{ "description": "Claimresponse profile for use in the different eAgreement flows from MyCareNet.", "_filename": "StructureDefinition-be-eagreementclaimresponse.json", "package_name": "ehealthplatform.be.r4.federalprofiles", "date": null, "derivation": "constraint", "publisher": null, "fhirVersion": "4.0.1", "name": "BeMyCareNetEagreementClaimResponse", "mapping": [ { "uri": "http://hl7.org/fhir/workflow", "name": "Workflow Pattern", "identity": "workflow" }, { "uri": "http://hl7.org/fhir/fivews", "name": "FiveWs Pattern Mapping", "identity": "w5" }, { "uri": "http://hl7.org/v3", "name": "RIM Mapping", "identity": "rim" } ], "abstract": false, "type": "ClaimResponse", "experimental": null, "resourceType": "StructureDefinition", "title": "MyCareNet eAgreement Claim Response BE profile", "package_version": "1.1.17-beta", "status": "active", "id": "13aeabf0-3a30-4c65-b9ec-d1e418162ecf", "kind": "resource", "url": "http://www.mycarenet.be/fhir/StructureDefinition/be-eagreementclaimresponse", "version": "1.0.0", "differential": { "element": [ { "id": "ClaimResponse.id", "min": 1, "path": "ClaimResponse.id", "mustSupport": true }, { "id": "ClaimResponse.meta", "min": 1, "path": "ClaimResponse.meta", "mustSupport": true }, { "id": "ClaimResponse.meta.profile", "max": "1", "min": 1, "path": "ClaimResponse.meta.profile" }, { "id": "ClaimResponse.status", "path": "ClaimResponse.status", "mustSupport": true }, { "id": "ClaimResponse.type", "path": "ClaimResponse.type", "mustSupport": true }, { "id": "ClaimResponse.type.coding", "max": "1", "min": 1, "path": "ClaimResponse.type.coding" }, { "id": "ClaimResponse.type.coding.system", "min": 1, "path": "ClaimResponse.type.coding.system" }, { "id": "ClaimResponse.type.coding.code", "min": 1, "path": "ClaimResponse.type.coding.code" }, { "id": "ClaimResponse.subType", "min": 1, "path": "ClaimResponse.subType", "mustSupport": true }, { "id": "ClaimResponse.subType.coding", "max": "1", "min": 1, "path": "ClaimResponse.subType.coding" }, { "id": "ClaimResponse.subType.coding.system", "min": 1, "path": "ClaimResponse.subType.coding.system", "patternUri": "http://www.mycarenet.be/fhir/CodeSystem/agreement-types" }, { "id": "ClaimResponse.subType.coding.code", "min": 1, "path": "ClaimResponse.subType.coding.code" }, { "id": "ClaimResponse.use", "path": "ClaimResponse.use", "mustSupport": true }, { "id": "ClaimResponse.patient", "path": "ClaimResponse.patient", "type": [ { "code": "Reference", "targetProfile": [ "https://www.ehealth.fgov.be/standards/fhir/StructureDefinition/be-patient" ] } ], "mustSupport": true }, { "id": "ClaimResponse.created", "path": "ClaimResponse.created", "mustSupport": true }, { "id": "ClaimResponse.insurer", "path": "ClaimResponse.insurer", "type": [ { "code": "Reference", "targetProfile": [ "https://www.ehealth.fgov.be/standards/fhir/StructureDefinition/be-organization" ] } ], "mustSupport": true }, { "id": "ClaimResponse.requestor", "min": 1, "path": "ClaimResponse.requestor", "type": [ { "code": "Reference", "targetProfile": [ "https://www.ehealth.fgov.be/standards/fhir/StructureDefinition/be-organization", "https://www.ehealth.fgov.be/standards/fhir/StructureDefinition/be-practitioner", "https://www.ehealth.fgov.be/standards/fhir/StructureDefinition/be-practitionerrole" ] } ], "mustSupport": true }, { "id": "ClaimResponse.requestor.reference", "min": 1, "path": "ClaimResponse.requestor.reference" }, { "id": "ClaimResponse.outcome", "path": "ClaimResponse.outcome", "mustSupport": true }, { "id": "ClaimResponse.preAuthRef", "min": 1, "path": "ClaimResponse.preAuthRef", "mustSupport": true }, { "id": "ClaimResponse.preAuthPeriod", "path": "ClaimResponse.preAuthPeriod", "mustSupport": true }, { "id": "ClaimResponse.preAuthPeriod.start", "min": 