FHIR Release 3 (STU) R4 Ballot #1 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.0.2: STU 3). (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

13.7.6 Resource ClaimResponse - Mappings

Financial Management Work Group Maturity Level : N/A Ballot Status : Informative Compartments : Patient , Practitioner

Mappings:

RIM Mapping FiveWs Pattern

Canadian Dental Association eclaims standard Workflow Pattern

Workflow RIM Mapping

Mappings for the claimresponse resource. resource (see Mappings to Other Standards for further information & status).

13.7.6.1 Mappings for RIM Mapping (http://hl7.org/v3) ClaimResponse     identifier     status     patient     created     insurer     requestProvider     requestOrganization     request     outcome     disposition     payeeType     item         sequenceLinkId         noteNumber         adjudication             category             reason             amount             value         detail             sequenceLinkId             noteNumber             adjudication             subDetail                 sequenceLinkId                 noteNumber                 adjudication     addItem         sequenceLinkId         revenue         category         service         modifier 24.C, 24.D mods         fee         noteNumber         adjudication         detail             revenue             category             service             modifier 24.C, 24.D mods             fee             noteNumber             adjudication     error         sequenceLinkId         detailSequenceLinkId         subdetailSequenceLinkId         code     totalCost     unallocDeductable     totalBenefit     payment         type         adjustment         adjustmentReason         date         amount         identifier     reserved     form     processNote         number         type         text         language     communicationRequest     insurance Coverage         sequence         focal         coverage         businessArrangement         preAuthRef         claimResponse FiveWs Pattern (http://hl7.org/fhir/fivews) 13.7.6.2 Mappings for Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/)

    identifier     status     patient     created     insurer     requestProvider B01     requestOrganization     request A02|G01     outcome     disposition     payeeType     item         sequenceLinkId F07         noteNumber         adjudication             category             reason             amount             value         detail             sequenceLinkId F07             noteNumber             adjudication             subDetail                 sequenceLinkId F07                 noteNumber                 adjudication     addItem         sequenceLinkId         revenue         category         service         modifier         fee         noteNumber         adjudication         detail             revenue             category             service             modifier             fee             noteNumber             adjudication     error         sequenceLinkId         detailSequenceLinkId         subdetailSequenceLinkId         code     totalCost     unallocDeductable     totalBenefit     payment
ClaimResponse         type         adjustment         adjustmentReason
        date         amount         identifier     identifier     reserved FiveWs.identifier
    form G42     status     processNote FiveWs.status
        number     type         type FiveWs.class
        text     subType G32 FiveWs.class
        language     use     communicationRequest     insurance FiveWs.class
        sequence     patient         focal FiveWs.subject[x]
        coverage     created         businessArrangement FiveWs.recorded
        preAuthRef     requestProvider F03 FiveWs.source
        claimResponse     request EOB FiveWs.why[x]

13.7.6.3 13.7.6.2 Mappings for Workflow Mapping Pattern (http://hl7.org/fhir/workflow)

    payeeType     item         sequenceLinkId         noteNumber         adjudication             category             reason             amount             value         detail             sequenceLinkId             noteNumber             adjudication
ClaimResponse Event
    identifier Event.identifier
    status Event.status
    patient     created Event.occurrence Event.occurrence[x]
    insurer Event.performer.onBehalfOf     requestProvider     requestOrganization Event.performer
    request Event.basedOn
    outcome     disposition Event.note
            subDetail

13.7.6.3 Mappings for RIM Mapping (http://hl7.org/v3)                 sequenceLinkId                 noteNumber

        service
                adjudication     addItem ClaimResponse         sequenceLinkId         revenue         category
        modifier         fee         noteNumber         adjudication         detail             revenue             category             service             modifier             fee             noteNumber             adjudication     error         sequenceLinkId         detailSequenceLinkId         subdetailSequenceLinkId         code     totalCost     unallocDeductable     totalBenefit     payment         type         adjustment         adjustmentReason         date         amount         identifier     reserved     form     processNote         number         type         text         language     communicationRequest 24.C, 24.D mods
    insurance         sequence         focal         coverage         businessArrangement         preAuthRef         claimResponse Coverage