupportingInfoType\",\n \"code\": \"releaseOfInformation\"\n }\n ]\n },\n \"valueString\": \"Y\"\n }\n ],\n \"diagnosis\": [\n {\n \"sequence\": 1,\n \"diagnosisReference\": {\n \"reference\": \"Condition/1\"\n }\n },\n {\n \"sequence\": 2,\n \"diagnosisReference\": {\n \"reference\": \"Condition/2\"\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/1\"\n }\n }\n ],\n \"item\": [\n {\n \"sequence\": 1,\n \"productOrService\": {\n \"coding\": [\n {\n \"system\": \"http://www.ama-assn.org/go/cpt\",\n \"code\": \"G0154\"\n }\n ]\n }\n },\n {\n \"sequence\": 2,\n \"productOrService\": {\n \"coding\": [\n {\n \"system\": \"http://www.ama-assn.org/go/cpt\",\n \"code\": \"B4184\"\n }\n ]\n }\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Organization/1\",\n \"resource\": {\n \"resourceType\": \"Organization\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: ETIN = 789312</p><p><b>type</b>: Utilization Management Organization <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/ENTITY_IDENTIFIER_CODE code 'X3' = 'X3', given as 'Utilization Management Organization'})</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>\"\n },\n \"identifier\": [\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://example.org/IDENTIFICATION_CODE_QUALIFIER\",\n \"code\": \"46\",\n \"display\": \"ETIN\"\n }\n ]\n },\n \"system\": \"http://example.org/ETIN\",\n \"value\": \"789312\"\n }\n ],\n \"type\": [\n {\n \"coding\": [\n {\n \"system\": \"http://example.org/ENTITY_IDENTIFIER_CODE\",\n \"code\": \"X3\",\n \"display\": \"Utilization Management Organization\"\n }\n ]\n }\n ],\n \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\"\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/PractitionerRole/1\",\n \"resource\": {\n \"resourceType\": \"PractitionerRole\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>practitioner</b>: <a href=\\\"Practitioner/1\\\">Practitioner/1</a></p><p><b>code</b>: Provider <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/ENTITY_IDENTIFIER_CODE code '1P' = '1P', given as 'Provider'})</span></p></div>\"\n },\n \"practitioner\": {\n \"reference\": \"Practitioner/1\"\n },\n \"code\": [\n {\n \"coding\": [\n {\n \"system\": \"http://example.org/ENTITY_IDENTIFIER_CODE\",\n \"code\": \"1P\",\n \"display\": \"Provider\"\n }\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Practitioner/1\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: SSN = 987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>\"\n },\n \"identifier\": [\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://example.org/IDENTIFICATION_CODE_QUALIFIER\",\n \"code\": \"34\",\n \"display\": \"SSN\"\n }\n ]\n },\n \"system\": \"http://example.org/SSN\",\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://example.org/fhir/Coverage/1\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>status</b>: active</p><p><b>beneficiary</b>: <a href=\\\"Patient/1\\\">Patient/1</a></p><p><b>payor</b>: <a href=\\\"Organization/1\\\">Organization/1</a></p></div>\"\n },\n \"status\": \"active\",\n \"beneficiary\": {\n \"reference\": \"Patient/1\"\n },\n \"payor\": [\n {\n \"reference\": \"Organization/1\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Patient/1\",\n \"resource\": {\n \"resourceType\": \"Patient\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: Member Identification Number = 12345678901</p><p><b>name</b>: JOE SMITH </p></div>\"\n },\n \"identifier\": [\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://example.org/IDENTIFICATION_CODE_QUALIFIER\",\n \"code\": \"MI\",\n \"display\": \"Member Identification Number\"\n }\n ]\n },\n \"system\": \"http://example.org/MIN\",\n \"value\": \"12345678901\"\n }\n ],\n \"name\": [\n {\n \"family\": \"SMITH\",\n \"given\": [\n \"JOE\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/ServiceRequest/1\",\n \"resource\": {\n \"resourceType\": \"ServiceRequest\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>code</b>: Medical Care <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/SERVICE_TYPE_CODE code '1' = '1', given as 'Medical Care'})</span></p><p><b>quantity</b>: 1 VS</p><p><b>subject</b>: <a href=\\\"Patient/1\\\">Patient/1</a></p><p><b>occurrence</b>: Do 3 per 1 weeks</p><p><b>performer</b>: <a href=\\\"Organization/2\\\">Organization/2</a></p></div>\"\n },\n \"status\": \"active\",\n \"intent\": \"plan\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://example.org/SERVICE_TYPE_CODE\",\n \"code\": \"1\",\n \"display\": \"Medical Care\"\n }\n ]\n },\n \"quantityQuantity\": {\n \"value\": 1,\n \"unit\": \"VS\"\n },\n \"subject\": {\n \"reference\": \"Patient/1\"\n },\n \"occurrenceTiming\": {\n \"repeat\": {\n \"boundsDuration\": {\n \"value\": 2,\n \"unit\": \"mo\"\n },\n \"frequency\": 3,\n \"period\": 1,\n \"periodUnit\": \"wk\"\n }\n },\n \"performer\": [\n {\n \"reference\": \"Organization/2\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Location/1\",\n \"resource\": {\n \"resourceType\": \"Location\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>type</b>: 11 <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/Place-of-Service-Codes code '11' = '11)</span></p></div>\"\n },\n \"type\": [\n {\n \"coding\": [\n {\n \"system\": \"http://example.org/Place-of-Service-Codes\",\n \"code\": \"11\"\n }\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Condition/1\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>code</b>: 183.0 <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://hl7.org/fhir/sid/icd-9-cm code '183.0' = '183.0)</span></p><p><b>subject</b>: <a href=\\\"Patient/1\\\">Patient/1</a></p><h3>Stages</h3><table class=\\\"grid\\\"><tr><td>-</td><td><b>Assessment</b></td></tr><tr><td>*</td><td><a href=\\\"ClinicalImpression/1\\\">ClinicalImpression/1</a></td></tr></table></div>\"\n },\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-9-cm\",\n \"code\": \"183.0\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/1\"\n },\n \"stage\": [\n {\n \"assessment\": [\n {\n \"reference\": \"ClinicalImpression/1\"\n }\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Condition/2\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"2\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 2</p><p><b>code</b>: 263.0 <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://hl7.org/fhir/sid/icd-9-cm code '263.0' = '263.0)</span></p><p><b>subject</b>: <a href=\\\"Patient/1\\\">Patient/1</a></p></div>\"\n },\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/icd-9-cm\",\n \"code\": \"263.0\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/1\"\n }\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/Organization/2\",\n \"resource\": {\n \"resourceType\": \"Organization\",\n \"id\": \"2\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 2</p><p><b>identifier</b>: EIN = 345678912</p><p><b>type</b>: Service Provider <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/ENTITY_IDENTIFIER_CODE code 'SJ' = 'SJ', given as 'Service Provider'})</span></p><p><b>name</b>: CARING HANDS HOME HEALTH AGENCY</p></div>\"\n },\n \"identifier\": [\n {\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://example.org/IDENTIFICATION_CODE_QUALIFIER\",\n \"code\": \"24\",\n \"display\": \"EIN\"\n }\n ]\n },\n \"system\": \"http://example.org/EIN\",\n \"value\": \"345678912\"\n }\n ],\n \"type\": [\n {\n \"coding\": [\n {\n \"system\": \"http://example.org/ENTITY_IDENTIFIER_CODE\",\n \"code\": \"SJ\",\n \"display\": \"Service Provider\"\n }\n ]\n }\n ],\n \"name\": \"CARING HANDS HOME HEALTH AGENCY\"\n }\n },\n {\n \"fullUrl\": \"http://example.org/fhir/ClinicalImpression/1\",\n \"resource\": {\n \"resourceType\": \"ClinicalImpression\",\n \"id\": \"1\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>status</b>: completed</p><p><b>subject</b>: <a href=\\\"Patient/1\\\">Patient/1</a></p><p><b>prognosisCodeableConcept</b>: 1 <span style=\\\"background: LightGoldenRodYellow\\\">(Details : {http://example.org/PROGNOSIS_CODE code '1' = '1)</span></p></div>\"\n },\n \"status\": \"completed\",\n \"subject\": {\n \"reference\": \"Patient/1\"\n },\n \"prognosisCodeableConcept\": [\n {\n \"coding\": [\n {\n \"system\": \"http://example.org/PROGNOSIS_CODE\",\n \"code\": \"1\"\n }\n ]\n }\n ]\n }\n }\n ]\n}"
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
]
},
"description": "Post the JSON PA Home Healthcare Request Example form the IG to the Claim/$submit endpoint."
