Submit a prior authorization request using the Da Vinci PAS Claim $submit operation

Verified steps

1. Review the Da Vinci PAS IG (hl7.org/fhir/us/davinci-pas) to understand the $submit operation's input: a Bundle of type collection containing a PAS Claim profile resource and all referenced resources (Patient, Coverage, Practitioner, Organization, ServiceRequest, etc.).
2. Construct the PAS Claim resource using the PAS Claim profile, setting Claim.use to 'preauthorization', populating Claim.item with the requested services (procedure codes, quantities, diagnosis), and referencing PAS ServiceRequest resources in the appropriate supportingInfo or item extension.
3. Build the complete Bundle including the Claim and all referenced resources (Patient using US Core Patient, Coverage, requesting Practitioner, servicing Organization/Practitioner) as Bundle.entry resources.
4. POST the Bundle to [base]/Claim/$submit on the payer's PAS endpoint using appropriate authentication (typically SMART Backend Services or intermediary-delegated credentials).
5. Parse the synchronous response: a ClaimResponse with an adjudication outcome (approved, denied, pended) or an OperationOutcome for errors; handle the pended case by extracting the prior authorization tracking number.
6. For pended responses, implement polling using the $inquire operation with the tracking number to check authorization status at defined intervals until a final approve or deny decision is received.