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: R3 R2

13.3.6 Resource EligibilityResponse - Mappings

Financial Management Work GroupMaturity Level: N/ABallot Status: Informative Compartments: Practitioner

Mappings:

FiveWs Pattern

Workflow Pattern

RIM Mapping

Canadian Dental Association eclaims standard

Mappings for the eligibilityresponse resource.

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

EligibilityResponse
    identifierFiveWs.identifier
    statusFiveWs.status
    createdFiveWs.recorded
    requestProviderFiveWs.source
    requestOrganizationFiveWs.source
    requestFiveWs.why[x]

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

EligibilityResponseEvent
    identifierEvent.identifier
    statusEvent.status
    requestOrganizationEvent.performer
    requestEvent.basedOn
    dispositionEvent.note

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

EligibilityResponse
    preAuthRef23

13.3.6.4 Mappings for Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/)

EligibilityResponse
    identifier
    status
    created
    requestProviderB01
    requestOrganization
    requestA02|G01
    outcome
    disposition
    insurer
    inforce
    insurance
        coverage
        contract
        benefitBalance
            category
            subCategory
            excluded
            name
            description
            network
            unit
            term
            financial
                type
                allowed[x]
                used[x]
    preAuthRef
    authorization
        authorizationSequence
        required
        note
    formG42
    error
        code