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13.6.6 Resource ExplanationOfBenefit - Mappings

Mappings for the explanationofbenefit resource.

13.6.6.1 Mappings for HL7 v2 Mapping (http://hl7.org/v2)

ExplanationOfBenefit
identifier
status
type
subType
patient
billablePeriod
created
enterer
insurer
provider
organization
referral
facility
claim
claimResponse
outcome
disposition
related
claim
relationship
reference
prescription
originalPrescription
payee
type
resourceType
party[x]
information
category
code
timing[x]
value[x]
reason
careTeam
sequence
provider
responsible
role
qualification
diagnosis
sequence
diagnosis[x]
type
packageCode
procedure
sequence
date
procedure[x]
precedence
insurance	Coverage
coverage
preAuthRef
accident
date
type
location[x]
employmentImpacted
hospitalization
item
sequence
careTeamLinkId
diagnosisLinkId
procedureLinkId
informationLinkId
revenue
category
service
modifier
programCode
serviced[x]
location[x]
quantity
unitPrice
factor
net
udi
bodySite
subSite
noteNumber
adjudication
category
reason
amount
value
detail
sequence
type
revenue
category
service
modifier
programCode
quantity
unitPrice
factor
net
udi
noteNumber
adjudication
subDetail
sequence
type
revenue
category
service
modifier
programCode
quantity
unitPrice
factor
net
udi
noteNumber
adjudication
prosthesis
initial
priorDate
priorMaterial
addItem
sequenceLinkId
revenue
category
service
modifier
fee
noteNumber
adjudication
detail
revenue
category
service
modifier
fee
noteNumber
adjudication
totalCost
unallocDeductable
totalBenefit
payment
type
adjustment
adjustmentReason
date
amount
identifier
form
note
number
type
text
language
benefitBalance
category
subCategory
excluded
name
description
network
unit
term
financial
type
benefit[x]
benefitUsed[x]

13.6.6.2 Mappings for Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/)

ExplanationOfBenefit
identifier
status
type
subType
patient	C06,C07,C08, C05, C04
billablePeriod
created
enterer
insurer	B02
provider	B02
organization	B02
referral	B05
facility
claim	A02|G01
claimResponse	A02|G01
outcome
disposition
related
claim
relationship
reference
prescription
originalPrescription
payee	F02
type
resourceType
party[x]	B03, B04
information
category
code	F23
timing[x]	F24
value[x]
reason
careTeam
sequence
provider
responsible
role
qualification
diagnosis
sequence
diagnosis[x]
type
packageCode
procedure
sequence
date
procedure[x]
precedence
insurance
coverage
preAuthRef	F03
accident
date	F02
type
location[x]
employmentImpacted
hospitalization
item
sequence	F07
careTeamLinkId
diagnosisLinkId
procedureLinkId
informationLinkId
revenue
category
service	F06
modifier	F16 (required field for Oral) and F05
programCode
serviced[x]	F09
location[x]
quantity
unitPrice	F12
factor	F13/F14
net	F13/F14
udi
bodySite	F10
subSite	F11
noteNumber
adjudication
category
reason
amount
value
detail
sequence	F07
type
revenue
category
service	F34/F35
modifier	F16 (required field for Oral) and F05
programCode
quantity
unitPrice	F13/F14
factor	F13/F14
net	F13/F14
udi
noteNumber
adjudication
subDetail
sequence	F07
type
revenue
category
service	F34/F35
modifier	F16 (required field for Oral) and F05
programCode
quantity
unitPrice	F13/F14
factor	F13/F14
net	F13/F14
udi
noteNumber
adjudication
prosthesis
initial	F15/F18 Only for Denture, Crown, Bridge
priorDate	F04/F19
priorMaterial	F20/F21
addItem
sequenceLinkId
revenue
category	F06
service
modifier	F16 (required field for Oral) and F05
fee
noteNumber
adjudication
detail
revenue
category	F06
service
modifier	F16 (required field for Oral) and F05
fee
noteNumber
adjudication
totalCost
unallocDeductable
totalBenefit
payment
type
adjustment
adjustmentReason
date
amount
identifier	G01, B.23
form	G42
note
number
type
text	G32
language
benefitBalance
category
subCategory
excluded
name
description
network
unit
term
financial
type
benefit[x]
benefitUsed[x]