Left: | C4BB ExplanationOfBenefit Outpatient Institutional (http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional) |
Right: | C4BB ExplanationOfBenefit Outpatient Institutional (http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional) |
Error | StructureDefinition.version | Values for version differ: '1.0.0' vs '1.1.0' |
Information | StructureDefinition.date | Values for date differ: '2020-11-23T17:15:54+00:00' vs '2021-07-02T17:53:32+00:00' |
Warning | ExplanationOfBenefit.meta.profile | Elements differ in comments: 'CPCDS data element (190)' 'meta.profile is required as a matter of convenience of receiving systems. The meta.profile should be used by the Server to hint/assert/declare that this instance conforms to one (or more) stated profiles (with business versions). meta.profile does not capture any business logic, processing directives, or semantics (for example, inpatient or outpatient). Clients should not assume that the Server will exhaustively indicate all profiles with all versions that this instance conforms to. Clients can (and should) perform their own validation of conformance to the indicated profile(s) and to any other profiles of interest. CPCDS data element (190)' |
Error | ExplanationOfBenefit.meta.profile | Elements differ in definition for mustSupport: 'true' 'false' |
Error | ExplanationOfBenefit.subType | Elements differ in definition for mustSupport: 'false' 'true' |
Name | Value | Comments | |
---|---|---|---|
abstract | false | ||
baseDefinition | http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit | ||
copyright | |||
date | 2020-11-23T17:15:54+00:00 | 2021-07-02T17:53:32+00:00 |
|
description | This profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for outpatient services, which may include including the use of equipment and supplies, laboratory services, radiology services and other charges. Outpatient claims are submitted for services rendered at an institution that are not part of an overnight stay. The claims data is based on the institutional claim form UB-04, submission standards adopted by the Department of Health and Human Services. | ||
experimental | |||
fhirVersion | 4.0.1 | ||
jurisdiction | |||
jurisdiction[0] | urn:iso:std:iso:3166#US | ||
kind | resource | ||
name | C4BBExplanationOfBenefitOutpatientInstitutional | ||
publisher | HL7 Financial Management Working Group | ||
purpose | |||
status | active | ||
title | C4BB ExplanationOfBenefit Outpatient Institutional | ||
type | ExplanationOfBenefit | ||
url | http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional | ||
version | 1.0.0 | 1.1.0 |
|
Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | L Type | L Description & Constraints | Comments |
---|---|---|---|---|---|---|---|---|---|
ExplanationOfBenefit | I | I | |||||||
id | Σ | Σ | |||||||
meta | SΣ | SΣ | |||||||
id | |||||||||
Slices for extension | Extension | Extension | |||||||
versionId | Σ | Σ | |||||||
lastUpdated | SΣ | SΣ | |||||||
source | Σ | Σ | |||||||
profile | SΣ | Σ |
| ||||||
security | Σ | Σ | |||||||
tag | Σ | Σ | |||||||
implicitRules | ?!Σ | ?!Σ | |||||||
language | |||||||||
text | |||||||||
contained | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?! | ?! | |||||||
identifier | S | S | |||||||
id | |||||||||
Slices for extension | Extension | Extension | |||||||
use | ?!Σ | ?!Σ | |||||||
type | SΣ | SΣ | |||||||
system | Σ | Σ | |||||||
value | Σ | Σ | |||||||
period | Σ | Σ | |||||||
assigner | Σ | Σ | |||||||
status | ?!SΣ | ?!SΣ | |||||||
type | SΣ | SΣ | |||||||
subType | S |
| |||||||
use | SΣ | SΣ | |||||||
patient | SΣ | SΣ | |||||||
billablePeriod | SΣ | SΣ | |||||||
id | |||||||||
Slices for extension | Extension | Extension | |||||||
start | ΣI | ΣI | |||||||
end | ΣI | ΣI | |||||||
created | SΣ | SΣ | |||||||
enterer | |||||||||
insurer | SΣ | SΣ | |||||||
provider | SΣ | SΣ | |||||||
priority | |||||||||
fundsReserveRequested | |||||||||
fundsReserve | |||||||||
related | S | S | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
claim | |||||||||
relationship | S | S | |||||||
reference | S | S | |||||||
prescription | |||||||||
originalPrescription | |||||||||
payee | S | S | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
type | S | S | |||||||
party | S | S | |||||||
referral | |||||||||
facility | |||||||||
claim | |||||||||
claimResponse | |||||||||
outcome | SΣ | SΣ | |||||||
disposition | |||||||||
preAuthRef | |||||||||
preAuthRefPeriod | |||||||||
careTeam | SI | SI | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
