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OpenMRS field | FHIR field | Note |
---|---|---|
claimCode | claimclaimResponse.identifier | Claim number |
uuid | Unique uuid code | |
adjustment | claimResponse.payment.adjustment | The contents of the adjustment message (getting from response) |
approvedTotal | claimResponse.totalBenefit | Total benefit payable for the Claim |
dateProcessed | claimResponse.created | Date of processing claim |
rejectionReason | claimResponse.error | Optional rejection reason message |
status | claimResponse.processNote | Information about current claim status |
...
uuid | claimResponse.communicationRequest - Reference(Claim) | Request for additional information |
Code Block | ||
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InsuranceClaimDiagnosis → claim.diagnosis
FHIR resources:
The diagnosis is a part of the FHIR Claim resource.
...
InsuranceClaimItem → Claim.item / ClaimResponse.item
FHIR resources:
...
{ "resourceType": "ClaimResponse", "id": "claim_uuid", "identifier": [ { "use": "usual", "type": { "coding": [ { "system": "https://hl7.org/fhir/ |
...
Code Block | ||
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| ||
{ "resourceType": "ClaimResponse", "id": "claim_uuid", "identifier": [ { "use": "usual", "type":valueset-identifier-type.html", "code": "ACSN" } ] }, "value": "claim_uuid" }, { "use": "usual", "type": { "coding": [ { "system": "https://hl7.org/fhir/valueset-identifier-type.html", "code": "MR" } ] }, "value": "claim_code" } ], "created": "2019-11-05T17:00:29+01:00", "request": { "reference": "Claim/8a589dc9-435f-4453-957a-31106cf0d932" }, "outcome": { "coding": [ { "codingcode": ["2" } { ], "text": "ENTERED" }, "systemerror": "https://hl7.org/fhir/valueset-identifier-type.html",[ { "code": "ACSN"{ }"coding": [ ] { }, "valuecode": "claimerror_uuidcode" }, } ], { "usetext": "usualerror_code", "type": {} } ], "codingtotalBenefit": [{ "value": 1234567890.21 }, "payment": { "adjustmentReason": { "systemtext": "https://hl7.org/fhir/valueset-identifier-type.html",adjustment reason" }, "codedate": "MR2019-11-05" }, "communicationRequest": [ ] { }, "valuereference": "CommunicationRequest/claim_codeuuid" } ], "created": "2019-11-05T17:00:29+01:00", "request": { "reference": "Claim/8a589dc9-435f-4453-957a-31106cf0d932" }, "outcome": { "coding": [ { "code": "2" } ], "text": "ENTERED" }, "error": [ { "code": { "coding": [ { "code": "error_code" } ], "text": "error_code" } } ], "totalBenefit": { "value": 1234567890.21 }, "payment": { "adjustmentReason": { "text": "adjustment reason" }, "date": "2019-11-05" }, "communicationRequest": [ { "reference": "CommunicationRequest/claim_uuid" } ] } } |
InsuranceClaimDiagnosis → claim.diagnosis
FHIR resources:
The diagnosis is a part of the FHIR Claim resource.
OpenMRS field | FHIR field | Request or response | Note |
---|---|---|---|
concept | claim.diagnosis | Request | The value of concept which describe the diagnosis |
claim | The claim which is connect with the diagnosis; not mapped because this is part of FHIR claim resource |
InsuranceClaimItem → Claim.item / ClaimResponse.item
FHIR resources:
- Claim.item - http://hl7.org/fhir/STU3/claim.html
- ClaimResponse.item - http://hl7.org/fhir/STU3/claimresponse.html
OpenMRS field | FHIR field | Request or response | Note |
---|---|---|---|
quantityProvided | claim.item.quantity | Request | Information about the amount of requested items |
quantityApproved | claimResponse.item.adjudication.value | Response | Information about the amount of approved items |
priceApproved | claimResponse.item.adjudication.amount | Response | The approved price |
priceAsked | claim.item.unitPrice | Request | The requested price. The value is determined based on value of price attribute from related ProvidedItem. |
explanation | claim.information | Request | Optional additional information for claimed item |
justification | claimResponse.processNote | Response | Optional additional information for claimed item (getting from response) |
rejectionReason | claimResponse.item.adjudication.reason | Response | Optional rejection reason message |
item | claim.item.service | Request | The related item. The related ProvidedItem provides the value of the product code which is entered into claim.item.service. |
claim | see above | The related claim | |
status | claimResponse.item.adjudication.reason / extension | Response | The related status for claimed item |
InsurancePolicy → Coverage
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