FHIR Resources Analysis for OpenIMIS Integration
- Insurance coverage details
- Coverage Eligibility Request https://www.hl7.org/fhir/coverageeligibilityrequest.html
- Coverage Eligibility Response:https://www.hl7.org/fhir/coverageeligibilityresponse.html
- Coverage https://www.hl7.org/fhir/coverage.html
- Difference between coverage and coverage eligibility
- Version decisions to be made in later meetings
- Claims Submission
- Claim Request :https://www.hl7.org/fhir/claim.html
- Different phases of claims request
- Predetermination
- Preauthorization
- Claim
- Claim Response: https://www.hl7.org/fhir/claimresponse.html
- Claim Response without Payor details https://www.hl7.org/fhir/explanationofbenefit.htm
- Claims Tracking
- Status Check : Task {code=status}
- Cancel Claim processing
- Reprocess claims request
- Resubmit claims after correcting the errors from the rejected claims
- Financial module https://www.hl7.org/fhir/financial-module.html
- Account
- Invoice
- Payment Notice
- Payment Reconciliation
Batch processing of Claims : eClaimBatches
- 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 ]
# Wiki links and References
- https://wiki.openmrs.org/display/projects/OpenMRS+FHIR+Module
- https://wiki.openmrs.org/display/projects/FHIR+Module+Enhancements+Project
- https://wiki.openmrs.org/display/projects/OpenMRS+FHIR+Module+Development%3A+Phase+01
- https://wiki.openmrs.org/display/projects/FHIR+Resource+List+for+Sync
- https://wiki.openmrs.org/display/projects/Changes+to+the+FHIR+module