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FHIR R4 field | OpenIMIS field | notes | mapping status | ||
---|---|---|---|---|---|
identifier | tblClaim.ClaimID / tblClaim.ClaimUUID / tblClaim.ClaimCode | Claim can have multiple identifiers. The most important one is mapped from ClaimUUID. | mapped | ||
patient | tblClaim.InsureeUUID | reference to Patient resource | mapped | ||
outcome | tblClaim.ClaimStatus | changed from CodeableConcept to code | mapped | ||
payment.adjustmentReason | tblClaim.Adjustment | mapped | |||
total.category.code | based on the state: Approved, Valuated, Reinsured, Claimed | returning the benefit amount | mapped | ||
total.amount | tblClaim.Approved / tblClaim.Valuated / tblClaim.Reinsured / tblClaim.Claimed | mapped as Money data type | mapped | ||
communicationRequest | tblClaim.feedbackId | reference to CommunicationRequest resource | mapped | ||
error.code.coding.code | tblClaim.rejectionReason | mapped | |||
error.code.text | tblClaim.rejectionReason as primary language text | to be mapped | |||
item.adjudication.reason | tblClaimItems.ClaimItemStatus / tblClaimItems.Justification / tblClaimItems.RejectionReason / tblClaimServices.ClaimServiceStatus / tblClaimServices.Justification / tblClaimServices.RejectionReason | adjudication.reason contains the rejection code | mapped | ||
item.adjudication.value | tblClaimItems.QtyProvided / tblClaimitems.QtyApproved / tblClaimServices.QtyProvided / tblClaimServices.QtyApproved | mapped | |||
item.adjudication.amount | tblClaimItems.PriceAdjusted / tblClaimitems.PriceAdjusted / tblClaimItems.PriceApproved / tblClaimitems.PriceValuated / tblClaimServices.PriceAdjusted / tblClaimServices.PriceAdjusted / tblClaimServices.PriceApproved / tblClaimServices.PriceValuated | Monetary amount / value is taken from limitation value by default The openIMIS field considered here depends on the status of the claims. | mapped | ||
processNote.text | tblClaimItems.Justification / tblClaimItems.PriceOrigin / tblClaimServices.Justification / tblClaimServices.PriceOrigin | claimResponse.item.noteNumber can be used to join information about the mapped field and claim item | mapped | ||
disposition | not mapped | ||||
created | TimeUtils.date | current date is taken on the moment of processing claim Should be mapped to ValidityTo for the date of last change? | mapped | ||
request | reference to Claim | mapped | |||
type | tblClaim.VisitType | mapped | |||
status | tblClaim.ReviewStatus | status in [1: “Idle“, 2: “Not Selected”, 4: “Selected for Review”, 8: “Reviewed”, 16: “ByPassed”] | not mapped | ||
insurerrequestor | tblHF.HealthFacility | reference to Organization HealthcareService resource | for the moment mapped as HealthcareService referencenot mapped | ||
use | “claim” | mapped | |||
use | “claim” | mapped“Organisation/openIMIS“ | “openIMIS” from module configuration key | not mapped |
Endpoint specification:
Example of endpoint URL:
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