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FHIR Resources Analysis for OpenIMIS Integration


  • Insurance coverage details

    1. Coverage Eligibility

...

    1. Request http://

...

    1. hl7.org/fhir/STU3/

...

    1. eligibilityrequest.html

    2. Coverage Eligibility Response:

...

    1. http://

...

    1. hl7.org/fhir/STU3/

...

    1. eligibilityresponse.html

    2. Coverage 

...

    1. http://

...

    1. hl7.org/fhir/STU3/coverage.html

    2. Difference between coverage and coverage eligibility

    3. Version decisions to be made in later meetings : Decision made on version as suggested by Kamil STU3

  • Claims Submission

    1. Claim Request :

...

    1. http://

...

    1. hl7.org/fhir/STU3/claim.html

    2. Different phases of claims request

      1. Predetermination

      2. Preauthorization

      3. Claim

    3. Claim Response:

...

    1.  http://

...

    1. hl7.org/fhir/STU3/claimresponse.html

    2. Claim Response without Payor

...

    1. details http://

...

    1. hl7.org/fhir/STU3/explanationofbenefit.

...

    1. html

    1. Account

    2. Invoice

    3. Payment Notice

    4. Payment Reconciliation

  • Batch processing of Claims : eClaimBatches

    1. eClaimBatches: https://www.hl7.org/fhir/financial-module.html#13.0.13.2

  • Relative order of use of financial resources [For reference of insurance flow using fhir ]

...

    1. http://

...

    1. hl7.org/fhir/STU3/financial-module.html#order


# Wiki links and References

  1. https://wiki.openmrs.org/display/projects/OpenMRS+FHIR+Module

  2. https://wiki.openmrs.org/display/projects/FHIR+Module+Enhancements+Project

  3. https://wiki.openmrs.org/display/projects/OpenMRS+FHIR+Module+Development%3A+Phase+01

  4. https://wiki.openmrs.org/display/projects/FHIR+Resource+List+for+Sync

  5. https://wiki.openmrs.org/display/projects/Changes+to+the+FHIR+module