Page Comparison

Claim

• Claim table (tblClaim)

• tblClaimItems

• tblClaimServices

Request properties are mapped to Claim

mostly mapped

ClaimResponse

• Claim table (tblClaim)

• tblClaimItems

• tblClaimServices

Response properties are mapped to Claim

mostly mapped

Coverage

tblPolicy

not mapped

Patient

tblInsuree

mostly mapped

Practitioner

tblClaimAdmin

used to represent base fields of Claim Administrator (without relation with health facility- FHIR Location)

mapped

PractitionerRole

tblClaimAdmin

used to represent a relation between base ClaimAdmin (FHIR Practitioner) and Health facility (FHIR Location)

tblHF / tblLocationsmapped

EligibilityRequestLocationEligibilityRequest

• tblHF

• tblLocations

tblFeedback

Identifier

tblClaim.ClaimID / tblClaim.ClaimUUID / tblClaim.ClaimCode

patient

tblClaim.InsureeID

billablePeriod

tblClaim.DateFrom / tblClaim.DateTo

diagnosis

tblClaim.ICDID / tblClaim.ICDID1 / tblClaim.ICDID2 / tblClaim.ICDID3 / tblClaim.ICDID4

outcome

tblClaim.ClaimStatus

provider

tblClaim.Adjuster

total

tblClaim.Claimed

created

tblClaim.DateClaimed

information

tblClaim.Explanation / GuaranteeId

facility

tblClaim.HFID

enterer

tblClaim.ClaimAdminId

type

tblClaim.VisitTypeFHIR location.mode field is used to switch between mapping from tblHF and tblLocations

mostly mapped

EligibilityRequest

EligibilityRequest

mapped, EligibilityRespone not fully mapped

CommunicationRequest

tblFeedback

mapped

PaymentNotice

tblpayment

not mapped