FHIR Release 3 (STU)

This page is part of the FHIR Specification (v3.0.2: STU 3). 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

13.6.6 Resource Claim - Mappings

Financial Management Work GroupMaturity Level: N/ABallot Status: InformativeCompartments: Encounter, Patient, Practitioner, RelatedPerson

Mappings:

RIM Mapping

Workflow Mapping

Mappings for the claim resource.

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

Claim
    identifier
    status
    type
    subType
    use
    patient
    billablePeriod
    created
    enterer
    insurer
    provider
    organization
    priority
    fundsReserve
    related
        claim
        relationship
        reference
    prescription
    originalPrescription
    payee
        type
        resourceType
        party
    referral
    facility
    careTeam
        sequence
        provider
        responsible
        role
        qualification
    information
        sequence
        category
        code
        timing[x]
        value[x]
        reason
    diagnosis
        sequence
        diagnosis[x]
        type
        packageCode
    procedure
        sequence
        date
        procedure[x]
    insuranceCoverage
        sequence
        focal
        coverage
        businessArrangement
        preAuthRef
        claimResponse
    accident
        date
        type
        location[x]
    employmentImpacted
    hospitalization
    item
        sequence
        careTeamLinkId
        diagnosisLinkId
        procedureLinkId
        informationLinkId
        revenue
        category
        service
        modifier
        programCode
        serviced[x]
        location[x]
        quantity
        unitPrice
        factor
        net
        udi
        bodySite
        subSite
        encounter
        detail
            sequence
            revenue
            category
            service
            modifier
            programCode
            quantity
            unitPrice
            factor
            net
            udi
            subDetail
                sequence
                revenue
                category
                service
                modifier
                programCode
                quantity
                unitPrice
                factor
                net
                udi
    total

13.6.6.2 Mappings for Workflow Mapping (http://hl7.org/fhir/workflow)

ClaimRequest
    identifierRequest.identifier
    statusRequest.status
    type
    subType
    use
    patientRequest.subject
    billablePeriod
    createdRequest.authoredOn
    enterer
    insurerRequest.performer
    providerRequest.requester.agent
    organizationRequest.requester.onBehalfOf
    priorityRequest.priority
    fundsReserve
    related
        claimRequest.replaces
        relationship
        reference
    prescription
    originalPrescription
    payee
        type
        resourceType
        party
    referral
    facility
    careTeam
        sequence
        provider
        responsible
        role
        qualification
    informationRequest.supportingInfo
        sequence
        category
        code
        timing[x]
        value[x]
        reason
    diagnosisRequest.reasonReference
        sequence
        diagnosis[x]
        type
        packageCode
    procedure
        sequence
        date
        procedure[x]
    insurance
        sequence
        focal
        coverage
        businessArrangement
        preAuthRef
        claimResponse
    accident
        date
        type
        location[x]
    employmentImpacted
    hospitalization
    item
        sequence
        careTeamLinkId
        diagnosisLinkId
        procedureLinkId
        informationLinkId
        revenue
        category
        service
        modifier
        programCode
        serviced[x]
        location[x]
        quantity
        unitPrice
        factor
        net
        udi
        bodySite
        subSite
        encounterRequest.context
        detail
            sequence
            revenue
            category
            service
            modifier
            programCode
            quantity
            unitPrice
            factor
            net
            udi
            subDetail
                sequence
                revenue
                category
                service
                modifier
                programCode
                quantity
                unitPrice
                factor
                net
                udi
    total