PCT Advanced EOB Summary - Mappings - Patient Cost Transparency Implementation Guide v2.0.0-ballot

Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot US

This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v2.0.0-ballot: STU 2 Ballot) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: PCTAdvancedEOBSummary - Mappings

Page standards status: Trial-use

Maturity Level: 1

Mappings for the davinci-pct-aeob-summary resource profile.

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

PCTAdvancedEOBSummary

ExplanationOfBenefit

Event

identifier

Event.identifier

identifier (INTER)

Event.identifier

status

Event.status

type

Event.code

patient

Event.subject

created

Event.occurrence[x]

insurer

Event.performer.agent

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

PCTAdvancedEOBSummary

ExplanationOfBenefit

identifier

FiveWs.identifier

identifier (INTER)

FiveWs.identifier

status

FiveWs.status

type

FiveWs.class

use

FiveWs.class

patient

FiveWs.subject[x], FiveWs.subject

billablePeriod

FiveWs.done[x]

created

FiveWs.recorded

insurer

FiveWs.author

provider

FiveWs.source

careTeam

provider

FiveWs.actor

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

PCTAdvancedEOBSummary

ExplanationOfBenefit

identifier

identifier (INTER)

use

N/A

type

CX.5

system

CX.4 / EI-2-4

value

CX.1 / EI.1

period

CX.7 + CX.8

assigner

CX.4 / (CX.4,CX.9,CX.10)

priority

Request.priority

insurance

Coverage

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

PCTAdvancedEOBSummary

ExplanationOfBenefit

Entity. Role, or Act

text

Act.text?

contained

N/A

modifierExtension

N/A

identifier

identifier (INTER)

id

n/a

extension

n/a

use

Role.code or implied by context

type

Role.code or implied by context

system

II.root or Role.id.root

value

II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)

period

Role.effectiveTime or implied by context

assigner

II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper

provider

id

n/a

extension

extension (dataAbsentReason)

ANY.nullFlavor

id

n/a

url

N/A

value[x]

N/A

n/a

extension

n/a

modifierExtension

N/A

careTeam

id

n/a

extension

n/a

modifierExtension

N/A

diagnosis

id

n/a

extension

n/a

modifierExtension

N/A

procedure

id

n/a

extension

n/a

modifierExtension

N/A

insurance

id

n/a

extension

n/a

modifierExtension

N/A

accident

id

n/a

extension

n/a

modifierExtension

N/A

total

id

n/a

extension

n/a

modifierExtension

N/A

total (submitted)

id

n/a

extension

n/a

modifierExtension

N/A

total (memberliability)

id

n/a

extension

n/a

modifierExtension

N/A

total (innetwork)

id

n/a

extension

n/a

modifierExtension

N/A

total (outofnetwork)

id

n/a

extension

n/a

modifierExtension

N/A

total (noncovered)

id

n/a

extension

n/a

modifierExtension

N/A

total (negotiated)

id

n/a

extension

n/a

modifierExtension

N/A

total (eligible)

id

n/a

extension

n/a

modifierExtension

N/A

total (benefit)

id

n/a

extension

n/a

modifierExtension

N/A

processNote

id

n/a

modifierExtension

N/A

benefitBalance

id

n/a

extension

n/a

modifierExtension

N/A

financial

id

n/a

extension

n/a

modifierExtension

N/A

IG © 2023+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pct#2.0.0-ballot based on FHIR 4.0.1. Generated 2024-04-08
Links: Table of Contents | QA Report | Version History | | Propose a change