Left: | C4BB ExplanationOfBenefit Professional NonClinician (http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician) |
Right: | C4BB ExplanationOfBenefit Professional NonClinician (http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician) |
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.item.productOrService | Elements differ in definition for mustSupport: 'false' 'true' |
Error | ExplanationOfBenefit.item.modifier | 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 physicians, suppliers and other non-institutional providers for professional services. These services may be rendered in inpatient or outpatient, including office locations. The claims data is based on the professional claim form 1500, submission standards adopted by the Department of Health and Human Services as form CMS-1500. | ||
experimental | |||
fhirVersion | 4.0.1 | ||
jurisdiction | |||
jurisdiction[0] | urn:iso:std:iso:3166#US | ||
kind | resource | ||
name | C4BBExplanationOfBenefitProfessionalNonClinician | ||
publisher | HL7 Financial Management Working Group | ||
purpose | |||
status | active | ||
title | C4BB ExplanationOfBenefit Professional NonClinician | ||
type | ExplanationOfBenefit | ||
url | http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician | ||
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 | |||||||||
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 | |||||||||
use | SΣ | SΣ | |||||||
patient | SΣ | SΣ | |||||||
billablePeriod | SΣ | SΣ | |||||||
id | |||||||||
Slices for extension | Extension | Extension | |||||||
start | ΣI | ΣI | |||||||
end | ΣI | ΣI | |||||||
created | Σ | Σ | |||||||
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 | S | S | |||||||
Slices for supportingInfo | S | S | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
sequence | |||||||||
category | |||||||||
code | |||||||||
timing[x] | |||||||||
value[x] | |||||||||
reason | |||||||||
diagnosis | S | S | |||||||
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 | |||||||||
category | |||||||||
productOrService | S |
| |||||||
modifier | S |
| |||||||
programCode | |||||||||
serviced[x] | |||||||||
location[x] | |||||||||
quantity | |||||||||
unitPrice | |||||||||
factor | |||||||||
net | |||||||||
udi | |||||||||
bodySite | |||||||||
subSite | |||||||||
encounter | |||||||||
noteNumber | S | S | |||||||
Slices for adjudication | S | S | |||||||
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 | |||||||||
adjudication | |||||||||
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 | |||||||||
amount | |||||||||
identifier | |||||||||
formCode | |||||||||
form | |||||||||
processNote | S | S | |||||||
id | |||||||||
extension | Extension | Extension | |||||||
modifierExtension | ?!Σ | ?!Σ | |||||||
number | |||||||||
type | |||||||||
text | |||||||||
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 |