openIMIS FHIR R4 Implementation Guide
1.0.0 - ci-build
openIMIS FHIR R4 Implementation Guide - Local Development build (v1.0.0). See the Directory of published versions
Official URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/openimis-claim-response | Version: 1.0.0 | |||
Active as of 2022-05-31 | Responsible: openIMIS Initiative | Computable Name: OpenIMISClaimResponse |
Defines a ClaimResponse for openIMIS which maps to a Claim. The ClaimResponse resource contains the adjudication result of a Claim.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from ClaimResponse
Summary
Mandatory: 16 elements (2 nested mandatory elements)
Must-Support: 2 elements
Prohibited: 18 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
This structure is derived from ClaimResponse
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
ClaimResponse | 0..* | ClaimResponse | Response to a claim predetermination or preauthorization | |
id | 0..1 | string | Claim UUID | |
Slices for identifier | S | 2..2 | Identifier | Business Identifier for a claim response Slice: Unordered, Closed by value:type.coding.code |
identifier:All Slices | Content/Rules for all slices | |||
type | 1..1 | CodeableConcept | Description of identifier | |
coding | ||||
code | 0..1 | code | Symbol in syntax defined by the system Binding: openIMIS Identifiers Value Set (required) | |
value | 1..1 | string | The value that is unique | |
identifier:Code | S | 1..1 | Identifier | Business Identifier for a claim response |
type | ||||
coding | ||||
code | 1..1 | code | Claim openIMIS Code Required Pattern: Code | |
identifier:UUID | 1..1 | Identifier | Business Identifier for a claim response | |
type | ||||
coding | ||||
code | 1..1 | code | Claim openIMIS UUID Required Pattern: UUID | |
status | 1..1 | code | FHIR Claim Status Required Pattern: active | |
type | ||||
coding | 0..* | Coding | Visit type Binding: Visit Type Codes (Claim) (required) | |
subType | 0..0 | |||
use | 1..1 | code | Claim Type Required Pattern: claim | |
patient | 1..1 | Reference(openIMIS Patient) | The recipient of the products and services | |
created | 1..1 | dateTime | Response creation date | |
insurer | 1..1 | Reference(openIMIS Insurance Organization) | Party responsible for reimbursement | |
requestor | 1..1 | Reference(openIMIS Claim Administrator Practitioner) | Party responsible for the claim | |
request | 1..1 | Reference(Claim) | Id of resource triggering adjudication | |
outcome | 1..1 | code | queued | complete | error | partial | |
disposition | 0..0 | |||
preAuthRef | 0..0 | |||
preAuthPeriod | 0..0 | |||
payeeType | 0..0 | |||
item | 1..* | BackboneElement | Adjudication for claim line items | |
Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |
claim-item-reference | 1..1 | Reference(openIMIS Medication | openIMIS ActivityDefinition) | Item Reference URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/claim-item-reference | |
noteNumber | 0..0 | |||
adjudication | 1..4 | BackboneElement | Adjudication details | |
category | 1..1 | CodeableConcept | Type of adjudication information Binding: Status of the claim (Claim|ClaimResponse) (required) | |
reason | 1..1 | CodeableConcept | Explanation of adjudication outcome | |
coding | 1..1 | Coding | Code defined by a terminology system Binding: Rejection reasons (Claim) (required) | |
text | 0..1 | string | Plain text representation of the concept | |
amount | 1..1 | Money | Monetary amount | |
value | 1..1 | decimal | Numerical value (with implicit precision) | |
value | 1..1 | decimal | Non-monetary value | |
detail | 0..0 | |||
addItem | 0..0 | |||
adjudication | 0..0 | |||
total | 1..4 | BackboneElement | Adjudication totals | |
category | 1..1 | CodeableConcept | Type of adjudication information Binding: Status of the claim (Claim|ClaimResponse) (required) | |
amount | ||||
value | 1..1 | decimal | Numerical value (with implicit precision) | |
payment | 0..0 | |||
fundsReserve | 0..0 | |||
formCode | 0..0 | |||
form | 0..0 | |||
processNote | 0..1 | BackboneElement | Note concerning adjudication | |
number | 0..0 | |||
type | 0..0 | |||
text | 1..1 | string | Note explanatory text | |
language | 0..0 | |||
communicationRequest | 0..1 | Reference(openIMIS CommunicationRequest) | Request for additional information | |
insurance | 0..0 | |||
error | 0..0 | |||
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
ClaimResponse | 0..* | ClaimResponse | Response to a claim predetermination or preauthorization | |||||
id | Σ | 0..1 | string | Claim UUID | ||||
meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
contained | 0..* | Resource | Contained, inline Resources | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
Slices for identifier | S | 2..2 | Identifier | Business Identifier for a claim response Slice: Unordered, Closed by value:type.coding.code | ||||
identifier:All Slices | Content/Rules for all slices | |||||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 0..* | Coding | Code defined by a terminology system | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
system | Σ | 0..1 | uri | Identity of the terminology system | ||||
version | Σ | 0..1 | string | Version of the system - if relevant | ||||
code | Σ | 0..1 | code | Symbol in syntax defined by the system Binding: openIMIS Identifiers Value Set (required) | ||||
display | Σ | 0..1 | string | Representation defined by the system | ||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | ||||
value | Σ | 1..1 | string | The value that is unique Example General: 123456 | ||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
identifier:Code | S | 1..1 | Identifier | Business Identifier for a claim response | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 0..* | Coding | Code defined by a terminology system | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
system | Σ | 0..1 | uri | Identity of the terminology system | ||||
version | Σ | 0..1 | string | Version of the system - if relevant | ||||
code | Σ | 1..1 | code | Claim openIMIS Code Required Pattern: Code | ||||
