CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
1.0.0 - STU1

This page is part of the CARIN Blue Button Implementation Guide (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: C4BBExplanationOfBenefit - Mappings

Mappings for the C4BB-ExplanationOfBenefit resource profile.

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

C4BBExplanationOfBenefit
ExplanationOfBenefitEvent
   identifierEvent.identifier
   statusEvent.status
   typeEvent.code
   patientEvent.subject
   createdEvent.occurrence[x]
   entererEvent.performer.agent
   insurerEvent.performer.agent
   facilityEvent.performer.location

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

C4BBExplanationOfBenefit
ExplanationOfBenefit
   identifierFiveWs.identifier
   statusFiveWs.status
   typeFiveWs.class
   subTypeFiveWs.class
   useFiveWs.class
   patientFiveWs.subject[x], FiveWs.subject
   billablePeriodFiveWs.done[x]
   createdFiveWs.recorded
   entererFiveWs.author
   insurerFiveWs.author
   providerFiveWs.source
   referralFiveWs.cause
   facilityFiveWs.where[x]
   claimFiveWs.why[x]
   careTeam
      providerFiveWs.actor
   item
      serviced[x]FiveWs.done[x]
      location[x]FiveWs.where[x]
   addItem
      providerFiveWs.source
      serviced[x]FiveWs.done[x]
      location[x]FiveWs.where[x]

Mappings for HL7 v2 Mapping (http://hl7.org/v2)

C4BBExplanationOfBenefit
ExplanationOfBenefit
   identifier
      useN/A
      typeCX.5
      systemCX.4 / EI-2-4
      valueCX.1 / EI.1
      periodCX.7 + CX.8
      assignerCX.4 / (CX.4,CX.9,CX.10)
   billablePeriod
      startDR.1
      endDR.2
   priorityRequest.priority
   insuranceCoverage

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

C4BBExplanationOfBenefit
ExplanationOfBenefitEntity. Role, or Act
   meta
      idn/a
      extensionn/a
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifier
      idn/a
      extensionn/a
      useRole.code or implied by context
      typeRole.code or implied by context
      systemII.root or Role.id.root
      valueII.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
      periodRole.effectiveTime or implied by context
      assignerII.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
   billablePeriod
      idn/a
      extensionn/a
      start./low
      end./high
   related
      idn/a
      extensionn/a
      modifierExtensionN/A
   payee
      idn/a
      extensionn/a
      modifierExtensionN/A
   careTeam
      idn/a
      extensionn/a
      modifierExtensionN/A
   supportingInfo
      idn/a
      extensionn/a
      modifierExtensionN/A
   diagnosis
      idn/a
      extensionn/a
      modifierExtensionN/A
   procedure
      idn/a
      extensionn/a
      modifierExtensionN/A
   insurance
      idn/a
      extensionn/a
      modifierExtensionN/A
   accident
      idn/a
      extensionn/a
      modifierExtensionN/A
   item
      idn/a
      extensionn/a
      modifierExtensionN/A
      adjudication
         idn/a
         extensionn/a
         modifierExtensionN/A
      detail
         idn/a
         extensionn/a
         modifierExtensionN/A
         subDetail
            idn/a
            extensionn/a
            modifierExtensionN/A
   addItem
      idn/a
      extensionn/a
      modifierExtensionN/A
      detail
         idn/a
         extensionn/a
         modifierExtensionN/A
         subDetail
            idn/a
            extensionn/a
            modifierExtensionN/A
   total
      idn/a
      extensionn/a
      modifierExtensionN/A
   payment
      idn/a
      extensionn/a
      modifierExtensionN/A
   processNote
      idn/a
      extensionn/a
      modifierExtensionN/A
   benefitBalance
      idn/a
      extensionn/a
      modifierExtensionN/A
      financial
         idn/a
         extensionn/a
         modifierExtensionN/A