{
  "schema": "varexis-index-free-publication-preview/1",
  "catalogue_version": "pub-8-tranche-58-v1",
  "route_id": "agentic_reviewed_fhir_claim_preauthorization_not_payment",
  "record_id": "VXI-EXT-ADMINISTRATION-FHIR-CLAIM-PREAUTHORIZATION-NOT-PAYMENT-01-v1",
  "question": "Does a FHIR preauthorization response mean that payment has been made?",
  "answer": "R5 ClaimResponse distinguishes preauthorization from an actual claim. A preauthorization response does not itself make a payment, although funds may be reserved for a claim submitted later. Preserve the later claim and financial outcome rather than recording reserved or authorised benefits as money received.",
  "records": [
    {
      "record_id": "VXI-EXT-ADMINISTRATION-FHIR-CLAIM-PREAUTHORIZATION-NOT-PAYMENT-01-v1",
      "url": "/varexis-index/records/fhir-claim-preauthorization-not-payment.json",
      "content_sha256": "74e445632947c822ee1302ddd83ddee9a54e5e4e895ce005803988b470bf1428",
      "evidence": {
        "schema": "varexis-public-evidence-record/0.3",
        "generated_at_utc": "2026-10-25T00:44:04.075Z",
        "record_id": "VXI-EXT-ADMINISTRATION-FHIR-CLAIM-PREAUTHORIZATION-NOT-PAYMENT-01-v1",
        "record_kind": "external_reference",
        "title": "FHIR R5 preauthorization versus payment",
        "system": "HL7 FHIR R5 5.0.0 — claimresponse",
        "evidence_family": "vendor_evidence_review",
        "index_status": "PUBLIC_SAFE_SOURCE_REVIEW",
        "evidence_state": "PRIMARY_DOCUMENTATION_REVIEW_ONLY",
        "canonical_question": "Does a FHIR preauthorization response mean that payment has been made?",
        "near_questions": [
          "Does a FHIR preauthorization transfer funds?",
          "Can reserved benefits be counted as money received?",
          "What separates an authorised claim estimate from payment?",
          "Which later evidence is needed after preauthorization?"
        ],
        "supported_claims": [
          {
            "claim": "R5 ClaimResponse distinguishes preauthorization from an actual claim. A preauthorization response does not itself make a payment, although funds may be reserved for a claim submitted later. Preserve the later claim and financial outcome rather than recording reserved or authorised benefits as money received.",
            "reliance": "DOCUMENTED_CAPABILITY_ONLY"
          }
        ],
        "not_demonstrated_claims": [
          "No clinical advice, patient-safety validation, legal compliance or confirmation of insurance cover.",
          "No independent proof of a live access decision, completed workflow, physical action or settled payment.",
          "The published R5 definition does not establish support or conformance in a buyer implementation.",
          "Buyer deployment testing, live runtime enforcement, certification or permission to act",
          "Expanded capabilities or licences for existing INDEX executables"
        ],
        "public_summary": "R5 ClaimResponse distinguishes preauthorization from an actual claim. A preauthorization response does not itself make a payment, although funds may be reserved for a claim submitted later. Preserve the later claim and financial outcome rather than recording reserved or authorised benefits as money received.",
        "related_record_ids": [],
        "source_review": {
          "source_type": "official_external_documentation",
          "source_title": "HL7 FHIR R5 5.0.0 — claimresponse",
          "source_url": "https://hl7.org/fhir/R5/claimresponse.html",
          "checked_on": "2026-10-25",
          "candidate_record_id": "VXI-EXT-ADMINISTRATION-FHIR-CLAIM-PREAUTHORIZATION-NOT-PAYMENT-01-v1",
          "candidate_record_sha256": "52eb64efe64f2442926124c60b542f707076460c438df9d0585664724a2fed27",
          "method": "Primary documentation reviewed for the published bounded statement.",
          "deployment_tested_by_varexis": false,
          "revalidation": "The delivered snapshot preserves the review date shown. Recheck current primary documentation and deployment context before relying on present applicability; payment does not trigger fresh research."
        },
        "answer_policy": {
          "classification": "DOCUMENTED_WITH_DEPLOYMENT_BOUNDARY",
          "bounded_answer": "R5 ClaimResponse distinguishes preauthorization from an actual claim. A preauthorization response does not itself make a payment, although funds may be reserved for a claim submitted later. Preserve the later claim and financial outcome rather than recording reserved or authorised benefits as money received.",
          "required_buyer_context": "ClaimResponse use; Referenced request; Later claim and independent payment evidence. Buyer deployment not inspected.",
          "missing_evidence": "A broader claim needs evidence matching the intended use. Payment does not upgrade the evidence state."
