FHIR STU3 Resource - Claim
OpenIMIS tables mapped - tblClaim, tblClaimItems , tblClaimServices
FHIR STU3 field | openIMIS field | Notes | Status |
|---|---|---|---|
Identifier | tblClaim.ClaimID / tblClaim.ClaimUUID / tblClaim.ClaimCode | Claim can have multiple identifiers. The most important one is mapped from ClaimCode | ClaimID and ClaimCode mapped |
patient | tblClaim.InsureeID | mapped | |
billablePeriod | tblClaim.DateFrom / tblClaim.DateTo | date from and date to are mapped to a period of time between them | mapped |
diagnosis | tblClaim.ICDID / tblClaim.ICDID1 / tblClaim.ICDID2 / tblClaim.ICDID3 / tblClaim.ICDID4 | ICDID values are mapped to a list of diagnosis | mapped |
provider | tblClaim.Adjuster | not mapped | |
claimCode | |||
dateFrom | |||
dateTo | |||
total | tblClaim.Claimed | mapped | |
created | tblClaim.DateClaimed | mapped | |
information | tblClaim.Explanation / tblClaim.GuaranteeId / tblClaimItems.Availability / tblClaimItems.Explanation / tblClaimServices.Explanation | information category is distinguishing the type of information | mapped |
facility | tblClaim.HFID | mapped | |
enterer | tblClaim.ClaimAdminId | mapped | |
type | tblClaim.VisitType | mapped | |
item.service | tblClaimItems.ItemId / tblClaimServices.ServiceID | claim.item.category.text is distinguishing whether mapping is done from tblClaimsServices or tblClaimItems | mapped |
item.quantity | tblClaimItems.QtyProvided / tblClaimServices.QtyProvided | claim.item.category.text is distinguishing whether mapping is done from tblClaimsServices or tblClaimItems | mapped |
item.unitPrice | tblClaimItems.PriceAsked / tblClaimServices.PriceAsked | claim.item.category.text is distinguishing whether mapping is done from tblClaimsServices or tblClaimItems | mapped |
Endpoint specification:
Example of endpoint URL:
http://127.0.0.1:8000/api_fhir/Claim/
Supported HTTP operation:
CREATE - used to submitting the claim. The FHIR claim representation is converted to python ClaimSubmit (https://github.com/openimis/openimis-be-claim_py/blob/master/claim/services.py#L38 ) which is used by the python claim service. List of supported fields can be found in the table which shows the mapping between OpenIMIS and FHIR. Should be used the POST HTTP method and the body as JSON representation (example can be found below).
Note:
The claim service is used to process the request (https://github.com/openimis/openimis-be-claim_py/blob/master/claim/services.py#L146 ).
The response is (example of the outcome can be found below)
OperationOutcome which notice about the failure (list of possible errors);
ClaimResponse which notice about the success
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/Claim/{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 currently not supported
DELETE - the operation currently not supported
Module configuration used by the endpoint:
Configuration key | Description | Default value |
|---|---|---|
default_audit_user_id | default value which will be used for 'audit_user_id' field | "default_audit_user_id": 1, |
stu3_fhir_identifier_type_config | configuration of system and codes used to represent the specific types of identifiers | "stu3_fhir_identifier_type_config":{ }, |
stu3_fhir_issue_type_config | configuration of system and codes used to represent the specific types of operation outcome | "stu3_fhir_issue_type_config":{ |
stu3_fhir_claim_config | configuration of system and codes used to represent the specific types of claim codes | "stu3_fhir_claim_config":{ }, |
Example JSON representation of content:
{
"resourceType": "Claim",
"billablePeriod": {
"end": "2019-06-12T00:00:00",
"start": "2019-06-01T00:00:00"
},
"created": "2019-06-12T00:00:00",
"diagnosis": [
{
"diagnosisCodeableConcept": {
"coding": [
{
"code": "ICD_CD"
}
]
},
"sequence": 1,
"type": [
{
"text": "icd_0"
}
]
}
],
"enterer": {
"reference": "Practitioner/1234abcd"
},
"facility": {
"reference": "Location/12345678"
},
"id": "code",
"identifier": [
{
"type": {
"coding": [
{
"code": "MR",
"system": "https://hl7.org/fhir/valueset-identifier-type.html"
}
]
},
"use": "usual",
"value": "code"
}
],
"information": [
{
"category": {
"text": "guarantee_id"
},
"sequence": 1,
"valueString": "guarantee_id"
},
{
"category": {
"text": "explanation"
},
"sequence": 2,
"valueString": "explanation"
},
{
"category": {
"text": "item_explanation"
},
"sequence": 3,
"valueString": "item_explanation"
},
{
"category": {
"text": "item_explanation"
},
"sequence": 4,
"valueString": "service_explanation"
}
],
"item": [
{
"category": {
"text": "item"
},
"informationLinkId": [
3
],
"quantity": {
"value": 4
},
"sequence": 1,
"service": {
"text": "iCode"
},
"unitPrice": {
"value": 21.1
}
},
{
"category": {
"text": "service"
},
"informationLinkId": [
4
],
"quantity": {
"value": 3
},
"sequence": 2,
"service": {
"text": "sCode"
},
"unitPrice": {
"value": 16.1
}
}
],
"patient": {
"reference": "Patient/TEST_CHF_ID"
},
"total": {
"value": 42
},
"type": {
"text": "E"
}
}