| Name | Flags | Card. | Type |
Description & Constraints
|
|---|---|---|---|---|
ExplanationOfBenefit
|
ExplanationOfBenefit | This is an abstract profile. Child profiles: ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit , ExplanationOfBenefit | ||
meta
|
S | 1.. | ||
lastUpdated
|
S | 1.. | ||
profile
|
1.. | |||
Slices for identifier
|
1 .. | Slice: Unordered, Open by pattern:type | ||
identifier:All Slices
|
Content/Rules for all slices | |||
type
|
||||
identifier:uniqueclaimid
|
S | 1..1 | Unique Claim Identifier | |
type
|
1.. | Required Pattern: At least the following | ||
coding
|
1..* | Coding |
Code defined by a terminology system Fixed Value: (complex) |
|
|
system
|
1..1 | uri |
Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType |
|
|
code
|
1..1 | code |
Symbol in syntax defined by the system Fixed Value: uc |
|
value
|
S | 1.. | Unique Claim Identifier | |
|
status
|
S | |||
|
type
|
S | Binding: Claim Type Codes ( required ) | ||
|
use
|
S | Required Pattern: claim | ||
patient
|
S | Reference (C4BB Patient) | ||
|
billablePeriod
|
S | 1.. | ||
|
start
|
S | 1.. | ||
|
end
|
||||
|
created
|
||||
|
insurer
|
S | Reference (C4BB Organization) | ||
|
provider
|
S | Reference (C4BB Organization | C4BB Practitioner) | ||
|
priority
|
Binding: Process Priority Codes ( required ) | |||
|
related
|
S | |||
|
relationship
|
S | 1.. | Binding: C4BB Related Claim Relationship Codes Value Set ( required ) | |
|
reference
|
S | 1.. | ||
|
payee
|
S C | EOB-payee-other-type-requires-party: Base EOB: if payee type is other, payee party is required | ||
|
type
|
S | 1.. | Binding: C4BB Payee Type Value Set ( required ) | |
|
party
|
S | Reference (C4BB Organization | C4BB Patient | C4BB Practitioner | C4BB RelatedPerson) | ||
|
outcome
|
S | |||
|
careTeam
|
S | |||
|
sequence
|
||||
|
provider
|
S | Reference (C4BB Organization | C4BB Practitioner) | ||
|
role
|
S | |||
|
supportingInfo
|
S | |||
|
sequence
|
||||
|
category
|
Binding: C4BB SupportingInfo Type Value Set ( extensible ) | |||
|
insurance
|
S C | EOB-insurance-focal: EOB.insurance: at most one with focal = true | ||
|
focal
|
S | |||
|
coverage
|
S | Reference (C4BB Coverage) | ||
|
item
|
S | 1.. | ||
|
sequence
|
S | |||
|
noteNumber
|
S | |||
|
adjudication
|
||||
|
category
|
S | |||
|
total
|
S | 1.. | ||
|
payment
|
S | |||
|
type
|
S | Binding: C4BB Payer Claim Payment Status Code Value Set ( required ) | ||
|
date
|
||||
|
processNote
|
S | |||
|
text
|
||||
|
Documentation for this format
|
||||