Universal API Implementation Guide - Local Development build (v1.1.19). See the Directory of published versions

Enrollment Mapping

Access Solutions & Patient Foundation Enrollment Mapping

An Access Solutions or Patient Foundation enrollment FHIR bundle consists of:

• information requested by Access Solutions/Patient Foundation,
• product specific questionnaires (refer to the Questionnaire page for details) AND
• data elements required by FHIR

Use the mapping tables below, product specific questionnaires, AND the sample enrollment payload when creating an enrollment bundle.

Italicized items are information that are not required by Access Solutions/Patient Foundation but are required by FHIR.

MessageHeader Resource

Field Name	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules Format	Accepted Values
Event Type	Required	Required	MessageHeader.eventCoding.code		enrollment-only consent-only enrollment-with-consent
Destination	Required	Required	MessageHeader.destination	Endpoint URL
Sender	Required	Required	MessageHeader.sender.reference	References the uuid for the Practice Organization sending the enrollment
Source	Required	Required	MessageHeader.source.name	Vendor Name	provided by GNE directly to vendors
Focus	Required	Required	MessageHeader.focus.reference	References the uuid for the List resource that contains all the resources in the bundle

Patient Resource

Field Name	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules Format	Accepted Values
Patient Identifier	Required	Required	Patient.identifier	use=official	Patient internal identifier This unique identifier is created by Mulesoft
First Name	Required	Required	Patient.name.given	Up to 255 Characters
Last Name	Required	Required	Patient.name.family	Up to 255 Characters
Date of Birth	Required	Required	Patient.name.birthDate	YYYY-MM-DD Date of Birth must be later than January 1, 1900	Date
Gender	Optional	Optional	Patient.gender	case sensitive	male female None/Null
Address	Required	Required	Patient.address.line	Up to 255 Characters
Address2	Optional	Optional	Patient.address.line	Up to 255 Characters
City	Required	Required	Patient.address.city	Up to 30 Characters
State	Required	Required	Patient.address.state	Standard 2 character State abbreviation
Zip Code	Required	Required	Patient.address.postalcode	5 characters
Phone number	Required	Required	Patient.telecom.value(system = phone)	XXX-XXX-XXXX (10 digit numeric values only )	Phone Number
Phone type	Required	Required	Patient.telecom.use(system = phone)	case sensitive	home mobile work
Email address	Optional	Optional	Patient.telecom.value(system = email)	<= 100 characters	Standard email validations. Something@domain.com
Email type	FHIR requirement	FHIR requirement	Patient.telecom.use(system = email)	FHIR requirement required if an email is provided
Practitioner	FHIR requirement	FHIR requirement	Patient.generalPractitioner	Practitioner reference that points to Practioner uuid
Managing Organization	Required by FHIR	Required by FHIR	Patient.managingOrganization	Organization reference that points to Organization uuid where type = “prov”
Preferred language	FHIR requirement	FHIR requirement	Patient.communication.language.coding.code Patient.communication.language.coding.code.display	FHIR requirement Accepted values are languages accepted by Access Solutions	“ar” Arabic “en” English “fr” French de” German “ja” Japanese “ko” Korean “zh” Mandarin “ru” Russian “es” Spanish “yue” Cantonese “tl” Tagalog “vi” Vietnamese “hi” Hindi “ht” Haitian Creole “it” Italian “fa” Farsi “pt” Portuguese “pl” Polish “yi” Yiddish “hmn” Hmong

RelatedPerson Resource

Field Name	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules/Format	Accepted Values
First Name	Optional	Optional	RelatedPerson.name.given	Up to 40 characters
Last Name	Required if a related person name is provided	Required if a related person name is provided	RelatedPerson.name.family	Up to 40 characters
Relationship to Patient	Required if a related person name is provided	Required if a related person name is provided	RelatedPerson.relationship.coding	For specific code, refer to value set listed in: http://hl7.org/fhir/R4B/valueset-relatedperson-relationshiptype.html	For specific code, refer to value set listed in: http://hl7.org/fhir/R4B/valueset-relatedperson-relationshiptype.html
Date of Birth	Optional	Optional	RelatedPerson.birthDate	YYYY-MM-DD Date of Birth must be later than January 1, 1900	Date
Phone number	Required if a related person name is provided	Required if a related person name is provided	RelatedPerson.telecom.value(system = phone)	XXX-XXX-XXXX (10 digit numeric values only )	Phone Number
Phone type	Required if a related person name is provided	Required if a related person name is provided	RelatedPerson.telecom.use(system = phone)	case sensitive	home mobile work

Practitioner Resource

Field Name	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules/Format	Accepted Values
First Name	Required	Required	Practitioner.name.given	Up to 80 chracters
Last Name	Required	Required	Practitioner.name.family	Up to 40 characters
National Provider Identifier (NPI)	Required	Required	Practitioner.identifier.value(type.coding.code= NPI)	Up to 40 characters	Prescriber’s NPI
Tax ID#	Optional	Optional	Practitioner.identifier.value(type.coding.code= TAX)	Up to 40 characters

