0.1.0 - ci-build
kenyaClaimsIG - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Official URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/ClaimResponseAuthorizationResponseProfile | Version: 0.1.0 | |||
Draft as of 2024-09-06 | Computable Name: ClaimResponseAuthorizationResponseProfile |
A response to a request for authorization or preauthorization of products and services.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from ClaimResponse
Name | Flags | Card. | Type | Description & Constraints![]() |
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0..* | ClaimResponse | Response to a claim predetermination or preauthorization | |
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1..1 | id | Unique string for reference purposes | |
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1..1 | Meta | Metadata about a resource | |
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1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | |
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0..* | Extension | Optional Extensions Element Slice: Unordered, Open by value:url | |
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0..1 | CodeableConcept | Extension for Diagnosis Related Group URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/diagnosis-related-group | |
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0..1 | CodeableConcept | ReissueReason URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/reissue-reason | |
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0..1 | CodeableConcept | AdjudicationOutcome URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/adjudication-outcome | |
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0..1 | string | TransferAuthorizationNumber URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-number | |
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0..1 | Period | TransferAuthorizationPeriod URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-period | |
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0..1 | Reference(SHAPractitioner | SHAOrganization) | TransferAuthorizationProvider URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-provider | |
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1..1 | Identifier | A unique identifier assigned to this claim response. | |
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1..1 | code | The status of the resource instance. | |
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1..1 | CodeableConcept | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. | |
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0..1 | CodeableConcept | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. | |
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1..1 | code | A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future. | |
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1..1 | Reference(Patient) | The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought. | |
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1..1 | dateTime | The date this resource was created. | |
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1..1 | Reference(Organization) | The party responsible for authorization, adjudication and reimbursement. | |
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1..1 | Reference(Practitioner | PractitionerRole | Organization) | The provider which is responsible for the claim, predetermination or preauthorization. | |
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1..1 | Reference(Claim) | Original request resource reference. | |
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1..1 | code | The outcome of the claim, predetermination, or preauthorization processing. | |
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0..1 | string | A human readable description of the status of the adjudication. | |
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0..1 | string | Reference from the Insurer which is used in later communications which refers to this adjudication. | |
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0..1 | Period | The time frame during which this authorization is effective. | |
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0..1 | CodeableConcept | Type of Party to be reimbursed: subscriber, provider, other. | |
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0..* | BackboneElement | A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details. | |
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |
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0..1 | CodeableConcept | AdjudicationOutcome URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/adjudication-outcome | |
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1..1 | positiveInt | A number to uniquely reference the claim detail entry. | |
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0..* | positiveInt | The numbers associated with notes below which apply to the adjudication of this item. | |
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1..* | BackboneElement | If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item. | |
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1..1 | CodeableConcept | If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item. | |
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0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. | |
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0..1 | Money | Monetary amount associated with the category. | |
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0..* | BackboneElement | A claim detail. Either a simple (a product or service) or a 'group' of sub-details which are simple items. | |
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1..1 | positiveInt | A number to uniquely reference the claim detail entry. | |
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1..* | BackboneElement | The adjudication results. | |
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1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. | |
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0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. | |
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0..1 | Money | Monetary amount associated with the category. | |
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0..* | BackboneElement | A sub-detail adjudication of a simple product or service. | |
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1..1 | positiveInt | A number to uniquely reference the claim sub-detail entry. | |
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0..* | positiveInt | The numbers associated with notes below which apply to the adjudication of this item. | |
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1..* | BackboneElement | The adjudication results. | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Monetary amount associated with the category. | |
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0..* | BackboneElement | Categorized monetary totals for the adjudication. | |
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1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item. | |
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1..1 | Money | Monetary total amount associated with the category. | |
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0..1 | CodeableConcept | A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom. | |
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0..* | BackboneElement | A note that describes or explains adjudication results in a human readable form. | |
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1..1 | positiveInt | A number to uniquely identify a note entry. | |
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1..1 | code | The business purpose of the note text. | |
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1..1 | string | The explanation or description associated with the processing. | |
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0..1 | CodeableConcept | A code to define the language used in the text of the note. | |
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0..1 | Reference(CommunicationRequest) | Request for additional supporting or authorizing information. | |
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0..* | BackboneElement | Financial instruments for reimbursement for the health care products and services specified on the claim. | |
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1..1 | positiveInt | A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order. | |
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1..1 | boolean | A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true. | |
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1..1 | Reference(Coverage) | Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system. | |
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0..1 | Reference(ClaimResponse) | The result of the adjudication of the line items for the Coverage specified. This is used when an insurer is able to not just adjudicate the claim they were sent but also able to detect that they are the processor for the sebsequent claims and can adjudicate them too. | |
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0..* | BackboneElement | Errors encountered during the processing of the adjudication. | |
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |
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0..1 | string | ErrorExtensionExpression URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/error-extension-expression | |
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0..1 | positiveInt | The sequence number of the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |
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0..1 | positiveInt | The sequence number of the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |
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0..1 | positiveInt | The sequence number of the sub-detail within the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |
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1..1 | CodeableConcept | An error code, from a specified code system, which details why the claim could not be adjudicated. | |
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Name | Flags | Card. | Type | Description & Constraints![]() | ||||
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0..* | ClaimResponse | Response to a claim predetermination or preauthorization | |||||
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Σ | 1..1 | id | Unique string for reference purposes | ||||
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Σ | 1..1 | Meta | Metadata about a resource | ||||
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Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | ||||
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?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
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0..* | Extension | Optional Extensions Element Slice: Unordered, Open by value:url | |||||
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0..1 | CodeableConcept | Extension for Diagnosis Related Group URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/diagnosis-related-group | |||||
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0..1 | CodeableConcept | ReissueReason URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/reissue-reason | |||||
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0..1 | CodeableConcept | AdjudicationOutcome URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/adjudication-outcome | |||||
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0..1 | string | TransferAuthorizationNumber URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-number | |||||
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0..1 | Period | TransferAuthorizationPeriod URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-period | |||||
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0..1 | Reference(SHAPractitioner | SHAOrganization) | TransferAuthorizationProvider URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-provider | |||||
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?! | 0..* | Extension | Extensions that cannot be ignored | ||||
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1..1 | Identifier | A unique identifier assigned to this claim response. | |||||
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?!Σ | 1..1 | code | The status of the resource instance. Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
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Σ | 1..1 | CodeableConcept | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. | ||||
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0..1 | CodeableConcept | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode. | |||||