},
"response": []
},
{
"name": "Claim: XML PA Home Healthcare Request Example",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"type": "text",
"value": "application/fhir+xml"
}
],
"body": {
"mode": "raw",
"raw": "<Bundle xmlns=\"http://hl7.org/fhir\">\n <id value=\"pa-request-example-homehealthcare\"/>\n <identifier>\n <system value=\"http://example.org/SUBMITTER_TRANSACTION_IDENTIFIER\"/>\n <value value=\"B56789\"/>\n </identifier>\n <type value=\"collection\"/>\n <timestamp value=\"2005-05-02T14:30:00+05:00\"/>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Claim/1\"/>\n <resource>\n <Claim>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>status</b>: active</p><p><b>type</b>: Health Services Review <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/UM_REQUEST_CATEGORY_CODE code 'HS' = 'HS', given as 'Health Services Review'})</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\"Patient/1\">Patient/1</a></p><p><b>created</b>: Jul 20, 2019, 12:00:00 AM</p><p><b>insurer</b>: <a href=\"Organization/1\">Organization/1</a></p><p><b>provider</b>: <a href=\"PractitionerRole/1\">PractitionerRole/1</a></p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow\">(Details : {http://terminology/hl7.org/CodeSystem/processpriority code 'normal' = 'normal', given as 'Normal'})</span></p><p><b>prescription</b>: see requested service extension</p><p><b>facility</b>: <a href=\"Location/1\">Location/1</a></p><h3>SupportingInfos</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>1</td><td>Release Of Information <span style=\"background: LightGoldenRodYellow\">(Details : {http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASSupportingInfoType code 'releaseOfInformation' = 'Release Of Information)</span></td><td>Y</td></tr></table><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 1</p><p><b>diagnosis</b>: <a href=\"Condition/1\">Condition/1</a></p></blockquote><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 2</p><p><b>diagnosis</b>: <a href=\"Condition/2\">Condition/2</a></p></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td><a href=\"Coverage/1\">Coverage/1</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: G0154 <span style=\"background: LightGoldenRodYellow\">(Details : {http://www.ama-assn.org/go/cpt code 'G0154' = 'G0154)</span></p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>productOrService</b>: B4184 <span style=\"background: LightGoldenRodYellow\">(Details : {http://www.ama-assn.org/go/cpt code 'B4184' = 'B4184)</span></p></blockquote></div>\n </text>\n <status value=\"active\"/>\n <type>\n <coding>\n <system value=\"http://example.org/UM_REQUEST_CATEGORY_CODE\"/>\n <code value=\"HS\"/>\n <display value=\"Health Services Review\"/>\n </coding>\n </type>\n <use value=\"preauthorization\">\n <extension\n url=\"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType\">\n <valueCode value=\"I\"/>\n </extension>\n </use>\n <patient>\n <reference value=\"Patient/1\"/>\n </patient>\n <created value=\"2019-07-20\"/>\n <insurer>\n <reference value=\"Organization/1\"/>\n </insurer>\n <provider>\n <reference value=\"PractitionerRole/1\"/>\n </provider>\n <priority>\n <coding>\n <system\n value=\"http://terminology/hl7.org/CodeSystem/processpriority\"/>\n <code value=\"normal\"/>\n <display value=\"Normal\"/>\n </coding>\n </priority>\n <prescription>\n <extension\n url=\"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService\">\n <valueReference>\n <reference value=\"ServiceRequest/1\"/>\n </valueReference>\n </extension>\n <display value=\"see requested service extension\"/>\n </prescription>\n <facility>\n <reference value=\"Location/1\"/>\n </facility>\n <supportingInfo>\n <sequence value=\"1\"/>\n <category>\n <coding>\n <system\n value=\"http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASSupportingInfoType\"/>\n <code value=\"releaseOfInformation\"/>\n </coding>\n </category>\n <valueString value=\"Y\"/>\n </supportingInfo>\n <diagnosis>\n <sequence value=\"1\"/>\n <diagnosisReference>\n <reference value=\"Condition/1\"/>\n </diagnosisReference>\n </diagnosis>\n <diagnosis>\n <sequence value=\"2\"/>\n <diagnosisReference>\n <reference value=\"Condition/2\"/>\n </diagnosisReference>\n </diagnosis>\n <insurance>\n <sequence value=\"1\"/>\n <focal value=\"true\"/>\n <coverage>\n <reference value=\"Coverage/1\"/>\n </coverage>\n </insurance>\n <item>\n <sequence value=\"1\"/>\n <productOrService>\n <coding>\n <system value=\"http://www.ama-assn.org/go/cpt\"/>\n <code value=\"G0154\"/>\n </coding>\n </productOrService>\n </item>\n <item>\n <sequence value=\"2\"/>\n <productOrService>\n <coding>\n <system value=\"http://www.ama-assn.org/go/cpt\"/>\n <code value=\"B4184\"/>\n </coding>\n </productOrService>\n </item>\n </Claim>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Organization/1\"/>\n <resource>\n <Organization>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: ETIN = 789312</p><p><b>type</b>: Utilization Management Organization <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/ENTITY_IDENTIFIER_CODE code 'X3' = 'X3', given as 'Utilization Management Organization'})</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>\n </text>\n <identifier>\n <type>\n <coding>\n <system value=\"http://example.org/IDENTIFICATION_CODE_QUALIFIER\"/>\n <code value=\"46\"/>\n <display value=\"ETIN\"/>\n </coding>\n </type>\n <system value=\"http://example.org/ETIN\"/>\n <value value=\"789312\"/>\n </identifier>\n <type>\n <coding>\n <system value=\"http://example.org/ENTITY_IDENTIFIER_CODE\"/>\n <code value=\"X3\"/>\n <display value=\"Utilization Management Organization\"/>\n </coding>\n </type>\n <name value=\"MARYLAND CAPITAL INSURANCE COMPANY\"/>\n </Organization>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/PractitionerRole/1\"/>\n <resource>\n <PractitionerRole>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>practitioner</b>: <a href=\"Practitioner/1\">Practitioner/1</a></p><p><b>code</b>: Provider <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/ENTITY_IDENTIFIER_CODE code '1P' = '1P', given as 'Provider'})</span></p></div>\n </text>\n <practitioner>\n <reference value=\"Practitioner/1\"/>\n </practitioner>\n <code>\n <coding>\n <system value=\"http://example.org/ENTITY_IDENTIFIER_CODE\"/>\n <code value=\"1P\"/>\n <display value=\"Provider\"/>\n </coding>\n </code>\n </PractitionerRole>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Practitioner/1\"/>\n <resource>\n <Practitioner>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: SSN = 987654321</p><p><b>name</b>: SUSAN WATSON </p><p><b>telecom</b>: ph: 4029993456</p></div>\n </text>\n <identifier>\n <type>\n <coding>\n <system value=\"http://example.org/IDENTIFICATION_CODE_QUALIFIER\"/>\n <code value=\"34\"/>\n <display value=\"SSN\"/>\n </coding>\n </type>\n <system value=\"http://example.org/SSN\"/>\n <value value=\"987654321\"/>\n </identifier>\n <name>\n <family value=\"WATSON\"/>\n <given value=\"SUSAN\"/>\n </name>\n <telecom>\n <system value=\"phone\"/>\n <value value=\"4029993456\"/>\n </telecom>\n </Practitioner>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Coverage/1\"/>\n <resource>\n <Coverage>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>status</b>: active</p><p><b>beneficiary</b>: <a href=\"Patient/1\">Patient/1</a></p><p><b>payor</b>: <a href=\"Organization/1\">Organization/1</a></p></div>\n </text>\n <status value=\"active\"/>\n <!-- This is actual the subscriber but beneficiary is mandatory -->\n <beneficiary>\n <reference value=\"Patient/1\"/>\n </beneficiary>\n <!-- Payor is mandatory but we don't actually have one so the insurer organization is specified here -->\n <payor>\n <reference value=\"Organization/1\"/>\n </payor>\n </Coverage>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Patient/1\"/>\n <resource>\n <Patient>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>identifier</b>: Member Identification Number = 12345678901</p><p><b>name</b>: JOE SMITH </p></div>\n </text>\n <identifier>\n <type>\n <coding>\n <system value=\"http://example.org/IDENTIFICATION_CODE_QUALIFIER\"/>\n <code value=\"MI\"/>\n <display value=\"Member Identification Number\"/>\n </coding>\n </type>\n <system value=\"http://example.org/MIN\"/>\n <value value=\"12345678901\"/>\n </identifier>\n <name>\n <family value=\"SMITH\"/>\n <given value=\"JOE\"/>\n </name>\n </Patient>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/ServiceRequest/1\"/>\n <resource>\n <ServiceRequest>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>status</b>: active</p><p><b>intent</b>: plan</p><p><b>code</b>: Medical Care <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/SERVICE_TYPE_CODE code '1' = '1', given as 'Medical Care'})</span></p><p><b>quantity</b>: 1 VS</p><p><b>subject</b>: <a href=\"Patient/1\">Patient/1</a></p><p><b>occurrence</b>: Do 3 per 1 weeks</p><p><b>performer</b>: <a href=\"Organization/2\">Organization/2</a></p></div>\n </text>\n <status value=\"active\"/>\n <intent value=\"plan\"/>\n <!-- NOTE: The X12 example doesn't include this because it has service level items. We have included medical care as a default code here. -->\n <code>\n <coding>\n <system value=\"http://example.org/SERVICE_TYPE_CODE\"/>\n <code value=\"1\"/>\n <display value=\"Medical Care\"/>\n </coding>\n </code>\n <quantityQuantity>\n <value value=\"1\"/>\n <unit value=\"VS\"/>\n </quantityQuantity>\n <subject>\n <reference value=\"Patient/1\"/>\n </subject>\n <occurrenceTiming>\n <repeat>\n <boundsDuration>\n <value value=\"2\"/>\n <unit value=\"mo\"/>\n </boundsDuration>\n <frequency value=\"3\"/>\n <period value=\"1\"/>\n <periodUnit value=\"wk\"/>\n </repeat>\n </occurrenceTiming>\n <performer>\n <reference value=\"Organization/2\"/>\n </performer>\n </ServiceRequest>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Location/1\"/>\n <resource>\n <Location>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>type</b>: 11 <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/Place-of-Service-Codes code '11' = '11)</span></p></div>\n </text>\n <type>\n <coding>\n <system value=\"http://example.org/Place-of-Service-Codes\"/>\n <code value=\"11\"/>\n </coding>\n </type>\n </Location>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Condition/1\"/>\n <resource>\n <Condition>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>code</b>: 183.0 <span style=\"background: LightGoldenRodYellow\">(Details : {http://hl7.org/fhir/sid/icd-9-cm code '183.0' = '183.0)</span></p><p><b>subject</b>: <a href=\"Patient/1\">Patient/1</a></p><h3>Stages</h3><table class=\"grid\"><tr><td>-</td><td><b>Assessment</b></td></tr><tr><td>*</td><td><a href=\"ClinicalImpression/1\">ClinicalImpression/1</a></td></tr></table></div>\n </text>\n <code>\n <coding>\n <system value=\"http://hl7.org/fhir/sid/icd-9-cm\"/>\n <code value=\"183.0\"/>\n </coding>\n </code>\n <subject>\n <reference value=\"Patient/1\"/>\n </subject>\n <stage>\n <assessment>\n <reference value=\"ClinicalImpression/1\"/>\n </assessment>\n </stage>\n </Condition>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Condition/2\"/>\n <resource>\n <Condition>\n <id value=\"2\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 2</p><p><b>code</b>: 263.0 <span style=\"background: LightGoldenRodYellow\">(Details : {http://hl7.org/fhir/sid/icd-9-cm code '263.0' = '263.0)</span></p><p><b>subject</b>: <a href=\"Patient/1\">Patient/1</a></p></div>\n </text>\n <code>\n <coding>\n <system value=\"http://hl7.org/fhir/sid/icd-9-cm\"/>\n <code value=\"263.0\"/>\n </coding>\n </code>\n <subject>\n <reference value=\"Patient/1\"/>\n </subject>\n </Condition>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/Organization/2\"/>\n <resource>\n <Organization>\n <id value=\"2\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 2</p><p><b>identifier</b>: EIN = 345678912</p><p><b>type</b>: Service Provider <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/ENTITY_IDENTIFIER_CODE code 'SJ' = 'SJ', given as 'Service Provider'})</span></p><p><b>name</b>: CARING HANDS HOME HEALTH AGENCY</p></div>\n </text>\n <identifier>\n <type>\n <coding>\n <system value=\"http://example.org/IDENTIFICATION_CODE_QUALIFIER\"/>\n <code value=\"24\"/>\n <display value=\"EIN\"/>\n </coding>\n </type>\n <system value=\"http://example.org/EIN\"/>\n <value value=\"345678912\"/>\n </identifier>\n <type>\n <coding>\n <system value=\"http://example.org/ENTITY_IDENTIFIER_CODE\"/>\n <code value=\"SJ\"/>\n <display value=\"Service Provider\"/>\n </coding>\n </type>\n <name value=\"CARING HANDS HOME HEALTH AGENCY\"/>\n </Organization>\n </resource>\n </entry>\n <entry>\n <fullUrl value=\"http://example.org/fhir/ClinicalImpression/1\"/>\n <resource>\n <ClinicalImpression>\n <id value=\"1\"/>\n <text>\n <status value=\"generated\"/>\n <div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 1</p><p><b>status</b>: completed</p><p><b>subject</b>: <a href=\"Patient/1\">Patient/1</a></p><p><b>prognosisCodeableConcept</b>: 1 <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/PROGNOSIS_CODE code '1' = '1)</span></p></div>\n </text>\n <status value=\"completed\"/>\n <subject>\n <reference value=\"Patient/1\"/>\n </subject>\n <prognosisCodeableConcept>\n <coding>\n <system value=\"http://example.org/PROGNOSIS_CODE\"/>\n <code value=\"1\"/>\n </coding>\n </prognosisCodeableConcept>\n </ClinicalImpression>\n </resource>\n </entry>\n</Bundle>"
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
]
},
"description": "Post the JSON PA Home Healthcare Request Example form the IG to the Claim/$submit endpoint."
