This page is part of the DaVinci Postable Remittance FHIR Implementation Guide (v1.0.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
| Official URL: http://hl7.org/fhir/us/davinci-pr/OperationDefinition/SearchByClaim | Version: 1.0.0 | |||
| 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
| Use | Name | Scope | Cardinality | Type | Binding | Documentation |
| IN | TIN | 1..1 | string | Medical Group / Billing Provider / Payee TIN | ||
| IN | PayerID | 0..1 | string | Payer Identifer | ||
| IN | PayerName | 0..1 | string | Payer Name | ||
| IN | ServiceStartDate | 0..1 | date | Start Date of Service | ||
| IN | ServiceEndDate | 0..1 | date | End Date of Service | ||
| IN | PatientID | 0..1 | string | Patient Member (or Subscriber) Insurance ID | ||
| IN | Claim | 1..1 | Information about the claim being searched for. | |||
| IN | Claim.ProviderClaimID | 1..1 | string | Provider generated Claim ID (also known as Patient Account Number) | ||
| IN | Claim.ProviderID | 0..1 | string | NPI or Payer Assigned Provider Identifier | ||
| IN | Claim.PayerClaimID | 0..1 | string | Payer Generated Claim ID (DCN or ICN) | ||
| IN | Claim.ClaimChargeAmount | 0..1 | Money | Claim Charge Amount | ||
| OUT | TIN | 1..1 | string | Medical Group / Billing Provider / Payee TIN | ||
| OUT | Payer | 1..1 | Details of payer information. | |||
| OUT | Payer.PayerID | 1..1 | string | Payer Identifier | ||
| OUT | Payer.PayerName | 1..1 | string | Payer Name | ||
| OUT | Claim | 1..* | Details to verify correct claim found. | |||
| OUT | Claim.PayerClaimID | 1..1 | string | Payer Generated Claim ID (DCN or ICN) | ||
| OUT | Claim.ProviderClaimID | 1..1 | string | Provider generated Claim ID | ||
| OUT | Claim.ClaimReceivedDate | 1..1 | date | Claim Received Date | ||
| OUT | Claim.ProviderID | 1..1 | string | NPI or Payer Assigned Provider Identifier | ||
| OUT | Claim.PaymentInfo | 1..* | Details of adjudicated payment. | |||
| OUT | Claim.PaymentInfo.PaymentDate | 1..1 | date | Payment Date | ||
| OUT | Claim.PaymentInfo.PaymentNumber | 1..1 | string | Payment Number | ||
| OUT | Claim.PaymentInfo.PaymentAmount | 1..1 | Money | Payment Amount | ||
| OUT | Claim.PaymentInfo.Remittance | 1..* | Details of remittance advice. | |||
| OUT | Claim.PaymentInfo.Remittance.RemittanceAdviceIdentifier | 1..1 | string | Remittance Advice Identifier | ||
| OUT | Claim.PaymentInfo.Remittance.RemittanceAdviceType | 1..1 | code | Remittance Advice Value Set (Required) | Remittance Advice Type | |
| OUT | Claim.PaymentInfo.Remittance.RemittanceAdviceDate | 1..1 | date | Remittance Advice Date | ||
| OUT | Claim.PaymentInfo.Remittance.RemittanceAdviceFileSize | 1..1 | integer | Remittance Advice File Size | ||
| OUT | Patient | 1..1 | Details to verify correct patient found. | |||
| OUT | Patient.DateOfBirth | 1..1 | date | Patient date of birth | ||
| OUT | Patient.PatientID | 1..1 | string | Patient Member (or Subscriber) Insurance ID | ||
| OUT | Patient.PatientFirstName | 1..1 | string | Patient First Name | ||
| OUT | Patient.PatientLastName | 1..1 | string | Patient Last Name |