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Σ | 1..1 | code | A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future. Binding: Use (required): Claim, preauthorization, predetermination. | ||||
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Σ | 1..1 | Reference(Patient) | The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought. | ||||
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Σ | 1..1 | dateTime | The date this resource was created. | ||||
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Σ | 1..1 | Reference(Organization) | The party responsible for authorization, adjudication and reimbursement. | ||||
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1..1 | Reference(Practitioner | PractitionerRole | Organization) | The provider which is responsible for the claim, predetermination or preauthorization. | |||||
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Σ | 1..1 | Reference(Claim) | Original request resource reference. | ||||
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Σ | 1..1 | code | The outcome of the claim, predetermination, or preauthorization processing. Binding: ClaimProcessingCodes (required): The result of the claim processing. | ||||
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0..1 | string | A human readable description of the status of the adjudication. | |||||
![]() ![]() ![]() |
0..1 | string | Reference from the Insurer which is used in later communications which refers to this adjudication. | |||||
![]() ![]() ![]() |
0..1 | Period | The time frame during which this authorization is effective. | |||||
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0..1 | CodeableConcept | Type of Party to be reimbursed: subscriber, provider, other. Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed. | |||||
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0..* | BackboneElement | A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details. | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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0..1 | CodeableConcept | AdjudicationOutcome URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/adjudication-outcome | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | positiveInt | A number to uniquely reference the claim detail entry. | |||||
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0..* | positiveInt | The numbers associated with notes below which apply to the adjudication of this item. | |||||
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1..* | BackboneElement | If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item. | |||||
![]() ![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | CodeableConcept | If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | |||||
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0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
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0..1 | Money | Monetary amount associated with the category. | |||||
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0..* | BackboneElement | A claim detail. Either a simple (a product or service) or a 'group' of sub-details which are simple items. | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | positiveInt | A number to uniquely reference the claim detail entry. | |||||
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1..* | BackboneElement | The adjudication results. | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Monetary amount associated with the category. | |||||
![]() ![]() ![]() ![]() ![]() |
0..* | BackboneElement | A sub-detail adjudication of a simple product or service. | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | positiveInt | A number to uniquely reference the claim sub-detail entry. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..* | positiveInt | The numbers associated with notes below which apply to the adjudication of this item. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
1..* | BackboneElement | The adjudication results. | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Monetary amount associated with the category. | |||||
![]() ![]() ![]() |
Σ | 0..* | BackboneElement | Categorized monetary totals for the adjudication. | ||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
Σ | 1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | ||||
![]() ![]() ![]() ![]() |
Σ | 1..1 | Money | Monetary total amount associated with the category. | ||||
![]() ![]() ![]() |
0..1 | CodeableConcept | A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom. Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None). | |||||
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0..* | BackboneElement | A note that describes or explains adjudication results in a human readable form. | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | positiveInt | A number to uniquely identify a note entry. | |||||
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1..1 | code | The business purpose of the note text. Binding: NoteType (required): The presentation types of notes. | |||||
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1..1 | string | The explanation or description associated with the processing. | |||||
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0..1 | CodeableConcept | A code to define the language used in the text of the note. Binding: CommonLanguages (preferred): A human language.
| |||||
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0..1 | Reference(CommunicationRequest) | Request for additional supporting or authorizing information. | |||||
![]() ![]() ![]() |
0..* | BackboneElement | Financial instruments for reimbursement for the health care products and services specified on the claim. | |||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
1..1 | positiveInt | A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order. | |||||
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1..1 | boolean | A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true. | |||||
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1..1 | Reference(Coverage) | Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system. | |||||
![]() ![]() ![]() ![]() |
0..1 | Reference(ClaimResponse) | The result of the adjudication of the line items for the Coverage specified. This is used when an insurer is able to not just adjudicate the claim they were sent but also able to detect that they are the processor for the sebsequent claims and can adjudicate them too. | |||||
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0..* | BackboneElement | Errors encountered during the processing of the adjudication. | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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0..1 | string | ErrorExtensionExpression URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/error-extension-expression | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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0..1 | positiveInt | The sequence number of the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |||||
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0..1 | positiveInt | The sequence number of the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |||||
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0..1 | positiveInt | The sequence number of the sub-detail within the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |||||
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1..1 | CodeableConcept | An error code, from a specified code system, which details why the claim could not be adjudicated. Binding: Adjudication Error Codes (example): The adjudication error codes. | |||||
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Path | Conformance | ValueSet | URI | |||
ClaimResponse.status | required | FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard | ||||
ClaimResponse.type | extensible | ClaimTypeCodeshttp://hl7.org/fhir/ValueSet/claim-type from the FHIR Standard | ||||
ClaimResponse.subType | example | ExampleClaimSubTypeCodeshttp://hl7.org/fhir/ValueSet/claim-subtype from the FHIR Standard | ||||
ClaimResponse.use | required | Usehttp://hl7.org/fhir/ValueSet/claim-use|4.0.1 from the FHIR Standard | ||||
ClaimResponse.outcome | required | ClaimProcessingCodeshttp://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1 from the FHIR Standard | ||||
ClaimResponse.payeeType | example | Claim Payee Type Codeshttp://hl7.org/fhir/ValueSet/payeetype from the FHIR Standard | ||||
ClaimResponse.item.adjudication.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.item.adjudication.reason | example | AdjudicationReasonCodeshttp://hl7.org/fhir/ValueSet/adjudication-reason from the FHIR Standard | ||||
ClaimResponse.item.detail.adjudication.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.item.detail.adjudication.reason | example | AdjudicationReasonCodeshttp://hl7.org/fhir/ValueSet/adjudication-reason from the FHIR Standard | ||||
ClaimResponse.item.detail.subDetail.adjudication.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.item.detail.subDetail.adjudication.reason | example | AdjudicationReasonCodeshttp://hl7.org/fhir/ValueSet/adjudication-reason from the FHIR Standard | ||||
ClaimResponse.total.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.fundsReserve | example | Funds Reservation Codeshttp://hl7.org/fhir/ValueSet/fundsreserve from the FHIR Standard | ||||
ClaimResponse.processNote.type | required | NoteTypehttp://hl7.org/fhir/ValueSet/note-type|4.0.1 from the FHIR Standard | ||||
ClaimResponse.processNote.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languages from the FHIR Standard | ||||
ClaimResponse.error.code | example | Adjudication Error Codeshttp://hl7.org/fhir/ValueSet/adjudication-error from the FHIR Standard |
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | ClaimResponse | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | ClaimResponse | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
dom-4 | error | ClaimResponse | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
dom-5 | error | ClaimResponse | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | ClaimResponse | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
Name | Flags | Card. | Type | Description & Constraints![]() | ||||
---|---|---|---|---|---|---|---|---|
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0..* | ClaimResponse | Response to a claim predetermination or preauthorization | |||||
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Σ | 1..1 | id | Unique string for reference purposes | ||||
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Σ | 1..1 | Meta | Metadata about a resource | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
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Σ | 0..1 | id | Version specific identifier | ||||
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Σ | 0..1 | instant | When the resource version last changed | ||||
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Σ | 0..1 | uri | Identifies where the resource comes from | ||||
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Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | ||||
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Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | ||||
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Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | ||||
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?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
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0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
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0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
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0..* | Resource | Contained, inline Resources | |||||
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0..* | Extension | Optional Extensions Element Slice: Unordered, Open by value:url | |||||
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0..1 | CodeableConcept | Extension for Diagnosis Related Group URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/diagnosis-related-group | |||||
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0..1 | CodeableConcept | ReissueReason URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/reissue-reason | |||||
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0..1 | CodeableConcept | AdjudicationOutcome URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/adjudication-outcome | |||||
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0..1 | string | TransferAuthorizationNumber URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-number | |||||
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0..1 | Period | TransferAuthorizationPeriod URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-period | |||||