},
"response": []
}
],
"_postman_isSubFolder": true
},
{
"name": "Claim: Post new items $submit ",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"name": "Content-Type",
"type": "text",
"value": "application/fhir+json"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"type\": \"collection\",\n \"entry\": [\n {\n \"fullUrl\": \"1234567890\",\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"id\": \"1234567890\",\n \"status\": \"active\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n \"code\": \"professional\",\n \"display\": \"Professional\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"patient\": {\n \"reference\": \"Patient/pat013\"\n },\n \"created\": \"2019-08-06\",\n \"provider\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"code\": \"normal\"\n }\n ]\n },\n \"prescription\": {\n \"reference\": \"DeviceRequest/devreq013\"\n },\n \"supportingInfo\": [\n {\n \"sequence\": 1,\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claiminformationcategory\",\n \"code\": \"info\",\n \"display\": \"Information\"\n }\n ]\n },\n \"valueReference\": {\n \"reference\": \"QuestionnaireResponse/response1\"\n }\n }\n ],\n \"diagnosis\": [\n {\n \"sequence\": 1,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013a\"\n }\n },\n {\n \"sequence\": 2,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013b\"\n }\n },\n {\n \"sequence\": 3,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013c\"\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/cov1234\"\n }\n }\n ],\n \"item\" : [\n \t{\n \t\t\"sequence\": 1,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"https://bluebutton.cms.gov/resources/codesystem/hcpcs\",\n\t \t\t\t\t\"code\": \"E0424\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": false\t\n \t\t\t}\t\n \t\t]\n \t},\n \t{\n \t\t\"sequence\": 2,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"http://www.ama-assn.org/go/cpt\",\n\t \t\t\t\t\"code\": \"82947\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": false\t\n \t\t\t}\t\n \t\t]\n \t}\n\t\t\t\t]\n }\n },\n {\n \"fullUrl\": \"response1\",\n \"resource\": {\n \"resourceType\": \"QuestionnaireResponse\",\n \"id\": \"response1\",\n \"authored\": \"2019-08-06\",\n \"status\": \"completed\",\n \"item\": [\n {\n \"linkId\": \"1\",\n \"text\": \"Patient Information\",\n \"item\": [\n {\n \"linkId\": \"1.1\",\n \"text\": \"Last Name but Different This Time\",\n \"answer\": [\n {\n \"valueString\": \"Quinton\"\n }\n ]\n },\n {\n \"linkId\": \"1.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Vlad\"\n }\n ]\n },\n {\n \"linkId\": \"1.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"A, N\"\n }\n ]\n },\n {\n \"linkId\": \"1.4\",\n \"text\": \"Date Of Birth\",\n \"answer\": [\n {\n \"valueDate\": \"1956-12-01\"\n }\n ]\n },\n {\n \"linkId\": \"1.5\",\n \"text\": \"Gender\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"male\",\n \"display\": \"Male\"\n }\n }\n ]\n },\n {\n \"linkId\": \"1.6\",\n \"text\": \"Medicare ID\",\n \"answer\": [\n {\n \"valueString\": \"10A3D58WH22\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"2\",\n \"text\": \"Provider who is performing face-to-face evaluation\",\n \"item\": [\n {\n \"linkId\": \"2.1\",\n \"text\": \"Last Name\",\n \"answer\": [\n {\n \"valueString\": \"Doe\"\n }\n ]\n },\n {\n \"linkId\": \"2.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Jane\"\n }\n ]\n },\n {\n \"linkId\": \"2.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"B\"\n }\n ]\n },\n {\n \"linkId\": \"2.4\",\n \"text\": \"NPI\",\n \"answer\": [\n {\n \"valueString\": \"1122334455\"\n }\n ]\n },\n {\n \"linkId\": \"2.5\",\n \"text\": \"Date of Face-To-Face Evaluation\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"3\",\n \"text\": \"Coverage Requirements\",\n \"item\": [\n {\n \"linkId\": \"3.1\",\n \"text\": \"Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"COPD\",\n \"display\": \"COPD\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Hypoxemia\",\n \"display\": \"Hypoxemia\"\n }\n }\n ]\n },\n {\n \"linkId\": \"3.2\",\n \"text\": \"Arterial oxygen saturation (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.3\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.4\",\n \"text\": \"Arterial oxygen saturation (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.5\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.6\",\n \"text\": \"Is there a documented improvement of hypoxemia during exercise with oxygen?\"\n }\n ]\n },\n {\n \"linkId\": \"4\",\n \"text\": \"Prescribed Use\",\n \"item\": [\n {\n \"linkId\": \"4.1\",\n \"text\": \"Start date\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n },\n {\n \"linkId\": \"4.2\",\n \"text\": \"Length of need: (months) (99 = lifetime)\"\n },\n {\n \"linkId\": \"4.4\",\n \"text\": \"Peak Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.4.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 2\n }\n ]\n },\n {\n \"linkId\": \"4.4.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 95\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.5\",\n \"text\": \"Average Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.5.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 3\n }\n ]\n },\n {\n \"linkId\": \"4.5.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 98\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.6\",\n \"text\": \"Frequency of use (choose all that apply)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"At rest and awake\",\n \"display\": \"At rest and awake\"\n }\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"5\",\n \"text\": \"Oxygen Supply Order Details\",\n \"item\": [\n {\n \"linkId\": \"5.1\",\n \"text\": \"Current Order Description\",\n \"answer\": [\n {\n \"valueString\": \"HCPCS E0424 - Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n {\n \"linkId\": \"5.1b\",\n \"text\": \"Current Order Is For A Portable Device\"\n },\n {\n \"linkId\": \"5.2\",\n \"text\": \"Type\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Compressed Gas\",\n \"display\": \"Compressed Gas\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.3\",\n \"text\": \"Means of oxygen delivery and accessories\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Nasal cannula\",\n \"display\": \"Nasal cannula\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Mask\",\n \"display\": \"Mask\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.4\",\n \"text\": \"Type of order\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Initial or original order for certification\",\n \"display\": \"Initial or original order for certification\"\n }\n }\n ]\n }\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"devreq013\",\n \"resource\": {\n \"resourceType\": \"DeviceRequest\",\n \"id\": \"devreq013\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-crd/STU3/StructureDefinition/profile-devicerequest-stu3\"\n ]\n },\n \"extension\": [\n {\n \"url\": \"http://build.fhir.org/ig/HL7/davinci-crd/STU3/ext-insurance.html\",\n \"valueReference\": {\n \"reference\": \"Coverage/cov013\"\n }\n }\n ],\n \"status\": \"draft\",\n \"codeCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://bluebutton.cms.gov/resources/codesystem/hcpcs\",\n \"code\": \"E0424\",\n \"display\": \"Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"performer\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"intent\": \"original-order\"\n }\n },\n {\n \"fullUrl\": \"pat013\",\n \"resource\": {\n \"resourceType\": \"Patient\",\n \"id\": \"pat013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.116-04:00\"\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><div class=\\\"hapiHeaderText\\\">Vlad Alan Nestor <b>QUINTON </b></div><table class=\\\"hapiPropertyTable\\\"><tbody><tr><td>Identifier</td><td>98765400001AZ</td></tr><tr><td>Date of birth</td><td><span>01 December 1956</span></td></tr></tbody></table></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-medicare\",\n \"value\": \"98765400001AZ\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Quinton\",\n \"given\": [\n \"Vlad\",\n \"Alan\",\n \"Nestor\"\n ]\n }\n ],\n \"gender\": \"male\",\n \"birthDate\": \"1956-12-01\"\n }\n },\n {\n \"fullUrl\": \"pra1234\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1234\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:47.101-04:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1122334455\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Doe\",\n \"given\": [\n \"Jane\",\n \"Betty\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"pra1255\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1255\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:52.089-04:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"348074389\"\n }\n ],\n \"name\": [\n {\n \"family\": \"Smythe\",\n \"given\": [\n \"Juliette\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"obs013\",\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.343-04:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"59408-5\",\n \"display\": \"Oxygen saturation in Arterial blood by Pulse oximetry\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"issued\": \"2019-03-20T15:30:10+01:00\",\n \"valueQuantity\": {\n \"value\": 85,\n \"unit\": \"%\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"%\"\n }\n }\n },\n {\n \"fullUrl\": \"obs013B\",\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013B\",\n \"meta\": {\n \"versionId\": \"2\",\n \"lastUpdated\": \"2019-06-13T09:55:51.583-04:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"31100-1\",\n \"display\": \"Hematocrit [Volume Fraction] of Blood by Impedance\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"issued\": \"2019-03-20T15:30:10+01:00\",\n \"valueQuantity\": {\n \"value\": 61,\n \"unit\": \"%\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"%\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013a\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013a\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.203-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"87837008\",\n \"display\": \"Chronic pulmonary heart disease (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013b\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013b\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.246-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"389087006\",\n \"display\": \"Hypoxemia (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013c\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013c\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.294-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"44054006\",\n \"display\": \"Diabetes mellitus type 2 (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov1234\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov1234\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:49.318-04:00\"\n },\n \"payor\": [\n {\n \"reference\": \"Organization/org1234\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov015\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov015\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.151-04:00\"\n },\n \"subscriberId\": \"10A3D58WH456\",\n \"payor\": [\n {\n \"reference\": \"Organization/org015\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov016\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov016\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.692-04:00\"\n },\n \"subscriberId\": \"64A3D58WH01\",\n \"payor\": [\n {\n \"reference\": \"Organization/org016\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov013\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov013\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.166-04:00\"\n },\n \"subscriberId\": \"10A3D58WH22\",\n \"payor\": [\n {\n \"reference\": \"Organization/org013\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov014\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov014\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.811-04:00\"\n },\n \"subscriberId\": \"10A3D58WH1600\",\n \"payor\": [\n {\n \"reference\": \"Organizarion/org014\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n }\n ]\n}\n",
"options": {
"raw": {}
}
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
]
},
"description": "Post a new Claim to the Claim/$submit endpoint with multiple items."
