FHIR R4 Resource - CoverageEligibilityRequest

OpenIMIS table - EligibilityRequest

FHIR R4 field	OpenIMIS field	notes	mapping status

FHIR R4 field	OpenIMIS field	notes	mapping status
patient	CHFID		mapped
item.category	ServiceCode or ItemCode	Item or Service code as defined in openIMIS	mapped
item.productOrService	Medical Item or Service type	Specify if the item is a Service or an Item	mapped

CoverageEligibilityRequest strategy change is mapped depending on the configuration set in openimis-be-api_fhir_r4_py/api_fhir_r4/apps.py file:

"R4_fhir_coverage_eligibility_config": {
        "fhir_serializer": "CoverageEligibilityRequestSerializer",
        "fhir_item_code": "item",
        "fhir_service_code": "service",
        "fhir_total_admissions_code": "total_admissions",
        "fhir_total_visits_code": "total_visits",
        "fhir_total_consultations_code": "total_consultations",
        "fhir_total_surgeries_code": "total_surgeries",
        "fhir_total_deliveries_code": "total_deliveries",
        "fhir_total_antenatal_code": "total_antenatal",
        "fhir_consultation_amount_code": "consultation_amount",
        "fhir_surgery_amount_code": "surgery_amount",
        "fhir_delivery_amount_code": "delivery_amount",
        "fhir_hospitalization_amount_code": "hospitalization_amount",
        "fhir_antenatal_amount_code": "antenatal_amount",
        "fhir_service_left_code": "service_left",
        "fhir_item_left_code": "item_left",
        "fhir_is_item_ok_code": "is_item_ok",
        "fhir_is_service_ok_code": "is_service_ok",
        "fhir_balance_code": "balance",
        "fhir_balance_default_category": "medical",
        "fhir_active_policy_status": ("A",)
    },

In "R4_fhir_coverage_eligibility_config" field, fhir_serializer need to be set that determines the CoverageElibilityRequest strategy.

"CoverageEligibilityRequestSerializer" is a default fhir_serializer.

Endpoint specification:

Example of endpoint URL:

http://localhost:8000/api_fhir_r4/CoverageEligibilityRequest/

Supported HTTP operation:

CREATE - used to request EligibilityService. The FHIR representation is converted to OpenIMIS python EligibilityRequest (link) which is used by the EligibilityService (link). 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 EligibilityService is used to process the request (link).
- The FHIR R4 CoverageEligibilityResponse will be returned as the outcome.. Example of the outcome can be found below.
- Currently the outcome shows an exception, which will soon be corrected.
READ - the operation currently not supported
UPDATE - the operation currently not supported
DELETE - the operation currently not supported

Module configuration used by the endpoint:

Configuration key	Description	Default value

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,
R4_fhir_coverage_eligibility_config	configuration of system and codes used to represent the specific codes used by eligibility endpoint	"R4_fhir_coverage_eligibility_config":{ "fhir_item_code":"item", "fhir_service_code":"service", "fhir_total_admissions_code":"total_admissions", "fhir_total_visits_code":"total_visits", "fhir_total_consultations_code":"total_consultations", "fhir_total_surgeries_code":"total_surgeries", "fhir_total_deliveries_code":"total_deliveries", "fhir_total_antenatal_code":"total_antenatal", "fhir_consultation_amount_code":"consultation_amount", "fhir_surgery_amount_code":"surgery_amount", "fhir_delivery_amount_code":"delivery_amount", "fhir_hospitalization_amount_code":"hospitalization_amount", "fhir_antenatal_amount_code":"antenatal_amount", "fhir_service_left_code":"service_left", "fhir_item_left_code":"item_left", "fhir_is_item_ok_code":"is_item_ok", "fhir_is_service_ok_code":"is_service_ok" }

Example JSON representation of content:

{
    "resourceType": "OperationOutcome",
    "issue": [
        {
            "code": "exception",
            "details": {
                "text": "Method \"GET\" not allowed."
            },
            "severity": "fatal"
        }
    ]
}

openIMIS

FHIR R4 - CoverageEligibilityRequest

Endpoint specification:

Example of endpoint URL:

Supported HTTP operation:

Module configuration used by the endpoint:

Example JSON representation of content:

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