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0..1 | Reference(SHAPractitioner | SHAOrganization) | TransferAuthorizationProvider URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-provider | |||||
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?! | 0..* | Extension | Extensions that cannot be ignored | ||||
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1..1 | Identifier | A unique identifier assigned to this claim response. | |||||
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?!Σ | 1..1 | code | The status of the resource instance. Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
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Σ | 1..1 | CodeableConcept | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. | ||||
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0..1 | CodeableConcept | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode. | |||||
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Σ | 1..1 | code | A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future. Binding: Use (required): Claim, preauthorization, predetermination. | ||||
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Σ | 1..1 | Reference(Patient) | The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought. | ||||
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Σ | 1..1 | dateTime | The date this resource was created. | ||||
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Σ | 1..1 | Reference(Organization) | The party responsible for authorization, adjudication and reimbursement. | ||||
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1..1 | Reference(Practitioner | PractitionerRole | Organization) | The provider which is responsible for the claim, predetermination or preauthorization. | |||||
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Σ | 1..1 | Reference(Claim) | Original request resource reference. | ||||
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Σ | 1..1 | code | The outcome of the claim, predetermination, or preauthorization processing. Binding: ClaimProcessingCodes (required): The result of the claim processing. | ||||
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0..1 | string | A human readable description of the status of the adjudication. | |||||
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0..1 | string | Reference from the Insurer which is used in later communications which refers to this adjudication. | |||||
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0..1 | Period | The time frame during which this authorization is effective. | |||||
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0..1 | CodeableConcept | Type of Party to be reimbursed: subscriber, provider, other. Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed. | |||||
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0..* | BackboneElement | A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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0..1 | CodeableConcept | AdjudicationOutcome URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/adjudication-outcome | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | positiveInt | A number to uniquely reference the claim detail entry. | |||||
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0..* | positiveInt | The numbers associated with notes below which apply to the adjudication of this item. | |||||
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1..* | BackboneElement | If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | CodeableConcept | If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | |||||
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0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
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0..1 | Money | Monetary amount associated with the category. | |||||
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0..1 | decimal | Non-monetary value | |||||
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0..* | BackboneElement | A claim detail. Either a simple (a product or service) or a 'group' of sub-details which are simple items. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | positiveInt | A number to uniquely reference the claim detail entry. | |||||
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0..* | positiveInt | Applicable note numbers | |||||
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1..* | BackboneElement | The adjudication results. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | |||||
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0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
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0..1 | Money | Monetary amount associated with the category. | |||||
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0..1 | decimal | Non-monetary value | |||||
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0..* | BackboneElement | A sub-detail adjudication of a simple product or service. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | positiveInt | A number to uniquely reference the claim sub-detail entry. | |||||
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0..* | positiveInt | The numbers associated with notes below which apply to the adjudication of this item. | |||||
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1..* | BackboneElement | The adjudication results. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | |||||
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0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
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0..1 | Money | Monetary amount associated with the category. | |||||
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0..1 | decimal | Non-monetary value | |||||
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0..* | BackboneElement | Insurer added line items | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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0..* | positiveInt | Item sequence number | |||||
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0..* | positiveInt | Detail sequence number | |||||
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0..* | positiveInt | Subdetail sequence number | |||||
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0..* | Reference(Practitioner | PractitionerRole | Organization) | Authorized providers | |||||
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1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||||
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0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||
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0..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | |||||
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0..1 | Date or dates of service or product delivery | ||||||
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date | |||||||
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Period | |||||||
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0..1 | Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc. | ||||||
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CodeableConcept | |||||||
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Address | |||||||
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Reference(Location) | |||||||
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0..1 | SimpleQuantity | Count of products or services | |||||
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0..1 | Money | Fee, charge or cost per item | |||||
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0..1 | decimal | Price scaling factor | |||||
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0..1 | Money | Total item cost | |||||
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0..1 | CodeableConcept | Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch. | |||||
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0..* | CodeableConcept | Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations. | |||||
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0..* | positiveInt | Applicable note numbers | |||||
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1..* | See adjudication (ClaimResponse) | Added items adjudication | |||||
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0..* | BackboneElement | Insurer added line details | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||||
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0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||
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0..1 | SimpleQuantity | Count of products or services | |||||
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0..1 | Money | Fee, charge or cost per item | |||||
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0..1 | decimal | Price scaling factor | |||||
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0..1 | Money | Total item cost | |||||
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0..* | positiveInt | Applicable note numbers | |||||
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1..* | See adjudication (ClaimResponse) | Added items detail adjudication | |||||
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0..* | BackboneElement | Insurer added line items | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||||
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0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||
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0..1 | SimpleQuantity | Count of products or services | |||||
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0..1 | Money | Fee, charge or cost per item | |||||
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0..1 | decimal | Price scaling factor | |||||
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0..1 | Money | Total item cost | |||||
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0..* | positiveInt | Applicable note numbers | |||||
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1..* | See adjudication (ClaimResponse) | Added items detail adjudication | |||||
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0..* | See adjudication (ClaimResponse) | Header-level adjudication | |||||
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Σ | 0..* | BackboneElement | Categorized monetary totals for the adjudication. | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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Σ | 1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | ||||
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Σ | 1..1 | Money | Monetary total amount associated with the category. | ||||
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0..1 | BackboneElement | Payment Details | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | CodeableConcept | Partial or complete payment Binding: ExamplePaymentTypeCodes (example): The type (partial, complete) of the payment. | |||||
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0..1 | Money | Payment adjustment for non-claim issues | |||||
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0..1 | CodeableConcept | Explanation for the adjustment Binding: PaymentAdjustmentReasonCodes (example): Payment Adjustment reason codes. | |||||
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0..1 | date | Expected date of payment | |||||
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1..1 | Money | Payable amount after adjustment | |||||
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0..1 | Identifier | Business identifier for the payment | |||||
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0..1 | CodeableConcept | A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom. Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None). | |||||
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0..1 | CodeableConcept | Printed form identifier Binding: Form Codes (example): The forms codes. | |||||
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0..1 | Attachment | Printed reference or actual form | |||||
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0..* | BackboneElement | A note that describes or explains adjudication results in a human readable form. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | positiveInt | A number to uniquely identify a note entry. | |||||
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1..1 | code | The business purpose of the note text. Binding: NoteType (required): The presentation types of notes. | |||||
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1..1 | string | The explanation or description associated with the processing. | |||||
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0..1 | CodeableConcept | A code to define the language used in the text of the note. Binding: CommonLanguages (preferred): A human language.