},
"response": []
},
{
"name": "Claim: Post $submit (diff items)",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"name": "Content-Type",
"type": "text",
"value": "application/fhir+json"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"type\": \"collection\",\n \"entry\": [\n {\n \"fullUrl\": \"1234567890\",\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"id\": \"1234567890\",\n \"status\": \"active\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n \"code\": \"professional\",\n \"display\": \"Professional\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"patient\": {\n \"reference\": \"Patient/pat013\"\n },\n \"created\": \"2019-08-06\",\n \"provider\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"code\": \"normal\"\n }\n ]\n },\n \"prescription\": {\n \"reference\": \"DeviceRequest/devreq013\"\n },\n \"supportingInfo\": [\n {\n \"sequence\": 1,\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claiminformationcategory\",\n \"code\": \"info\",\n \"display\": \"Information\"\n }\n ]\n },\n \"valueReference\": {\n \"reference\": \"QuestionnaireResponse/response1\"\n }\n }\n ],\n \"diagnosis\": [\n {\n \"sequence\": 1,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013a\"\n }\n },\n {\n \"sequence\": 2,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013b\"\n }\n },\n {\n \"sequence\": 3,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013c\"\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/cov1234\"\n }\n }\n ],\n \"item\" : [\n \t{\n \t\t\"sequence\": 1,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"https://bluebutton.cms.gov/resources/codesystem/hcpcs\",\n\t \t\t\t\t\"code\": \"J7505\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": false\t\n \t\t\t}\t\n \t\t]\n \t},\n \t{\n \t\t\"sequence\": 2,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"https://bluebutton.cms.gov/resources/codesystem/hcpcs\",\n\t \t\t\t\t\"code\": \"E0250\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": false\t\n \t\t\t}\t\n \t\t]\n \t}\n\t\t\t\t]\n }\n },\n {\n \"fullUrl\": \"response1\",\n \"resource\": {\n \"resourceType\": \"QuestionnaireResponse\",\n \"id\": \"response1\",\n \"authored\": \"2019-08-06\",\n \"status\": \"completed\",\n \"item\": [\n {\n \"linkId\": \"1\",\n \"text\": \"Patient Information\",\n \"item\": [\n {\n \"linkId\": \"1.1\",\n \"text\": \"Last Name but Different This Time\",\n \"answer\": [\n {\n \"valueString\": \"Quinton\"\n }\n ]\n },\n {\n \"linkId\": \"1.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Vlad\"\n }\n ]\n },\n {\n \"linkId\": \"1.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"A, N\"\n }\n ]\n },\n {\n \"linkId\": \"1.4\",\n \"text\": \"Date Of Birth\",\n \"answer\": [\n {\n \"valueDate\": \"1956-12-01\"\n }\n ]\n },\n {\n \"linkId\": \"1.5\",\n \"text\": \"Gender\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"male\",\n \"display\": \"Male\"\n }\n }\n ]\n },\n {\n \"linkId\": \"1.6\",\n \"text\": \"Medicare ID\",\n \"answer\": [\n {\n \"valueString\": \"10A3D58WH22\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"2\",\n \"text\": \"Provider who is performing face-to-face evaluation\",\n \"item\": [\n {\n \"linkId\": \"2.1\",\n \"text\": \"Last Name\",\n \"answer\": [\n {\n \"valueString\": \"Doe\"\n }\n ]\n },\n {\n \"linkId\": \"2.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Jane\"\n }\n ]\n },\n {\n \"linkId\": \"2.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"B\"\n }\n ]\n },\n {\n \"linkId\": \"2.4\",\n \"text\": \"NPI\",\n \"answer\": [\n {\n \"valueString\": \"1122334455\"\n }\n ]\n },\n {\n \"linkId\": \"2.5\",\n \"text\": \"Date of Face-To-Face Evaluation\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"3\",\n \"text\": \"Coverage Requirements\",\n \"item\": [\n {\n \"linkId\": \"3.1\",\n \"text\": \"Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"COPD\",\n \"display\": \"COPD\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Hypoxemia\",\n \"display\": \"Hypoxemia\"\n }\n }\n ]\n },\n {\n \"linkId\": \"3.2\",\n \"text\": \"Arterial oxygen saturation (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.3\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.4\",\n \"text\": \"Arterial oxygen saturation (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.5\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.6\",\n \"text\": \"Is there a documented improvement of hypoxemia during exercise with oxygen?\"\n }\n ]\n },\n {\n \"linkId\": \"4\",\n \"text\": \"Prescribed Use\",\n \"item\": [\n {\n \"linkId\": \"4.1\",\n \"text\": \"Start date\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n },\n {\n \"linkId\": \"4.2\",\n \"text\": \"Length of need: (months) (99 = lifetime)\"\n },\n {\n \"linkId\": \"4.4\",\n \"text\": \"Peak Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.4.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 2\n }\n ]\n },\n {\n \"linkId\": \"4.4.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 95\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.5\",\n \"text\": \"Average Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.5.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 3\n }\n ]\n },\n {\n \"linkId\": \"4.5.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 98\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.6\",\n \"text\": \"Frequency of use (choose all that apply)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"At rest and awake\",\n \"display\": \"At rest and awake\"\n }\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"5\",\n \"text\": \"Oxygen Supply Order Details\",\n \"item\": [\n {\n \"linkId\": \"5.1\",\n \"text\": \"Current Order Description\",\n \"answer\": [\n {\n \"valueString\": \"HCPCS E0424 - Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n {\n \"linkId\": \"5.1b\",\n \"text\": \"Current Order Is For A Portable Device\"\n },\n {\n \"linkId\": \"5.2\",\n \"text\": \"Type\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Compressed Gas\",\n \"display\": \"Compressed Gas\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.3\",\n \"text\": \"Means of oxygen delivery and accessories\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Nasal cannula\",\n \"display\": \"Nasal cannula\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Mask\",\n \"display\": \"Mask\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.4\",\n \"text\": \"Type of order\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Initial or original order for certification\",\n \"display\": \"Initial or original order for certification\"\n }\n }\n ]\n }\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"devreq013\",\n \"resource\": {\n \"resourceType\": \"DeviceRequest\",\n \"id\": \"devreq013\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-crd/STU3/StructureDefinition/profile-devicerequest-stu3\"\n ]\n },\n \"extension\": [\n {\n \"url\": \"http://build.fhir.org/ig/HL7/davinci-crd/STU3/ext-insurance.html\",\n \"valueReference\": {\n \"reference\": \"Coverage/cov013\"\n }\n }\n ],\n \"status\": \"draft\",\n \"codeCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://bluebutton.cms.gov/resources/codesystem/hcpcs\",\n \"code\": \"E0424\",\n \"display\": \"Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"performer\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"intent\": \"original-order\"\n }\n },\n {\n \"fullUrl\": \"pat013\",\n \"resource\": {\n \"resourceType\": \"Patient\",\n \"id\": \"pat013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.116-04:00\"\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><div class=\\\"hapiHeaderText\\\">Vlad Alan Nestor <b>QUINTON </b></div><table class=\\\"hapiPropertyTable\\\"><tbody><tr><td>Identifier</td><td>98765400001AZ</td></tr><tr><td>Date of birth</td><td><span>01 December 1956</span></td></tr></tbody></table></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-medicare\",\n \"value\": \"98765400001AZ\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Quinton\",\n \"given\": [\n \"Vlad\",\n \"Alan\",\n \"Nestor\"\n ]\n }\n ],\n \"gender\": \"male\",\n \"birthDate\": \"1956-12-01\"\n }\n },\n {\n \"fullUrl\": \"pra1234\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1234\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:47.101-04:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1122334455\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Doe\",\n \"given\": [\n \"Jane\",\n \"Betty\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"pra1255\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1255\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:52.089-04:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"348074389\"\n }\n ],\n \"name\": [\n {\n \"family\": \"Smythe\",\n \"given\": [\n \"Juliette\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"obs013\",\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.343-04:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"59408-5\",\n \"display\": \"Oxygen saturation in Arterial blood by Pulse oximetry\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"issued\": \"2019-03-20T15:30:10+01:00\",\n \"valueQuantity\": {\n \"value\": 85,\n \"unit\": \"%\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"%\"\n }\n }\n },\n {\n \"fullUrl\": \"obs013B\",\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013B\",\n \"meta\": {\n \"versionId\": \"2\",\n \"lastUpdated\": \"2019-06-13T09:55:51.583-04:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"31100-1\",\n \"display\": \"Hematocrit [Volume Fraction] of Blood by Impedance\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"issued\": \"2019-03-20T15:30:10+01:00\",\n \"valueQuantity\": {\n \"value\": 61,\n \"unit\": \"%\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"%\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013a\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013a\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.203-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"87837008\",\n \"display\": \"Chronic pulmonary heart disease (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013b\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013b\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.246-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"389087006\",\n \"display\": \"Hypoxemia (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013c\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013c\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.294-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"44054006\",\n \"display\": \"Diabetes mellitus type 2 (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov1234\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov1234\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:49.318-04:00\"\n },\n \"payor\": [\n {\n \"reference\": \"Organization/org1234\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov015\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov015\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.151-04:00\"\n },\n \"subscriberId\": \"10A3D58WH456\",\n \"payor\": [\n {\n \"reference\": \"Organization/org015\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov016\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov016\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.692-04:00\"\n },\n \"subscriberId\": \"64A3D58WH01\",\n \"payor\": [\n {\n \"reference\": \"Organization/org016\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov013\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov013\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.166-04:00\"\n },\n \"subscriberId\": \"10A3D58WH22\",\n \"payor\": [\n {\n \"reference\": \"Organization/org013\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov014\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov014\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.811-04:00\"\n },\n \"subscriberId\": \"10A3D58WH1600\",\n \"payor\": [\n {\n \"reference\": \"Organizarion/org014\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n }\n ]\n}\n",
"options": {
"raw": {}
}
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
]
},
"description": "Post a new Claim to the Claim/$submit endpoint with multiple items."
