80-Daily Totals Response - New Fields
The Response to Daily Totals is constructed as a Bundle with a Message Header Response and the Daily Totals Response Details. This response must be supported during MVP in full, as there is it not backward compatible with CPHA3.
The Response indicates a few key details in support of paging:
- The total number of matches in the query
- The number of records returned
- A page link. If the number of records returned is less than the total number of matches in the query, a link is included
Totals are returned as a whole for the period specified and additionally, will be returned by carrier if specified in the query request.
Mappable fields are not included in the table below. Please consult the
Daily Totals Response Details Mappings for these details. The full details are found in the message profile (link below) for further details.
| Feature | MVP Scope | Details | Sender Responsibility | Receiver Responsibility |
|---|---|---|---|---|
| Daily Totals Response | Totals:Parameters:OUT | |||
| Determine number of records to be returned | MANDATORY | 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 | MANDATORY |
MANDATORY |
| Number of Records Returned | MANDATORY | 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) | MANDATORY |
MANDATORY |
| FHIR Paging Mechanism | MANDATORY | 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 | MANDATORY Must support paging or always set a maximum number of records low enough as to not invoke paging |
MANDATORY |
| Remove ability to return results based on group. | NOT APPLICABLE | The PCS implementation committee confirmed that this feature is not used and therefore will not be supported in FHIR | NOT APPLICABLE this is not present in the FHIR queries |
NOT APPLICABLE this is not present in the FHIR queries |
| New Results Rule New Functionality |
MANDATORY | 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 | MANDATORY |
MANDATORY |
| No backward compatibility to CPHA3 | MANDATORY | New query style and mechanisms for FHIR | MANDATORY Must natively support new FHIR queries and send to FHIR adjudicators |
MANDATORY Must support FHIR queries natively |
