R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 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

13.6.6 Resource Claim - Mappings

Financial Management Work GroupMaturity Level: N/ABallot Status: Informative Compartments: Encounter, Patient, Practitioner, RelatedPerson

Mappings:

FiveWs Pattern

Workflow Pattern

RIM Mapping

Mappings for the claim resource.

13.6.6.1 Mappings for FiveWs Pattern (http://hl7.org/fhir/fivews)

Claim
    identifierFiveWs.identifier
    statusFiveWs.status
    typeFiveWs.class
    subTypeFiveWs.class
    useFiveWs.class
    patientFiveWs.subject[x]
    billablePeriodFiveWs.done[x]
    createdFiveWs.recorded
    entererFiveWs.author
    providerFiveWs.source
    organizationFiveWs.source
    referralFiveWs.cause
    facilityFiveWs.where[x]
        providerFiveWs.actor
        identifierFiveWs.identifier
        serviced[x]FiveWs.done[x]
        location[x]FiveWs.where[x]

13.6.6.2 Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

ClaimRequest
    identifierRequest.identifier
    statusRequest.status
    patientRequest.subject
    createdRequest.authoredOn
    insurerRequest.performer
    providerRequest.requester
    organizationRequest.requester
    priorityRequest.priority
        claimRequest.replaces
    informationRequest.supportingInfo
    diagnosisRequest.reasonReference
        identifierRequest.identifier
        encounterRequest.context

13.6.6.3 Mappings for RIM Mapping (http://hl7.org/v3)

Claim
    insuranceCoverage