},
"response": []
},
{
"name": "Claim: Post $submit (diff items) Copy",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"name": "Content-Type",
"type": "text",
"value": "application/fhir+json"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"type\": \"collection\",\n \"entry\": [\n {\n \"fullUrl\": \"1234567890\",\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"id\": \"1234567890\",\n \"status\": \"active\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n \"code\": \"professional\",\n \"display\": \"Professional\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"patient\": {\n \"reference\": \"Patient/pat013\"\n },\n \"created\": \"2019-08-06\",\n \"provider\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"code\": \"normal\"\n }\n ]\n },\n \"prescription\": {\n \"reference\": \"DeviceRequest/devreq013\"\n },\n \"supportingInfo\": [\n {\n \"sequence\": 1,\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claiminformationcategory\",\n \"code\": \"info\",\n \"display\": \"Information\"\n }\n ]\n },\n \"valueReference\": {\n \"reference\": \"QuestionnaireResponse/response1\"\n }\n }\n ],\n \"diagnosis\": [\n {\n \"sequence\": 1,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013a\"\n }\n },\n {\n \"sequence\": 2,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013b\"\n }\n },\n {\n \"sequence\": 3,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013c\"\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/cov1234\"\n }\n }\n ],\n \"item\" : [\n \t{\n \t\t\"sequence\": 1,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"https://bluebutton.cms.gov/resources/codesystem/hcpcs\",\n\t \t\t\t\t\"code\": \"J7505\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": false\t\n \t\t\t}\t\n \t\t]\n \t},\n \t{\n \t\t\"sequence\": 2,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"https://bluebutton.cms.gov/resources/codesystem/hcpcs\",\n\t \t\t\t\t\"code\": \"E0250\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": false\t\n \t\t\t}\t\n \t\t]\n \t}\n\t\t\t\t]\n }\n },\n {\n \"fullUrl\": \"response1\",\n \"resource\": {\n \"resourceType\": \"QuestionnaireResponse\",\n \"id\": \"response1\",\n \"authored\": \"2019-08-06\",\n \"status\": \"completed\",\n \"item\": [\n {\n \"linkId\": \"1\",\n \"text\": \"Patient Information\",\n \"item\": [\n {\n \"linkId\": \"1.1\",\n \"text\": \"Last Name but Different This Time\",\n \"answer\": [\n {\n \"valueString\": \"Quinton\"\n }\n ]\n },\n {\n \"linkId\": \"1.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Vlad\"\n }\n ]\n },\n {\n \"linkId\": \"1.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"A, N\"\n }\n ]\n },\n {\n \"linkId\": \"1.4\",\n \"text\": \"Date Of Birth\",\n \"answer\": [\n {\n \"valueDate\": \"1956-12-01\"\n }\n ]\n },\n {\n \"linkId\": \"1.5\",\n \"text\": \"Gender\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"male\",\n \"display\": \"Male\"\n }\n }\n ]\n },\n {\n \"linkId\": \"1.6\",\n \"text\": \"Medicare ID\",\n \"answer\": [\n {\n \"valueString\": \"10A3D58WH22\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"2\",\n \"text\": \"Provider who is performing face-to-face evaluation\",\n \"item\": [\n {\n \"linkId\": \"2.1\",\n \"text\": \"Last Name\",\n \"answer\": [\n {\n \"valueString\": \"Doe\"\n }\n ]\n },\n {\n \"linkId\": \"2.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Jane\"\n }\n ]\n },\n {\n \"linkId\": \"2.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"B\"\n }\n ]\n },\n {\n \"linkId\": \"2.4\",\n \"text\": \"NPI\",\n \"answer\": [\n {\n \"valueString\": \"1122334455\"\n }\n ]\n },\n {\n \"linkId\": \"2.5\",\n \"text\": \"Date of Face-To-Face Evaluation\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"3\",\n \"text\": \"Coverage Requirements\",\n \"item\": [\n {\n \"linkId\": \"3.1\",\n \"text\": \"Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"COPD\",\n \"display\": \"COPD\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Hypoxemia\",\n \"display\": \"Hypoxemia\"\n }\n }\n ]\n },\n {\n \"linkId\": \"3.2\",\n \"text\": \"Arterial oxygen saturation (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.3\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.4\",\n \"text\": \"Arterial oxygen saturation (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.5\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.6\",\n \"text\": \"Is there a documented improvement of hypoxemia during exercise with oxygen?\"\n }\n ]\n },\n {\n \"linkId\": \"4\",\n \"text\": \"Prescribed Use\",\n \"item\": [\n {\n \"linkId\": \"4.1\",\n \"text\": \"Start date\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n },\n {\n \"linkId\": \"4.2\",\n \"text\": \"Length of need: (months) (99 = lifetime)\"\n },\n {\n \"linkId\": \"4.4\",\n \"text\": \"Peak Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.4.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 2\n }\n ]\n },\n {\n \"linkId\": \"4.4.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 95\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.5\",\n \"text\": \"Average Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.5.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 3\n }\n ]\n },\n {\n \"linkId\": \"4.5.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 98\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.6\",\n \"text\": \"Frequency of use (choose all that apply)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"At rest and awake\",\n \"display\": \"At rest and awake\"\n }\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"5\",\n \"text\": \"Oxygen Supply Order Details\",\n \"item\": [\n {\n \"linkId\": \"5.1\",\n \"text\": \"Current Order Description\",\n \"answer\": [\n {\n \"valueString\": \"HCPCS E0424 - Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n {\n \"linkId\": \"5.1b\",\n \"text\": \"Current Order Is For A Portable Device\"\n },\n {\n \"linkId\": \"5.2\",\n \"text\": \"Type\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Compressed Gas\",\n \"display\": \"Compressed Gas\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.3\",\n \"text\": \"Means of oxygen delivery and accessories\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Nasal cannula\",\n \"display\": \"Nasal cannula\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Mask\",\n \"display\": \"Mask\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.4\",\n \"text\": \"Type of order\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Initial or original order for certification\",\n \"display\": \"Initial or original order for certification\"\n }\n }\n ]\n }\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"devreq013\",\n \"resource\": {\n \"resourceType\": \"DeviceRequest\",\n \"id\": \"devreq013\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-crd/STU3/StructureDefinition/profile-devicerequest-stu3\"\n ]\n },\n \"extension\": [\n {\n \"url\": \"http://build.fhir.org/ig/HL7/davinci-crd/STU3/ext-insurance.html\",\n \"valueReference\": {\n \"reference\": \"Coverage/cov013\"\n }\n }\n ],\n \"status\": \"draft\",\n \"codeCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://bluebutton.cms.gov/resources/codesystem/hcpcs\",\n \"code\": \"E0424\",\n \"display\": \"Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"performer\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"intent\": \"original-order\"\n }\n },\n {\n \"fullUrl\": \"pat013\",\n \"resource\": {\n \"resourceType\": \"Patient\",\n \"id\": \"pat013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.116-04:00\"\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><div class=\\\"hapiHeaderText\\\">Vlad Alan Nestor <b>QUINTON </b></div><table class=\\\"hapiPropertyTable\\\"><tbody><tr><td>Identifier</td><td>98765400001AZ</td></tr><tr><td>Date of birth</td><td><span>01 December 1956</span></td></tr></tbody></table></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-medicare\",\n \"value\": \"98765400001AZ\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Quinton\",\n \"given\": [\n \"Vlad\",\n \"Alan\",\n \"Nestor\"\n ]\n }\n ],\n \"gender\": \"male\",\n \"birthDate\": \"1956-12-01\"\n }\n },\n {\n \"fullUrl\": \"pra1234\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1234\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:47.101-04:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1122334455\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Doe\",\n \"given\": [\n \"Jane\",\n \"Betty\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"pra1255\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1255\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:52.089-04:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"348074389\"\n }\n ],\n \"name\": [\n {\n \"family\": \"Smythe\",\n \"given\": [\n \"Juliette\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"obs013\",\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.343-04:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"59408-5\",\n \"display\": \"Oxygen saturation in Arterial blood by Pulse oximetry\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"issued\": \"2019-03-20T15:30:10+01:00\",\n \"valueQuantity\": {\n \"value\": 85,\n \"unit\": \"%\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"%\"\n }\n }\n },\n {\n \"fullUrl\": \"obs013B\",\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013B\",\n \"meta\": {\n \"versionId\": \"2\",\n \"lastUpdated\": \"2019-06-13T09:55:51.583-04:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"31100-1\",\n \"display\": \"Hematocrit [Volume Fraction] of Blood by Impedance\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"issued\": \"2019-03-20T15:30:10+01:00\",\n \"valueQuantity\": {\n \"value\": 61,\n \"unit\": \"%\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"%\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013a\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013a\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.203-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"87837008\",\n \"display\": \"Chronic pulmonary heart disease (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013b\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013b\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.246-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"389087006\",\n \"display\": \"Hypoxemia (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013c\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013c\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.294-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"44054006\",\n \"display\": \"Diabetes mellitus type 2 (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov1234\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov1234\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:49.318-04:00\"\n },\n \"payor\": [\n {\n \"reference\": \"Organization/org1234\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov015\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov015\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.151-04:00\"\n },\n \"subscriberId\": \"10A3D58WH456\",\n \"payor\": [\n {\n \"reference\": \"Organization/org015\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov016\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov016\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.692-04:00\"\n },\n \"subscriberId\": \"64A3D58WH01\",\n \"payor\": [\n {\n \"reference\": \"Organization/org016\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov013\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov013\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.166-04:00\"\n },\n \"subscriberId\": \"10A3D58WH22\",\n \"payor\": [\n {\n \"reference\": \"Organization/org013\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov014\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov014\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.811-04:00\"\n },\n \"subscriberId\": \"10A3D58WH1600\",\n \"payor\": [\n {\n \"reference\": \"Organizarion/org014\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n }\n ]\n}\n",
"options": {
"raw": {}
}
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
]
},
"description": "Post a new Claim to the Claim/$submit endpoint with multiple items."
},
"response": []
},
{
"name": "Claim: Post R4 $submit",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"name": "Content-Type",
"type": "text",
