This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.0.1: STU 2) 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
Page standards status: Informative |
Generated Narrative: ClaimResponse
Resource ClaimResponse "ErrorResponseExample"
Profile: PAS Claim Response
identifier: id: 111099
status: active
type: Professional (Claim Type Codes#professional)
use: preauthorization
patient: Patient/SubscriberExample " SMITH"
created: 2005-05-02 11:02:00+0500
insurer: Organization/InsurerExample "MARYLAND CAPITAL INSURANCE COMPANY"
requestor: Organization/UMOExample "DR. JOE SMITH CORPORATION"
outcome: error
error
code: 04 (901#04)
error
ErrorElement: 2010A-NM103
ErrorPath: Bundle.entry[1].Organization.name
ErrorFollowupAction: C (889#C)
code: T4 (901#T4)