This page is part of the Quality Improvement Core Framework (v6.0.0: STU6 (v6.0.0)) 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

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Resource Profile: QICoreClaimResponse - Mappings

Draft as of 2022-04-20

Mappings for the qicore-claimresponse resource profile.

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

QICoreClaimResponse
ClaimResponse	Event
identifier	Event.identifier
status	Event.status
created	Event.occurrence[x]
insurer	Event.performer
request	Event.basedOn
disposition	Event.note

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

QICoreClaimResponse
ClaimResponse
identifier	FiveWs.identifier
status	FiveWs.status
type	FiveWs.class
subType	FiveWs.class
use	FiveWs.class
patient	FiveWs.subject[x], FiveWs.subject
created	FiveWs.recorded
requestor	FiveWs.source
request	FiveWs.why[x]
addItem
provider	FiveWs.source
serviced[x]	FiveWs.done[x]
location[x]	FiveWs.where[x]

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

QICoreClaimResponse
ClaimResponse	Entity. Role, or Act
text	Act.text?
contained	N/A
extension	N/A
modifierExtension	N/A
item
id	n/a
extension	n/a
modifierExtension	N/A
adjudication
id	n/a
extension	n/a
modifierExtension	N/A
detail
id	n/a
extension	n/a
modifierExtension	N/A
subDetail
id	n/a
extension	n/a
modifierExtension	N/A
addItem
id	n/a
extension	n/a
modifierExtension	N/A
modifier	24.C, 24.D mods
programCode	24.H
serviced[x]	24.A
location[x]	24.B
quantity	24.G
net	24.F
detail
id	n/a
extension	n/a
modifierExtension	N/A
modifier	24.C, 24.D mods
quantity	24.G
net	24.F
subDetail
id	n/a
extension	n/a
modifierExtension	N/A
modifier	24.C, 24.D mods
quantity	24.G
net	24.F
total
id	n/a
extension	n/a
modifierExtension	N/A
payment
id	n/a
extension	n/a
modifierExtension	N/A
processNote
id	n/a
extension	n/a
modifierExtension	N/A
insurance	Coverage
id	n/a
extension	n/a
modifierExtension	N/A
error
id	n/a
extension	n/a
modifierExtension	N/A