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FHIR R4 field | openIMIS field | notes | mapping status |
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tblClaim.ClaimID / tblClaim.ClaimUUID / tblClaim.ClaimCode | Claim can have multiple identifiers. The most important one is mapped from ClaimUUID. | mapped | |
one of [entered, checked, reviewed, valuated] based on tblClaim.ClaimStatus | entered state by default | ||
tblClaim.InsureeUUID | reference to Patient resource | mapped - mandatory | |
tblClaim.DateFrom / tblClaim.DateTo | DateFrom and DateTo are mapped to a period of time between them | mapped - mandatory | |
tblClaim.ICDID / tblClaim.ICDID1 / tblClaim.ICDID2 / tblClaim.ICDID3 / tblClaim.ICDID4 | reference to Condition resource There is an error with the POST for both versions. When the error is found complete the mapping. | mapped - mandatory from fhir to imis not mapped (diagnosis) | |
provider | tblClaim.Adjuster | to be validated | not mapped |
tblClaim.Claimed | mapped as Money data type | mapped - mandatory | |
tblClaim.DateClaimed | mapped - mandatory | ||
supportingInfo | tblClaim.Explanation / tblClaim.GuaranteeId / tblClaimItems.Availability / tblClaimItems.Explanation / tblClaimServices.Explanation | information category is distinguishing the type of information | mapped |
ClaimAttachment | |||
tblClaim.HFID | reference to HealthcareService resource | mapped - mandatory | |
tblClaim.ClaimAdminId | reference to Practitioner resource | mapped | |
tblClaim.VisitType | mapped - mandatory | ||
item.productOrService | tblClaimItems.tblItem.ItemCode / tblClaimServices.tblServices.ServiceCode | actual Code value | mapped - mandatory |
item.extension.productOrServiceReference | tblClaimItems.ItemUUID / tblClaimServices.ServiceUUID | reference to Medication resource if medical item | mapped |
item.quantity | tblClaimItems.QtyProvided / tblClaimServices.QtyProvided | mapped | |
item.unitPrice | tblClaimItems.PriceAsked / tblClaimServices.PriceAsked | price could differ from the price defined in medical item/service definition | mapped |
item.category.text | “service” or “item” | distinguishing whether mapping is done from tblClaimsServices or tblClaimItems | mapped - mandatory |
provider | tblClaimAdmin.ClaimAdminUUID | reference to PractitionerRole resource | mapped for db tool reason |
priority | code = “normal” | CodeableConcept | mapped for db tool reason |
use | “claim” | mapped for db tool reason | |
status | “active” | mapped for db tool reason | |
claim.insurance.focal | True | mapped for db tool reason | |
claim.insurance.sequence | 0 | mapped for db tool reason | |
claim.insurance.coverage | tblPolicy.PolicyUUID | reference to Coverage resource | mapped for db tool reason |
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Configuration key | Description | Default value |
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default_audit_user_id | default value which will be used for 'audit_user_id' field | "default_audit_user_id": 1, |
R4_fhir_identifier_type_config | configuration of system and codes used to represent the specific types of identifiers | "R4_fhir_identifier_type_config":{ |
R4_fhir_issue_type_config | configuration of system and codes used to represent the specific types of operation outcome | "R4_fhir_issue_type_config":{ |
R4_fhir_claim_config | configuration of system and codes used to represent the specific types of claim codes | "R4_fhir_claim_config":{ |
Example JSON representation of content:
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"fhir_claim_organization_code":"openIMIS", |
Claim Attachments
The following mapping is considered:
FHIR Field | openIMIS Field | Description | ||||||
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One element for each attachment. | ||||||||
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The content of the attachment.
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ClaimAttachment.mime | The document mime type (e.g.
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ClaimAttachment.document | The attachment content data as base64. Not available for GET ALL Claims.
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N/A | Only for POST Claim. SHA-1 hash value of the data as base64 to validate the data. If missing, data is not validated.
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ClaimAttachment.filename | Filename
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ClaimAttachment.date | Date attachment was created. If missing, current date and time.
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Example JSON representation of content
As in the other resources there is an error and therefore this file is shown.
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