display | Σ | 0..1 | string | Representation defined by the system | ||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | ||||
value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
identifier:UUID | 1..1 | Identifier | Business Identifier for a claim response | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 0..* | Coding | Code defined by a terminology system | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
system | Σ | 0..1 | uri | Identity of the terminology system | ||||
version | Σ | 0..1 | string | Version of the system - if relevant | ||||
code | Σ | 1..1 | code | Claim openIMIS UUID Required Pattern: UUID | ||||
display | Σ | 0..1 | string | Representation defined by the system | ||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | ||||
value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
status | ?!Σ | 1..1 | code | FHIR Claim Status Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Required Pattern: active | ||||
type | Σ | 1..1 | CodeableConcept | More granular claim type Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 0..* | Coding | Visit type Binding: Visit Type Codes (Claim) (required) | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
use | Σ | 1..1 | code | Claim Type Binding: Use (required): Claim, preauthorization, predetermination. Required Pattern: claim | ||||
patient | Σ | 1..1 | Reference(openIMIS Patient) | The recipient of the products and services | ||||
created | Σ | 1..1 | dateTime | Response creation date | ||||
insurer | Σ | 1..1 | Reference(openIMIS Insurance Organization) | Party responsible for reimbursement | ||||
requestor | 1..1 | Reference(openIMIS Claim Administrator Practitioner) | Party responsible for the claim | |||||
request | Σ | 1..1 | Reference(Claim) | Id of resource triggering adjudication | ||||
outcome | Σ | 1..1 | code | queued | complete | error | partial Binding: ClaimProcessingCodes (required): The result of the claim processing. | ||||
item | 1..* | BackboneElement | Adjudication for claim line items | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
claim-item-reference | 1..1 | Reference(openIMIS Medication | openIMIS ActivityDefinition) | Item Reference URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/claim-item-reference | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
itemSequence | 1..1 | positiveInt | Claim item instance identifier | |||||
adjudication | 1..4 | BackboneElement | Adjudication details | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
category | 1..1 | CodeableConcept | Type of adjudication information Binding: Status of the claim (Claim|ClaimResponse) (required) | |||||
reason | 1..1 | CodeableConcept | Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 1..1 | Coding | Code defined by a terminology system Binding: Rejection reasons (Claim) (required) | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
amount | 1..1 | Money | Monetary amount | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
value | Σ | 1..1 | decimal | Numerical value (with implicit precision) | ||||
currency | Σ | 0..1 | code | ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. | ||||
value | 1..1 | decimal | Non-monetary value | |||||
total | Σ | 1..4 | BackboneElement | Adjudication totals | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
category | Σ | 1..1 | CodeableConcept | Type of adjudication information Binding: Status of the claim (Claim|ClaimResponse) (required) | ||||
amount | Σ | 1..1 | Money | Financial total for the category | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
value | Σ | 1..1 | decimal | Numerical value (with implicit precision) | ||||
currency | Σ | 0..1 | code | ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. | ||||
processNote | 0..1 | BackboneElement | Note concerning adjudication | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
text | 1..1 | string | Note explanatory text | |||||
communicationRequest | 0..1 | Reference(openIMIS CommunicationRequest) | Request for additional information | |||||
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
ClaimResponse | 0..* | ClaimResponse | Response to a claim predetermination or preauthorization | |
Slices for identifier | 2..2 | Identifier | Business Identifier for a claim response Slice: Unordered, Closed by value:type.coding.code | |
identifier:Code | 1..1 | Identifier | Business Identifier for a claim response | |
Documentation for this format |
This structure is derived from ClaimResponse
Summary
Mandatory: 16 elements (2 nested mandatory elements)
Must-Support: 2 elements
Prohibited: 18 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from ClaimResponse
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
ClaimResponse | 0..* | ClaimResponse | Response to a claim predetermination or preauthorization | |
id | 0..1 | string | Claim UUID | |
Slices for identifier | S | 2..2 | Identifier | Business Identifier for a claim response Slice: Unordered, Closed by value:type.coding.code |
identifier:All Slices | Content/Rules for all slices | |||
type | 1..1 | CodeableConcept | Description of identifier | |
coding | ||||
code | 0..1 | code | Symbol in syntax defined by the system Binding: openIMIS Identifiers Value Set (required) | |
value | 1..1 | string | The value that is unique | |
identifier:Code | S | 1..1 | Identifier | Business Identifier for a claim response |
type | ||||
coding | ||||
code | 1..1 | code | Claim openIMIS Code Required Pattern: Code | |
identifier:UUID | 1..1 | Identifier | Business Identifier for a claim response | |
type | ||||
coding | ||||
code | 1..1 | code | Claim openIMIS UUID Required Pattern: UUID | |
status | 1..1 | code | FHIR Claim Status Required Pattern: active | |
type | ||||
coding | 0..* | Coding | Visit type Binding: Visit Type Codes (Claim) (required) | |
subType | 0..0 | |||
use | 1..1 | code | Claim Type Required Pattern: claim | |
patient | 1..1 | Reference(openIMIS Patient) | The recipient of the products and services | |
created | 1..1 | dateTime | Response creation date | |
