Uploaded image for project: 'FHIR Specification Feedback'
  1. FHIR Specification Feedback
  2. FHIR-35378

Add entry slices on Bundles for expected and required resource types

    XMLWordPrintableJSON

Details

    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Highest Highest
    • US Da Vinci Patient Cost Transparency (PCT) (FHIR)
    • 0.1.0 [deprecated]
    • Financial Mgmt
    • STU
    • PCT AEOB Bundle
      PCT GFE Bundle
    • Formal Specification
    • Hide

      GFE Bundle requirements

      Add the following slice requirements to the GFE Bundle profile (davinci-pct-gfe-bundle)

      entry[patient] 1..2 MS - Reference(PCT Patient) - "Entry in the bundle - will have the patient subject of care and may be a separate subscriber"

       

      entry[coverage] 1..1 MS - Reference(PCT Coverage) - "Entry in the bundle - will have one Coverage"

       

      entry[organization] 1..* MS - Reference(PCT Organization) - "Entry in the bundle - will have the payer organization and may have provider organization(s)"

       

      entry[practitioner] 0..* MS - Reference(PCT Practitioner) - "Entry in the bundle - may have the provider Practitioner(s)"

       

      entry[gfeInstitutional] 0..* MS - Reference(PCTGFEInstitutional) - Entry in the bundle - may have PCTGFEInstitutional resource(s)

      entry[gfeProfessional] 0..* MS - Reference(PCTGFEProfessional) - Entry in the bundle - may have PCTGFEProfessional resource(s)

       

      entry[gfeInstitutional] 0..* MS - Reference(DocumentReference) - Entry in the bundle - may have attachments as DocumentReference resource(s)

      entry[gfeProfessional] 0..* MS - Reference(DocumentReference) - Entry in the bundle - may have attachments as DocumentReference resource(s)

       

      Add Invariant requiring there be one entry for a payer organization (Organization.type = pay)

      Create an invariant requiring at least one of a gfeInstitutional slice or gfeProfessional slice on GFE bundle root.

      Create an Invariant that requires all referenced resources be contained within the bundle.

       

      The GFE Submitter does not require any additional invariant requirements as the GFEs require a GFE submitter and the submitter must be the same across al GFEs (FHIR-35014). Additionally all resources are required to be contained in the bundle.

       

      Create at least one example of a full GFE Bundle

       

      AEOB Bundle requirements

      Add the following slice requirements to the AEOB Bundle profile (davinci-pct-aeob-bundle)

      entry[patient] 1..2 MS - Reference(PCT Patient) - "Entry in the bundle - will have the patient subject of care and may be a separate subscriber"

       

      entry[coverage] 1..1 MS - Reference(PCT Coverage) - "Entry in the bundle - will have one Coverage"

       

      entry[organization] 1..* MS - Reference(PCT Organization) - "Entry in the bundle - will have the payer organization and may have provider organization(s)"

       

      entry[practitioner] 0..* MS - Reference(PCT Practitioner) - "Entry in the bundle - may have the provider Practitioner(s)"

       

      entry[aeob] 1..* - Reference(AEOB) - "Entry in the bundle - will have the AEOB resource(s)"

       

      entry[gfeBundle] 0..1 - Reference(GFE Bundle) - "Entry in the bundle - may contain the original GFE Bundle this AEOB Bundle addresses"

       

      Add Invariant requiring there be one entry for a payer organization (Organization.type = pay)

      Create an Invariant that requires all referenced resources, excluding the GFEBundleReference which may or may not be contained within the bundle.

       

      Create at least one example of a full AEOB Bundle

      Show
      GFE Bundle requirements Add the following slice requirements to the GFE Bundle profile (davinci-pct-gfe-bundle) entry [patient] 1..2 MS - Reference(PCT Patient) - "Entry in the bundle - will have the patient subject of care and may be a separate subscriber"   entry [coverage] 1..1 MS - Reference(PCT Coverage) - "Entry in the bundle - will have one Coverage"   entry [organization] 1..* MS - Reference(PCT Organization) - "Entry in the bundle - will have the payer organization and may have provider organization(s)"   entry [practitioner] 0..* MS - Reference(PCT Practitioner) - "Entry in the bundle - may have the provider Practitioner(s)"   entry [gfeInstitutional] 0..* MS - Reference(PCTGFEInstitutional) - Entry in the bundle - may have PCTGFEInstitutional resource(s) entry [gfeProfessional] 0..* MS - Reference(PCTGFEProfessional) - Entry in the bundle - may have PCTGFEProfessional resource(s)   entry [gfeInstitutional] 0..* MS - Reference(DocumentReference) - Entry in the bundle - may have attachments as DocumentReference resource(s) entry [gfeProfessional] 0..* MS - Reference(DocumentReference) - Entry in the bundle - may have attachments as DocumentReference resource(s)   Add Invariant requiring there be one entry for a payer organization (Organization.type = pay) Create an invariant requiring at least one of a gfeInstitutional slice or gfeProfessional slice on GFE bundle root. Create an Invariant that requires all referenced resources be contained within the bundle.   The GFE Submitter does not require any additional invariant requirements as the GFEs require a GFE submitter and the submitter must be the same across al GFEs ( FHIR-35014 ). Additionally all resources are required to be contained in the bundle.   Create at least one example of a full GFE Bundle   AEOB Bundle requirements Add the following slice requirements to the AEOB Bundle profile (davinci-pct-aeob-bundle) entry [patient] 1..2 MS - Reference(PCT Patient) - "Entry in the bundle - will have the patient subject of care and may be a separate subscriber"   entry [coverage] 1..1 MS - Reference(PCT Coverage) - "Entry in the bundle - will have one Coverage"   entry [organization] 1..* MS - Reference(PCT Organization) - "Entry in the bundle - will have the payer organization and may have provider organization(s)"   entry [practitioner] 0..* MS - Reference(PCT Practitioner) - "Entry in the bundle - may have the provider Practitioner(s)"   entry [aeob] 1..* - Reference(AEOB) - "Entry in the bundle - will have the AEOB resource(s)"   entry [gfeBundle] 0..1 - Reference(GFE Bundle) - "Entry in the bundle - may contain the original GFE Bundle this AEOB Bundle addresses"   Add Invariant requiring there be one entry for a payer organization (Organization.type = pay) Create an Invariant that requires all referenced resources, excluding the GFEBundleReference which may or may not be contained within the bundle.   Create at least one example of a full AEOB Bundle
    • Rachel Foerster/Rick Geimer: 11-0-0
    • Correction
    • Non-compatible

    Description

      This IG requires the GFE and the AEOB bundles to be fully contained (include all references like the Practitioners and Organizations referenced by the associated claims and/or EOBs.

      However, there are no entry slices reflecting this and there are several that should be required (e.g. a practitioner or organization is required).

      Please add slices with the expected entry resource types along with their expected requirements (including Must Support and cardinality required including invariant such as requiring a Practitioner or organization for submitter)

       

      This also needs to be clearly stated and reflected in the diagrams in section 4.2.2 (which currently does not show any of those resources inside the bundle).

      Additionally the bundle samples need to meeting this requirement and adequately demonstrate the data.

      Attachments

        Activity

          People

            rgeimer Rick Geimer
            corey_spears Corey Spears
            Watchers:
            4 Start watching this issue

            Dates

              Created:
              Updated:
              Resolved: