This page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). 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
13.10.6 Resource ExplanationOfBenefit - Mappings Mappings for the explanationofbenefit resource (see Mappings to Other Standards for further information & status).
13.10.6.1 Mappings for FiveWs Pattern (http://hl7.org/fhir/fivews)
ExplanationOfBenefit identifier FiveWs.identifier status FiveWs.status type FiveWs.class subType FiveWs.class use FiveWs.class patient FiveWs.subject[x] billablePeriod FiveWs.done[x] created FiveWs.recorded enterer FiveWs.author insurer FiveWs.author provider FiveWs.source referral FiveWs.cause facility FiveWs.where[x] claim FiveWs.why[x] provider FiveWs.actor serviced[x] FiveWs.done[x] location[x] FiveWs.where[x]
13.10.6.2 Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)
ExplanationOfBenefit Event identifier Event.identifier status Event.status type Event.code patient Event.subject created Event.occurrence[x] enterer Event.performer.agent insurer Event.performer.agent facility Event.performer.location
13.10.6.3 Mappings for HL7 v2 Mapping (http://hl7.org/v2)
ExplanationOfBenefit identifier status type subType use patient billablePeriod created enterer insurer provider referral facility claim claimResponse outcome disposition related claim relationship reference prescription originalPrescription payee type resource party information sequence category code timing[x] value[x] reason careTeam sequence provider responsible role qualification diagnosis sequence diagnosis[x] type packageCode procedure sequence date procedure[x] precedence insurance Coverage coverage preAuthRef accident date type location[x] item sequence careTeamSequence diagnosisSequence procedureSequence informationSequence revenue category service modifier programCode serviced[x] location[x] quantity unitPrice factor net udi bodySite subSite encounter noteNumber adjudication category reason amount value detail sequence revenue category service modifier programCode quantity unitPrice factor net udi noteNumber adjudication subDetail sequence revenue category service modifier programCode quantity unitPrice factor net udi noteNumber adjudication addItem itemSequence detailSequence subDetailSequence service modifier fee noteNumber adjudication total category amount payment type adjustment adjustmentReason date amount identifier form processNote number type text language benefitBalance category subCategory excluded name description network unit term financial type allowed[x] used[x]
Financial
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