FHIR R4

13.6.7 Resource Claim - Mappings

Financial Management Work GroupMaturity Level: N/AStandards Status: InformativeSecurity Category: Patient Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Mappings:

FiveWs Pattern Mapping

Workflow Pattern

RIM Mapping

Mappings for the claim resource (see Mappings to Other Standards for further information & status).

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

Claim
    identifierFiveWs.identifier
    statusFiveWs.status
    typeFiveWs.class
    subTypeFiveWs.class
    useFiveWs.class
    patientFiveWs.subject[x]
    billablePeriodFiveWs.done[x]
    createdFiveWs.recorded
    entererFiveWs.author
    providerFiveWs.source
    referralFiveWs.cause
    facilityFiveWs.where[x]
        providerFiveWs.actor
        identifierFiveWs.identifier
        serviced[x]FiveWs.done[x]
        location[x]FiveWs.where[x]

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

ClaimRequest
    identifierRequest.identifier
    statusRequest.status
    patientRequest.subject
    createdRequest.authoredOn
    insurerRequest.performer
    providerRequest.requester
    priorityRequest.priority
        claimRequest.replaces
    supportingInfoRequest.supportingInfo
    diagnosisRequest.reasonReference
        identifierRequest.identifier
        encounterRequest.context

13.6.7.3 RIM Mapping (http://hl7.org/v3 )

Claim
    insuranceCoverage