Organization Resource

Field Name	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules/Format	Accepted Values
Identifer	Required	Required	Organization.Identifier.value(use = usual)	Unique identifier of practice organization	Up to 255 Characters
Type	Required	Required	Organization.type.coding.code		“prov”
Name	Required	Required	Organization.Name	Up to 80 chracters
Contact First Name	Required	Required	Organization.contact.name.given	Up to 255 Characters
Contact Last Name	Required	Required	Organization.contact.name.family	Up to 80 chracters
Practice Phone	Optional	Optional	Organization.telecom.value(system = phone)	Phone#: XXX-XXX-XXXX (10 digit numeric values only)
Practice Fax	Optional	Optional	Organization.telecom.value(system = fax)	Phone#: XXX-XXX-XXXX (10 digit numeric values only)
Contact Phone	Required	Required	Organization.contact.telecom.value(system = phone)	Phone#: XXX-XXX-XXXX (10 digit numeric values only)
Contact Fax	Required	Required	Organization.contact.telecom.value(system = fax)	Phone#: XXX-XXX-XXXX (10 digit numeric values only)
Contact Email	Optional	Optional	Organization.contact.telecom.value(system = email)	<= 100 characters	Standard email validations Something@domain.com
Address	Required	Required	Organization.address.line	Up to 80 chracters
Address2	Optional	Optional	Organization.address.line	Up to 255 characters
City	Required	Required	Organization.address.city	Up to 255 characters
State	Required	Required	Organization.address.state	Standard 2 character State abbreviation
Zip Code	Required	Required	Organization.address.postalcode	5 characters	In Access Solutions system, only 5 characters are accepted
NPI	Optional	Optional	Organizationr.identifier.value (type.coding.code= NPI)	Up to 40 characters	Organization (practice) NPI
Tax ID#	Optional	Optional	Organization.identifier.value (type.coding.code= TAX)	Up to 40 characters

Organization Resource - Payer/Insurance

Field Name	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules/Format	Accepted Values
Payer Name	Required	Optional	Organization.name	Can provide multiple payers Up to 255 Characters (for each payer)
Type	Required	Optional	Organization.type.coding.code		“ins”
Identifier	Required	Optional	Organization.identifier.value	Up to 255 Characters
Phone	Optional	Optional	Organization.telecom.value(system = phone)	Phone#: XXX-XXX-XXXX (10 digit numeric values only)

Organization Resource - Site of Treatment (SOT)

Field Name	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules/Format	Accepted Values
Site of Treatment Name	Required if Place of Service = “Infusion Center” or Hospital Outpatient or Ambulatory Surgical Center (Susvimo Only)	Required if ‘Ship To’ = Site of Treatment OR if Place of Service = Infusion Center or Hospital Outpatient	Organization.Name	Name of Site of Treatment, Infusion Center, Hospital Outpatient or Ambulatory Surgical Center (Susvimo Only)
Type	Required if SOT is provided	Required if SOT is provided	Organization.type.coding.code	Required if Site of Treatment Name is provided	“other”
Display	Required if SOT is provided	Required if SOT is provided	Organization.type.coding.display	Required if Site of Treatment Name is provided	“Site of Treatment”
Contact Name	Required if SOT is provided	Required if SOT is provided	Organization.contact.name	Required if Site of Treatment Name is provided Up to 255 Characters
Address	Required if SOT is provided	Required if SOT is provided	Organization.address.line	Required if Site of Treatment Name is provided Up to 80 chracters
Address2	Optional	Optional	Organization.address.line	Required if Site of Treatment Name is provided Up to 255 characters
City	Required if SOT is provided	Required if SOT is provided	Organization.address.city	Required if Site of Treatment Name is provided Up to 255 characters
State	Required if SOT is provided	Required if SOT is provided	Organization.address.state	Required if Site of Treatment Name is provided	Standard 2 character State abbreviation
Zip Code	Required if SOT is provided	Required if SOT is provided	Organization.address.postalcode	Required if Site of Treatment Name is provided 5 characters	In Access Solutions system, only 5 characters are accepted
National Provider Identifier (NPI)	Optional	Optional	Organization.identifier.value(type.coding.code= NPI)	Up to 40 characters
Tax ID#	Optional	Optional	Organization.identifier.value(type.coding.code= TAX)	Up to 40 characters
Contact Phone	Optional	Optional	Organization.contact.telecom.value(system = phone)	XXX-XXX-XXXX (10 digit numeric values only)	phone
Contact Fax	Optional	Optional	Organization.contact.telecom.value(system = fax)	XXX-XXX-XXXX (10 digit numeric values only)	phone
Contact Email	Optional	Optional	Organization.contact.telecom.value(system = email)	<= 100 characters	Standard email validations Something@domain.com

