Finance and Insurance Service (FAIS)
1.0.0 - trial-use
Finance and Insurance Service (FAIS)
1.0.0 - trial-use
This page is part of the IHE ITI Finance and Insurance Services (v1.0.0: Publication) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
| Official URL: https://profiles.ihe.net/ITI/FAIS/CapabilityStatement/IHE.FAIS.BeneficiaryManager | Version: 1.0.0 | |||
| Active as of 2024-07-17 | Computable Name: IHE_FAIS_BeneficiaryManager | |||
CapabilityStatement for Beneficiary Manager Actor.
The Beneficiary Manager processes requests from the Beneficiary Requestor actor. It follows internal business processes to enroll beneficiaries from the Beneficiary Requestor that are beyond the scope of this profile and will return the result of the enrollment. It also responds to queries about insurance plans.
Raw OpenAPI-Swagger Definition file | Download
Generated Narrative: CapabilityStatement IHE.FAIS.BeneficiaryManager
application/fhir+xml, application/fhir+jsonNote 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.
serverFAIS Beneficiary Manager processes requests from the Beneficiary Requestor on Insurance Plans and Enrollment Responses and receives the Enrollment Request submission.
Recommend ATNA, encouraged IHE-IUA or SMART-app-launch
search-systeminteraction.The summary table lists the resources that are part of this configuration, and for each resource it lists:
_include_revinclude| Resource Type | Profile | R | S | U | C | Searches | _include | _revinclude | Operations |
|---|---|---|---|---|---|---|---|---|---|
| InsurancePlan | Supported Profiles FAIS InsurancePlan Profile | y | y | _lastUpdated, _id, status, type, name, identifier, administered-by, owned-by, network, coverage-area, benefit-type | |||||
| EnrollmentRequest | Supported Profiles FAIS EnrollmentRequest Profile | $submit | |||||||
| EnrollmentResponse | Supported Profiles FAIS EnrollmentResponse Profile | y | y | _lastUpdated, _id, status, request |
FAIS Query Insurance Plan transaction [ITI-121]
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _lastUpdated | date | When the resource version last changed. The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb. |
| SHALL | _id | token | Logical id of this artifact |
| SHALL | status | token | The status of the Insurance Plan |
| SHALL | type | token | The type of the Insurance Plan |
| SHALL | name | string | The name of the Insurance Plan |
| SHALL | identifier | token | The business identifiers of the Insurance Plan |
| SHALL | administered-by | reference | Who administers the Insurance Plan |
| SHALL | owned-by | reference | Who owns the Insurance Plan |
| SHOULD | network | reference | The Insurance Plan network |
| SHOULD | coverage-area | reference | The Insurance Plan coverage area |
| SHOULD | benefit-type | token | The Insurance Plan type of benefit |
FAIS Enroll Beneficiary transaction [ITI-122]
read, search-type.FAIS Check Enrollment Status transaction [ITI-123]
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _lastUpdated | date | When the resource version last changed. The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb. |
| SHALL | _id | token | Logical id of this artifact |
| SHALL | status | token | The status of the response |
| SHALL | request | reference | The enrollment request |
IG © 2024+ IHE IT Infrastructure Technical Committee. Package ihe.iti.fais#1.0.0 based on FHIR 4.0.1. Generated 2024-11-13
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