        },
        "private_boundary": "Raw logs, thresholds, private paths, source code, protected mechanisms and reconstruction-level details are excluded from public and paid delivery.",
        "decision_profile": {
          "schema": "varexis-vendor-evidence-review/1",
          "review_status": "documentation_review_only",
          "checked_on": "2026-10-25",
          "claim_to_check": "Does a FHIR preauthorization response mean that payment has been made?",
          "documented_statement": {
            "status": "documented",
            "statement": "R5 ClaimResponse distinguishes preauthorization from an actual claim. A preauthorization response does not itself make a payment, although funds may be reserved for a claim submitted later. Preserve the later claim and financial outcome rather than recording reserved or authorised benefits as money received.",
            "source_ids": [
              "fhir-claimresponse"
            ]
          },
          "review_inference": {
            "status": "review_inference",
            "statement": "Separate reserved benefits from actual payment. This is a documentation-review judgment, not an observed outcome.",
            "source_ids": [
              "fhir-claimresponse"
            ]
          },
          "buyer_evidence_required": [
            "ClaimResponse use",
            "Referenced request",
            "Later claim and independent payment evidence"
          ],
          "review_condition": {
            "status": "varexis_review_policy",
            "statement": "Refuse paid or settled status from a preauthorization response."
          },
          "unknowns": "The applicable implementation guide, live system and actual administrative outcome were not inspected.",
          "unknown_finding": {
            "status": "unknown",
            "statement": "The applicable implementation guide, live system and actual administrative outcome were not inspected."
          },
          "evidence_sources": [
            {
              "source_id": "fhir-claimresponse",
              "url": "https://hl7.org/fhir/R5/claimresponse.html",
              "final_url": "https://hl7.org/fhir/R5/claimresponse.html",
              "status": 200,
              "captured_at_utc": "2026-10-25T00:21:10.371Z",
              "sha256": "c8deff6e6ebf3b7a19a9fa734096fcbad0872ca0513004683256a1c439fc339d",
              "bytes": 1194166,
              "title": "HL7 FHIR R5 5.0.0 — claimresponse",
              "hash_basis": "SHA-256 of unmodified HTTP response body bytes",
              "rights_review": "Original factual paraphrase of the HL7 FHIR core specification under CC0. Third-party terminology and trademarks have separate terms; no document, schema, code or modified standard is redistributed. No endorsement or patient data.",
              "checked_on": "2026-10-25",
              "capture_status": 200,
              "claim_review_completed": true,
              "reviewed_sections": [
                "13.7.1 Scope and Usage"
              ],
              "version_context": "Permanent FHIR R5 5.0.0 publication. Resource-specific maturity and normative/Trial Use status apply; no universal normative or implementation-conformance claim."
            }
          ],
          "observed_deployment": false,
          "commercial_reliance_boundary": "Documentation review only; the buyer must establish applicability and actual outcomes. INDEX does not inspect or control the deployment.",
          "paid_value": {
            "decision_context": "Separate reserved benefits from actual payment.",
            "free": "Complete review, sources, practical questions and limitations; may be saved locally.",
            "single_request": "Existing server-saved version-bound route snapshot for later authenticated retrieval.",
            "evidence_receipt": "The same snapshot plus the existing unsigned delivery receipt.",
            "excluded": [
              "Fresh vendor research",
              "Continuous monitoring or change alerts",
              "Testing the buyer configuration",
              "Private evidence or vendor certification"
            ],
            "integrity": "Hashes identify content versions; they do not prove truth or provide a signature."
          },
          "revalidation": {
            "trigger": "A saved purchase does not recheck the source or buyer configuration.",
            "specific_watch": "Recheck the applicable FHIR version, implementation guide, resource profile and independent administrative outcome before relying on a current workflow."
          },
          "buyer_relevance": "Separate reserved benefits from actual payment.",
          "refusal_conditions": [
            "Refuse paid or settled status from a preauthorization response."
          ]
        },
        "niche": {
          "niche_id": "agent-authority-action-evidence",
          "label": "Agent Authority & Action Evidence",
          "classification_id": "payments",
          "classification_label": "Agent Payments, Authority & Transaction Evidence",
          "topic_id": "payments",
          "buyer_intent": "Separate reserved benefits from actual payment.",
          "comparison_role": "supplementary_discovery"
        },
        "paid_access_note": "The full published answer and boundaries are free. Paid access saves the selected route and source versions, with an unsigned receipt when purchased. Preview coverage before paying. Fresh research, bespoke assessment and protected evidence are excluded.",
        "service_route": {
          "request_guide": "/varexis-index/request.html",
          "request_workflow": "/varexis-index/request-workflow.json",
          "service_id": "single_request",
          "service_routes_url": "/varexis-index/service-routes.json",
          "payment_required": true,
          "availability_endpoint": "/api/index/capabilities",
          "operational_status": "AUTOMATIC_SERVICE_CAPABILITIES_GATED",
          "checkout_url": "/index-access"
        },
        "authority_boundary": "VAREXIS-INDEX informs evidence reliance. It does not provide advice, certification, deployment authority, security assurance, production approval, or guarantee.",
        "human_page": "/varexis-index/catalog.html#fhir-claim-preauthorization-not-payment",
        "machine_readable_record": "/varexis-index/records/fhir-claim-preauthorization-not-payment.json"
      }
    }
  ],
  "access": {
    "mode": "exact_http_only",
    "payment_required": false,
    "purchase_url": null,
    "mcp_preview_available": false,
    "paid_saved_retrieval_available": false,
    "natural_language_search_qualified": false
  },
  "boundary": "Catalogue additions are available free through the exact HTTP JSON links below. Enhanced natural-language discovery is not yet qualified for these records. They are outside MCP search, MCP preview and paid saved retrieval. No search qualification, executable capability or entitlement is added.",
  "content_sha256": "53b33b495eae4524970542e757057df869d5c319e5c21f02ed811ade1c76018a"
}