"value": "application/fhir+json"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"id\": \"f001\",\n \"type\": \"collection\",\n \"entry\": [\n {\n \"fullUrl\": \"https://example.com/base/Claim/claim1\",\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"id\": \"claim1\",\n \"status\": \"active\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n \"code\": \"professional\",\n \"display\": \"Professional\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"patient\": {\n \"reference\": \"Patient/pat013\"\n },\n \"created\": \"2019-08-06\",\n \"provider\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"code\": \"normal\"\n }\n ]\n },\n \"prescription\": {\n \"reference\": \"DeviceRequest/devreq013\"\n },\n \"supportingInfo\": [\n {\n \"sequence\": 1,\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claiminformationcategory\",\n \"code\": \"info\",\n \"display\": \"Information\"\n }\n ]\n },\n \"valueReference\": {\n \"reference\": \"QuestionnaireResponse/response1\"\n }\n }\n ],\n \"diagnosis\": [\n {\n \"sequence\": 1,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013a\"\n }\n },\n {\n \"sequence\": 2,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013b\"\n }\n },\n {\n \"sequence\": 3,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013c\"\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/cov1234\"\n }\n }\n ]\n }\n },\n {\n \"fullUrl\": \"https://example.com/base/Patient/pat013\",\n \"resource\": {\n \"resourceType\": \"Patient\",\n \"id\": \"pat013\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\">\\n\\t\\t\\t<table>\\n\\t\\t\\t\\t<tbody>\\n\\t\\t\\t\\t\\t<tr>\\n\\t\\t\\t\\t\\t\\t<td>Name</td>\\n\\t\\t\\t\\t\\t\\t<td>Peter James \\n <b>Chalmers</b> ("Jim")\\n </td>\\n\\t\\t\\t\\t\\t</tr>\\n\\t\\t\\t\\t\\t<tr>\\n\\t\\t\\t\\t\\t\\t<td>Address</td>\\n\\t\\t\\t\\t\\t\\t<td>534 Erewhon, Pleasantville, Vic, 3999</td>\\n\\t\\t\\t\\t\\t</tr>\\n\\t\\t\\t\\t\\t<tr>\\n\\t\\t\\t\\t\\t\\t<td>Contacts</td>\\n\\t\\t\\t\\t\\t\\t<td>Home: unknown. Work: (03) 5555 6473</td>\\n\\t\\t\\t\\t\\t</tr>\\n\\t\\t\\t\\t\\t<tr>\\n\\t\\t\\t\\t\\t\\t<td>Id</td>\\n\\t\\t\\t\\t\\t\\t<td>MRN: 12345 (Acme Healthcare)</td>\\n\\t\\t\\t\\t\\t</tr>\\n\\t\\t\\t\\t</tbody>\\n\\t\\t\\t</table>\\n\\t\\t</div>\"\n },\n \"identifier\": [\n {\n \"use\": \"usual\",\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/v2-0203\",\n \"code\": \"MR\"\n }\n ]\n },\n \"system\": \"urn:oid:1.2.36.146.595.217.0.1\",\n \"value\": \"12345\",\n \"period\": {\n \"start\": \"2001-05-06\"\n },\n \"assigner\": {\n \"display\": \"Acme Healthcare\"\n }\n }\n ],\n \"active\": true,\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Chalmers\",\n \"given\": [\"Peter\", \"James\"]\n },\n {\n \"use\": \"usual\",\n \"given\": [\"Jim\"]\n },\n {\n \"use\": \"maiden\",\n \"family\": \"Windsor\",\n \"given\": [\"Peter\", \"James\"],\n \"period\": {\n \"end\": \"2002\"\n }\n }\n ],\n \"telecom\": [\n {\n \"use\": \"home\"\n },\n {\n \"system\": \"phone\",\n \"value\": \"(03) 5555 6473\",\n \"use\": \"work\",\n \"rank\": 1\n },\n {\n \"system\": \"phone\",\n \"value\": \"(03) 3410 5613\",\n \"use\": \"mobile\",\n \"rank\": 2\n },\n {\n \"system\": \"phone\",\n \"value\": \"(03) 5555 8834\",\n \"use\": \"old\",\n \"period\": {\n \"end\": \"2014\"\n }\n }\n ],\n \"gender\": \"male\",\n \"birthDate\": \"1974-12-25\",\n \"_birthDate\": {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/StructureDefinition/patient-birthTime\",\n \"valueDateTime\": \"1974-12-25T14:35:45-05:00\"\n }\n ]\n },\n \"deceasedBoolean\": false,\n \"address\": [\n {\n \"use\": \"home\",\n \"type\": \"both\",\n \"text\": \"534 Erewhon St PeasantVille, Rainbow, Vic 3999\",\n \"line\": [\"534 Erewhon St\"],\n \"city\": \"PleasantVille\",\n \"district\": \"Rainbow\",\n \"state\": \"Vic\",\n \"postalCode\": \"3999\",\n \"period\": {\n \"start\": \"1974-12-25\"\n }\n }\n ],\n \"contact\": [\n {\n \"relationship\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/v2-0131\",\n \"code\": \"N\"\n }\n ]\n }\n ],\n \"name\": {\n \"family\": \"du Marché\",\n \"_family\": {\n \"extension\": [\n {\n \"url\": \"http://hl7.org/fhir/StructureDefinition/humanname-own-prefix\",\n \"valueString\": \"VV\"\n }\n ]\n },\n \"given\": [\"Bénédicte\"]\n },\n \"telecom\": [\n {\n \"system\": \"phone\",\n \"value\": \"+33 (237) 998327\"\n }\n ],\n \"address\": {\n \"use\": \"home\",\n \"type\": \"both\",\n \"line\": [\"534 Erewhon St\"],\n \"city\": \"PleasantVille\",\n \"district\": \"Rainbow\",\n \"state\": \"Vic\",\n \"postalCode\": \"3999\",\n \"period\": {\n \"start\": \"1974-12-25\"\n }\n },\n \"gender\": \"female\",\n \"period\": {\n \"start\": \"2012\"\n }\n }\n ],\n \"managingOrganization\": {\n \"reference\": \"Organization/1\"\n }\n }\n },\n {\n \"fullUrl\": \"https://example.com/base/DiagnosticReport/f001\",\n \"resource\": {\n \"resourceType\": \"DiagnosticReport\",\n \"id\": \"f001\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: f001</p><p><b>identifier</b>: nr1239044 (OFFICIAL)</p><p><b>basedOn</b>: <a>ServiceRequest/req</a></p><p><b>status</b>: final</p><p><b>category</b>: Haematology test <span>(Details : {SNOMED CT code '252275004' = 'Haematology test', given as 'Haematology test'}; {http://terminology.hl7.org/CodeSystem/v2-0074 code 'HM' = 'Hematology)</span></p><p><b>code</b>: Complete blood count (hemogram) panel - Blood by Automated count <span>(Details : {LOINC code '58410-2' = 'Complete blood count (hemogram) panel - Blood by Automated count', given as 'Complete blood count (hemogram) panel - Blood by Automated count'})</span></p><p><b>subject</b>: <a>P. van den Heuvel</a></p><p><b>issued</b>: 15/05/2013 7:32:52 PM</p><p><b>performer</b>: <a>Burgers University Medical Centre</a></p><p><b>result</b>: </p><ul><li><a>Observation/f001</a></li><li><a>Observation/f002</a></li><li><a>Observation/f003</a></li><li><a>Observation/f004</a></li><li><a>Observation/f005</a></li></ul><p><b>conclusion</b>: Core lab</p></div>\"\n },\n \"identifier\": [\n {\n \"use\": \"official\",\n \"system\": \"http://www.bmc.nl/zorgportal/identifiers/reports\",\n \"value\": \"nr1239044\"\n }\n ],\n \"basedOn\": [\n {\n \"reference\": \"ServiceRequest/req\"\n }\n ],\n \"status\": \"final\",\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"252275004\",\n \"display\": \"Haematology test\"\n },\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/v2-0074\",\n \"code\": \"HM\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"58410-2\",\n \"display\": \"Complete blood count (hemogram) panel - Blood by Automated count\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/f001\",\n \"display\": \"P. van den Heuvel\"\n },\n \"issued\": \"2013-05-15T19:32:52+01:00\",\n \"performer\": [\n {\n \"reference\": \"Organization/f001\",\n \"display\": \"Burgers University Medical Centre\"\n }\n ],\n \"result\": [\n {\n \"reference\": \"Observation/f001\"\n },\n {\n \"reference\": \"Observation/f002\"\n },\n {\n \"reference\": \"Observation/f003\"\n },\n {\n \"reference\": \"Observation/f004\"\n },\n {\n \"reference\": \"Observation/f005\"\n }\n ],\n \"conclusion\": \"Core lab\"\n }\n },\n {\n \"fullUrl\": \"https://example.com/base/ServiceRequest/req\",\n \"resource\": {\n \"resourceType\": \"ServiceRequest\",\n \"id\": \"req\",\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: req</p><p><b>identifier</b>: L2381</p><p><b>status</b>: active</p><p><b>intent</b>: original-order</p><p><b>code</b>: Complete blood count (hemogram) panel - Blood by Automated count <span>(Details : {LOINC code '58410-2' = 'Complete blood count (hemogram) panel - Blood by Automated count', given as 'Complete blood count (hemogram) panel - Blood by Automated count'})</span></p><p><b>subject</b>: <a>P. van den Heuvel</a></p><p><b>encounter</b>: <a>Encounter/f001</a></p><p><b>requester</b>: <a>E.van den Broek</a></p><p><b>note</b>: patient almost fainted during procedure</p></div>\"\n },\n \"extension\": [\n {\n \"url\": \"http://example.org/bodysitecode\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"14975008\",\n \"display\": \"Forearm structure\"\n }\n ]\n }\n }\n ],\n \"identifier\": [\n {\n \"system\": \"http://www.bmc.nl/zorgportal/identifiers/labresults\",\n \"value\": \"L2381\"\n }\n ],\n \"status\": \"active\",\n \"intent\": \"original-order\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"58410-2\",\n \"display\": \"Complete blood count (hemogram) panel - Blood by Automated count\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/f001\",\n \"display\": \"P. van den Heuvel\"\n },\n \"encounter\": {\n \"reference\": \"Encounter/f001\"\n },\n \"requester\": {\n \"reference\": \"Practitioner/f001\",\n \"display\": \"E.van den Broek\"\n },\n \"note\": [\n {\n \"text\": \"patient almost fainted during procedure\"\n }\n ]\n }\n },\n {\n \"fullUrl\": \"https://example.com/base/Observation/obs1\",\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs1\",\n \"status\": \"final\",\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/observation-category\",\n \"code\": \"imaging\",\n \"display\": \"imaging\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"21905-5\",\n \"display\": \"Primary tumor.clinical [Class] Cancer\"\n }\n ],\n \"text\": \"Primary tumor.clinical [Class] Cancer\"\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"encounter\": {\n \"reference\": \"Encounter/enc001\"\n },\n \"effectiveDateTime\": \"2019-02-01T00:33:16-05:00\",\n \"issued\": \"2019-02-01T00:33:16.310-05:00\",\n \"valueCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"23351008\",\n \"display\": \"T1 category (finding)\"\n },\n {\n \"system\": \"http://cancerstaging.org\",\n \"code\": \"cT1\"\n }\n ],\n \"text\": \"T1 category (finding)\"\n },\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tnm-clinical-primary-tumor-category\"\n ]\n },\n \"focus\": [\n {\n \"reference\": \"Condition/75402dea-d2a8-498b-bc3b-f4e045277517\"\n }\n ]\n }\n }\n ]\n}\n"
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
]
},
"description": "Post a new Claim to the Claim/$submit endpoint with multiple items (validated R4)."
},
"response": []
},
{
"name": "Claim: Post update items $submit",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"name": "Content-Type",
"value": "application/fhir+json",
"type": "text"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"type\": \"collection\",\n \"entry\": [\n {\n \"fullUrl\": \"1234567890\",\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"id\": \"1234567890\",\n \"status\": \"active\",\n \"related\": [\n \t{\n \t\t\"id\": \"0000000000\",\n \t\t\"relationship\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n \t\t\t\t\t\"code\": \"replaces\",\n \t\t\t\t\t\"display\": \"replaces\"\n \t\t\t\t}\t\n \t\t\t]\n \t\t}\n \t}\n ],\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n \"code\": \"professional\",\n \"display\": \"Professional\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"patient\": {\n \"reference\": \"Patient/pat013\"\n },\n \"created\": \"2019-08-06\",\n \"provider\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"code\": \"normal\"\n }\n ]\n },\n \"prescription\": {\n \"reference\": \"DeviceRequest/devreq013\"\n },\n \"supportingInfo\": [\n {\n 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\t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": true\t\n \t\t\t}\t\n \t\t]\n \t},\n \t{\n \t\t\"sequence\": 2,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"http://www.ama-assn.org/go/cpt\",\n\t \t\t\t\t\"code\": \"B4184\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": false\t\n \t\t\t}\t\n \t\t]\n \t},\n \t{\n \t\t\"sequence\": 3,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"http://www.ama-assn.org/go/cpt\",\n\t \t\t\t\t\"code\": \"B4184\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n 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\"linkId\": \"4.1\",\n \"text\": \"Start date\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n },\n {\n \"linkId\": \"4.2\",\n \"text\": \"Length of need: (months) (99 = lifetime)\"\n },\n {\n \"linkId\": \"4.4\",\n \"text\": \"Peak Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.4.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 2\n }\n ]\n },\n {\n \"linkId\": \"4.4.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 95\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.5\",\n \"text\": \"Average Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.5.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 3\n }\n ]\n },\n {\n \"linkId\": \"4.5.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 98\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.6\",\n \"text\": \"Frequency of use (choose all that apply)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"At rest and awake\",\n \"display\": \"At rest and awake\"\n }\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"5\",\n \"text\": \"Oxygen Supply Order Details\",\n \"item\": [\n {\n \"linkId\": \"5.1\",\n \"text\": \"Current Order Description\",\n \"answer\": [\n {\n \"valueString\": \"HCPCS E0424 - Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n {\n \"linkId\": \"5.1b\",\n \"text\": \"Current Order Is For A Portable Device\"\n },\n {\n \"linkId\": \"5.2\",\n \"text\": \"Type\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Compressed Gas\",\n \"display\": \"Compressed Gas\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.3\",\n \"text\": \"Means of oxygen delivery and accessories\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Nasal cannula\",\n \"display\": \"Nasal cannula\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Mask\",\n \"display\": \"Mask\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.4\",\n \"text\": \"Type of order\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Initial or original order for 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\"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013b\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013b\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.246-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"389087006\",\n \"display\": \"Hypoxemia (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013c\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013c\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.294-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"44054006\",\n \"display\": \"Diabetes mellitus type 2 (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov1234\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov1234\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:49.318-04:00\"\n },\n \"payor\": [\n {\n \"reference\": \"Organization/org1234\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov015\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov015\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.151-04:00\"\n },\n \"subscriberId\": \"10A3D58WH456\",\n \"payor\": [\n {\n \"reference\": \"Organization/org015\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov016\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov016\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.692-04:00\"\n },\n \"subscriberId\": \"64A3D58WH01\",\n \"payor\": [\n {\n \"reference\": \"Organization/org016\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov013\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov013\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.166-04:00\"\n },\n \"subscriberId\": \"10A3D58WH22\",\n \"payor\": [\n {\n \"reference\": \"Organization/org013\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov014\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov014\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.811-04:00\"\n },\n \"subscriberId\": \"10A3D58WH1600\",\n \"payor\": [\n {\n \"reference\": \"Organizarion/org014\"\n }\n ],\n \"beneficiary\": {\n \"reference\": 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},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
]
},
"description": "Post an update to a Claim to the Claim/$submit endpoint with multiple items."
