Da Vinci Prior Authorization Support (PAS) FHIR IG
1.0.0 - STU 1

This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

Resource Profile: PASClaim - Mappings

Mappings for the profile-claim resource profile.

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

PASClaim
ClaimRequest
   identifierRequest.identifier
   statusRequest.status
   patientRequest.subject
   createdRequest.authoredOn
   insurerRequest.performer
   providerRequest.requester
   priorityRequest.priority
   related
      claimRequest.replaces
   supportingInfoRequest.supportingInfo
   supportingInfo (PatientEvent)Request.supportingInfo
   supportingInfo (AdmissionReview)Request.supportingInfo
   supportingInfo (AdditionalInformation)Request.supportingInfo
   supportingInfo (MessageText)Request.supportingInfo
   supportingInfo (InstitutionalEncounter)Request.supportingInfo
   diagnosisRequest.reasonReference
   insurance
      identifierRequest.identifier
   item
      encounterRequest.context

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

PASClaim
Claim
   identifierFiveWs.identifier
   statusFiveWs.status
   typeFiveWs.class
   subTypeFiveWs.class
   useFiveWs.class
   patientFiveWs.subject[x], FiveWs.subject
   billablePeriodFiveWs.done[x]
   createdFiveWs.recorded
   entererFiveWs.author
   providerFiveWs.source
   referralFiveWs.cause
   facilityFiveWs.where[x]
   careTeam
      providerFiveWs.actor
   insurance
      identifierFiveWs.identifier
   item
      serviced[x]FiveWs.done[x]
      location[x]FiveWs.where[x]
      location[x] (locationCodeableConcept)FiveWs.where[x]

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

PASClaim
ClaimEntity. Role, or Act
   textAct.text?
   containedN/A
   extension (levelOfServiceType)n/a, N/A
   modifierExtensionN/A
   identifier
      idn/a
      extensionn/a
      extension (subDepartment)n/a, N/A
      useRole.code or implied by context
      typeRole.code or implied by context
      systemII.root or Role.id.root
      valueII.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
      periodRole.effectiveTime or implied by context
      assignerII.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
   related
      idn/a
      extensionn/a
      modifierExtensionN/A
   payee
      idn/a
      extensionn/a
      modifierExtensionN/A
   careTeam
      idn/a
      extensionn/a
      modifierExtensionN/A
   supportingInfo
      idn/a
      extensionn/a
      modifierExtensionN/A
   supportingInfo (PatientEvent)
      idn/a
      extensionn/a
      modifierExtensionN/A
   supportingInfo (AdmissionReview)
      idn/a
      extensionn/a
      modifierExtensionN/A
   supportingInfo (AdditionalInformation)
      idn/a
      extensionn/a
      modifierExtensionN/A
   supportingInfo (MessageText)
      idn/a
      extensionn/a
      modifierExtensionN/A
   supportingInfo (InstitutionalEncounter)
      idn/a
      extensionn/a
      modifierExtensionN/A
   diagnosis
      idn/a
      extension (recordedDate)n/a, N/A
      modifierExtensionN/A
   procedure
      idn/a
      extensionn/a
      modifierExtensionN/A
   insuranceCoverage
      idn/a
      extensionn/a
      modifierExtensionN/A
   accident
      idn/a
      extensionn/a
      modifierExtensionN/A
   item
      idn/a
      extension
      extension (itemTraceNumber)n/a, N/A
      extension (authorizationNumber)n/a, N/A
      extension (administrationReferenceNumber)n/a, N/A
      extension (requestType)n/a, N/A
      extension (certificationType)n/a, N/A
      extension (productOrServiceCodeEnd)n/a, N/A
      extension (epsdtIndicator)n/a, N/A
      extension (nursingHomeResidentialStatus)n/a, N/A
         idn/a
         urlN/A
         value[x]N/A
         value[x] (valueCodeableConcept)N/A
      extension (nursingHomeLevelOfCare)n/a, N/A
      extension (revenueUnitRateLimit)n/a, N/A
      extension (requestedService)n/a, N/A
      modifierExtensionN/A
      detail
         idn/a
         extensionn/a
         modifierExtensionN/A
         subDetail
            idn/a
            extensionn/a
            modifierExtensionN/A