1, "path": "ClaimResponse.preAuthPeriod.start" }, { "id": "ClaimResponse.item", "path": "ClaimResponse.item", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Item" } ] }, { "id": "ClaimResponse.item.adjudication", "max": "1", "path": "ClaimResponse.item.adjudication", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Adjudication" } ], "mustSupport": true }, { "id": "ClaimResponse.item.adjudication.category.coding", "max": "1", "min": 1, "path": "ClaimResponse.item.adjudication.category.coding" }, { "id": "ClaimResponse.item.adjudication.category.coding.system", "min": 1, "path": "ClaimResponse.item.adjudication.category.coding.system", "patternUri": "http://www.mycarenet.be/fhir/CodeSystem/decision-values" }, { "id": "ClaimResponse.item.adjudication.category.coding.code", "min": 1, "path": "ClaimResponse.item.adjudication.category.coding.code" }, { "id": "ClaimResponse.item.adjudication.reason.coding", "max": "1", "min": 1, "path": "ClaimResponse.item.adjudication.reason.coding", "binding": { "strength": "extensible", "valueSet": "http://www.mycarenet.be/fhir/ValueSet/eagreementadjudicationreason" } }, { "id": "ClaimResponse.item.adjudication.reason.coding.system", "min": 1, "path": "ClaimResponse.item.adjudication.reason.coding.system" }, { "id": "ClaimResponse.item.adjudication.reason.coding.code", "min": 1, "path": "ClaimResponse.item.adjudication.reason.coding.code" }, { "id": "ClaimResponse.item.detail", "path": "ClaimResponse.item.detail", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "ItemDetail" } ] }, { "id": "ClaimResponse.item.detail.subDetail", "path": "ClaimResponse.item.detail.subDetail", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "SubDetail" } ] }, { "id": "ClaimResponse.addItem", "path": "ClaimResponse.addItem", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "AddedItem" } ], "mustSupport": true }, { "id": "ClaimResponse.addItem.itemSequence", "max": "1", "min": 1, "path": "ClaimResponse.addItem.itemSequence", "mustSupport": true }, { "id": "ClaimResponse.addItem.productOrService", "path": "ClaimResponse.addItem.productOrService", "binding": { "strength": "extensible", "valueSet": "http://www.mycarenet.be/fhir/ValueSet/eagreementproductorservice" } }, { "id": "ClaimResponse.addItem.productOrService.coding", "max": "1", "min": 1, "path": "ClaimResponse.addItem.productOrService.coding" }, { "id": "ClaimResponse.addItem.productOrService.coding.system", "min": 1, "path": "ClaimResponse.addItem.productOrService.coding.system" }, { "id": "ClaimResponse.addItem.productOrService.coding.code", "min": 1, "path": "ClaimResponse.addItem.productOrService.coding.code" }, { "id": "ClaimResponse.addItem.adjudication", "max": "1", "path": "ClaimResponse.addItem.adjudication", "mustSupport": true }, { "id": "ClaimResponse.addItem.detail", "path": "ClaimResponse.addItem.detail", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "AddedItemDetail" } ] }, { "id": "ClaimResponse.addItem.detail.subDetail", "path": "ClaimResponse.addItem.detail.subDetail", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "AddedItemSubDetail" } ] }, { "id": "ClaimResponse.total", "path": "ClaimResponse.total", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Total" } ] }, { "id": "ClaimResponse.payment", "path": "ClaimResponse.payment", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Payment" } ] }, { "id": "ClaimResponse.processNote", "path": "ClaimResponse.processNote", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Note" } ] }, { "id": "ClaimResponse.insurance", "path": "ClaimResponse.insurance", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Insurance" } ] }, { "id": "ClaimResponse.error", "path": "ClaimResponse.error", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Error" } ] } ] }, "baseDefinition": "http://hl7.org/fhir/StructureDefinition/ClaimResponse" }