This page is part of the FHIR Specification (v4.3.0: R4B - STU). 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 |
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A ClaimResponse for a Claim that contains processing errors
@prefix fhir: <http://hl7.org/fhir/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- <http://hl7.org/fhir/ClaimResponse/R3501> a fhir:ClaimResponse; fhir:nodeRole fhir:treeRoot; fhir:Resource.id [ fhir:value "R3501"]; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ]; fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ClaimResponse that demonstrates returning errors</div>" ]; fhir:ClaimResponse.identifier [ fhir:index 0; fhir:Identifier.system [ fhir:value "http://www.BenefitsInc.com/fhir/remittance" ]; fhir:Identifier.value [ fhir:value "R3501" ] ]; fhir:ClaimResponse.status [ fhir:value "active"]; fhir:ClaimResponse.type [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ]; fhir:Coding.code [ fhir:value "oral" ] ] ]; fhir:ClaimResponse.use [ fhir:value "claim"]; fhir:ClaimResponse.patient [ fhir:link <http://hl7.org/fhir/Patient/1>; fhir:Reference.reference [ fhir:value "Patient/1" ] ]; fhir:ClaimResponse.created [ fhir:value "2014-08-16"^^xsd:date]; fhir:ClaimResponse.insurer [ fhir:Reference.identifier [ fhir:Identifier.system [ fhir:value "http://www.jurisdiction.org/insurers" ]; fhir:Identifier.value [ fhir:value "555123" ] ] ]; fhir:ClaimResponse.requestor [ fhir:link <http://hl7.org/fhir/Practitioner/1>; fhir:Reference.reference [ fhir:value "Practitioner/1" ] ]; fhir:ClaimResponse.request [ fhir:link <http://hl7.org/fhir/Claim/100156>; fhir:Reference.reference [ fhir:value "Claim/100156" ] ]; fhir:ClaimResponse.outcome [ fhir:value "error"]; fhir:ClaimResponse.disposition [ fhir:value "Claim could not be processed"]; fhir:ClaimResponse.formCode [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/forms-codes" ]; fhir:Coding.code [ fhir:value "2" ] ] ]; fhir:ClaimResponse.processNote [ fhir:index 0; fhir:ClaimResponse.processNote.number [ fhir:value "1"^^xsd:positiveInteger ]; fhir:ClaimResponse.processNote.type [ fhir:value "display" ]; fhir:ClaimResponse.processNote.text [ fhir:value "Invalid claim" ]; fhir:ClaimResponse.processNote.language [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "urn:ietf:bcp:47" ]; fhir:Coding.code [ fhir:value "en-CA" ] ] ] ]; fhir:ClaimResponse.communicationRequest [ fhir:index 0; fhir:link <http://hl7.org/fhir/CommunicationRequest/fm-solicit>; fhir:Reference.reference [ fhir:value "CommunicationRequest/fm-solicit" ] ]; fhir:ClaimResponse.error [ fhir:index 0; fhir:ClaimResponse.error.itemSequence [ fhir:value "3"^^xsd:positiveInteger ]; fhir:ClaimResponse.error.detailSequence [ fhir:value "2"^^xsd:positiveInteger ]; fhir:ClaimResponse.error.code [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication-error" ]; fhir:Coding.code [ fhir:value "a002" ] ] ] ] . <http://hl7.org/fhir/Patient/1> a fhir:Patient . <http://hl7.org/fhir/Practitioner/1> a fhir:Practitioner . <http://hl7.org/fhir/Claim/100156> a fhir:Claim . <http://hl7.org/fhir/CommunicationRequest/fm-solicit> a fhir:CommunicationRequest . # - ontology header ------------------------------------------------------------ <http://hl7.org/fhir/ClaimResponse/R3501.ttl> a owl:Ontology; owl:imports fhir:fhir.ttl; owl:versionIRI <http://build.fhir.org/ClaimResponse/R3501.ttl> . # -------------------------------------------------------------------------------------
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.