STU 3 Candidate

This page is part of the FHIR Specification (v1.4.0: STU 3 Ballot 3). 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: R3 R2

5.10 Resource ProcessResponse - Content

Financial Management Work GroupMaturity Level: 0Compartments: Practitioner

This resource provides processing status, errors and notes from the processing of a resource.

5.10.1 Scope and Usage

NOTE: This resource is slated to be refactored and reduced in scope as some of its functionality is taken over by the Task resource as part of the FHIR Workflow refactoring. Readers of this resource are encouraged to review the Task resource and consider using it instead and/or to provide feedback if they feel it will be inadequate to satisfy the use-cases associated with this resource and to express opinions about which purposes they feel ProcessRequest and ProcessResponse should be retained for.

The ProcessResponse resource indicates the resource for which the processing status is requested and provides simple acknowledgement and status information of application level errors. It may also be used to convey additional processing requirements in a text form.

This is the formal response to a ProcessRequest and may be used as a application level response to PaymentNotice and SupportingDocumentation resources.

5.10.2 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ProcessResponse ΣDomainResourceProcessResponse resource
... identifier Σ0..*IdentifierBusiness Identifier
... request[x] Σ0..1Request reference
.... requestIdentifierIdentifier
.... requestReferenceReference(Any)
... outcome Σ0..1CodingProcessing outcome
Process Outcome Codes (Example)
... disposition Σ0..1stringDisposition Message
... ruleset Σ0..1CodingResource version
Ruleset Codes (Example)
... originalRuleset Σ0..1CodingOriginal version
Ruleset Codes (Example)
... created Σ0..1dateTimeCreation date
... organization[x] Σ0..1Authoring Organization
.... organizationIdentifierIdentifier
.... organizationReferenceReference(Organization)
... requestProvider[x] Σ0..1Responsible Practitioner
.... requestProviderIdentifierIdentifier
.... requestProviderReferenceReference(Practitioner)
... requestOrganization[x] Σ0..1Responsible organization
.... requestOrganizationIdentifierIdentifier
.... requestOrganizationReferenceReference(Organization)
... form Σ0..1CodingPrinted Form Identifier
Form Codes (Required)
... notes Σ0..*BackboneElementNotes
.... type Σ0..1Codingdisplay | print | printoper
NoteType (Required)
.... text Σ0..1stringNotes text
... error Σ0..*CodingError code
Adjudication Error Codes (Required)

doco Documentation for this format

UML Diagram

ProcessResponse (DomainResource)The Response business identifieridentifier : Identifier [0..*]Original request resource referencerequest[x] : Type [0..1] « Identifier|Reference(Any) »Transaction status: error, complete, heldoutcome : Coding [0..1] « Local status of outcome codes (Strength=Example)Process Outcome ?? »A description of the status of the adjudication or processingdisposition : string [0..1]The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resourcesruleset : Coding [0..1] « The static and dynamic model to which contents conform, which may be business version or standard/version. (Strength=Example)Ruleset ?? »The style (standard) and version of the original material which was converted into this resourceoriginalRuleset : Coding [0..1] « The static and dynamic model to which contents conform, which may be business version or standard/version. (Strength=Example)Ruleset ?? »The date when the enclosed suite of services were performed or completedcreated : dateTime [0..1]The organization who produced this adjudicated responseorganization[x] : Type [0..1] « Identifier|Reference(Organization) »The practitioner who is responsible for the services rendered to the patientrequestProvider[x] : Type [0..1] « Identifier|Reference(Practitioner) »The organization which is responsible for the services rendered to the patientrequestOrganization[x] : Type [0..1] « Identifier|Reference( Organization) »The form to be used for printing the contentform : Coding [0..1] « The forms codes. (Strength=Required)Form ! »Processing errorserror : Coding [0..*] « The error codes for adjudication processing. (Strength=Required)Adjudication Error ! »NotesThe note purpose: Print/Displaytype : Coding [0..1] « The presentation types of notes. (Strength=Required)NoteType! »The note texttext : string [0..1]Suite of processing note or additional requirements is the processing has been heldnotes[0..*]

