FHIR R4

13.7.7 Resource ClaimResponse - Mappings

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

Mappings:

FiveWs Pattern Mapping

Workflow Pattern

RIM Mapping

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

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

ClaimResponse
    identifierFiveWs.identifier
    statusFiveWs.status
    typeFiveWs.class
    subTypeFiveWs.class
    useFiveWs.class
    patientFiveWs.subject[x]
    createdFiveWs.recorded
    requestorFiveWs.source
    requestFiveWs.why[x]
        providerFiveWs.source
        serviced[x]FiveWs.done[x]
        location[x]FiveWs.where[x]

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

ClaimResponseEvent
    identifierEvent.identifier
    statusEvent.status
    createdEvent.occurrence[x]
    insurerEvent.performer
    requestEvent.basedOn
    dispositionEvent.note

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

ClaimResponse
        modifier24.C, 24.D mods
        programCode24.H
        serviced[x]24.A
        location[x]24.B
        quantity24.G
        net24.F
            modifier24.C, 24.D mods
            quantity24.G
            net24.F
                modifier24.C, 24.D mods
                quantity24.G
                net24.F
    insuranceCoverage