insurer | 1..1 | Reference(openIMIS Insurance Organization) | Party responsible for reimbursement | |
requestor | 1..1 | Reference(openIMIS Claim Administrator Practitioner) | Party responsible for the claim | |
request | 1..1 | Reference(Claim) | Id of resource triggering adjudication | |
outcome | 1..1 | code | queued | complete | error | partial | |
disposition | 0..0 | |||
preAuthRef | 0..0 | |||
preAuthPeriod | 0..0 | |||
payeeType | 0..0 | |||
item | 1..* | BackboneElement | Adjudication for claim line items | |
Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |
claim-item-reference | 1..1 | Reference(openIMIS Medication | openIMIS ActivityDefinition) | Item Reference URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/claim-item-reference | |
noteNumber | 0..0 | |||
adjudication | 1..4 | BackboneElement | Adjudication details | |
category | 1..1 | CodeableConcept | Type of adjudication information Binding: Status of the claim (Claim|ClaimResponse) (required) | |
reason | 1..1 | CodeableConcept | Explanation of adjudication outcome | |
coding | 1..1 | Coding | Code defined by a terminology system Binding: Rejection reasons (Claim) (required) | |
text | 0..1 | string | Plain text representation of the concept | |
amount | 1..1 | Money | Monetary amount | |
value | 1..1 | decimal | Numerical value (with implicit precision) | |
value | 1..1 | decimal | Non-monetary value | |
detail | 0..0 | |||
addItem | 0..0 | |||
adjudication | 0..0 | |||
total | 1..4 | BackboneElement | Adjudication totals | |
category | 1..1 | CodeableConcept | Type of adjudication information Binding: Status of the claim (Claim|ClaimResponse) (required) | |
amount | ||||
value | 1..1 | decimal | Numerical value (with implicit precision) | |
payment | 0..0 | |||
fundsReserve | 0..0 | |||
formCode | 0..0 | |||
form | 0..0 | |||
processNote | 0..1 | BackboneElement | Note concerning adjudication | |
number | 0..0 | |||
type | 0..0 | |||
text | 1..1 | string | Note explanatory text | |
language | 0..0 | |||
communicationRequest | 0..1 | Reference(openIMIS CommunicationRequest) | Request for additional information | |
insurance | 0..0 | |||
error | 0..0 | |||
Documentation for this format |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
ClaimResponse | 0..* | ClaimResponse | Response to a claim predetermination or preauthorization | |||||
id | Σ | 0..1 | string | Claim UUID | ||||
meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
contained | 0..* | Resource | Contained, inline Resources | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
Slices for identifier | S | 2..2 | Identifier | Business Identifier for a claim response Slice: Unordered, Closed by value:type.coding.code | ||||
identifier:All Slices | Content/Rules for all slices | |||||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 0..* | Coding | Code defined by a terminology system | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
system | Σ | 0..1 | uri | Identity of the terminology system | ||||
version | Σ | 0..1 | string | Version of the system - if relevant | ||||
code | Σ | 0..1 | code | Symbol in syntax defined by the system Binding: openIMIS Identifiers Value Set (required) | ||||
display | Σ | 0..1 | string | Representation defined by the system | ||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | ||||
value | Σ | 1..1 | string | The value that is unique Example General: 123456 | ||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
identifier:Code | S | 1..1 | Identifier | Business Identifier for a claim response | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 0..* | Coding | Code defined by a terminology system | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
system | Σ | 0..1 | uri | Identity of the terminology system | ||||
version | Σ | 0..1 | string | Version of the system - if relevant | ||||
code | Σ | 1..1 | code | Claim openIMIS Code Required Pattern: Code | ||||
display | Σ | 0..1 | string | Representation defined by the system | ||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | ||||
value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
identifier:UUID | 1..1 | Identifier | Business Identifier for a claim response | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 0..* | Coding | Code defined by a terminology system | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
system | Σ | 0..1 | uri | Identity of the terminology system | ||||
version | Σ | 0..1 | string | Version of the system - if relevant | ||||
code | Σ | 1..1 | code | Claim openIMIS UUID Required Pattern: UUID | ||||
display | Σ | 0..1 | string | Representation defined by the system | ||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | ||||
value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
status | ?!Σ | 1..1 | code | FHIR Claim Status Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Required Pattern: active | ||||
type | Σ | 1..1 | CodeableConcept | More granular claim type Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim. | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 0..* | Coding | Visit type Binding: Visit Type Codes (Claim) (required) | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
use | Σ | 1..1 | code | Claim Type Binding: Use (required): Claim, preauthorization, predetermination. Required Pattern: claim | ||||
patient | Σ | 1..1 | Reference(openIMIS Patient) | The recipient of the products and services | ||||
created | Σ | 1..1 | dateTime | Response creation date | ||||
insurer | Σ | 1..1 | Reference(openIMIS Insurance Organization) | Party responsible for reimbursement | ||||
requestor | 1..1 | Reference(openIMIS Claim Administrator Practitioner) | Party responsible for the claim | |||||
request | Σ | 1..1 | Reference(Claim) | Id of resource triggering adjudication | ||||
outcome | Σ | 1..1 | code | queued | complete | error | partial Binding: ClaimProcessingCodes (required): The result of the claim processing. | ||||
item | 1..* | BackboneElement | Adjudication for claim line items | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