XML Template

<ProcessResponse xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier --></identifier>
 <request[x]><!-- 0..1 Identifier|Reference(Any) Request reference --></request[x]>
 <outcome><!-- 0..1 Coding Processing outcome --></outcome>
 <disposition value="[string]"/><!-- 0..1 Disposition Message -->
 <ruleset><!-- 0..1 Coding Resource version --></ruleset>
 <originalRuleset><!-- 0..1 Coding Original version --></originalRuleset>
 <created value="[dateTime]"/><!-- 0..1 Creation date -->
 <organization[x]><!-- 0..1 Identifier|Reference(Organization) Authoring Organization --></organization[x]>
 <requestProvider[x]><!-- 0..1 Identifier|Reference(Practitioner) Responsible Practitioner --></requestProvider[x]>
 <requestOrganization[x]><!-- 0..1 Identifier|Reference(Organization) Responsible organization --></requestOrganization[x]>
 <form><!-- 0..1 Coding Printed Form Identifier --></form>
 <notes>  <!-- 0..* Notes -->
  <type><!-- 0..1 Coding display | print | printoper --></type>
  <text value="[string]"/><!-- 0..1 Notes text -->
 </notes>
 <error><!-- 0..* Coding Error code --></error>
</ProcessResponse>

JSON Template

{doco
  "resourceType" : "ProcessResponse",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier
  // request[x]: Request reference. One of these 2:
  "requestIdentifier" : { Identifier },
  "requestReference" : { Reference(Any) },
  "outcome" : { Coding }, // Processing outcome
  "disposition" : "<string>", // Disposition Message
  "ruleset" : { Coding }, // Resource version
  "originalRuleset" : { Coding }, // Original version
  "created" : "<dateTime>", // Creation date
  // organization[x]: Authoring Organization. One of these 2:
  "organizationIdentifier" : { Identifier },
  "organizationReference" : { Reference(Organization) },
  // requestProvider[x]: Responsible Practitioner. One of these 2:
  "requestProviderIdentifier" : { Identifier },
  "requestProviderReference" : { Reference(Practitioner) },
  // requestOrganization[x]: Responsible organization. One of these 2:
  "requestOrganizationIdentifier" : { Identifier },
  "requestOrganizationReference" : { Reference(Organization) },
  "form" : { Coding }, // Printed Form Identifier
  "notes" : [{ // Notes
    "type" : { Coding }, // display | print | printoper
    "text" : "<string>" // Notes text
  }],
  "error" : [{ Coding }] // Error code
}

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ProcessResponse ΣDomainResourceProcessResponse resource
... identifier Σ0..*IdentifierBusiness Identifier
... request[x] Σ0..1Request reference
.... requestIdentifierIdentifier
.... requestReferenceReference(Any)
... outcome Σ0..1CodingProcessing outcome
Process Outcome Codes (Example)
... disposition Σ0..1stringDisposition Message
... ruleset Σ0..1CodingResource version
Ruleset Codes (Example)
... originalRuleset Σ0..1CodingOriginal version
Ruleset Codes (Example)
... created Σ0..1dateTimeCreation date
... organization[x] Σ0..1Authoring Organization
.... organizationIdentifierIdentifier
.... organizationReferenceReference(Organization)
... requestProvider[x] Σ0..1Responsible Practitioner
.... requestProviderIdentifierIdentifier
.... requestProviderReferenceReference(Practitioner)
... requestOrganization[x] Σ0..1Responsible organization
.... requestOrganizationIdentifierIdentifier
.... requestOrganizationReferenceReference(Organization)
... form Σ0..1CodingPrinted Form Identifier
Form Codes (Required)
... notes Σ0..*BackboneElementNotes
.... type Σ0..1Codingdisplay | print | printoper
NoteType (Required)
.... text Σ0..1stringNotes text
... error Σ0..*CodingError code
Adjudication Error Codes (Required)

doco Documentation for this format

UML Diagram

ProcessResponse (DomainResource)The Response business identifieridentifier : Identifier [0..*]Original request resource referencerequest[x] : Type [0..1] « Identifier|Reference(Any) »Transaction status: error, complete, heldoutcome : Coding [0..1] « Local status of outcome codes (Strength=Example)Process Outcome ?? »A description of the status of the adjudication or processingdisposition : string [0..1]The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resourcesruleset : Coding [0..1] « The static and dynamic model to which contents conform, which may be business version or standard/version. (Strength=Example)Ruleset ?? »The style (standard) and version of the original material which was converted into this resourceoriginalRuleset : Coding [0..1] « The static and dynamic model to which contents conform, which may be business version or standard/version. (Strength=Example)Ruleset ?? »The date when the enclosed suite of services were performed or completedcreated : dateTime [0..1]The organization who produced this adjudicated responseorganization[x] : Type [0..1] « Identifier|Reference(Organization) »The practitioner who is responsible for the services rendered to the patientrequestProvider[x] : Type [0..1] « Identifier|Reference(Practitioner) »The organization which is responsible for the services rendered to the patientrequestOrganization[x] : Type [0..1] « Identifier|Reference( Organization) »The form to be used for printing the contentform : Coding [0..1] « The forms codes. (Strength=Required)Form ! »Processing errorserror : Coding [0..*] « The error codes for adjudication processing. (Strength=Required)Adjudication Error ! »NotesThe note purpose: Print/Displaytype : Coding [0..1] « The presentation types of notes. (Strength=Required)NoteType! »The note texttext : string [0..1]Suite of processing note or additional requirements is the processing has been heldnotes[0..*]

