R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

Operation-claim-submit.json

Financial Management Work GroupMaturity Level: N/ABallot Status: InformativeCompartments: Encounter, Patient, Practitioner, RelatedPerson

Raw JSON (canonical form)

Operation Definition

{
  "resourceType": "OperationDefinition",
  "id": "Claim-submit",
  "text": {
    "status": "generated",
    "div": "<div>!-- Snipped for Brevity --></div>"
  },
  "url": "http://hl7.org/fhir/OperationDefinition/Claim-submit",
  "name": "Submit a Claim resource for adjudication",
  "status": "draft",
  "kind": "operation",
  "date": "2017-12-20T15:52:34+11:00",
  "publisher": "HL7 (FHIR Project)",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://hl7.org/fhir"
        },
        {
          "system": "email",
          "value": "fhir@lists.hl7.org"
        }
      ]
    }
  ],
  "description": "This operation is used to submit a Claim, Pre-Authorization or Pre-Determination (all instances of Claim resources) for adjudication either as a single Claim resource instance or as a Bundle containing the Claim and other referenced resources, or Bundle containing a batch of Claim resources, either as single Claims resources or Bundle resources, for processing. The only input parameter is the single Claim or Bundle resource and the only output is a single ClaimResponse, Bundle of ClaimResponses or an OperationOutcome resource.",
  "code": "submit",
  "resource": [
    "Claim"
  ],
  "system": false,
  "type": true,
  "instance": false,
  "parameter": [
    {
      "name": "resource",
      "use": "in",
      "min": 1,
      "max": "1",
      "documentation": "A Claim resource or Bundle of claims, either as individual Claim resources or as Bundles each containing a single Claim plus referenced resources.",
      "type": "Resource"
    },
    {
      "name": "return",
      "use": "out",
      "min": 1,
      "max": "1",
      "documentation": "A ClaimResponse resource or Bundle of claim responses, either as individual ClaimResponse resources or as Bundles each containing a single ClaimResponse plus referenced resources.",
      "type": "Resource"
    }
  ]
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.