sequence | |||||||||
provider | S | S | |||||||
responsible | |||||||||
role | S | S | |||||||
qualification | |||||||||
Slices for supportingInfo | S | S | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
sequence | |||||||||
category | |||||||||
code | |||||||||
timing[x] | |||||||||
value[x] | |||||||||
reason | |||||||||
diagnosis | |||||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
sequence | |||||||||
diagnosis[x] | S | S | |||||||
type | S | S | |||||||
onAdmission | |||||||||
packageCode | |||||||||
procedure | |||||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
sequence | |||||||||
type | |||||||||
date | |||||||||
procedure[x] | |||||||||
udi | |||||||||
precedence | |||||||||
insurance | SΣI | SΣI | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
focal | SΣ | SΣ | |||||||
coverage | SΣ | SΣ | |||||||
preAuthRef | |||||||||
accident | |||||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
date | |||||||||
type | |||||||||
location[x] | |||||||||
item | S | S | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
sequence | S | S | |||||||
careTeamSequence | |||||||||
diagnosisSequence | |||||||||
procedureSequence | |||||||||
informationSequence | |||||||||
revenue | S | S | |||||||
category | |||||||||
productOrService | S | SI | |||||||
modifier | S | S | |||||||
programCode | |||||||||
Slices for serviced[x] | |||||||||
location[x] | |||||||||
quantity | S | S | |||||||
unitPrice | |||||||||
factor | |||||||||
net | |||||||||
udi | |||||||||
bodySite | |||||||||
subSite | |||||||||
encounter | |||||||||
noteNumber | S | S | |||||||
Slices for adjudication | SI | SI | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
category | S | S | |||||||
reason | |||||||||
amount | |||||||||
value | |||||||||
detail | |||||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
sequence | |||||||||
revenue | |||||||||
category | |||||||||
productOrService | |||||||||
modifier | |||||||||
programCode | |||||||||
quantity | |||||||||
unitPrice | |||||||||
factor | |||||||||
net | |||||||||
udi | |||||||||
noteNumber | |||||||||
adjudication | |||||||||
subDetail | |||||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
sequence | |||||||||
revenue | |||||||||
category | |||||||||
productOrService | |||||||||
modifier | |||||||||
programCode | |||||||||
quantity | |||||||||
unitPrice | |||||||||
factor | |||||||||
net | |||||||||
udi | |||||||||
noteNumber | |||||||||
adjudication | |||||||||
addItem | |||||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
itemSequence | |||||||||
detailSequence | |||||||||
subDetailSequence | |||||||||
provider | |||||||||
productOrService | |||||||||
modifier | |||||||||
programCode | |||||||||
serviced[x] | |||||||||
location[x] | |||||||||
quantity | |||||||||
unitPrice | |||||||||
factor | |||||||||
net | |||||||||
bodySite | |||||||||
subSite | |||||||||
noteNumber | |||||||||
adjudication | |||||||||
detail | |||||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
productOrService | |||||||||
modifier | |||||||||
quantity | |||||||||
unitPrice | |||||||||
factor | |||||||||
net | |||||||||
noteNumber | |||||||||
adjudication | |||||||||
subDetail | |||||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
productOrService | |||||||||
modifier | |||||||||
quantity | |||||||||
unitPrice | |||||||||
factor | |||||||||
net | |||||||||
noteNumber | |||||||||
adjudication | |||||||||
Slices for adjudication | SI | SI | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
category | S | S | |||||||
reason | |||||||||
amount | |||||||||
value | |||||||||
Slices for total | SΣ | SΣ | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
category | SΣ | SΣ | |||||||
amount | Σ | Σ | |||||||
payment | S | S | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
type | S | S | |||||||
adjustment | |||||||||
adjustmentReason | |||||||||
date | S | S | |||||||
amount | |||||||||
identifier | |||||||||
formCode | |||||||||
form | |||||||||
processNote | S | S | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
number | |||||||||
type | |||||||||
text | S | S | |||||||
language | |||||||||
benefitPeriod | |||||||||
benefitBalance | |||||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
category | |||||||||
excluded | |||||||||
name | |||||||||
description | |||||||||
network | |||||||||
unit | |||||||||
term | |||||||||
financial | |||||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
type | |||||||||
allowed[x] | |||||||||
used[x] | |||||||||
Documentation for this format |