},
"response": []
},
{
"name": "Claim: Post cancel $submit",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"name": "Content-Type",
"value": "application/fhir+json",
"type": "text"
}
],
"body": {
"mode": "raw",
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\"valueReference\": {\n \"reference\": \"QuestionnaireResponse/response1\"\n }\n }\n ],\n \"diagnosis\": [\n {\n \"sequence\": 1,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013a\"\n }\n },\n {\n \"sequence\": 2,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013b\"\n }\n },\n {\n \"sequence\": 3,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013c\"\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/cov1234\"\n }\n }\n ],\n \"item\" : [\n \t{\n \t\t\"sequence\": 1,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"http://www.ama-assn.org/go/cpt\",\n\t \t\t\t\t\"code\": \"G0154\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": true\t\n \t\t\t}\t\n \t\t]\n \t},\n \t{\n \t\t\"sequence\": 2,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"http://www.ama-assn.org/go/cpt\",\n\t \t\t\t\t\"code\": \"B4184\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": false\t\n \t\t\t}\t\n \t\t]\n \t}\n\t\t\t\t]\n }\n },\n {\n \"fullUrl\": \"response1\",\n \"resource\": {\n \"resourceType\": \"QuestionnaireResponse\",\n \"id\": \"response1\",\n \"authored\": \"2019-08-06\",\n \"status\": \"completed\",\n \"item\": [\n {\n \"linkId\": \"1\",\n \"text\": \"Patient Information\",\n \"item\": [\n {\n \"linkId\": \"1.1\",\n \"text\": \"Last Name but Different This Time\",\n \"answer\": [\n {\n \"valueString\": \"Quinton\"\n }\n ]\n },\n {\n \"linkId\": \"1.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Vlad\"\n }\n ]\n },\n {\n \"linkId\": \"1.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"A, N\"\n }\n ]\n },\n {\n \"linkId\": \"1.4\",\n \"text\": \"Date Of Birth\",\n \"answer\": [\n {\n \"valueDate\": \"1956-12-01\"\n }\n ]\n },\n {\n \"linkId\": \"1.5\",\n \"text\": \"Gender\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"male\",\n \"display\": \"Male\"\n }\n }\n ]\n },\n {\n \"linkId\": \"1.6\",\n \"text\": \"Medicare ID\",\n \"answer\": [\n {\n \"valueString\": \"10A3D58WH22\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"2\",\n \"text\": \"Provider who is performing face-to-face evaluation\",\n \"item\": [\n {\n \"linkId\": \"2.1\",\n \"text\": \"Last Name\",\n \"answer\": [\n {\n \"valueString\": \"Doe\"\n }\n ]\n },\n {\n \"linkId\": \"2.2\",\n \"text\": \"First Name\",\n \"answer\": [\n {\n \"valueString\": \"Jane\"\n }\n ]\n },\n {\n \"linkId\": \"2.3\",\n \"text\": \"Middle Initial\",\n \"answer\": [\n {\n \"valueString\": \"B\"\n }\n ]\n },\n {\n \"linkId\": \"2.4\",\n \"text\": \"NPI\",\n \"answer\": [\n {\n \"valueString\": \"1122334455\"\n }\n ]\n },\n {\n \"linkId\": \"2.5\",\n \"text\": \"Date of Face-To-Face Evaluation\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"3\",\n \"text\": \"Coverage Requirements\",\n \"item\": [\n {\n \"linkId\": \"3.1\",\n \"text\": \"Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"COPD\",\n \"display\": \"COPD\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Hypoxemia\",\n \"display\": \"Hypoxemia\"\n }\n }\n ]\n },\n {\n \"linkId\": \"3.2\",\n \"text\": \"Arterial oxygen saturation (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.3\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient on room air while at rest and awake when tested)\"\n },\n {\n \"linkId\": \"3.4\",\n \"text\": \"Arterial oxygen saturation (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.5\",\n \"text\": \"Arterial Partial Pressure of Oxygen (PO2) (Patient tested during exercise)\"\n },\n {\n \"linkId\": \"3.6\",\n \"text\": \"Is there a documented improvement of hypoxemia during exercise with oxygen?\"\n }\n ]\n },\n {\n \"linkId\": \"4\",\n \"text\": \"Prescribed Use\",\n \"item\": [\n {\n \"linkId\": \"4.1\",\n \"text\": \"Start date\",\n \"answer\": [\n {\n \"valueDate\": \"2019-08-06\"\n }\n ]\n },\n {\n \"linkId\": \"4.2\",\n \"text\": \"Length of need: (months) (99 = lifetime)\"\n },\n {\n \"linkId\": \"4.4\",\n \"text\": \"Peak Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.4.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 2\n }\n ]\n },\n {\n \"linkId\": \"4.4.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 95\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.5\",\n \"text\": \"Average Flow Rate\",\n \"item\": [\n {\n \"linkId\": \"4.5.1\",\n \"text\": \"LPM\",\n \"answer\": [\n {\n \"valueInteger\": 3\n }\n ]\n },\n {\n \"linkId\": \"4.5.2\",\n \"text\": \"oxygen %\",\n \"answer\": [\n {\n \"valueInteger\": 98\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"4.6\",\n \"text\": \"Frequency of use (choose all that apply)\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"At rest and awake\",\n \"display\": \"At rest and awake\"\n }\n }\n ]\n }\n ]\n },\n {\n \"linkId\": \"5\",\n \"text\": \"Oxygen Supply Order Details\",\n \"item\": [\n {\n \"linkId\": \"5.1\",\n \"text\": \"Current Order Description\",\n \"answer\": [\n {\n \"valueString\": \"HCPCS E0424 - Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n {\n \"linkId\": \"5.1b\",\n \"text\": \"Current Order Is For A Portable Device\"\n },\n {\n \"linkId\": \"5.2\",\n \"text\": \"Type\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Compressed Gas\",\n \"display\": \"Compressed Gas\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.3\",\n \"text\": \"Means of oxygen delivery and accessories\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Nasal cannula\",\n \"display\": \"Nasal cannula\"\n }\n },\n {\n \"valueCoding\": {\n \"code\": \"Mask\",\n \"display\": \"Mask\"\n }\n }\n ]\n },\n {\n \"linkId\": \"5.4\",\n \"text\": \"Type of order\",\n \"answer\": [\n {\n \"valueCoding\": {\n \"code\": \"Initial or original order for certification\",\n \"display\": \"Initial or original order for certification\"\n }\n }\n ]\n }\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"devreq013\",\n \"resource\": {\n \"resourceType\": \"DeviceRequest\",\n \"id\": \"devreq013\",\n \"meta\": {\n \"profile\": [\n \"http://hl7.org/fhir/us/davinci-crd/STU3/StructureDefinition/profile-devicerequest-stu3\"\n ]\n },\n \"extension\": [\n {\n \"url\": \"http://build.fhir.org/ig/HL7/davinci-crd/STU3/ext-insurance.html\",\n \"valueReference\": {\n \"reference\": \"Coverage/cov013\"\n }\n }\n ],\n \"status\": \"draft\",\n \"codeCodeableConcept\": {\n \"coding\": [\n {\n \"system\": \"https://bluebutton.cms.gov/resources/codesystem/hcpcs\",\n \"code\": \"E0424\",\n \"display\": \"Stationary Compressed Gaseous Oxygen System, Rental\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"performer\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"intent\": \"original-order\"\n }\n },\n {\n \"fullUrl\": \"pat013\",\n \"resource\": {\n \"resourceType\": \"Patient\",\n \"id\": \"pat013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.116-04:00\"\n },\n \"text\": {\n \"status\": \"generated\",\n \"div\": \"<div xmlns=\\\"http://www.w3.org/1999/xhtml\\\"><div class=\\\"hapiHeaderText\\\">Vlad Alan Nestor <b>QUINTON </b></div><table class=\\\"hapiPropertyTable\\\"><tbody><tr><td>Identifier</td><td>98765400001AZ</td></tr><tr><td>Date of birth</td><td><span>01 December 1956</span></td></tr></tbody></table></div>\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-medicare\",\n \"value\": \"98765400001AZ\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Quinton\",\n \"given\": [\n \"Vlad\",\n \"Alan\",\n \"Nestor\"\n ]\n }\n ],\n \"gender\": \"male\",\n \"birthDate\": \"1956-12-01\"\n }\n },\n {\n \"fullUrl\": \"pra1234\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1234\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:47.101-04:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"1122334455\"\n }\n ],\n \"name\": [\n {\n \"use\": \"official\",\n \"family\": \"Doe\",\n \"given\": [\n \"Jane\",\n \"Betty\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"pra1255\",\n \"resource\": {\n \"resourceType\": \"Practitioner\",\n \"id\": \"pra1255\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:52.089-04:00\"\n },\n \"identifier\": [\n {\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\n \"value\": \"348074389\"\n }\n ],\n \"name\": [\n {\n \"family\": \"Smythe\",\n \"given\": [\n \"Juliette\"\n ],\n \"prefix\": [\n \"Dr.\"\n ]\n }\n ]\n }\n },\n {\n \"fullUrl\": \"obs013\",\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.343-04:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"59408-5\",\n \"display\": \"Oxygen saturation in Arterial blood by Pulse oximetry\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"issued\": \"2019-03-20T15:30:10+01:00\",\n \"valueQuantity\": {\n \"value\": 85,\n \"unit\": \"%\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"%\"\n }\n }\n },\n {\n \"fullUrl\": \"obs013B\",\n \"resource\": {\n \"resourceType\": \"Observation\",\n \"id\": \"obs013B\",\n \"meta\": {\n \"versionId\": \"2\",\n \"lastUpdated\": \"2019-06-13T09:55:51.583-04:00\"\n },\n \"status\": \"final\",\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://loinc.org\",\n \"code\": \"31100-1\",\n \"display\": \"Hematocrit [Volume Fraction] of Blood by Impedance\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n },\n \"issued\": \"2019-03-20T15:30:10+01:00\",\n \"valueQuantity\": {\n \"value\": 61,\n \"unit\": \"%\",\n \"system\": \"http://unitsofmeasure.org\",\n \"code\": \"%\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013a\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013a\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.203-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"87837008\",\n \"display\": \"Chronic pulmonary heart disease (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013b\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013b\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.246-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"389087006\",\n \"display\": \"Hypoxemia (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cond013c\",\n \"resource\": {\n \"resourceType\": \"Condition\",\n \"id\": \"cond013c\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.294-04:00\"\n },\n \"clinicalStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-clinical\",\n \"code\": \"active\"\n }\n ]\n },\n \"verificationStatus\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-ver-status\",\n \"code\": \"confirmed\"\n }\n ]\n },\n \"category\": [\n {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/condition-category\",\n \"code\": \"encounter-diagnosis\",\n \"display\": \"Encounter Diagnosis\"\n }\n ]\n }\n ],\n \"code\": {\n \"coding\": [\n {\n \"system\": \"http://snomed.info/sct\",\n \"code\": \"44054006\",\n \"display\": \"Diabetes mellitus type 2 (disorder)\"\n }\n ]\n },\n \"subject\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov1234\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov1234\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:49.318-04:00\"\n },\n \"payor\": [\n {\n \"reference\": \"Organization/org1234\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov015\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov015\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.151-04:00\"\n },\n \"subscriberId\": \"10A3D58WH456\",\n \"payor\": [\n {\n \"reference\": \"Organization/org015\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov016\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov016\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:50.692-04:00\"\n },\n \"subscriberId\": \"64A3D58WH01\",\n \"payor\": [\n {\n \"reference\": \"Organization/org016\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov013\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov013\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.166-04:00\"\n },\n \"subscriberId\": \"10A3D58WH22\",\n \"payor\": [\n {\n \"reference\": \"Organization/org013\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n },\n {\n \"fullUrl\": \"cov014\",\n \"resource\": {\n \"resourceType\": \"Coverage\",\n \"id\": \"cov014\",\n \"status\": \"active\",\n \"meta\": {\n \"versionId\": \"1\",\n \"lastUpdated\": \"2019-06-13T09:55:51.811-04:00\"\n },\n \"subscriberId\": \"10A3D58WH1600\",\n \"payor\": [\n {\n \"reference\": \"Organizarion/org014\"\n }\n ],\n \"beneficiary\": {\n \"reference\": \"Patient/pat013\"\n }\n }\n }\n ]\n}\n"
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
]
},
"description": "Post a cancel existing Claim to the Claim/$submit endpoint."
