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

Usecases

Introduction

There are three types of searches that are supported by this Implementation Guide.

Search for Remittance by Claim

Provider has a long outstanding claim submission without a corresponding remittance. Assuming that the claim is adjudicated, parameters to identify the claim are submitted and a list of remittances associated with that claim are returned.

Search for Remittance by Patient

Provider has claim submissions for a patient without a corresponding remittance. Rather than providing information on a single claim, patient information is submitted and a list of remittances associated with that patient are returned.

Search for Remittance by Payment

Provider has received the notification of a payment (either by cheque or EFT deposit) but there is no remittance accompanying the payment. Information about the payment is submitted and a list of remittances assocaited with that payment are returned.

Download Remittance

Once a list of remittances has been returned via one of the previous search mechanisms, a specific remittance identifier is specified and a copy of the remittance, either in 835 format or PDF format, is returned as an encoded attachment in a FHIR DocumentReference instance.