This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU) in it's permanent home (it will always be available at this URL). 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: Device, Encounter, Patient, Practitioner, RelatedPerson |
Raw XML (canonical form + also see XML Format Specification)
Operation Definition
<?xml version="1.0" encoding="UTF-8"?> <OperationDefinition xmlns="http://hl7.org/fhir"> <id value="Claim-submit"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <h2> Submit a Claim resource for adjudication</h2> <p> OPERATION: Submit a Claim resource for adjudication</p> <p> The official URL for this operation definition is: </p> <pre> http://hl7.org/fhir/OperationDefinition/Claim-submit</pre> <div> <p> This operation is used to submit a Claim, Pre-Authorization or Pre-Determination (all instances of Claim resources) for adjudication either as a single Claim resource instance or as a Bundle containing the Claim and other referenced resources, or Bundle containing a batch of Claim resources, either as single Claims resources or Bundle resources, for processing. The only input parameter is the single Claim or Bundle resource and the only output is a single ClaimResponse, Bundle of ClaimResponses or an OperationOutcome resource.</p> </div> <p> URL: [base]/Claim/$submit</p> <p> Parameters</p> <table class="grid"> <tr> <td> <b> Use</b> </td> <td> <b> Name</b> </td> <td> <b> Cardinality</b> </td> <td> <b> Type</b> </td> <td> <b> Binding</b> </td> <td> <b> Documentation</b> </td> </tr> <tr> <td> IN</td> <td> resource</td> <td> 1..1</td> <td> <a href="resource.html">Resource</a> </td> <td/> <td> <div> <p> A Claim resource or Bundle of claims, either as individual Claim resources or as Bundles each containing a single Claim plus referenced resources.</p> </div> </td> </tr> <tr> <td> OUT</td> <td> return</td> <td> 1..1</td> <td> <a href="resource.html">Resource</a> </td> <td/> <td> <div> <p> A ClaimResponse resource or Bundle of claim responses, either as individual ClaimResponse resources or as Bundles each containing a single ClaimResponse plus referenced resources.</p> </div> </td> </tr> </table> <div/> </div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="2"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="trial-use"/> </extension> <url value="http://hl7.org/fhir/OperationDefinition/Claim-submit"/> <version value="4.0.1"/> <name value="Submit a Claim resource for adjudication"/> <status value="draft"/> <kind value="operation"/> <date value="2019-11-01T09:29:23+11:00"/> <publisher value="HL7 (FHIR Project)"/> <contact> <telecom> <system value="url"/> <value value="http://hl7.org/fhir"/> </telecom> <telecom> <system value="email"/> <value value="fhir@lists.hl7.org"/> </telecom> </contact> <description value="This operation is used to submit a Claim, Pre-Authorization or Pre-Determination (all instances of Claim resources) for adjudication either as a single Claim resource instance or as a Bundle containing the Claim and other referenced resources, or Bundle containing a batch of Claim resources, either as single Claims resources or Bundle resources, for processing. The only input parameter is the single Claim or Bundle resource and the only output is a single ClaimResponse, Bundle of ClaimResponses or an OperationOutcome resource."/> <code value="submit"/> <resource value="Claim"/> <system value="false"/> <type value="true"/> <instance value="false"/> <parameter> <name value="resource"/> <use value="in"/> <min value="1"/> <max value="1"/> <documentation value="A Claim resource or Bundle of claims, either as individual Claim resources or as Bundles each containing a single Claim plus referenced resources."/> <type value="Resource"/> </parameter> <parameter> <name value="return"/> <use value="out"/> <min value="1"/> <max value="1"/> <documentation value="A ClaimResponse resource or Bundle of claim responses, either as individual ClaimResponse resources or as Bundles each containing a single ClaimResponse plus referenced resources."/> <type value="Resource"/> </parameter> </OperationDefinition>
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.