Da Vinci Prior Authorization Support (PAS) FHIR IG
2.0.1 - STU 2 United States of America flag

This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.0.1: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: PASClaimInquiryResponse - Mappings

Page standards status: Trial-use Maturity Level: 3

Mappings for the profile-claiminquiryresponse resource profile.

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

PASClaimInquiryResponse
ClaimResponseEvent
   statusEvent.status
   createdEvent.occurrence[x]
   insurerEvent.performer
   requestEvent.basedOn
   dispositionEvent.note

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

PASClaimInquiryResponse
ClaimResponse
   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)

PASClaimInquiryResponse
ClaimResponseEntity. Role, or Act
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifiern/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]
   item
      idn/a
      modifierExtensionN/A
      adjudication
         idn/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
      detail
         idn/a
         extensionn/a
         modifierExtensionN/A
         modifier24.C, 24.D mods
         quantity24.G
         net24.F
         subDetail
            idn/a
            extensionn/a
            modifierExtensionN/A
            modifier24.C, 24.D mods
            quantity24.G
            net24.F
   total
      idn/a
      extensionn/a
      modifierExtensionN/A
   payment
      idn/a
      extensionn/a
      modifierExtensionN/A
   processNote
      idn/a
      extensionn/a
      modifierExtensionN/A
   insuranceCoverage
      idn/a
      extensionn/a
      modifierExtensionN/A
   error
      idn/a
      modifierExtensionN/A