claim-item-reference | 1..1 | Reference(openIMIS Medication | openIMIS ActivityDefinition) | Item Reference URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/claim-item-reference | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
itemSequence | 1..1 | positiveInt | Claim item instance identifier | |||||
adjudication | 1..4 | BackboneElement | Adjudication details | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
category | 1..1 | CodeableConcept | Type of adjudication information Binding: Status of the claim (Claim|ClaimResponse) (required) | |||||
reason | 1..1 | CodeableConcept | Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): The adjudication reason codes. | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | Σ | 1..1 | Coding | Code defined by a terminology system Binding: Rejection reasons (Claim) (required) | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
amount | 1..1 | Money | Monetary amount | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
value | Σ | 1..1 | decimal | Numerical value (with implicit precision) | ||||
currency | Σ | 0..1 | code | ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. | ||||
value | 1..1 | decimal | Non-monetary value | |||||
total | Σ | 1..4 | BackboneElement | Adjudication totals | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
category | Σ | 1..1 | CodeableConcept | Type of adjudication information Binding: Status of the claim (Claim|ClaimResponse) (required) | ||||
amount | Σ | 1..1 | Money | Financial total for the category | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
value | Σ | 1..1 | decimal | Numerical value (with implicit precision) | ||||
currency | Σ | 0..1 | code | ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. | ||||
processNote | 0..1 | BackboneElement | Note concerning adjudication | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
text | 1..1 | string | Note explanatory text | |||||
communicationRequest | 0..1 | Reference(openIMIS CommunicationRequest) | Request for additional information | |||||
Documentation for this format |
Other representations of profile: CSV, Excel, Schematron
Path | Conformance | ValueSet / Code |
ClaimResponse.language | preferred | CommonLanguages Max Binding: AllLanguages |
ClaimResponse.identifier.use | required | IdentifierUse |
ClaimResponse.identifier.type | extensible | Identifier Type Codes |
ClaimResponse.identifier.type.coding.code | required | OpenIMISIdentifierVS |
ClaimResponse.identifier:Code.use | required | IdentifierUse |
ClaimResponse.identifier:Code.type | extensible | Identifier Type Codes |
ClaimResponse.identifier:UUID.use | required | IdentifierUse |
ClaimResponse.identifier:UUID.type | extensible | Identifier Type Codes |
ClaimResponse.status | required | Pattern: active |
ClaimResponse.type | extensible | ClaimTypeCodes |
ClaimResponse.type.coding | required | ClaimVisitTypeVS |
ClaimResponse.use | required | Pattern: claim |
ClaimResponse.outcome | required | ClaimProcessingCodes |
ClaimResponse.item.adjudication.category | required | ClaimStatusVS |
ClaimResponse.item.adjudication.reason | example | AdjudicationReasonCodes |
ClaimResponse.item.adjudication.reason.coding | required | ClaimRejectionReasonsVS |
ClaimResponse.item.adjudication.amount.currency | required | Currencies |
ClaimResponse.addItem.productOrService | example | USCLSCodes |
ClaimResponse.addItem.modifier | example | ModifierTypeCodes |
ClaimResponse.addItem.programCode | example | ExampleProgramReasonCodes |
ClaimResponse.addItem.location[x] | example | ExampleServicePlaceCodes |
ClaimResponse.addItem.bodySite | example | OralSiteCodes |
ClaimResponse.addItem.subSite | example | SurfaceCodes |
ClaimResponse.addItem.detail.productOrService | example | USCLSCodes |
ClaimResponse.addItem.detail.modifier | example | ModifierTypeCodes |
ClaimResponse.addItem.detail.subDetail.productOrService | example | USCLSCodes |
ClaimResponse.addItem.detail.subDetail.modifier | example | ModifierTypeCodes |
ClaimResponse.total.category | required | ClaimStatusVS |
ClaimResponse.total.amount.currency | required | Currencies |
ClaimResponse.payment.type | example | ExamplePaymentTypeCodes |
ClaimResponse.payment.adjustmentReason | example | PaymentAdjustmentReasonCodes |
ClaimResponse.error.code | example | Adjudication Error Codes |
Id | Grade | Path | Details | Requirements |
dom-2 | error | ClaimResponse | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | ClaimResponse | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
dom-4 | error | ClaimResponse | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
dom-5 | error | ClaimResponse | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | Best Practice | ClaimResponse | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | ClaimResponse.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.identifier.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.identifier.use | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.type.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.identifier.type.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.identifier.type.coding | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.type.coding.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.identifier.type.coding.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.identifier.type.coding.system | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.type.coding.version | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.type.coding.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.type.coding.display | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.type.coding.userSelected | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.type.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.system | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.value | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.period | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier.assigner | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.identifier:Code.