| |||||
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0..1 | Reference(CommunicationRequest) | Request for additional supporting or authorizing information. | |||||
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0..* | BackboneElement | Financial instruments for reimbursement for the health care products and services specified on the claim. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | positiveInt | A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order. | |||||
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1..1 | boolean | A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true. | |||||
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1..1 | Reference(Coverage) | Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system. | |||||
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0..1 | string | Additional provider contract number | |||||
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0..1 | Reference(ClaimResponse) | The result of the adjudication of the line items for the Coverage specified. This is used when an insurer is able to not just adjudicate the claim they were sent but also able to detect that they are the processor for the sebsequent claims and can adjudicate them too. | |||||
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0..* | BackboneElement | Errors encountered during the processing of the adjudication. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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0..1 | string | ErrorExtensionExpression URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/error-extension-expression | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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0..1 | positiveInt | The sequence number of the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |||||
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0..1 | positiveInt | The sequence number of the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |||||
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0..1 | positiveInt | The sequence number of the sub-detail within the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |||||
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1..1 | CodeableConcept | An error code, from a specified code system, which details why the claim could not be adjudicated. Binding: Adjudication Error Codes (example): The adjudication error codes. | |||||
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Path | Conformance | ValueSet | URI | |||
ClaimResponse.meta.security | extensible | All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard | ||||
ClaimResponse.meta.tag | example | CommonTagshttp://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard | ||||
ClaimResponse.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languages from the FHIR Standard | ||||
ClaimResponse.status | required | FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard | ||||
ClaimResponse.type | extensible | ClaimTypeCodeshttp://hl7.org/fhir/ValueSet/claim-type from the FHIR Standard | ||||
ClaimResponse.subType | example | ExampleClaimSubTypeCodeshttp://hl7.org/fhir/ValueSet/claim-subtype from the FHIR Standard | ||||
ClaimResponse.use | required | Usehttp://hl7.org/fhir/ValueSet/claim-use|4.0.1 from the FHIR Standard | ||||
ClaimResponse.outcome | required | ClaimProcessingCodeshttp://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1 from the FHIR Standard | ||||
ClaimResponse.payeeType | example | Claim Payee Type Codeshttp://hl7.org/fhir/ValueSet/payeetype from the FHIR Standard | ||||
ClaimResponse.item.adjudication.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.item.adjudication.reason | example | AdjudicationReasonCodeshttp://hl7.org/fhir/ValueSet/adjudication-reason from the FHIR Standard | ||||
ClaimResponse.item.detail.adjudication.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.item.detail.adjudication.reason | example | AdjudicationReasonCodeshttp://hl7.org/fhir/ValueSet/adjudication-reason from the FHIR Standard | ||||
ClaimResponse.item.detail.subDetail.adjudication.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.item.detail.subDetail.adjudication.reason | example | AdjudicationReasonCodeshttp://hl7.org/fhir/ValueSet/adjudication-reason from the FHIR Standard | ||||
ClaimResponse.addItem.productOrService | example | USCLSCodeshttp://hl7.org/fhir/ValueSet/service-uscls from the FHIR Standard | ||||
ClaimResponse.addItem.modifier | example | ModifierTypeCodeshttp://hl7.org/fhir/ValueSet/claim-modifiers from the FHIR Standard | ||||
ClaimResponse.addItem.programCode | example | ExampleProgramReasonCodeshttp://hl7.org/fhir/ValueSet/ex-program-code from the FHIR Standard | ||||
ClaimResponse.addItem.location[x] | example | ExampleServicePlaceCodeshttp://hl7.org/fhir/ValueSet/service-place from the FHIR Standard | ||||
ClaimResponse.addItem.bodySite | example | OralSiteCodeshttp://hl7.org/fhir/ValueSet/tooth from the FHIR Standard | ||||
ClaimResponse.addItem.subSite | example | SurfaceCodeshttp://hl7.org/fhir/ValueSet/surface from the FHIR Standard | ||||
ClaimResponse.addItem.detail.productOrService | example | USCLSCodeshttp://hl7.org/fhir/ValueSet/service-uscls from the FHIR Standard | ||||
ClaimResponse.addItem.detail.modifier | example | ModifierTypeCodeshttp://hl7.org/fhir/ValueSet/claim-modifiers from the FHIR Standard | ||||
ClaimResponse.addItem.detail.subDetail.productOrService | example | USCLSCodeshttp://hl7.org/fhir/ValueSet/service-uscls from the FHIR Standard | ||||
ClaimResponse.addItem.detail.subDetail.modifier | example | ModifierTypeCodeshttp://hl7.org/fhir/ValueSet/claim-modifiers from the FHIR Standard | ||||
ClaimResponse.total.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.payment.type | example | ExamplePaymentTypeCodeshttp://hl7.org/fhir/ValueSet/ex-paymenttype from the FHIR Standard | ||||
ClaimResponse.payment.adjustmentReason | example | PaymentAdjustmentReasonCodeshttp://hl7.org/fhir/ValueSet/payment-adjustment-reason from the FHIR Standard | ||||
ClaimResponse.fundsReserve | example | Funds Reservation Codeshttp://hl7.org/fhir/ValueSet/fundsreserve from the FHIR Standard | ||||
ClaimResponse.formCode | example | Form Codeshttp://hl7.org/fhir/ValueSet/forms from the FHIR Standard | ||||
ClaimResponse.processNote.type | required | NoteTypehttp://hl7.org/fhir/ValueSet/note-type|4.0.1 from the FHIR Standard | ||||
ClaimResponse.processNote.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languages from the FHIR Standard | ||||
ClaimResponse.error.code | example | Adjudication Error Codeshttp://hl7.org/fhir/ValueSet/adjudication-error from the FHIR Standard |
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | ClaimResponse | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | ClaimResponse | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
dom-4 | error | ClaimResponse | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
dom-5 | error | ClaimResponse | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | ClaimResponse | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from ClaimResponse
Summary
Mandatory: 6 elements(3 nested mandatory elements)
Extensions
This structure refers to these extensions:
Differential View
This structure is derived from ClaimResponse
Name | Flags | Card. | Type | Description & Constraints![]() |
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0..* | ClaimResponse | Response to a claim predetermination or preauthorization | |
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1..1 | id | Unique string for reference purposes | |
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1..1 | Meta | Metadata about a resource | |
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1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | |
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0..* | Extension | Optional Extensions Element Slice: Unordered, Open by value:url | |
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0..1 | CodeableConcept | Extension for Diagnosis Related Group URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/diagnosis-related-group | |
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0..1 | CodeableConcept | ReissueReason URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/reissue-reason | |
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0..1 | CodeableConcept | AdjudicationOutcome URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/adjudication-outcome | |
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0..1 | string | TransferAuthorizationNumber URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-number | |
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0..1 | Period | TransferAuthorizationPeriod URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-period | |
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0..1 | Reference(SHAPractitioner | SHAOrganization) | TransferAuthorizationProvider URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-provider | |
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1..1 | Identifier | A unique identifier assigned to this claim response. | |
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1..1 | code | The status of the resource instance. | |
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1..1 | CodeableConcept | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. | |
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0..1 | CodeableConcept | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. | |
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1..1 | code | A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future. | |
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1..1 | Reference(Patient) | The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought. | |
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1..1 | dateTime | The date this resource was created. | |
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1..1 | Reference(Organization) | The party responsible for authorization, adjudication and reimbursement. | |
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1..1 | Reference(Practitioner | PractitionerRole | Organization) | The provider which is responsible for the claim, predetermination or preauthorization. | |
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1..1 | Reference(Claim) | Original request resource reference. | |
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1..1 | code | The outcome of the claim, predetermination, or preauthorization processing. | |
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0..1 | string | A human readable description of the status of the adjudication. | |
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0..1 | string | Reference from the Insurer which is used in later communications which refers to this adjudication. | |
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0..1 | Period | The time frame during which this authorization is effective. | |
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0..1 | CodeableConcept | Type of Party to be reimbursed: subscriber, provider, other. | |
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0..* | BackboneElement | A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details. | |
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |
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0..1 | CodeableConcept | AdjudicationOutcome URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/adjudication-outcome | |
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1..1 | positiveInt | A number to uniquely reference the claim detail entry. | |
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0..* | positiveInt | The numbers associated with notes below which apply to the adjudication of this item. | |
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1..* | BackboneElement | If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item. | |
![]() ![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item. | |
![]() ![]() ![]() ![]() ![]() |
