Da Vinci Postable Remittance
1.0.0-ballot - STU 1 Ballot United States of America flag

This page is part of the DaVinci Postable Remittance FHIR Implementation Guide (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

OperationDefinition: Search for Postable Remittance By Claim

Official URL: http://hl7.org/fhir/us/davinci-pr/OperationDefinition/SearchByClaim Version: 1.0.0-ballot
Standards status: Trial-use Maturity Level: 1 Computable Name: SearchByClaim
Other Identifiers: OID:2.16.840.1.113883.4.642.40.41.33.2

This operation is used to search for a postable remittance by providing claim information.

Generated Narrative: OperationDefinition SearchByClaim

URL: [base]/$searchByClaim

Input parameters Profile:Search By Claim Incoming Parameters

Output parameters Profile:Search Result Outgoing Parameters

Parameters

UseNameScopeCardinalityTypeBindingDocumentation
INTIN1..1string

Medical Group / Billing Provider / Payee TIN

INDateOfService0..1Period

Date of Service

INPayerID0..1string

Payer Identifer

INPayerName0..1string

Payer Name

INPatientID0..1string

Patient Member (or Subscriber) Insurance ID

INClaim1..1

Information about the claim being searched for.

INClaim.ProviderClaimID1..1string

Provider generated Claim ID (also known as Patient Account Number)

INClaim.ProviderID0..1string

NPI or Payer Assigned Provider Identifier

INClaim.PayerClaimID0..1string

Payer Generated Claim ID (DCN or ICN)

INClaim.ClaimChargeAmount0..1Money

Claim Charge Amount

OUTTIN0..1string

Medical Group / Billing Provider / Payee TIN

OUTPayer0..1

Details of payer information.

OUTPayer.PayerID1..1string

Payer Identifier

OUTPayer.PayerName1..1string

Payer Name

OUTClaim0..*

Details to verify correct claim found.

OUTClaim.PayerClaimID1..1string

Payer Generated Claim ID (DCN or ICN)

OUTClaim.ProviderClaimID1..1string

Provider generated Claim ID

OUTClaim.ClaimReceivedDate1..1date

Claim Received Date

OUTClaim.ProviderID1..1string

NPI or Payer Assigned Provider Identifier

OUTClaim.PaymentInfo0..*

Details of adjudicated payment.

OUTClaim.PaymentInfo.PaymentDate1..1date

Payment Date

OUTClaim.PaymentInfo.PaymentNumber1..1string

Payment Number

OUTClaim.PaymentInfo.PaymentAmount1..1Money

Payment Amount

OUTClaim.PaymentInfo.Remittance0..*

Details of remittance advice.

OUTClaim.PaymentInfo.Remittance.RemittanceAdviceIdentifier1..1string

Remittance Advice Identifier

OUTClaim.PaymentInfo.Remittance.RemittanceAdviceType1..1codeRemittance Advice Value Set (Required)

Remittance Advice Type

OUTClaim.PaymentInfo.Remittance.RemittanceAdviceDate1..1date

Remittance Advice Date

OUTClaim.PaymentInfo.Remittance.RemittanceAdviceFileSize1..1integer

Remittance Advice File Size

OUTPatient1..1

Details to verify correct patient found.

OUTPatient.DateOfBirth1..1date

Patient date of birth

OUTPatient.PatientID1..1string

Patient Member (or Subscriber) Insurance ID

OUTPatient.PatientFirstName1..1string

Patient First Name

OUTPatient.PatientLastName1..1string

Patient Last Name