Scenario Library

Synthetic PAS fixtures for Analyze, Build, and Compare. Do not submit PHI.

Sets insurer identity on load. Default is FHIR Health Plan (payer-neutral). Observed payer overlays are optional for certification only.

Profiles now declare their own member-ID grammar and dependent indexing — one runs a single sequence per household, another restarts it per relationship and carries a relationship token in the ID. Caregiver and notification contacts are still not modelled.

Switching the profile here still only re-stamps insurer identity: these scenarios carry fixed member IDs rather than minting them per profile, so the IDs on screen will not change.

Showing 16 of 16 scenarios

  • Valid PAS Inquiry (request)

    Happy path inquiry: sparse Claim asking about a prior request by trace number

    Happy pathfullDemonstration onlyno payer code
  • Valid PAS Submit (directory match)

    Happy path: provider + facility exact match, POS allowed

    Happy pathfullDemonstration onlyNPI: 1234567893no payer code
  • Missing ordering provider NPI

    Capability: provider present without usable NPI for directory matching

    Identifier missingfullAuthoritative for this fixtureno payer code
  • Facility not found

    Capability: facility directory ZERO_MATCH

    Identifier unresolvablefullAuthoritative for this fixtureNPI: 1000000012no payer code
  • Provider not found

    Capability: directory ZERO_MATCH on ordering provider; Onyx config maps to PAR205 (Onyx context declared explicitly, never a default)

    Identifier unresolvablefullAuthoritative for this fixtureNPI: 1000000004no payer code
  • Facility ambiguous (PAR209)

    Capability: facility MULTIPLE_MATCHES; Onyx config maps to PAR209 (Onyx context declared explicitly, never a default)

    Identifier ambiguousfullAuthoritative for this fixtureNPI: 1888888882no payer code
  • Provider ambiguous

    Capability: directory MULTIPLE_MATCHES; Onyx config maps to PAR205 (Onyx context declared explicitly, never a default)

    Identifier ambiguousfullAuthoritative for this fixtureNPI: 1555555552no payer code
  • Member not found

    Capability: member registry ZERO_MATCH

    Member unknownfullAuthoritative for this fixtureMember ID: SYN-MEMBER-UNKNOWNno payer code
  • Inactive coverage

    Capability: member found; coverage cancelled (and also outside period) for service date

    Coverage inactivefullAuthoritative for this fixtureMember ID: SYN-MEMBER-INACTIVEno payer code
  • Coverage not yet effective

    Capability: member found; prior plan lapsed and the incoming plan starts after the service date — resubmit later, do not correct the coverage

    Coverage not yet effectivefullAuthoritative for this fixtureMember ID: SYN-MEMBER-GAPEnrollment tier: SOLOPlan class: COMMERCIAL PPOno payer code
  • POS conflict (PAR220)

    Capability: POS↔facility conflict condition; Onyx config maps to PAR220 (Onyx context declared explicitly, never a default)

    Place of service conflictfullAuthoritative for this fixturePlace of service: 11no payer code
  • Invalid diagnosis

    Observed case: diagnosis code outside synthetic allow-list

    Code not coveredfullDemonstration onlyno payer code
  • Unsupported procedure

    Observed case: procedure known but not supported for PAS routing

    Code not coveredfullDemonstration onlyProcedure code: SYN-PROC-UNSUPPORTEDno payer code
  • Multiple programs

    Observed case: diagnosis+procedure match 2+ synthetic programs

    Routing ambiguousfullDemonstration onlyProgram: PROG-MEDICALProgram: PROG-SPECIALTYno payer code
  • Dependent attached to the wrong subscriber

    Capability: both member ids are well-formed and the dependent is a real directory member — what is wrong is the family link

    Family link incoherentfullAuthoritative for this fixtureMember ID: FHP33947278-02Enrollment tier: FAMILY_DEPENDENTPlan class: COMMERCIAL PPOno payer code
  • TS02B payload inspector

    Regression: one observed Onyx-implementation Bundle for identity, terminology, and careTeam FA site-of-care path. Onyx-observed evidence (Category 2), not a canonical PAS example.

    ConformancefullDemonstration onlyno payer code