0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. | |
![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Monetary amount associated with the category. | |
![]() ![]() ![]() ![]() |
0..* | BackboneElement | A claim detail. Either a simple (a product or service) or a 'group' of sub-details which are simple items. | |
![]() ![]() ![]() ![]() ![]() |
1..1 | positiveInt | A number to uniquely reference the claim detail entry. | |
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1..* | BackboneElement | The adjudication results. | |
![]() ![]() ![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. | |
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. | |
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Monetary amount associated with the category. | |
![]() ![]() ![]() ![]() ![]() |
0..* | BackboneElement | A sub-detail adjudication of a simple product or service. | |
![]() ![]() ![]() ![]() ![]() ![]() |
1..1 | positiveInt | A number to uniquely reference the claim sub-detail entry. | |
![]() ![]() ![]() ![]() ![]() ![]() |
0..* | positiveInt | The numbers associated with notes below which apply to the adjudication of this item. | |
![]() ![]() ![]() ![]() ![]() ![]() |
1..* | BackboneElement | The adjudication results. | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Monetary amount associated with the category. | |
![]() ![]() ![]() |
0..* | BackboneElement | Categorized monetary totals for the adjudication. | |
![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item. | |
![]() ![]() ![]() ![]() |
1..1 | Money | Monetary total amount associated with the category. | |
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0..1 | CodeableConcept | A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom. | |
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0..* | BackboneElement | A note that describes or explains adjudication results in a human readable form. | |
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1..1 | positiveInt | A number to uniquely identify a note entry. | |
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1..1 | code | The business purpose of the note text. | |
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1..1 | string | The explanation or description associated with the processing. | |
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0..1 | CodeableConcept | A code to define the language used in the text of the note. | |
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0..1 | Reference(CommunicationRequest) | Request for additional supporting or authorizing information. | |
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0..* | BackboneElement | Financial instruments for reimbursement for the health care products and services specified on the claim. | |
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1..1 | positiveInt | A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order. | |
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1..1 | boolean | A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true. | |
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1..1 | Reference(Coverage) | Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system. | |
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0..1 | Reference(ClaimResponse) | The result of the adjudication of the line items for the Coverage specified. This is used when an insurer is able to not just adjudicate the claim they were sent but also able to detect that they are the processor for the sebsequent claims and can adjudicate them too. | |
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0..* | BackboneElement | Errors encountered during the processing of the adjudication. | |
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |
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0..1 | string | ErrorExtensionExpression URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/error-extension-expression | |
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0..1 | positiveInt | The sequence number of the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |
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0..1 | positiveInt | The sequence number of the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |
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0..1 | positiveInt | The sequence number of the sub-detail within the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |
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1..1 | CodeableConcept | An error code, from a specified code system, which details why the claim could not be adjudicated. | |
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Key Elements View
Name | Flags | Card. | Type | Description & Constraints![]() | ||||
---|---|---|---|---|---|---|---|---|
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0..* | ClaimResponse | Response to a claim predetermination or preauthorization | |||||
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Σ | 1..1 | id | Unique string for reference purposes | ||||
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Σ | 1..1 | Meta | Metadata about a resource | ||||
![]() ![]() ![]() ![]() |
Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | ||||
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?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
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0..* | Extension | Optional Extensions Element Slice: Unordered, Open by value:url | |||||
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0..1 | CodeableConcept | Extension for Diagnosis Related Group URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/diagnosis-related-group | |||||
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0..1 | CodeableConcept | ReissueReason URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/reissue-reason | |||||
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0..1 | CodeableConcept | AdjudicationOutcome URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/adjudication-outcome | |||||
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0..1 | string | TransferAuthorizationNumber URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-number | |||||
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0..1 | Period | TransferAuthorizationPeriod URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-period | |||||
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0..1 | Reference(SHAPractitioner | SHAOrganization) | TransferAuthorizationProvider URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-provider | |||||
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?! | 0..* | Extension | Extensions that cannot be ignored | ||||
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1..1 | Identifier | A unique identifier assigned to this claim response. | |||||
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?!Σ | 1..1 | code | The status of the resource instance. Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
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Σ | 1..1 | CodeableConcept | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. | ||||
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0..1 | CodeableConcept | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode. | |||||
![]() ![]() ![]() |
Σ | 1..1 | code | A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future. Binding: Use (required): Claim, preauthorization, predetermination. | ||||
![]() ![]() ![]() |
Σ | 1..1 | Reference(Patient) | The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought. | ||||
![]() ![]() ![]() |
Σ | 1..1 | dateTime | The date this resource was created. | ||||
![]() ![]() ![]() |
Σ | 1..1 | Reference(Organization) | The party responsible for authorization, adjudication and reimbursement. | ||||
![]() ![]() ![]() |
1..1 | Reference(Practitioner | PractitionerRole | Organization) | The provider which is responsible for the claim, predetermination or preauthorization. | |||||
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Σ | 1..1 | Reference(Claim) | Original request resource reference. | ||||
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Σ | 1..1 | code | The outcome of the claim, predetermination, or preauthorization processing. Binding: ClaimProcessingCodes (required): The result of the claim processing. | ||||
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0..1 | string | A human readable description of the status of the adjudication. | |||||
![]() ![]() ![]() |
0..1 | string | Reference from the Insurer which is used in later communications which refers to this adjudication. | |||||
![]() ![]() ![]() |
0..1 | Period | The time frame during which this authorization is effective. | |||||
![]() ![]() ![]() |
0..1 | CodeableConcept | Type of Party to be reimbursed: subscriber, provider, other. Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed. | |||||
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0..* | BackboneElement | A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details. | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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0..1 | CodeableConcept | AdjudicationOutcome URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/adjudication-outcome | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | positiveInt | A number to uniquely reference the claim detail entry. | |||||
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0..* | positiveInt | The numbers associated with notes below which apply to the adjudication of this item. | |||||
![]() ![]() ![]() ![]() |
1..* | BackboneElement | If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item. | |||||
![]() ![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Monetary amount associated with the category. | |||||
![]() ![]() ![]() ![]() |
0..* | BackboneElement | A claim detail. Either a simple (a product or service) or a 'group' of sub-details which are simple items. | |||||
![]() ![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() |
1..1 | positiveInt | A number to uniquely reference the claim detail entry. | |||||
![]() ![]() ![]() ![]() ![]() |
1..* | BackboneElement | The adjudication results. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Monetary amount associated with the category. | |||||
![]() ![]() ![]() ![]() ![]() |
0..* | BackboneElement | A sub-detail adjudication of a simple product or service. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() ![]() |
1..1 | positiveInt | A number to uniquely reference the claim sub-detail entry. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..* | positiveInt | The numbers associated with notes below which apply to the adjudication of this item. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
1..* | BackboneElement | The adjudication results. | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Monetary amount associated with the category. | |||||
![]() ![]() ![]() |
Σ | 0..* | BackboneElement | Categorized monetary totals for the adjudication. | ||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
Σ | 1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | ||||
![]() ![]() ![]() ![]() |
Σ | 1..1 | Money | Monetary total amount associated with the category. | ||||
![]() ![]() ![]() |
0..1 | CodeableConcept | A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom. Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None). | |||||
![]() ![]() ![]() |
0..* | BackboneElement | A note that describes or explains adjudication results in a human readable form. | |||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
1..1 | positiveInt | A number to uniquely identify a note entry. | |||||
![]() ![]() ![]() ![]() |
1..1 | code | The business purpose of the note text. Binding: NoteType (required): The presentation types of notes. | |||||
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1..1 | string | The explanation or description associated with the processing. | |||||
![]() ![]() ![]() ![]() |
0..1 | CodeableConcept | A code to define the language used in the text of the note. Binding: CommonLanguages (preferred): A human language.