XML Template

<ProcessResponse xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier --></identifier>
 <request[x]><!-- 0..1 Identifier|Reference(Any) Request reference --></request[x]>
 <outcome><!-- 0..1 Coding Processing outcome --></outcome>
 <disposition value="[string]"/><!-- 0..1 Disposition Message -->
 <ruleset><!-- 0..1 Coding Resource version --></ruleset>
 <originalRuleset><!-- 0..1 Coding Original version --></originalRuleset>
 <created value="[dateTime]"/><!-- 0..1 Creation date -->
 <organization[x]><!-- 0..1 Identifier|Reference(Organization) Authoring Organization --></organization[x]>
 <requestProvider[x]><!-- 0..1 Identifier|Reference(Practitioner) Responsible Practitioner --></requestProvider[x]>
 <requestOrganization[x]><!-- 0..1 Identifier|Reference(Organization) Responsible organization --></requestOrganization[x]>
 <form><!-- 0..1 Coding Printed Form Identifier --></form>
 <notes>  <!-- 0..* Notes -->
  <type><!-- 0..1 Coding display | print | printoper --></type>
  <text value="[string]"/><!-- 0..1 Notes text -->
 </notes>
 <error><!-- 0..* Coding Error code --></error>
</ProcessResponse>

JSON Template

{doco
  "resourceType" : "ProcessResponse",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier
  // request[x]: Request reference. One of these 2:
  "requestIdentifier" : { Identifier },
  "requestReference" : { Reference(Any) },
  "outcome" : { Coding }, // Processing outcome
  "disposition" : "<string>", // Disposition Message
  "ruleset" : { Coding }, // Resource version
  "originalRuleset" : { Coding }, // Original version
  "created" : "<dateTime>", // Creation date
  // organization[x]: Authoring Organization. One of these 2:
  "organizationIdentifier" : { Identifier },
  "organizationReference" : { Reference(Organization) },
  // requestProvider[x]: Responsible Practitioner. One of these 2:
  "requestProviderIdentifier" : { Identifier },
  "requestProviderReference" : { Reference(Practitioner) },
  // requestOrganization[x]: Responsible organization. One of these 2:
  "requestOrganizationIdentifier" : { Identifier },
  "requestOrganizationReference" : { Reference(Organization) },
  "form" : { Coding }, // Printed Form Identifier
  "notes" : [{ // Notes
    "type" : { Coding }, // display | print | printoper
    "text" : "<string>" // Notes text
  }],
  "error" : [{ Coding }] // Error code
}

 

Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON), Questionnaire

5.10.2.1 Terminology Bindings

PathDefinitionTypeReference
ProcessResponse.outcome Local status of outcome codesExampleProcess Outcome Codes
ProcessResponse.ruleset
ProcessResponse.originalRuleset 		The static and dynamic model to which contents conform, which may be business version or standard/version.ExampleRuleset Codes
ProcessResponse.form The forms codes.RequiredForm Codes
ProcessResponse.notes.type The presentation types of notes.RequiredNoteType
ProcessResponse.error The error codes for adjudication processing.RequiredAdjudication Error Codes

5.10.3 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionPaths
identifiertokenThe business identifier of the Explanation of BenefitProcessResponse.identifier
organizationidentifiertokenThe organization who generated this resourceProcessResponse.organizationIdentifier
organizationreferencereferenceThe organization who generated this resourceProcessResponse.organizationReference
(Organization)
requestidentifiertokenThe reference to the claimProcessResponse.requestIdentifier
requestorganizationidentifiertokenThe Organization who is responsible the request transactionProcessResponse.requestOrganizationIdentifier
requestorganizationreferencereferenceThe Organization who is responsible the request transactionProcessResponse.requestOrganizationReference
(Organization)
requestprovideridentifiertokenThe Provider who is responsible the request transactionProcessResponse.requestProviderIdentifier
requestproviderreferencereferenceThe Provider who is responsible the request transactionProcessResponse.requestProviderReference
(Practitioner)
requestreferencereferenceThe reference to the claimProcessResponse.requestReference
(Any)