Release 4B 5

This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0: R5 - STU ). The This is the current published version which supercedes in it's permanent home (it will always be available at this version is 5.0.0 . URL). For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R5 R4B R4

Operation-claim-submit.xml

Example OperationDefinition/Claim-submit (XML)

Financial Management Work Group Maturity Level : N/A Standards Status : Informative

Raw XML ( canonical form + also see XML Format Specification )

Operation Definition

<?xml version="1.0" encoding="UTF-8"?>


  
  
    
    
      
      
      
      
      
        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.

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

            
          
        
        
          
          
          
          
            
          
          
          
            

<OperationDefinition xmlns="http://hl7.org/fhir">
  <id value="Claim-submit"/> 
  <text> 
    <status value="extensions"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p> URL: [base]/Claim/$submit</p> 
      <p> Parameters</p> 
      <table class="grid">
        <tr> 
          <td> 
            <b> Use</b> 
          </td> 
          <td> 
            <b> Name</b> 
          </td> 
          <td> 
            <b> Scope</b> 
          </td> 
          <td> 
            <b> Cardinality</b> 
          </td> 
          <td> 
            <b> Type</b> 
          </td> 
          <td> 
            <b> Binding</b> 
          </td> 
          <td> 
            <b> Documentation</b> 
          </td> 
        </tr> 
        <tr> 
          <td> IN</td> 
          <td> resource</td> 
          <td/>  
          <td> 1..1</td> 
          <td> 
            <a href="resource.html">Resource</a> 
          </td> 
          <td/>  
          <td> 
            <div> 
              <p> A Claim resource or Bundle of claims, either as individual Claim resources or as
                 Bundles each containing a single Claim plus referenced resources.</p> 
            </div>           </td>         </tr>         <tr>           <td> OUT</td>           <td> return</td>           <td/>            <td> 1..1</td>           <td>             <a href="resource.html">Resource</a>           </td>           <td/>            <td>             <div> 
              <p> A ClaimResponse resource or Bundle of claim responses, either as individual ClaimResponse
                 resources or as Bundles each containing a single ClaimResponse plus referenced resources.

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

                 resources or as Bundles each containing a single ClaimResponse plus referenced
                 resources.</p> 
            </div>           </td>         </tr>       </table>     </div>   </text>   <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">    <valueInteger value="2"/>   </extension>   <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">    <valueCode value="trial-use"/>   </extension>   <url value="http://hl7.org/fhir/OperationDefinition/Claim-submit"/>   <version value="5.0.0"/>   <name value="Submit"/>   <title value="Submit a Claim resource for adjudication"/>   <status value="draft"/>   <kind value="operation"/>   <experimental value="false"/>   <date value="2023-03-26T15:21:02+11:00"/>   <publisher value="HL7 (FHIR Project)"/>   <contact>     <telecom>       <system value="url"/>       <value value="http://hl7.org/fhir"/>     </telecom>     <telecom>       <system value="email"/>       <value value="fhir@lists.hl7.org"/>     </telecom>   </contact>   <description value="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."/> 
  <jurisdiction>     <coding>       <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>       <code value="001"/>       <display value="World"/>     </coding>   </jurisdiction>   <affectsState value="true"/>   <code value="submit"/>   <resource value="Claim"/>   <system value="false"/>   <type value="true"/>   <instance value="false"/>   <parameter>     <name value="resource"/>     <use value="in"/>     <min value="1"/>     <max value="1"/>     <documentation value="A Claim resource or Bundle of claims, either as individual Claim resources or as

     Bundles each containing a single Claim plus referenced resources."/> 
    <type value="Resource"/>   </parameter>   <parameter>     <name value="return"/>     <use value="out"/>     <min value="1"/>     <max value="1"/> 
    <documentation value="A ClaimResponse resource or Bundle of claim responses, either as individual ClaimResponse
     resources or as Bundles each containing a single ClaimResponse plus referenced resources.
    
  

     resources or as Bundles each containing a single ClaimResponse plus referenced
     resources."/> 
    <type value="Resource"/>   </parameter> 


</

OperationDefinition

>



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.