{ "resourceType" : "Bundle", "id" : "uapi-status-update-1", "meta" : { "profile" : ["https://fhir.developer.gene.com/StructureDefinition/uapi-bundle-status-update"] }, "type" : "message", "timestamp" : "2020-03-11T08:10:13-05:00", "entry" : [{ "fullUrl" : "urn:uuid:5c0cdcfa-4e39-4c4d-bff2-9d70a2f49eaa", "resource" : { "resourceType" : "MessageHeader", "id" : "5c0cdcfa-4e39-4c4d-bff2-9d70a2f49eaa", "meta" : { "profile" : ["https://fhir.developer.gene.com/StructureDefinition/uapi-messageheader"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: MessageHeader 5c0cdcfa-4e39-4c4d-bff2-9d70a2f49eaa

Profile: UAPI MessageHeader

event: uapi-event-type status-update: status-update

sender: Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500

Sources

-NameEndpoint
*Genentech-PACThttps://genentech-pps.my.salesforce.com

focus: Bundle: identifier = Resource identifier: 7c8f5054-015b-4bce-99f5-4160a82a4225; type = message; timestamp = 2020-03-11 08:10:13-0500

" }, "eventCoding" : { "system" : "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type", "code" : "status-update" }, "sender" : { "reference" : "urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088", "type" : "Organization" }, "source" : { "name" : "Genentech-PACT", "endpoint" : "https://genentech-pps.my.salesforce.com" }, "focus" : [{ "reference" : "urn:uuid:8e055260-dd74-4c89-9ccf-3d2f47135ee0", "type" : "List" }] } }, { "fullUrl" : "urn:uuid:8e055260-dd74-4c89-9ccf-3d2f47135ee0", "resource" : { "resourceType" : "List", "id" : "8e055260-dd74-4c89-9ccf-3d2f47135ee0", "text" : { "status" : "generated", "div" : "

Generated Narrative: List 8e055260-dd74-4c89-9ccf-3d2f47135ee0

messageContext

Mode: Change List Status: Current
Items
Bundle: type = message; timestamp = 2020-03-11 08:10:17-0500
Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500
Bundle: type = message; timestamp = 2020-03-11 08:10:13-0500
Bundle: type = message; timestamp = 2020-03-11 08:10:13-0500
" }, "status" : "current", "mode" : "changes", "title" : "messageContext", "entry" : [{ "item" : { "reference" : "urn:uuid:b3d46ea3-62e6-4171-b818-d64712edfe55", "type" : "Patient" } }, { "item" : { "reference" : "urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088", "type" : "Organization" } }, { "item" : { "reference" : "urn:uuid:223ec8d6-fdc6-4598-9694-74f782eb5104", "type" : "CoverageEligibilityRequest" } }, { "item" : { "reference" : "urn:uuid:0bd127dd-6ba9-4fcf-9a3a-607fc15dd450", "type" : "CoverageEligibilityResponse" } }] } }, { "fullUrl" : "urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088", "resource" : { "resourceType" : "Organization", "id" : "01c31a2f-321d-4c6e-8349-206af8a88088", "meta" : { "profile" : ["https://fhir.developer.gene.com/StructureDefinition/uapi-organization"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Organization 01c31a2f-321d-4c6e-8349-206af8a88088

Profile: UAPI Organization

identifier: http://vendor.com/ab/HOSP-12345\u00a0(use:\u00a0usual,\u00a0), http://dev.gene.com/fhir/mulesoft/Vendor_AB_HOSP-12345\u00a0(use:\u00a0official,\u00a0)

type: Healthcare Provider

name: Mid Atlantic Retina

telecom: ph: -unknown-

address: 8 Ranoldo Terrace Cherry Hill NJ 08034 US

contact

name: Venus Yardav (Official)

telecom: ph: 8882704882(Work), fax: 8179974042(Work)

" }, "identifier" : [{ "use" : "usual", "system" : "http://vendor.com/ab", "value" : "HOSP-12345", "assigner" : { "display" : "AB Vendor" } }, { "use" : "official", "system" : "http://dev.gene.com/fhir/mulesoft", "value" : "Vendor_AB_HOSP-12345", "assigner" : { "display" : "UAPI Process API Mulesoft" } }], "type" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/organization-type", "code" : "prov", "display" : "Healthcare Provider" }] }], "name" : "Mid Atlantic Retina", "telecom" : [{ "system" : "phone" }], "address" : [{ "line" : ["8 Ranoldo Terrace"], "city" : "Cherry Hill", "state" : "NJ", "postalCode" : "08034", "country" : "US" }], "contact" : [{ "name" : { "use" : "official", "family" : "Yardav", "given" : ["Venus"] }, "telecom" : [{ "system" : "phone", "value" : "8882704882", "use" : "work", "rank" : 1 }, { "system" : "fax", "value" : "8179974042", "use" : "work", "rank" : 2 }] }] } }, { "fullUrl" : "urn:uuid:7c0c0017-e08d-4a14-9889-9eea26303ff2", "resource" : { "resourceType" : "Patient", "id" : "7c0c0017-e08d-4a14-9889-9eea26303ff2", "meta" : { "profile" : ["https://fhir.developer.gene.com/StructureDefinition/uapi-patient"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Patient 7c0c0017-e08d-4a14-9889-9eea26303ff2

