HL7.FHIR.US.DAVINCI-PAS\PAS Claim Inquiry - Mappings

Da Vinci Prior Authorization Support (PAS) FHIR IG
1.2.0-ballot - STU 1.2 US

This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v1.2.0-ballot: STU 1.2 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

Resource Profile: PASClaimInquiry - Mappings

Active as of 2022-02-17

Mappings for the profile-claim-inquiry resource profile.

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

PASClaimInquiry

Claim

Request

status

Request.status

patient

Request.subject

created

Request.authoredOn

insurer

Request.performer

provider

Request.requester

priority

Request.priority

Request.replaces

supportingInfo

Request.supportingInfo

supportingInfo (PatientEvent)

Request.supportingInfo

supportingInfo (AdmissionDates)

Request.supportingInfo

supportingInfo (DischargeDates)

Request.supportingInfo

diagnosis

Request.reasonReference

insurance

identifier

Request.identifier

item

encounter

Request.context

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

PASClaimInquiry

Claim

status

FiveWs.status

type

FiveWs.class

subType

FiveWs.class

use

FiveWs.class

patient

FiveWs.subject[x], FiveWs.subject

billablePeriod

FiveWs.done[x]

created

FiveWs.recorded

enterer

FiveWs.author

provider

FiveWs.source

referral

FiveWs.cause

facility

FiveWs.where[x]

careTeam

provider

FiveWs.actor

careTeam (OverallClaimMember)

provider

FiveWs.actor

careTeam (ItemClaimMember)

provider

FiveWs.actor

insurance

identifier

FiveWs.identifier

item

serviced[x]

FiveWs.done[x]

location[x]

FiveWs.where[x]

location[x] (locationCodeableConcept)

FiveWs.where[x]

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

PASClaimInquiry

Claim

Entity. Role, or Act

text

Act.text?

contained

N/A

modifierExtension

N/A

identifier

n/a, II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]

n/a

extension

n/a

modifierExtension

N/A

payee

id

n/a

extension

n/a

modifierExtension

N/A

careTeam

id

n/a

extension

extension (careTeamClaimScope)

modifierExtension

N/A

careTeam (OverallClaimMember)

id

n/a

extension

extension (careTeamClaimScope)

id

n/a

url

N/A

value[x]

N/A

value[x] (valueBoolean)

N/A

modifierExtension

N/A

careTeam (ItemClaimMember)

id

n/a

extension

extension (careTeamClaimScope)

id

n/a

url

N/A

value[x]

N/A

value[x] (valueBoolean)

N/A

modifierExtension

N/A

supportingInfo

id

n/a

extension

n/a

modifierExtension

N/A

timing[x]

supportingInfo (PatientEvent)

id

n/a

extension

n/a

modifierExtension

N/A

timing[x]

timing[x] (timingDate)

timing[x] (timingPeriod)

id

n/a

extension

n/a

start

./low

end

./high

supportingInfo (AdmissionDates)

id

n/a

extension

n/a

modifierExtension

N/A

timing[x]

timing[x] (timingDate)

timing[x] (timingPeriod)

id

n/a

extension

n/a

start

./low

end

./high

supportingInfo (DischargeDates)

id

n/a

extension

n/a

modifierExtension

N/A

timing[x]

timing[x] (timingDate)

timing[x] (timingPeriod)

id

n/a

extension

n/a

start

./low

end

./high

diagnosis

id

n/a

extension

n/a

modifierExtension

N/A

procedure

id

n/a

extension

n/a

modifierExtension

N/A

insurance

Coverage

id

n/a

extension

n/a

modifierExtension

N/A

accident

id

n/a

extension

n/a

modifierExtension

N/A

item

id

n/a

modifierExtension

N/A

detail

id

n/a

extension

n/a

modifierExtension

N/A

subDetail

id

n/a

extension

n/a

modifierExtension

N/A

IG © 2020+ HL7 International - Financial Management Work Group. Package hl7.fhir.us.davinci-pas#1.2.0-ballot based on FHIR 4.0.1. Generated 2022-02-17
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