Release 4 4B

This page is part of the FHIR Specification (v4.0.1: R4 (v4.3.0: R4B - Mixed Normative and STU ) in it's permanent home (it will always be available at this URL). ). 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 R4B R4

Operation-claim-submit

Financial Management Work Group Maturity Level : N/A Standards Status : Informative Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

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Submit a Claim resource for adjudication

OPERATION: Submit a Claim resource for adjudication

The official URL for this operation definition is: 

http://hl7.org/fhir/OperationDefinition/Claim-submit

This operation is used to submit a Claim, Pre-Authorization or Pre-Determination (all instances of Claim resources) for adjudication either as a single Claim resource instance or as a Bundle containing the Claim and other referenced resources, or Bundle containing a batch of Claim resources, either as single Claims resources or Bundle resources, for processing. The only input parameter is the single Claim or Bundle resource and the only output is a single ClaimResponse, Bundle of ClaimResponses or an OperationOutcome resource.

URL: [base]/Claim/$submit

Parameters

Use Name Cardinality Type Binding Documentation
IN resource 1..1 Resource

A Claim resource or Bundle of claims, either as individual Claim resources or as Bundles each containing a single Claim plus referenced resources.

OUT return 1..1 Resource

A ClaimResponse resource or Bundle of claim responses, either as individual ClaimResponse resources or as Bundles each containing a single ClaimResponse plus referenced resources.

 

 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.