| |||||
![]() ![]() ![]() |
0..1 | Reference(CommunicationRequest) | Request for additional supporting or authorizing information. | |||||
![]() ![]() ![]() |
0..* | BackboneElement | Financial instruments for reimbursement for the health care products and services specified on the claim. | |||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
1..1 | positiveInt | A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order. | |||||
![]() ![]() ![]() ![]() |
1..1 | boolean | A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true. | |||||
![]() ![]() ![]() ![]() |
1..1 | Reference(Coverage) | Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system. | |||||
![]() ![]() ![]() ![]() |
0..1 | Reference(ClaimResponse) | The result of the adjudication of the line items for the Coverage specified. This is used when an insurer is able to not just adjudicate the claim they were sent but also able to detect that they are the processor for the sebsequent claims and can adjudicate them too. | |||||
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0..* | BackboneElement | Errors encountered during the processing of the adjudication. | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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0..1 | string | ErrorExtensionExpression URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/error-extension-expression | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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0..1 | positiveInt | The sequence number of the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |||||
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0..1 | positiveInt | The sequence number of the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |||||
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0..1 | positiveInt | The sequence number of the sub-detail within the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |||||
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1..1 | CodeableConcept | An error code, from a specified code system, which details why the claim could not be adjudicated. Binding: Adjudication Error Codes (example): The adjudication error codes. | |||||
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Path | Conformance | ValueSet | URI | |||
ClaimResponse.status | required | FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard | ||||
ClaimResponse.type | extensible | ClaimTypeCodeshttp://hl7.org/fhir/ValueSet/claim-type from the FHIR Standard | ||||
ClaimResponse.subType | example | ExampleClaimSubTypeCodeshttp://hl7.org/fhir/ValueSet/claim-subtype from the FHIR Standard | ||||
ClaimResponse.use | required | Usehttp://hl7.org/fhir/ValueSet/claim-use|4.0.1 from the FHIR Standard | ||||
ClaimResponse.outcome | required | ClaimProcessingCodeshttp://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1 from the FHIR Standard | ||||
ClaimResponse.payeeType | example | Claim Payee Type Codeshttp://hl7.org/fhir/ValueSet/payeetype from the FHIR Standard | ||||
ClaimResponse.item.adjudication.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.item.adjudication.reason | example | AdjudicationReasonCodeshttp://hl7.org/fhir/ValueSet/adjudication-reason from the FHIR Standard | ||||
ClaimResponse.item.detail.adjudication.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.item.detail.adjudication.reason | example | AdjudicationReasonCodeshttp://hl7.org/fhir/ValueSet/adjudication-reason from the FHIR Standard | ||||
ClaimResponse.item.detail.subDetail.adjudication.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.item.detail.subDetail.adjudication.reason | example | AdjudicationReasonCodeshttp://hl7.org/fhir/ValueSet/adjudication-reason from the FHIR Standard | ||||
ClaimResponse.total.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.fundsReserve | example | Funds Reservation Codeshttp://hl7.org/fhir/ValueSet/fundsreserve from the FHIR Standard | ||||
ClaimResponse.processNote.type | required | NoteTypehttp://hl7.org/fhir/ValueSet/note-type|4.0.1 from the FHIR Standard | ||||
ClaimResponse.processNote.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languages from the FHIR Standard | ||||
ClaimResponse.error.code | example | Adjudication Error Codeshttp://hl7.org/fhir/ValueSet/adjudication-error from the FHIR Standard |
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | ClaimResponse | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | ClaimResponse | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
dom-4 | error | ClaimResponse | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
dom-5 | error | ClaimResponse | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | ClaimResponse | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints![]() | ||||
---|---|---|---|---|---|---|---|---|
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0..* | ClaimResponse | Response to a claim predetermination or preauthorization | |||||
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Σ | 1..1 | id | Unique string for reference purposes | ||||
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Σ | 1..1 | Meta | Metadata about a resource | ||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
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Σ | 0..1 | id | Version specific identifier | ||||
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Σ | 0..1 | instant | When the resource version last changed | ||||
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Σ | 0..1 | uri | Identifies where the resource comes from | ||||
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Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | ||||
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Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | ||||
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Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | ||||
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?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
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0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
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0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
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0..* | Resource | Contained, inline Resources | |||||
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0..* | Extension | Optional Extensions Element Slice: Unordered, Open by value:url | |||||
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0..1 | CodeableConcept | Extension for Diagnosis Related Group URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/diagnosis-related-group | |||||
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0..1 | CodeableConcept | ReissueReason URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/reissue-reason | |||||
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0..1 | CodeableConcept | AdjudicationOutcome URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/adjudication-outcome | |||||
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0..1 | string | TransferAuthorizationNumber URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-number | |||||
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0..1 | Period | TransferAuthorizationPeriod URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-period | |||||
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0..1 | Reference(SHAPractitioner | SHAOrganization) | TransferAuthorizationProvider URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/transfer-authorization-provider | |||||
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?! | 0..* | Extension | Extensions that cannot be ignored | ||||
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1..1 | Identifier | A unique identifier assigned to this claim response. | |||||
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?!Σ | 1..1 | code | The status of the resource instance. Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
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Σ | 1..1 | CodeableConcept | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. | ||||
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0..1 | CodeableConcept | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode. | |||||
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Σ | 1..1 | code | A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future. Binding: Use (required): Claim, preauthorization, predetermination. | ||||
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Σ | 1..1 | Reference(Patient) | The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought. | ||||
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Σ | 1..1 | dateTime | The date this resource was created. | ||||
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Σ | 1..1 | Reference(Organization) | The party responsible for authorization, adjudication and reimbursement. | ||||
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1..1 | Reference(Practitioner | PractitionerRole | Organization) | The provider which is responsible for the claim, predetermination or preauthorization. | |||||
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Σ | 1..1 | Reference(Claim) | Original request resource reference. | ||||
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Σ | 1..1 | code | The outcome of the claim, predetermination, or preauthorization processing. Binding: ClaimProcessingCodes (required): The result of the claim processing. | ||||
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0..1 | string | A human readable description of the status of the adjudication. | |||||
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0..1 | string | Reference from the Insurer which is used in later communications which refers to this adjudication. | |||||
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0..1 | Period | The time frame during which this authorization is effective. | |||||
