Identifier

tblClaim.ClaimID / tblClaim.ClaimUUID / tblClaim.ClaimCode

Claim can have multiple identifiers. The most important one is mapped from ClaimCode

patient

tblClaim.InsureeID

billablePeriod

tblClaim.DateFrom / tblClaim.DateTo

date from and date to are mapped to a period of time between them

diagnosis

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

ICDID values are mapped to a list of diagnosis

outcome

tblClaim.ClaimStatus

provider

tblClaim.Adjuster

total

tblClaim.Claimed

created

tblClaim.DateClaimed

information

tblClaim.Explanation / tblClaim.GuaranteeId / tblClaimItems.Availability / tblClaimItems.Explanation / tblClaimServices.Explanation

information category is distinguishing the type of information

facility

tblClaim.HFID

enterer

tblClaim.ClaimAdminId

type

tblClaim.VisitType

item.service

tblClaimItems.ItemId / tblClaimServices.ServiceID

claim.item.category.text is distinguishing whether mapping is done from tblClaimsServices or tblClaimItems

item.quantity

tblClaimItems.QtyProvided / tblClaimServices.QtyProvided

claim.item.category.text is distinguishing whether mapping is done from tblClaimsServices or tblClaimItems

item.unitPrice

tblClaimItems.PriceAsked / tblClaimServices.PriceAsked

claim.item.category.text is distinguishing whether mapping is done from tblClaimsServices or tblClaimItems

{

"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"

}

}