# text.div
Generated Narrative: CapabilityStatement davinci-pct

version: 1; Last updated: 2023-03-28 19:21:32+0000

Patient Cost Transparency Implementation Guide Payer Capability Statement

Implementation Guide Version: 2.0.0

FHIR Version: 4.0.1

Supported Formats: SHALL support json, SHOULD support xml

Published on: 2023-03-28 14:21:32-0500

Published by: HL7 International / Financial Management

Note to Implementers: FHIR Capabilities

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

This CapabilityStatement imports the CapabilityStatement US Core Server CapabilityStatementversion: 7.0.0)

FHIR RESTful Capabilities

Mode: server

Capabilities by Resource/Profile

Summary

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

The relevant profiles (if any)

The interactions supported by each resource (Read, Search, Update, and Create, are always shown, while VRead, Patch, Delete, History on Instance, or History on Type are only present if at least one of the resources has support for them.

The required, recommended, and some optional search parameters (if any).

The linked resources enabled for _include

The other resources enabled for _revinclude

The operations on the resource (if any)

Resource Type | Profile | R | V-R | S | U | P | C | D | H-I | H-T | Searches | _include | _revinclude | Operations

Bundle

Supported Profiles
PCT AEOB Packet
PCT GFE Bundle
PCT GFE Packet

Y

y?

Y

y?

y?

y?

y?

y?

y?

$GFESubmit

ExplanationOfBenefit

Supported Profiles
PCT Advanced EOB

Y

y?

Y

y?

y?

y?

y?

y?

y?

Coverage

Supported Profiles
PCT Coverage

Y

y?

Y

y?

y?

y?

y?

y?

y?

Claim

Supported Profiles
PCT Good Faith Estimate Professional
PCT Good Faith Estimate Institutional

Y

y?

Y

y?

y?

y?

y?

y?

y?

Organization

Supported Profiles
PCT Organization

Y

y?

Y

y?

y?

y?

y?

y?

y?

Practitioner

Supported Profiles
PCT Practitioner

Y

y?

Y

y?

y?

y?

y?

y?

y?

DocumentReference

Supported Profiles
PCT AEOB Packet Document Reference
PCT GFE Bundle
PCT GFE Packet

Y

y?

Y

y?

y?

category, status, doc-status, type, date, patient, estimate-initiation-time, estimate-service, estimate-condition, linking-identifier, planned-period, author, relatesto

Resource Conformance: SHALL Bundle

Core FHIR Resource
Bundle

Reference Policy

Interaction summary

SHALL support search-type, read.

MAY support create, vread, update, patch, delete, history-instance, history-type.

Supported Profiles
PCT AEOB Packet
PCT GFE Bundle
PCT GFE Packet

Extended Operations

Conformance | Operation | Documentation

SHALL

$GFESubmit

This operation is used by an entity to submit one or multiple GFEs as a Bundle containing the GFE(s) and other referenced resources for processing. The only input parameter is the single Bundle resource with one or multiple GFE(s) - each of which is based on the Claim resource (along with other referenced resources). The only output is a url for subsequent polling per async pattern. If after polling the response is complete, then the result will either be a single Bundle with the AEOB - which is based on the ExplanationOfBenefit resource, (and other referenced resources) or an OperationOutcome resource indicating the AEOB will be sent directly to the patient.

Resource Conformance: SHOULD ExplanationOfBenefit

Core FHIR Resource
ExplanationOfBenefit

Reference Policy

Interaction summary

SHALL support search-type, read.

MAY support create, vread, update, patch, delete, history-instance, history-type.

Supported Profiles
PCT Advanced EOB

Resource Conformance: SHOULD Coverage

Core FHIR Resource
Coverage

Reference Policy

Interaction summary

SHALL support search-type, read.

MAY support create, vread, update, patch, delete, history-instance, history-type.

Supported Profiles
PCT Coverage

Resource Conformance: SHOULD Claim

Core FHIR Resource
Claim

Reference Policy

Interaction summary

SHALL support search-type, read.

MAY support create, vread, update, patch, delete, history-instance, history-type.

Supported Profiles
PCT Good Faith Estimate Professional
PCT Good Faith Estimate Institutional

Resource Conformance: SHOULD Organization

Core FHIR Resource
Organization

Reference Policy

Interaction summary

SHALL support search-type, read.

MAY support create, vread, update, patch, delete, history-instance, history-type.

Supported Profiles
PCT Organization

Resource Conformance: SHOULD Practitioner

Core FHIR Resource
Practitioner

Reference Policy

Interaction summary

SHALL support search-type, read.

MAY support create, vread, update, patch, delete, history-instance, history-type.

Supported Profiles
PCT Practitioner

Resource Conformance: SHOULD DocumentReference

Core FHIR Resource
DocumentReference

Reference Policy

Interaction summary

SHOULD support search-type, read.

MAY support vread, history-instance, history-type.

Supported Profiles
PCT AEOB Packet Document Reference
PCT GFE Bundle
PCT GFE Packet

Search Parameters

Conformance | Parameter | Type | Documentation

SHALL

category

token

Categorization of document.

SHALL

status

token

current | superseded | entered-in-error

SHALL

doc-status

token

preliminary | final | amended | entered-in-error

SHALL

type

token

Kind of document

SHALL

date

date

Kind of document

SHALL

patient

reference

Who/what is the subject of the document

SHOULD

estimate-initiation-time

date

Instant from which the request originating request was being initiated.

SHOULD

estimate-service

token

Significant Procedures and/or products involved in an estimate in the packet.

SHOULD

estimate-condition

token

Significant condition involved in an estimate in the packet.

SHOULD

linking-identifier

token

An identifier assigned to a particular service or series of services to enabling linking.

SHOULD

planned-period

date

Planned date(s) of a particular admission/service or a series of admissions/services.

SHOULD

author

reference

All involved authoring parties, including payer all Good Faith Estimate (GFE) providers.

SHOULD

relatesto

reference

Target of the relationship.

# title
Patient Cost Transparency Implementation Guide Payer Capability Statement

# publisher
HL7 International / Financial Management

# contact[].name
HL7 International / Financial Management

# description
Payer capability statement for the Da Vinci Patient Cost Transparency Implementation Guide

# copyright
Used by permission of HL7 International, all rights reserved Creative Commons License

# rest[].resource[].operation[].documentation
This operation is used by an entity to submit one or multiple GFEs as a Bundle containing the GFE(s) and other referenced resources for processing. The only input parameter is the single Bundle resource with one or multiple GFE(s) - each of which is based on the Claim resource (along with other referenced resources). The only output is a url for subsequent polling per [async pattern](https://hl7.org/fhir/R5/async-bundle.html). If after polling the response is complete, then the result will either be a single Bundle with the AEOB - which is based on the ExplanationOfBenefit resource, (and other referenced resources) or an OperationOutcome resource indicating the AEOB will be sent directly to the patient.

# rest[].resource[].searchParam[].documentation
preliminary | final | amended | entered-in-error

# rest[].resource[].searchParam[].documentation
Instant from which the request originating request was being initiated.

# rest[].resource[].searchParam[].documentation
Significant Procedures and/or products involved in an estimate in the packet.

# rest[].resource[].searchParam[].documentation
Significant condition involved in an estimate in the packet.

# rest[].resource[].searchParam[].documentation
An identifier assigned to a particular service or series of services to enabling linking.

# rest[].resource[].searchParam[].documentation
Planned date(s) of a particular admission/service or a series of admissions/services.

# rest[].resource[].searchParam[].documentation
All involved authoring parties, including payer all Good Faith Estimate (GFE) providers.