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0..1 | CodeableConcept | Type of Party to be reimbursed: subscriber, provider, other. Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed. | |||||
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0..* | BackboneElement | A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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0..1 | CodeableConcept | AdjudicationOutcome URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/adjudication-outcome | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | positiveInt | A number to uniquely reference the claim detail entry. | |||||
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0..* | positiveInt | The numbers associated with notes below which apply to the adjudication of this item. | |||||
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1..* | BackboneElement | If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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1..1 | CodeableConcept | If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | |||||
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0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
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0..1 | Money | Monetary amount associated with the category. | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | decimal | Non-monetary value | |||||
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0..* | BackboneElement | A claim detail. Either a simple (a product or service) or a 'group' of sub-details which are simple items. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() |
1..1 | positiveInt | A number to uniquely reference the claim detail entry. | |||||
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0..* | positiveInt | Applicable note numbers | |||||
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1..* | BackboneElement | The adjudication results. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | |||||
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0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Monetary amount associated with the category. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | decimal | Non-monetary value | |||||
![]() ![]() ![]() ![]() ![]() |
0..* | BackboneElement | A sub-detail adjudication of a simple product or service. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() ![]() |
1..1 | positiveInt | A number to uniquely reference the claim sub-detail entry. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..* | positiveInt | The numbers associated with notes below which apply to the adjudication of this item. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
1..* | BackboneElement | The adjudication results. | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | CodeableConcept | A code supporting the understanding of the adjudication result and explaining variance from expected amount. Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Monetary amount associated with the category. | |||||
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0..1 | decimal | Non-monetary value | |||||
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0..* | BackboneElement | Insurer added line items | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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0..* | positiveInt | Item sequence number | |||||
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0..* | positiveInt | Detail sequence number | |||||
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0..* | positiveInt | Subdetail sequence number | |||||
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0..* | Reference(Practitioner | PractitionerRole | Organization) | Authorized providers | |||||
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1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||||
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0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||
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0..* | CodeableConcept | Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes. | |||||
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0..1 | Date or dates of service or product delivery | ||||||
![]() ![]() ![]() ![]() ![]() |
date | |||||||
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Period | |||||||
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0..1 | Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc. | ||||||
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CodeableConcept | |||||||
![]() ![]() ![]() ![]() ![]() |
Address | |||||||
![]() ![]() ![]() ![]() ![]() |
Reference(Location) | |||||||
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0..1 | SimpleQuantity | Count of products or services | |||||
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0..1 | Money | Fee, charge or cost per item | |||||
![]() ![]() ![]() ![]() |
0..1 | decimal | Price scaling factor | |||||
![]() ![]() ![]() ![]() |
0..1 | Money | Total item cost | |||||
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0..1 | CodeableConcept | Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch. | |||||
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0..* | CodeableConcept | Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations. | |||||
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0..* | positiveInt | Applicable note numbers | |||||
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1..* | See adjudication (ClaimResponse) | Added items adjudication | |||||
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0..* | BackboneElement | Insurer added line details | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||||
![]() ![]() ![]() ![]() ![]() |
0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | SimpleQuantity | Count of products or services | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Fee, charge or cost per item | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | decimal | Price scaling factor | |||||
![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Total item cost | |||||
![]() ![]() ![]() ![]() ![]() |
0..* | positiveInt | Applicable note numbers | |||||
![]() ![]() ![]() ![]() ![]() |
1..* | See adjudication (ClaimResponse) | Added items detail adjudication | |||||
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0..* | BackboneElement | Insurer added line items | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..* | CodeableConcept | Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | SimpleQuantity | Count of products or services | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Fee, charge or cost per item | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | decimal | Price scaling factor | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..1 | Money | Total item cost | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
0..* | positiveInt | Applicable note numbers | |||||
![]() ![]() ![]() ![]() ![]() ![]() |
1..* | See adjudication (ClaimResponse) | Added items detail adjudication | |||||
![]() ![]() ![]() |
0..* | See adjudication (ClaimResponse) | Header-level adjudication | |||||
![]() ![]() ![]() |
Σ | 0..* | BackboneElement | Categorized monetary totals for the adjudication. | ||||
![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
Σ | 1..1 | CodeableConcept | A code to indicate the information type of this adjudication record. Information types may include: the value submitted, maximum values or percentages allowed or payable under the plan, amounts that the patient is responsible for in aggregate or pertaining to this item, amounts paid by other coverages, and the benefit payable for this item. Binding: AdjudicationValueCodes (example): The adjudication codes. | ||||
![]() ![]() ![]() ![]() |
Σ | 1..1 | Money | Monetary total amount associated with the category. | ||||
![]() ![]() ![]() |
0..1 | BackboneElement | Payment Details | |||||
![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
1..1 | CodeableConcept | Partial or complete payment Binding: ExamplePaymentTypeCodes (example): The type (partial, complete) of the payment. | |||||
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0..1 | Money | Payment adjustment for non-claim issues | |||||
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0..1 | CodeableConcept | Explanation for the adjustment Binding: PaymentAdjustmentReasonCodes (example): Payment Adjustment reason codes. | |||||
![]() ![]() ![]() ![]() |
0..1 | date | Expected date of payment | |||||
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1..1 | Money | Payable amount after adjustment | |||||
![]() ![]() ![]() ![]() |
0..1 | Identifier | Business identifier for the payment | |||||
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0..1 | CodeableConcept | A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom. Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None). | |||||
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0..1 | CodeableConcept | Printed form identifier Binding: Form Codes (example): The forms codes. | |||||
![]() ![]() ![]() |
0..1 | Attachment | Printed reference or actual form | |||||
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0..* | BackboneElement | A note that describes or explains adjudication results in a human readable form. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
1..1 | positiveInt | A number to uniquely identify a note entry. | |||||
![]() ![]() ![]() ![]() |
1..1 | code | The business purpose of the note text. Binding: NoteType (required): The presentation types of notes. | |||||
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1..1 | string | The explanation or description associated with the processing. | |||||
![]() ![]() ![]() ![]() |
0..1 | CodeableConcept | A code to define the language used in the text of the note. Binding: CommonLanguages (preferred): A human language.
