FHIR R4 - CoverageEligibilityResponse

FHIR R4 Resource - CoverageEligibilityResponse

OpenIMIS table - https://openimis.atlassian.net/wiki/spaces/OP/pages/814153821

FHIR R4 field

OpenIMIS field

notes

mapping status

FHIR R4 field

OpenIMIS field

notes

mapping status

patient

eligibility_request

 

not mapped

insurance.item.benefit.allowedUnsignedInt

prod_id / total_admissions_left / total_visits_left / total-consultations_left / total_surgeries_left / total_deliveries_left / total_antenatals_left / service_left / item_left

item field contains all the information mapped to all listed fields

benefitBalance is redefined as item and financial as item.benefit

mapped

insurance.item.benefit.allowedMoney

consultation_amount_left / surgery_amount_left / delivery_amount_left / hospitalization_amount_left / antenatal_amount_left

item field contains all the information mapped to all listed fields

benefitBalance is redefined as item and financial as item.benefit

mapped

insurance.item.excluded

is_item_ok / is_service_ok

item field contains all the information mapped to all listed fields

mapped

Example JSON representation of content:

{ "resourceType": "CoverageEligibilityResponse", "status": "active", "purpose": [ "benefits" ], "patient": { "reference": "Patient/070707070" }, "created": "2021-09-28", "request": { "reference": "CoverageEligibilityRequest" }, "outcome": "complete", "insurer": { "reference": "openIMIS" }, "insurance": [ { "item": [ { "category": { "text": "total_admissions" }, "benefit": [ { "allowedUnsignedInt": 0 } ] }, { "category": { "text": "total_visits" }, "benefit": [ { "allowedUnsignedInt": 0 } ] }, { "category": { "text": "total_consultations" }, "benefit": [ { "allowedUnsignedInt": 0 } ] }, { "category": { "text": "total_surgeries" }, "benefit": [ { "allowedUnsignedInt": 0 } ] }, { "category": { "text": "total_deliveries" }, "benefit": [ { "allowedUnsignedInt": 0 } ] }, { "category": { "text": "total_antenatal" }, "benefit": [ { "allowedUnsignedInt": 0 } ] }, { "category": { "text": "consultation_amount" }, "benefit": [ { "allowedMoney": { "value": 0 } } ] }, { "category": { "text": "surgery_amount" }, "benefit": [ { "allowedMoney": { "value": 0 } } ] }, { "category": { "text": "delivery_amount" }, "benefit": [ { "allowedMoney": { "value": 0 } } ] }, { "category": { "text": "hospitalization_amount" }, "benefit": [ { "allowedMoney": { "value": 0 } } ] }, { "category": { "text": "antenatal_amount" }, "benefit": [ { "allowedMoney": { "value": 0 } } ] }, { "category": { "text": "service_left" }, "benefit": [ { "allowedUnsignedInt": 0 } ] }, { "category": { "text": "item_left" }, "benefit": [ { "allowedUnsignedInt": 0 } ] }, { "category": { "text": "is_service_ok" }, "excluded": false }, { "category": { "text": "is_item_ok" }, "excluded": false } ] } ] }

 

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