},
"response": []
},
{
"name": "Claim: Post update differential $submit",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"value": "application/fhir+json",
"type": "text"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Bundle\",\n \"type\": \"collection\",\n \"entry\": [\n {\n \"fullUrl\": \"1234567890\",\n \"resource\": {\n \"resourceType\": \"Claim\",\n \"id\": \"1234567890\",\n \"status\": \"active\",\n \"related\": [\n \t{\n \t\t\"id\": \"0000000000\",\n \t\t\"relationship\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n \t\t\t\t\t\"code\": \"replaces\",\n \t\t\t\t\t\"display\": \"replaces\"\n \t\t\t\t}\t\n \t\t\t]\n \t\t}\n \t}\n ],\n \"meta\": {\n\t\t \t\"security\": [\n\t\t \t\t\t{\n\t\t \t\t\t\"system\": \"http://terminology.hl7.org/CodeSystem/v3-ObservationValue\",\n\t\t \t\t\t\"code\": \"SUBSETTED\"\n\t\t \t\t\t}\n\t\t \t\t]\n\t\t },\n \"type\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\n \"code\": \"professional\",\n \"display\": \"Professional\"\n }\n ]\n },\n \"use\": \"preauthorization\",\n \"patient\": {\n \"reference\": \"Patient/pat013\"\n },\n \"created\": \"2019-08-06\",\n \"provider\": {\n \"reference\": \"Practitioner/pra1234\"\n },\n \"priority\": {\n \"coding\": [\n {\n \"code\": \"normal\"\n }\n ]\n },\n \"prescription\": {\n \"reference\": \"DeviceRequest/devreq013\"\n },\n \"supportingInfo\": [\n {\n \"sequence\": 1,\n \"category\": {\n \"coding\": [\n {\n \"system\": \"http://terminology.hl7.org/CodeSystem/claiminformationcategory\",\n \"code\": \"info\",\n \"display\": \"Information\"\n }\n ]\n },\n \"valueReference\": {\n \"reference\": \"QuestionnaireResponse/response1\"\n }\n }\n ],\n \"diagnosis\": [\n {\n \"sequence\": 1,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013a\"\n }\n },\n {\n \"sequence\": 2,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013b\"\n }\n },\n {\n \"sequence\": 3,\n \"diagnosisReference\": {\n \"reference\": \"Condition/cond013c\"\n }\n }\n ],\n \"insurance\": [\n {\n \"sequence\": 1,\n \"focal\": true,\n \"coverage\": {\n \"reference\": \"Coverage/cov1234\"\n }\n }\n ],\n \"item\" : [\n \t{\n \t\t\"sequence\": 1,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"http://www.ama-assn.org/go/cpt\",\n\t \t\t\t\t\"code\": \"G0154\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": true\t\n \t\t\t}\t\n \t\t]\n \t},\n \t{\n \t\t\"sequence\": 2,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"http://www.ama-assn.org/go/cpt\",\n\t \t\t\t\t\"code\": \"B4184\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": false\t\n \t\t\t}\t\n \t\t]\n \t},\n \t{\n \t\t\"sequence\": 3,\n \t\t\"productOrService\": {\n \t\t\t\"coding\": [\n \t\t\t\t{\n\t \t\t\t\t\"system\": \"http://www.ama-assn.org/go/cpt\",\n\t \t\t\t\t\"code\": \"B4184\"\n \t\t\t\t}\n \t\t\t]\n \t\t},\n \t\t\"modifierExtension\": [\n \t\t\t{\n \t\t\t\t\"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCancelled\",\n \t\t\t\t\"valueBoolean\": false\t\n \t\t\t}\t\n \t\t]\n \t}\n\t\t\t\t]\n }\n }\n ]\n}\n"
},
"url": {
"raw": "{{rest-root}}/fhir/Claim/$submit",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Claim",
"$submit"
]
}
},
"response": []
}
]
},
{
"name": "Subscription",
"item": [
{
"name": "Subscription: Get All",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "GET",
"header": [
{
"key": "Accept",
"value": "application/fhir+json",
"type": "text"
}
],
"url": {
"raw": "{{rest-root}}/fhir/Subscription?patient.identifier=98765400001AZ",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Subscription"
],
"query": [
{
"key": "patient.identifier",
"value": "98765400001AZ"
}
]
},
"description": "http://localhost:9000/fhir/ClaimResponse"
},
"response": []
},
{
"name": "Subscription: Get by ID",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "GET",
"header": [
{
"key": "Accept",
"value": "application/fhir+json",
"type": "text"
}
],
"url": {
"raw": "{{rest-root}}/fhir/Subscription?identifier=&patient.identifier=98765400001AZ&status=active",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Subscription"
],
"query": [
{
"key": "identifier",
"value": ""
},
{
"key": "patient.identifier",
"value": "98765400001AZ"
},
{
"key": "status",
"value": "active"
}
]
},
"description": "http://localhost:9000/fhir/ClaimResponse/30c0ef95-f047-40c8-89b5-6005cdf54d96"
},
"response": []
},
{
"name": "Subscription: Post rest-hook",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"name": "Content-Type",
"type": "text",
"value": "application/fhir+json"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Subscription\",\n \"status\": \"requested\",\n \"reason\": \"subscribe to updates for a pended ClaimResponse (priorauthorization)\",\n \"criteria\": \"identifier=0000000000&patient.identifier=98765400001AZ&status=active\",\n \"channel\": {\n \"type\": \"rest-hook\",\n \"endpoint\": \"http://localhost:9090/fhir/SubscriptionNotification?identifier=0000000000&patient.identifier=98765400001AZ&status=active\"\n }\n}"
},
"url": {
"raw": "{{rest-root}}/fhir/Subscription",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Subscription"
]
},
"description": "Post a new rest-hook subscription to the `Subscription` endpoint"
},
"response": []
},
{
"name": "Subscription: Post websocket",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "POST",
"header": [
{
"key": "Content-Type",
"name": "Content-Type",
"type": "text",
"value": "application/fhir+json"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"resourceType\": \"Subscription\",\n \"status\": \"requested\",\n \"reason\": \"subscribe to updates for a pended ClaimResponse (priorauthorization)\",\n \"criteria\": \"identifier=0000000000&patient.identifier=98765400001AZ&status=active\",\n \"channel\": {\n \"type\": \"websocket\"\n }\n}"
},
"url": {
"raw": "{{rest-root}}/fhir/Subscription",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Subscription"
]
},
"description": "Post a new websocket subscription to the `Subscription` endpoint"
},
"response": []
},
{
"name": "Subscription: Delete",
"request": {
"auth": {
"type": "bearer",
"bearer": [
{
"key": "token",
"value": "Y3YWq2l08kvFqy50fQJY",
"type": "string"
}
]
},
"method": "DELETE",
"header": [
{
"key": "Content-Type",
"type": "text",
"value": "application/json"
}
],
"url": {
"raw": "{{rest-root}}/fhir/Subscription?identifier=&patient.identifier=98765400001AZ",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"Subscription"
],
"query": [
{
"key": "identifier",
"value": ""
},
{
"key": "patient.identifier",
"value": "98765400001AZ"
}
]
},
"description": "http://localhost:9000/fhir/ClaimResponse/c7ea09d0-49af-4ea8-8813-0f4a2653e1f8"
},
"response": []
}
],
"description": "Queries to the Subscription endpoint"
},
{
"name": "OAuth",
"item": [
{
"name": "Register (JKWS)",
"request": {
"method": "POST",
"header": [
{
"key": "Content-Type",
"value": "application/json",
"type": "text"
}
],
"body": {
"mode": "raw",
"raw": "{\n \"jwks\": {\n \"keys\": [\n {\n \"kty\": \"RSA\",\n \"alg\": \"RS384\",\n \"n\": \"52tcPrGJgzyGqjcUiHsbSk_PxQ7Uovz4saGxva3iyBoidsekonigJJ3LnFlHYb3vBa2NA-0GpX2E1KhNNcYWAWQFcu069zi0YZ_wWGn6PWZURuonUoKH4dGHggym3xxVUxuA8OPubGe5ji56eic4RPINg0z-TtPlS-H9dnDIVznRUTXf3fy2dqWMuTY4D2e4fXGII6OpFAsEyrOqIoR8pLWGu7AiQkothunopp9q_Gu2xqB6l8BNulsbiwsQMeRE-9SGfeFpyblHiizHDwSqeZ3iv49Ellk4yjmrf6wOaFA2IXRqL1cCLj86B6KIDrjdzOL4lOSiES-PclNpioG2rQ\",\n \"e\": \"AQAB\",\n \"key_ops\": [\"verify\"],\n \"ext\": true,\n \"kid\": \"3ab8b05b64d799e289e10a201786b38c\"\n }\n ]\n },\n \"organization_name\": \"MITRE\",\n \"organization_contact\": \"[email protected]\"\n}"
},
"url": {
"raw": "{{rest-root}}/fhir/auth/register",
"host": [
"{{rest-root}}"
],
"path": [
"fhir",
"auth",
"register"
]
}
},
"response": []
},
{
"name": "Token Request",
"request": {
"method": "POST",
"header": [],
"url": {
"raw": "{{rest-root}}/fhir/auth/token?scope=system/*.read&grant_type=client_credentials&client_assertion_type=urn:ietf:params:oauth:client-assertion-type:jwt-bearer&client_assertion=",
"host": [