<del class="diff-old">
This
page
is
part
of
the
FHIR
Specification
(v0.0.82:
DSTU
1).
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
Content
Examples
Detailed
Descriptions
Mappings
Profiles
7.6.4
Resource
ExplanationOfBenefit
-
Detailed
Descriptions
Detailed
Descriptions
for
the
elements
in
the
ExplanationOfBenefit
resource.
ExplanationOfBenefit
Definition
This
resource
provides:
the
claim
details;
adjudication
details
from
the
processing
of
a
Claim;
and
optionally
account
balance
information,
for
informing
the
subscriber
of
the
benefits
provided.
Control
1..1
Alternate
Names
EOB
ExplanationOfBenefit.identifier
Definition
The
Response
Business
Identifier.
Note
This
is
a
business
identifer,
not
a
resource
identifier
(see
discussion
)
Control
0..*
Type
Identifier
ExplanationOfBenefit.request
Definition
Original
request
resource
reference.
Control
0..1
Type
Reference
(
Claim
)
ExplanationOfBenefit.outcome
Definition
Transaction
status:
error,
complete.
Control
0..1
Binding
RemittanceOutcome:
Required
:
http://hl7.org/fhir/RS-link
(The
outcome
of
the
processing.)
Type
code
ExplanationOfBenefit.disposition
Definition
A
description
of
the
status
of
the
adjudication.
Control
0..1
Type
string
ExplanationOfBenefit.ruleset
Definition
The
version
of
the
style
of
resource
contents.
This
should
be
mapped
to
the
allowable
profiles
for
this
and
supporting
resources.
Control
0..1
Binding
Ruleset:
Example
:
See
http://hl7.org/fhir/vs/ruleset
(The
static
and
dynamic
model
to
which
contents
conform,
may
be
business
version
or
standard
and
version.)
Type
Coding
ExplanationOfBenefit.originalRuleset
Definition
The
style
(standard)
and
version
of
the
original
material
which
was
converted
into
this
resource.
Control
0..1
Binding
Ruleset:
Example
:
See
http://hl7.org/fhir/vs/ruleset
(The
static
and
dynamic
model
to
which
contents
conform,
may
be
business
version
or
standard
and
version.)
Type
Coding
Requirements
Knowledge
of
the
original
version
can
inform
the
processing
of
this
instance
so
that
information
which
is
processable
by
the
originating
system
may
be
generated.
ExplanationOfBenefit.created
Definition
The
date
when
the
enclosed
suite
of
services
were
performed
or
completed.
Control
0..1
Type
dateTime
ExplanationOfBenefit.organization
Definition
The
Insurer
who
produced
this
adjudicated
response.
Control
0..1
Type
Reference
(
Organization
)
ExplanationOfBenefit.requestProvider
Definition
The
practitioner
who
is
responsible
for
the
services
rendered
to
the
patient.
Control
0..1
Type
Reference
(
Practitioner
)
ExplanationOfBenefit.requestOrganization
Definition
The
organization
which
is
responsible
for
the
services
rendered
to
the
patient.
Control
0..1
Type
Reference
(
Organization
)
©
HL7.org
2011+.
FHIR
DSTU
(v0.4.0-4902)
generated
on
Fri,
Mar
27,
2015
00:20+1100.
Links:
What's
a
DSTU?
|
Version
History
|
Specification
Map
|
Compare
to
DSTU1
|
|
Propose
a
change
</del>