Profile: UAPI Patient

Ryan Michaelson (official) Male, DoB: 1972-10-29 ( Patient internal identifier: MPAT-000123\u00a0(use:\u00a0usual,\u00a0))

Other Id:Patient internal identifier/540002\u00a0(use:\u00a0official,\u00a0)
Contact Detail
Language:English (preferred)
Links:
" }, "identifier" : [{ "use" : "official", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "PI", "display" : "Patient internal identifier" }] }, "system" : "http://vendor.com/ab", "value" : "540002", "assigner" : { "display" : "AB Vendor" } }, { "use" : "usual", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "PI", "display" : "Patient internal identifier" }] }, "system" : "http://dev.gene.com/patientmaster", "value" : "MPAT-000123", "assigner" : { "display" : "Genentech Patient Master" } }], "name" : [{ "use" : "official", "family" : "Michaelson", "given" : ["Ryan"] }], "telecom" : [{ "system" : "phone", "value" : "1231231234", "use" : "home", "rank" : 1 }, { "system" : "phone", "value" : "1234561234", "use" : "mobile", "rank" : 2 }, { "system" : "email", "value" : "bobster83@example.com", "use" : "home", "rank" : 3 }], "gender" : "male", "birthDate" : "1972-10-29", "address" : [{ "line" : ["1234 Main St"], "city" : "San Francisco", "state" : "CA", "postalCode" : "94105", "country" : "US" }], "communication" : [{ "language" : { "coding" : [{ "system" : "urn:ietf:bcp:47", "code" : "en", "display" : "English" }] }, "preferred" : true }], "managingOrganization" : { "reference" : "urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088" } } }, { "fullUrl" : "urn:uuid:223ec8d6-fdc6-4598-9694-74f782eb5104", "resource" : { "resourceType" : "CoverageEligibilityRequest", "id" : "223ec8d6-fdc6-4598-9694-74f782eb5104", "meta" : { "profile" : ["https://fhir.developer.gene.com/StructureDefinition/uapi-coverage-eligibility-request"] }, "text" : { "status" : "extensions", "div" : "

Generated Narrative: CoverageEligibilityRequest 223ec8d6-fdc6-4598-9694-74f782eb5104

Profile: UAPI CoverageEligibilityRequest

UAPI CoverageEligibilityRequest ServiceRequestType: Patient Foundation

UAPI CoverageEligibilityRequest Product: Lucentis

UAPI CoverageEligibilityRequest Product: Susvimo

identifier: https://fhir.developer.gene.com/enrollment/bundle-enrollment-id/c78bde64-95e8-41f9-8a37-b2ac9aaf33d6\u00a0(use:\u00a0old,\u00a0), https://fhir.developer.gene.com/enrollment/Case/00928066\u00a0(use:\u00a0official,\u00a0)

status: Active

purpose: Coverage benefits

patient: Bundle: type = message; timestamp = 2020-03-11 08:10:13-0500

created: 2021-05-27 08:10:13-0500

provider: Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500

insurer: Organization Genentech Patient Foundation

Generated Narrative: Organization #8a0a8882-2667-4703-8c35-fdff0f6cf19f

Profile: UAPI Organization

identifier: http://gene.com/ORG-00001\u00a0(use:\u00a0usual,\u00a0)

type: Insurance Company

name: Genentech Patient Foundation

telecom: ph: 1800654332211(Work)