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.identifier:Code.use | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.type.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.identifier:Code.type.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.identifier:Code.type.coding | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.type.coding.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.identifier:Code.type.coding.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.identifier:Code.type.coding.system | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.type.coding.version | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.type.coding.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.type.coding.display | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.type.coding.userSelected | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.type.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.system | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.value | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.period | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:Code.assigner | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.identifier:UUID.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.identifier:UUID.use | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.type.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.identifier:UUID.type.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.identifier:UUID.type.coding | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.type.coding.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.identifier:UUID.type.coding.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.identifier:UUID.type.coding.system | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.type.coding.version | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.type.coding.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.type.coding.display | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.type.coding.userSelected | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.type.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.system | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.value | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.period | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.identifier:UUID.assigner | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.status | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.type.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.type.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.type.coding | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.type.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.use | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.patient | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.created | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.insurer | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.requestor | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.request | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.outcome | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.item.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.item.extension:itemReference | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.item.extension:itemReference | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.item.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.item.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.item.itemSequence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.adjudication | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.adjudication.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.item.adjudication.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.item.adjudication.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.item.adjudication.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.item.adjudication.category | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.adjudication.reason | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.adjudication.reason.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.item.adjudication.reason.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.item.adjudication.reason.coding | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.adjudication.reason.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.adjudication.amount | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.adjudication.amount.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.item.adjudication.amount.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.item.adjudication.amount.value | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.adjudication.amount.currency | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.adjudication.value | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.detail.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.item.detail.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.item.detail.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.item.detail.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.item.detail.detailSequence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.detail.noteNumber | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.detail.adjudication | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.detail.subDetail | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.detail.subDetail.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.item.detail.subDetail.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.item.detail.subDetail.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.item.detail.subDetail.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.item.detail.subDetail.subDetailSequence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.detail.subDetail.noteNumber | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.item.detail.subDetail.adjudication | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.addItem.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.addItem.