ClaimResponse
ClaimResponse view.
Columns
Name | Type | Description |
id | String | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
lastUpdated | Datetime | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
implicitRules | String | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
language | String | The base language in which the resource is written. |
text_div | String | The div of the text. A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it 'clinically safe' for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
text_status | String | The status of the text. A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it 'clinically safe' for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
contained | String | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. |
extension | String | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
modifierExtension | String | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
identifier_value | String | The value of the identifier. A unique identifier assigned to this claim response. |
identifier_use | String | The identifier-use of the identifier-use. A unique identifier assigned to this claim response. |
identifier_type_coding | String | The coding of the identifier-type. A unique identifier assigned to this claim response. |
identifier_type_text | String | The text of the identifier-type. A unique identifier assigned to this claim response. |
identifier_system | String | The identifier-system of the identifier-system. A unique identifier assigned to this claim response. |
identifier_period_start | String | The start of the identifier-period. A unique identifier assigned to this claim response. |
identifier_period_end | String | The end of the identifier-period. A unique identifier assigned to this claim response. |
status | String | The status of the resource instance. |
type_coding | String | The coding of the type. A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. |
type_text | String | The text of the type. A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. |
subType_coding | String | The coding of the subType. A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. |
subType_text | String | The text of the subType. A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. |
use | String | A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future. |
patient_display | String | The display of the patient. The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought. |
patient_reference | String | The reference of the patient. The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought. |
patient_identifier_value | String | The value of the patient-identifier. The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought. |
patient_type | String | The patient-type of the patient-type. The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought. |
created | Datetime | The date this resource was created. |
insurer_display | String | The display of the insurer. The party responsible for authorization, adjudication and reimbursement. |
insurer_reference | String | The reference of the insurer. The party responsible for authorization, adjudication and reimbursement. |
insurer_identifier_value | String | The value of the insurer-identifier. The party responsible for authorization, adjudication and reimbursement. |
insurer_type | String | The insurer-type of the insurer-type. The party responsible for authorization, adjudication and reimbursement. |
requestor_display | String | The display of the requestor. The provider which is responsible for the claim, predetermination or preauthorization. |
requestor_reference | String | The reference of the requestor. The provider which is responsible for the claim, predetermination or preauthorization. |
requestor_identifier_value | String | The value of the requestor-identifier. The provider which is responsible for the claim, predetermination or preauthorization. |
requestor_type | String | The requestor-type of the requestor-type. The provider which is responsible for the claim, predetermination or preauthorization. |
request_display | String | The display of the request. Original request resource reference. |
request_reference | String | The reference of the request. Original request resource reference. |
request_identifier_value | String | The value of the request-identifier. Original request resource reference. |
request_type | String | The request-type of the request-type. Original request resource reference. |
outcome | String | The outcome of the claim, predetermination, or preauthorization processing. |
disposition | String | A human readable description of the status of the adjudication. |
preAuthRef | String | Reference from the Insurer which is used in later communications which refers to this adjudication. |
preAuthPeriod_start | Datetime | The start of the preAuthPeriod. The time frame during which this authorization is effective. |
preAuthPeriod_end | Datetime | The end of the preAuthPeriod. The time frame during which this authorization is effective. |
payeeType_coding | String | The coding of the payeeType. Type of Party to be reimbursed: subscriber, provider, other. |
payeeType_text | String | The text of the payeeType. Type of Party to be reimbursed: subscriber, provider, other. |
item_id | String | The item-id of the item-id. Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
item_extension | String | The item-extension of the item-extension. May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
item_modifierExtension | String | The item-modifierExtension of the item-modifierExtension. May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
item_itemSequence | Int | The item-itemSequence of the item-itemSequence. A number to uniquely reference the claim item entries. |
item_noteNumber | String | The item-noteNumber of the item-noteNumber. The numbers associated with notes below which apply to the adjudication of this item. |
item_adjudication_id | String | The item-adjudication-id of the item-adjudication-id. Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
item_adjudication_extension | String | The item-adjudication-extension of the item-adjudication-extension. May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
item_adjudication_modifierExtension | String | The item-adjudication-modifierExtension of the item-adjudication-modifierExtension. May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
item_adjudication_category_coding | String | The coding of the item-adjudication-category. A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. |
item_adjudication_category_text | String | The text of the item-adjudication-category. A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. |
item_adjudication_reason_coding | String | The coding of the item-adjudication-reason. A code supporting the understanding of the adjudication result and explaining variance from expected amount. |
item_adjudication_reason_text | String | The text of the item-adjudication-reason. A code supporting the understanding of the adjudication result and explaining variance from expected amount. |
item_adjudication_amount | String | The item-adjudication-amount of the item-adjudication-amount. Monetary amount associated with the category. |
item_adjudication_value | Decimal | The item-adjudication-value of the item-adjudication-value. A non-monetary value associated with the category. Mutually exclusive to the amount element above. |
item_detail_id | String | The item-detail-id of the item-detail-id. Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
item_detail_extension | String | The item-detail-extension of the item-detail-extension. May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
item_detail_modifierExtension | String | The item-detail-modifierExtension of the item-detail-modifierExtension. May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
item_detail_detailSequence | Int | The item-detail-detailSequence of the item-detail-detailSequence. A number to uniquely reference the claim detail entry. |
item_detail_noteNumber | String | The item-detail-noteNumber of the item-detail-noteNumber. The numbers associated with notes below which apply to the adjudication of this item. |
SP_source | String | The SP_source search parameter. |
SP_payment_date | String | The SP_payment_date search parameter. |
SP_text | String | The SP_text search parameter. |
SP_content | String | The SP_content search parameter. |
SP_securitySP_start | String | The SP_securitySP_start search parameter. |
SP_request | String | The SP_request search parameter. |
SP_tagSP_start | String | The SP_tagSP_start search parameter. |
SP_requestor | String | The SP_requestor search parameter. |
SP_identifier_start | String | The SP_identifier_start search parameter. |
SP_list | String | The SP_list search parameter. |
SP_identifier_end | String | The SP_identifier_end search parameter. |
SP_profile | String | The SP_profile search parameter. |
SP_insurer | String | The SP_insurer search parameter. |
SP_tagSP_end | String | The SP_tagSP_end search parameter. |
SP_patient | String | The SP_patient search parameter. |
SP_securitySP_end | String | The SP_securitySP_end search parameter. |
SP_filter | String | The SP_filter search parameter. |