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FHIR Resource - Claim Response

OpenIMIS tables mapped - tblClaim, tblClaimItems , tblClaimServices

FHIR field

OpenIMIS field

notes

mapping status

outcome

tblClaim.ClaimStatus

mapped

payment.adjustmentReason

tblClaim.Adjustment

mapped

totalBenefit

tblClaim.Approved

mapped

payment.date

tblClaimed.DateProcessed

mapped

communicationRequest

tblClaim.feedbackId

mapped

error

tblClaim.rejectionReason

mapped

item.adjudication.reason

tblClaimItems.ClaimItemStatus / tblClaimItems.RejectionReason / tblClaimServices.RejectionReason

adjudication.reason contains the rejection code
(with adjudication.category = "rejected_reason")

mapped

item.adjudication.value

tblClaimItems.QtyApproved

mapped

item.adjudication.amount

tblClaimItems.PriceAdjusted / tblClaimItems.PriceApproved / tblClaimitems.PriceValuated / tblClaimItems.LimitationValue / tblClaimItems.RemuneratedAmount / tblClaimItems.DeductableAmount / tblClaimItems.ExceedCeilingAmount / tblClaimServices.PriceAdjusted / tblClaimServices.PriceApproved / tblClaimServices.PriceValuated / tblClaimServices.LimitationValue / tblClaimServices.RemunratedAmount / tblClaimServices.DeductableAmount / tblClaimServices.ExceededCeilingAmount

Monetary amount / value is taken from limitation value by default

only tblClaimItems.LimitationValue and tblClaimServices.LimitationValue mapped

processNote

tblClaimItems.Justification / tblClaimItems.PriceOrigin / tblClaimServices.Justification / tblClaimServices.Limitation / tblClaimServices.PriceOrigin

claimResponse.item.noteNumber can be used to join information about the mapped field and claim item

mapped

...

  • CREATE - the operation not supported

  • READ - by default return list of all available resources. To fetch information about a specific object you should add the primary key to URL for instance:
    http://127.0.0.1:8000/api_fhir/ClaimResponse/{claimcode}
    , where "{claimcode}" is the value of the primary key (claim code in case of that resource). Should be used the GET HTTP method.

  • UPDATE - the operation not supported

  • DELETE - the operation not supported

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