Example of Organization-Site of Treatment

MedicationRequest Resource

Field Name	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules/Format	Accepted Values
Product Name	Required	Required	MedicationRequest.medicationCodeableConcept.coding.code	Up to 255 Characters
Intent	FHIR requirement	FHIR requirement	MedicationRequest.intent	_FHIR requirement	“order”
Prescription	Refer to “Product Specifics” page https://uapi-fhirapi-doc-root.s3.amazonaws.com/products-specifics.html	Required for Upfront Shipment	Refer to Business Rules section	Refer to Business Rules section for specific Product prescription where applicable	Refer to Business Rules section for specific Product prescription where applicable

Coverage Resource

Field Name	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules/Format	Accepted Values
Beneficiary	Required	Optional	Coverage.beneficiary.type		“Patient”
Group Number	Optional	Optional	Coverage.class.coding.value(code = group)	Up to 40 characters
Subscriber	Required	Optional	Coverage.subscriber.type	When type = RelatedPerson, subscriber details must be provided in related person resource	Patient or RelatedPerson
Subscriber ID	Required	Optional	Coverage.subscriberId	Up to 255 characters
Payor	Required	Optional	Coverage.payor.reference(type = organization)	References the Payor/Insurance Organization resource uuid
Type	Required	Optional	Coverage.type.coding.code		“HIP” https://hl7.org/fhir/R4/valueset-coverage-type.html

Condition Resource

Field Name	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules/Format	Accepted Values
Code	Required	Required	Condition.code	Multiple codes can be indicated by appending the ‘+’ sign e.g. C43.1+C43.0+C43.10+C43.11	Can provide a max of four ICD 10 codes in bundle
Subject	Required	Required	Condition.subject.reference(type=patient)	References the Patient resource uuid

Provenance Resource

The Provenance resource is only needed if an HCP signature is required Refer to the Products Specific page to see which products require an HCP signature.

Since patients/relatedPerson signing on patient behalf are obtained via digital consent, the Provenance resource is not needed for their signatures.

Field Name	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules/Format	Accepted Values
Agent	Required if an HCP signature is required Refer to the Products Specific page to see which products require an HCP signature	Required	Provenance.agent.who.reference Provenance.agent.who.type		uuid of Practitioner resource “Practitioner”
Record Date	Required if an HCP signature is required	Required	Provenance.recorded	YYYY-MM-DDTHH:MM:SS+00:00 E.g. 2021-07-26T18:22:19.804851+00:00	Date activity was recorded
Target	Required if an HCP signature is required	Required	Provenance.target		uuid of the Consent resource (for HCP signature)
Signature Type	Required if an HCP signature is required	Required	Provenance.signature.type.display	Indication of the reason the agent signed the object(s)	Prescriber Signature
Who Signed	Required if an HCP signature is required	Required	Provenance.signature.who.reference Provenance.signature.who.type	uuid of Practitioner resource “Practitioner”
Activity Date	Required if an HCP signature is required	Required	Provenance.signature.when	Date activity occured Required by FHIR	same value as Provenance.recorded

Consent Resource

Purpose	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules/Format	Accepted Values
Category	Required, only if -patient consent info is provided or -patient is opting-in to Marketing communications or -a prescriber signature is required	Required	Consent.category.coding.code Consent.category.coding.display	Indicate what type of consent or signature type is being provided. There are several types of consents/signature that can be provided: - patient consent: required if patient consent is being provided in bundle or - prescriber signature: required if prescriber is providing signature for an enrollment or - marketing info consent: optional; needed if patient consents to opt-into marketing communication If both a patient consent and a prescriber signature are required, then a separate Consent resource is needed for each consent type.	code: “59284-0” display: “Patient Authorization Signature” code: “59284-0” display: “Prescriber Signature” code: “59284-0” display: “Marketing Info Consent”
Privacy Consent	Required	Required	Consent.scope.coding		“patient-privacy” Example: code: “patient-privacy” display: Privacy Consent
HIPAA Authorization	Required	Required	Consent.policyRule.coding		“hipaa-auth” Example: code: “hipaa-auth” display: HIPAA Authorization
Performer	Required	Required	Consent.performer		“Patient” or “RelatedPerson” Example: “performer”: [{ “reference”: “urn:uuid:047fc715-b22b-2756-beec-e2ee83c33b3e”, “type”: “Patient”
Consent Timestamp	Required	Required	Consent.dateTime	YYYY-MM-DDTHH:MM:SS	“dateTime” Example: “dateTime”: “2023-09-26T22:56:03Z”
Type	Required	Required	Consent.provision.type		permit” Example: “provision”: { “type”: “permit”

ServiceRequest Resource

Field Name	Access Solutions Enrollment	Patient Foundation Enrollment	Resource-ElementID	Business Rules/Format	Accepted Values
Intent	FHIR requirement	FHIR requirement	ServiceRequest.intent	FHIR requirement	order
Service Requested	Required	Required	ServiceRequest.code	Validations: - Starter SR can only be requested for: Actemra Subcutaneous Alecensa Evrysdi Gavreto Hemlibra Rozlytrek Venclexta Xolair Can’t request for both C&R (BIPA, Copay, Appeals, Starter) and Patient Foundation in the same bundle.	Case sensitive: bipa copay appeal starter patient foundation