" }, "contained" : [{ "resourceType" : "Organization", "id" : "8a0a8882-2667-4703-8c35-fdff0f6cf19f", "meta" : { "profile" : ["https://fhir.developer.gene.com/StructureDefinition/uapi-organization"] }, "identifier" : [{ "use" : "usual", "system" : "http://gene.com", "value" : "ORG-00001", "assigner" : { "display" : "Genentech" } }], "type" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/organization-type", "code" : "ins" }] }], "name" : "Genentech Patient Foundation", "telecom" : [{ "system" : "phone", "value" : "1800654332211", "use" : "work", "rank" : 1 }] }], "extension" : [{ "url" : "https://fhir.developer.gene.com/StructureDefinition/SRType", "valueCodeableConcept" : { "coding" : [{ "system" : "https://fhir.developer.gene.com/CodeSystem/uapi-sr-type", "code" : "gpf", "display" : "Patient Foundation" }] } }, { "url" : "https://fhir.developer.gene.com/StructureDefinition/Product", "valueCodeableConcept" : { "coding" : [{ "system" : "https://fhir.developer.gene.com/CodeSystem/uapi-product-name", "code" : "lucentis", "display" : "Lucentis" }] } }, { "url" : "https://fhir.developer.gene.com/StructureDefinition/Product", "valueCodeableConcept" : { "coding" : [{ "system" : "https://fhir.developer.gene.com/CodeSystem/uapi-product-name", "code" : "susvimo", "display" : "Susvimo" }] } }], "identifier" : [{ "use" : "old", "system" : "https://fhir.developer.gene.com/enrollment/bundle-enrollment-id", "value" : "c78bde64-95e8-41f9-8a37-b2ac9aaf33d6" }, { "use" : "official", "system" : "https://fhir.developer.gene.com/enrollment/Case", "value" : "00928066" }], "status" : "active", "purpose" : ["benefits"], "patient" : { "reference" : "urn:uuid:7c0c0017-e08d-4a14-9889-9eea26303ff2", "type" : "Patient" }, "created" : "2021-05-27T08:10:13-05:00", "provider" : { "reference" : "urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088", "type" : "Organization" }, "insurer" : { "reference" : "#8a0a8882-2667-4703-8c35-fdff0f6cf19f", "type" : "Organization" } } }, { "fullUrl" : "urn:uuid:0bd127dd-6ba9-4fcf-9a3a-607fc15dd450", "resource" : { "resourceType" : "CoverageEligibilityResponse", "id" : "0bd127dd-6ba9-4fcf-9a3a-607fc15dd450", "meta" : { "profile" : ["https://fhir.developer.gene.com/StructureDefinition/uapi-coverage-eligibility-response"] }, "text" : { "status" : "extensions", "div" : "

Generated Narrative: CoverageEligibilityResponse 0bd127dd-6ba9-4fcf-9a3a-607fc15dd450

Profile: UAPI CoverageEligibilityResponse

UAPI CoverageEligibilityResponse Shipment Method: Upfront

UAPI CoverageEligibilityResponse Status: Approved

identifier: https://fhir.developer.gene.com/enrollment/bundle-enrollment-id/c78bde64-95e8-41f9-8a37-b2ac9aaf33d6\u00a0(use:\u00a0old,\u00a0), https://fhir.developer.gene.com/enrollment/Case/00928066\u00a0(use:\u00a0official,\u00a0)

status: Active

purpose: Coverage benefits

patient: Bundle: type = message; timestamp = 2020-03-11 08:10:13-0500

serviced: 2021-06-01

created: 2021-05-27 08:10:13-0500

request: Bundle: type = message; timestamp = 2020-03-11 08:10:13-0500

outcome: Complete

disposition: Not Insured

insurer: Organization Genentech Patient Foundation

Generated Narrative: Organization #8a0a8882-2667-4703-8c35-fdff0f6cf19f

Profile: UAPI Organization

identifier: http://gene.com/ORG-00001\u00a0(use:\u00a0usual,\u00a0)

type: Insurance Company

name: Genentech Patient Foundation

telecom: ph: 1800654332211(Work)

" }, "contained" : [{ "resourceType" : "Organization", "id" : "8a0a8882-2667-4703-8c35-fdff0f6cf19f", "meta" : { "profile" : ["https://fhir.developer.gene.com/StructureDefinition/uapi-organization"] }, "identifier" : [{ "use" : "usual", "system" : "http://gene.com", "value" : "ORG-00001", "assigner" : { "display" : "Genentech" } }], "type" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/organization-type", "code" : "ins" }] }], "name" : "Genentech Patient Foundation", "telecom" : [{ "system" : "phone", "value" : "1800654332211", "use" : "work", "rank" : 1 }] }], "extension" : [{ "url" : "https://fhir.developer.gene.com/StructureDefinition/gpf-shipment-method", "valueCodeableConcept" : { "coding" : [{ "system" : "https://fhir.developer.gene.com/CodeSystem/gpf-shipment-method", "code" : "upfront", "display" : "Upfront" }] } }, { "url" : "https://fhir.developer.gene.com/StructureDefinition/statusOutcome", "valueCodeableConcept" : { "coding" : [{ "system" : "https://fhir.developer.gene.com/CodeSystem/uapi-coverage-outcome", "code" : "approved", "display" : "Approved" }] } }], "identifier" : [{ "use" : "old", "system" : "https://fhir.developer.gene.com/enrollment/bundle-enrollment-id", "value" : "c78bde64-95e8-41f9-8a37-b2ac9aaf33d6" }, { "use" : "official", "system" : "https://fhir.developer.gene.com/enrollment/Case", "value" : "00928066" }], "status" : "active", "purpose" : ["benefits"], "patient" : { "reference" : "urn:uuid:7c0c0017-e08d-4a14-9889-9eea26303ff2", "type" : "Patient" }, "servicedDate" : "2021-06-01", "created" : "2021-05-27T08:10:13-05:00", "request" : { "reference" : "urn:uuid:223ec8d6-fdc6-4598-9694-74f782eb5104", "type" : "CoverageEligibilityRequest" }, "outcome" : "complete", "disposition" : "Not Insured", "insurer" : { "reference" : "#8a0a8882-2667-4703-8c35-fdff0f6cf19f", "type" : "Organization" } } }] }