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 | 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 |
disposition | not mapped | ||
created | TimeUtils.date | current date is taken on the moment of processing claim | mapped |
Endpoint specification:
Example of endpoint URL:
http://127.0.0.1:8000/api_fhir/ClaimResponse/
Supported HTTP operation:
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
Module configuration used by the endpoint:
Configuration key | Description | Default value |
---|---|---|
iso_date_format | iso format used for FHIR date representation | "iso_date_format": "%Y-%m-%d", |
iso_datetime_format | iso format used for FHIR datetime representation | "iso_datetime_format": "%Y-%m-%dT%H:%M:%S", |
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_claim_config | configuration of system and codes used to represent the specific types of claim codes | "stu3_fhir_claim_config":{ }, |
stu3_fhir_communication_request_config | configuration of system and codes used to represent the specific codes for IMIS feedback attributes | "stu3_fhir_communication_request_config":{ |
Example JSON Representation of Content:
{ "resourceType": "ClaimResponse", "communicationRequest": [ { "reference": "CommunicationRequest/1" } ], "error": [ { "code": { "coding": [ { "code": "1" } ] } } ], "id": "code", "identifier": [ { "type": { "coding": [ { "code": "ACSN", "system": "https://hl7.org/fhir/valueset-identifier-type.html" } ] }, "use": "usual", "value": 1 }, { "type": { "coding": [ { "code": "MR", "system": "https://hl7.org/fhir/valueset-identifier-type.html" } ] }, "use": "usual", "value": "code" } ], "item": [ { "adjudication": [ { "amount": { "value": 2 }, "category": { "text": "general" }, "reason": { "coding": [ { "code": "1", "system": "passed" } ] }, "value": 4 }, { "category": { "text": "rejected_reason" }, "reason": { "coding": [ { "code": "1" } ] } } ], "noteNumber": [ 1 ], "sequenceLinkId": 1 }, { "adjudication": [ { "amount": { "value": 4 }, "category": { "text": "general" }, "reason": { "coding": [ { "code": "2", "system": "rejected" } ] }, "value": 3 }, { "category": { "text": "rejected_reason" }, "reason": { "coding": [ { "code": "3" } ] } } ], "noteNumber": [ 2 ], "sequenceLinkId": 2 } ], "outcome": { "coding": [ { "code": "1" } ], "text": "rejected" }, "payment": { "adjustmentReason": { "text": "adjustment" }, "date": "2010-11-16T00:00:00" }, "processNote": [ { "number": 1, "text": "item justification" }, { "number": 2, "text": "service justification" } ], "totalBenefit": { "value": 214.25 } } |