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.addItem.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.addItem.itemSequence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detailSequence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.subdetailSequence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.provider | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.productOrService | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.modifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.programCode | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.serviced[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.location[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.quantity | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.unitPrice | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.factor | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.net | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.bodySite | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.subSite | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.noteNumber | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.adjudication | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.addItem.detail.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.addItem.detail.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.addItem.detail.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.addItem.detail.productOrService | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.modifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.quantity | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.unitPrice | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.factor | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.net | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.noteNumber | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.adjudication | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.subDetail | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.subDetail.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.addItem.detail.subDetail.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.addItem.detail.subDetail.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.addItem.detail.subDetail.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.addItem.detail.subDetail.productOrService | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.subDetail.modifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.subDetail.quantity | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.subDetail.unitPrice | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.subDetail.factor | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.subDetail.net | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.subDetail.noteNumber | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.addItem.detail.subDetail.adjudication | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.total | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.total.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.total.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.total.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.total.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.total.category | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.total.amount | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.total.amount.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.total.amount.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.total.amount.value | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.total.amount.currency | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.payment.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.payment.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.payment.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.payment.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.payment.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.payment.adjustment | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.payment.adjustmentReason | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.payment.date | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.payment.amount | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.payment.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.processNote | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.processNote.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.processNote.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.processNote.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.processNote.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.processNote.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.communicationRequest | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.insurance.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.insurance.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.insurance.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.insurance.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.insurance.sequence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.insurance.focal | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.insurance.coverage | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.insurance.businessArrangement | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.insurance.claimResponse | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.error.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.error.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.error.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | ClaimResponse.error.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | error | ClaimResponse.error.itemSequence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.error.detailSequence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.error.subDetailSequence | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | error | ClaimResponse.error.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |