80 & 81 - Daily Totals Response Details

Overview

The Response to Daily Totals is constructed as a Bundle with a Message Header Response and the Daily Totals Response Details.

The Response indicates a few key details:

  1. The total number of matches in the query
  2. The number of records returned
  3. A page link. If the number of records returned is less than the total number of matches in the query, a link is included

Daily Totals Response Details - DRAFT

No. Feature Details Sender Responsibility Receiver Responsibility
1 Determine number of records to be returned The responder must consider the maximum number of records (from the query request). If the number of matches exceeds this, the adjudicator must respect this maximum
2 Number of Records Returned The response to a query will be a FHIR bundle, that can return the number of records requested (eg 250) or that can be managed by the server if less (eg 200). The "message" bundle will include the entries (up to the requested count or servers limit per page), the total number of records found and a link for subsequent requests (URL's to navigate through pages; client follows the next link).
3 FHIR Paging Mechansim FHIR does not impose a maximum on the number of records returned. If the record max exceeds the maximum supported by the sender and/or receiver, FHIR paging can be used. This allows vendors to send a single query request for details or totals, instead of having to send many requests to achieve the same result Must support paging Must support FHIR paging
2 Remove ability to return results based on group. The PCS implementation committee confirmed that this feature is not used and therefore will not be supported in FHIR Not applicable as this is not present in the FHIR queries Not applicable as this is not present in the FHIR queries
5 New Results Rule Requestors can specify a "results rule" to indicate whether they want the response to "include" or "exclude" one or more carriers or one or more carrier/groups, or whether they wish to include ALL. Today they can only include Must support Must Support
4 No backward compatibility to CPHA3 New query style and mechanisms for FHIR Must natively support new FHIR queries and send to FHIR adjudicators Must support FHIR queries natively