Da Vinci - Coverage Requirements Discovery
1.1.0-ballot - STU 1.1 US

This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v1.1.0-ballot: STU 1.1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: ClaimResponse - Mappings

Draft as of 2020-11-09

Mappings for the profile-claimresponse resource profile.

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

ClaimResponse
ClaimResponseEvent
   identifierEvent.identifier
   statusEvent.status
   createdEvent.occurrence[x]
   insurerEvent.performer
   requestEvent.basedOn
   dispositionEvent.note

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

ClaimResponse
ClaimResponse
   identifierFiveWs.identifier
   statusFiveWs.status
   typeFiveWs.class
   subTypeFiveWs.class
   useFiveWs.class
   patientFiveWs.subject[x], FiveWs.subject
   createdFiveWs.recorded
   requestorFiveWs.source
   requestFiveWs.why[x]
   addItem
      providerFiveWs.source
      serviced[x]FiveWs.done[x]
      location[x]FiveWs.where[x]

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

ClaimResponse
ClaimResponseEntity. Role, or Act
   textAct.text?
   containedN/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
      modifier24.C, 24.D mods
      programCode24.H
      serviced[x]24.A
      location[x]24.B
      quantity24.G
      net24.F
      adjudication
         idn/a
         extensionn/a
         modifierExtensionN/A
      detail
         idn/a
         extensionn/a
         modifierExtensionN/A
         modifier24.C, 24.D mods
         quantity24.G
         net24.F
         adjudication
            idn/a
            extensionn/a
            modifierExtensionN/A
         subDetail
            idn/a
            extensionn/a
            modifierExtensionN/A
            modifier24.C, 24.D mods
            quantity24.G
            net24.F
            adjudication
               idn/a
               extensionn/a
               modifierExtensionN/A
   total
      idn/a
      extensionn/a
      modifierExtensionN/A
   processNote
      idn/a
      extensionn/a
      modifierExtensionN/A
   insuranceCoverage
      idn/a
      extensionn/a
      modifierExtensionN/A