| |||||
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0..1 | Reference(CommunicationRequest) | Request for additional supporting or authorizing information. | |||||
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0..* | BackboneElement | Financial instruments for reimbursement for the health care products and services specified on the claim. | |||||
![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() |
1..1 | positiveInt | A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order. | |||||
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1..1 | boolean | A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true. | |||||
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1..1 | Reference(Coverage) | Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system. | |||||
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0..1 | string | Additional provider contract number | |||||
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0..1 | Reference(ClaimResponse) | The result of the adjudication of the line items for the Coverage specified. This is used when an insurer is able to not just adjudicate the claim they were sent but also able to detect that they are the processor for the sebsequent claims and can adjudicate them too. | |||||
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0..* | BackboneElement | Errors encountered during the processing of the adjudication. | |||||
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0..1 | string | Unique id for inter-element referencing | |||||
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0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
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0..1 | string | ErrorExtensionExpression URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/error-extension-expression | |||||
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?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
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0..1 | positiveInt | The sequence number of the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |||||
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0..1 | positiveInt | The sequence number of the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |||||
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0..1 | positiveInt | The sequence number of the sub-detail within the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure. | |||||
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1..1 | CodeableConcept | An error code, from a specified code system, which details why the claim could not be adjudicated. Binding: Adjudication Error Codes (example): The adjudication error codes. | |||||
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Path | Conformance | ValueSet | URI | |||
ClaimResponse.meta.security | extensible | All Security Labelshttp://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard | ||||
ClaimResponse.meta.tag | example | CommonTagshttp://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard | ||||
ClaimResponse.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languages from the FHIR Standard | ||||
ClaimResponse.status | required | FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard | ||||
ClaimResponse.type | extensible | ClaimTypeCodeshttp://hl7.org/fhir/ValueSet/claim-type from the FHIR Standard | ||||
ClaimResponse.subType | example | ExampleClaimSubTypeCodeshttp://hl7.org/fhir/ValueSet/claim-subtype from the FHIR Standard | ||||
ClaimResponse.use | required | Usehttp://hl7.org/fhir/ValueSet/claim-use|4.0.1 from the FHIR Standard | ||||
ClaimResponse.outcome | required | ClaimProcessingCodeshttp://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1 from the FHIR Standard | ||||
ClaimResponse.payeeType | example | Claim Payee Type Codeshttp://hl7.org/fhir/ValueSet/payeetype from the FHIR Standard | ||||
ClaimResponse.item.adjudication.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.item.adjudication.reason | example | AdjudicationReasonCodeshttp://hl7.org/fhir/ValueSet/adjudication-reason from the FHIR Standard | ||||
ClaimResponse.item.detail.adjudication.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.item.detail.adjudication.reason | example | AdjudicationReasonCodeshttp://hl7.org/fhir/ValueSet/adjudication-reason from the FHIR Standard | ||||
ClaimResponse.item.detail.subDetail.adjudication.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.item.detail.subDetail.adjudication.reason | example | AdjudicationReasonCodeshttp://hl7.org/fhir/ValueSet/adjudication-reason from the FHIR Standard | ||||
ClaimResponse.addItem.productOrService | example | USCLSCodeshttp://hl7.org/fhir/ValueSet/service-uscls from the FHIR Standard | ||||
ClaimResponse.addItem.modifier | example | ModifierTypeCodeshttp://hl7.org/fhir/ValueSet/claim-modifiers from the FHIR Standard | ||||
ClaimResponse.addItem.programCode | example | ExampleProgramReasonCodeshttp://hl7.org/fhir/ValueSet/ex-program-code from the FHIR Standard | ||||
ClaimResponse.addItem.location[x] | example | ExampleServicePlaceCodeshttp://hl7.org/fhir/ValueSet/service-place from the FHIR Standard | ||||
ClaimResponse.addItem.bodySite | example | OralSiteCodeshttp://hl7.org/fhir/ValueSet/tooth from the FHIR Standard | ||||
ClaimResponse.addItem.subSite | example | SurfaceCodeshttp://hl7.org/fhir/ValueSet/surface from the FHIR Standard | ||||
ClaimResponse.addItem.detail.productOrService | example | USCLSCodeshttp://hl7.org/fhir/ValueSet/service-uscls from the FHIR Standard | ||||
ClaimResponse.addItem.detail.modifier | example | ModifierTypeCodeshttp://hl7.org/fhir/ValueSet/claim-modifiers from the FHIR Standard | ||||
ClaimResponse.addItem.detail.subDetail.productOrService | example | USCLSCodeshttp://hl7.org/fhir/ValueSet/service-uscls from the FHIR Standard | ||||
ClaimResponse.addItem.detail.subDetail.modifier | example | ModifierTypeCodeshttp://hl7.org/fhir/ValueSet/claim-modifiers from the FHIR Standard | ||||
ClaimResponse.total.category | example | AdjudicationValueCodeshttp://hl7.org/fhir/ValueSet/adjudication from the FHIR Standard | ||||
ClaimResponse.payment.type | example | ExamplePaymentTypeCodeshttp://hl7.org/fhir/ValueSet/ex-paymenttype from the FHIR Standard | ||||
ClaimResponse.payment.adjustmentReason | example | PaymentAdjustmentReasonCodeshttp://hl7.org/fhir/ValueSet/payment-adjustment-reason from the FHIR Standard | ||||
ClaimResponse.fundsReserve | example | Funds Reservation Codeshttp://hl7.org/fhir/ValueSet/fundsreserve from the FHIR Standard | ||||
ClaimResponse.formCode | example | Form Codeshttp://hl7.org/fhir/ValueSet/forms from the FHIR Standard | ||||
ClaimResponse.processNote.type | required | NoteTypehttp://hl7.org/fhir/ValueSet/note-type|4.0.1 from the FHIR Standard | ||||
ClaimResponse.processNote.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languages from the FHIR Standard | ||||
ClaimResponse.error.code | example | Adjudication Error Codeshttp://hl7.org/fhir/ValueSet/adjudication-error from the FHIR Standard |
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | ClaimResponse | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | ClaimResponse | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
dom-4 | error | ClaimResponse | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
dom-5 | error | ClaimResponse | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | ClaimResponse | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from ClaimResponse
Summary
Mandatory: 6 elements(3 nested mandatory elements)
Extensions
This structure refers to these extensions:
Other representations of profile: CSV, Excel, Schematron
IG © 2024+ intellisoftkenya. Package fhir.kenyaClaimsIG#0.1.0 based on FHIR 4.0.1. Generated 2024-09-06
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