This page is part of the FHIR Specification (v5.0.0-ballot: FHIR R5 Ballot Preview). 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
Financial Management Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Patient, Practitioner |
Raw JSON (canonical form + also see JSON Format Specification)
A ClaimResponse for a Claim that contains processing errors
{ "resourceType": "ClaimResponse", "id": "R3501", "text": { "status": "generated", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ClaimResponse that demonstrates returning errors</div>" }, "identifier": [ { "system": "http://www.BenefitsInc.com/fhir/remittance", "value": "R3501" } ], "status": "active", "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/claim-type", "code": "oral" } ] }, "use": "claim", "patient": { "reference": "Patient/1" }, "created": "2014-08-16", "insurer": { "identifier": { "system": "http://www.jurisdiction.org/insurers", "value": "555123" } }, "requestor": { "reference": "Practitioner/1" }, "request": { "reference": "Claim/100156" }, "outcome": "error", "disposition": "Claim could not be processed", "formCode": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/forms-codes", "code": "2" } ] }, "processNote": [ { "number": 1, "type": "display", "text": "Invalid claim", "language": { "coding": [ { "system": "urn:ietf:bcp:47", "code": "en-CA" } ] } } ], "communicationRequest": [ { "reference": "CommunicationRequest/fm-solicit" } ], "error": [ { "itemSequence": 3, "detailSequence": 2, "code": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/adjudication-error", "code": "a002" } ] } } ] }
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.