{
"description": "A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.",
"_filename": "SpireCore-Claim.StructureDefinition.json",
"package_name": "fhir.r4.spirecore",
"date": null,
"derivation": "constraint",
"publisher": null,
"fhirVersion": "4.0.1",
"name": "SpireCoreClaim",
"abstract": false,
"type": "Claim",
"experimental": null,
"resourceType": "StructureDefinition",
"title": null,
"package_version": "0.1.0-alpha",
"status": "draft",
"id": "8ea120dd-9a1a-4336-8c40-0f7066b2d8fb",
"kind": "resource",
"url": "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Claim",
"version": null,
"differential": {
"element": [ {
"id": "Claim.identifier.assigner",
"path": "Claim.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.patient",
"path": "Claim.patient",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Patient", "http://hl7.org/fhir/StructureDefinition/Patient" ]
} ]
}, {
"id": "Claim.patient.identifier.assigner",
"path": "Claim.patient.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.enterer",
"path": "Claim.enterer",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Practitioner", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole" ]
} ]
}, {
"id": "Claim.enterer.identifier.assigner",
"path": "Claim.enterer.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.insurer",
"path": "Claim.insurer",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.insurer.identifier.assigner",
"path": "Claim.insurer.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.provider",
"path": "Claim.provider",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Practitioner", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-PractitionerRole", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.provider.identifier.assigner",
"path": "Claim.provider.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.related.claim",
"path": "Claim.related.claim",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Claim", "http://hl7.org/fhir/StructureDefinition/Claim" ]
} ]
}, {
"id": "Claim.related.claim.identifier.assigner",
"path": "Claim.related.claim.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.related.reference.assigner",
"path": "Claim.related.reference.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.prescription",
"path": "Claim.prescription",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-DeviceRequest", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-MedicationRequest", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-VisionPrescription", "http://hl7.org/fhir/StructureDefinition/DeviceRequest", "http://hl7.org/fhir/StructureDefinition/MedicationRequest", "http://hl7.org/fhir/StructureDefinition/VisionPrescription" ]
} ]
}, {
"id": "Claim.prescription.identifier.assigner",
"path": "Claim.prescription.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.originalPrescription",
"path": "Claim.originalPrescription",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-DeviceRequest", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-MedicationRequest", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-VisionPrescription", "http://hl7.org/fhir/StructureDefinition/DeviceRequest", "http://hl7.org/fhir/StructureDefinition/MedicationRequest", "http://hl7.org/fhir/StructureDefinition/VisionPrescription" ]
} ]
}, {
"id": "Claim.originalPrescription.identifier.assigner",
"path": "Claim.originalPrescription.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.payee.party",
"path": "Claim.payee.party",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Practitioner", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-PractitionerRole", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Patient", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson" ]
} ]
}, {
"id": "Claim.payee.party.identifier.assigner",
"path": "Claim.payee.party.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.referral",
"path": "Claim.referral",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-ServiceRequest", "http://hl7.org/fhir/StructureDefinition/ServiceRequest" ]
} ]
}, {
"id": "Claim.referral.identifier.assigner",
"path": "Claim.referral.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.facility",
"path": "Claim.facility",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Location", "http://hl7.org/fhir/StructureDefinition/Location" ]
} ]
}, {
"id": "Claim.facility.identifier.assigner",
"path": "Claim.facility.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.careTeam.provider",
"path": "Claim.careTeam.provider",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Practitioner", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-PractitionerRole", "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.careTeam.provider.identifier.assigner",
"path": "Claim.careTeam.provider.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.supportingInfo.value[x]",
"path": "Claim.supportingInfo.value[x]",
"type": [ {
"code": "boolean"
}, {
"code": "string"
}, {
"code": "Quantity"
}, {
"code": "Attachment"
}, {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Resource", "http://hl7.org/fhir/StructureDefinition/Resource" ]
} ]
}, {
"id": "Claim.diagnosis.diagnosis[x]",
"path": "Claim.diagnosis.diagnosis[x]",
"type": [ {
"code": "CodeableConcept"
}, {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Condition", "http://hl7.org/fhir/StructureDefinition/Condition" ]
} ]
}, {
"id": "Claim.procedure.procedure[x]",
"path": "Claim.procedure.procedure[x]",
"type": [ {
"code": "CodeableConcept"
}, {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Procedure", "http://hl7.org/fhir/StructureDefinition/Procedure" ]
} ]
}, {
"id": "Claim.procedure.udi",
"path": "Claim.procedure.udi",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Device", "http://hl7.org/fhir/StructureDefinition/Device" ]
} ]
}, {
"id": "Claim.procedure.udi.identifier.assigner",
"path": "Claim.procedure.udi.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.insurance.identifier.assigner",
"path": "Claim.insurance.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.insurance.coverage",
"path": "Claim.insurance.coverage",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Coverage", "http://hl7.org/fhir/StructureDefinition/Coverage" ]
} ]
}, {
"id": "Claim.insurance.coverage.identifier.assigner",
"path": "Claim.insurance.coverage.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.insurance.claimResponse",
"path": "Claim.insurance.claimResponse",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-ClaimResponse", "http://hl7.org/fhir/StructureDefinition/ClaimResponse" ]
} ]
}, {
"id": "Claim.insurance.claimResponse.identifier.assigner",
"path": "Claim.insurance.claimResponse.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.accident.location[x]",
"path": "Claim.accident.location[x]",
"type": [ {
"code": "Address"
}, {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Location", "http://hl7.org/fhir/StructureDefinition/Location" ]
} ]
}, {
"id": "Claim.item.location[x]",
"path": "Claim.item.location[x]",
"type": [ {
"code": "CodeableConcept"
}, {
"code": "Address"
}, {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Location", "http://hl7.org/fhir/StructureDefinition/Location" ]
} ]
}, {
"id": "Claim.item.udi",
"path": "Claim.item.udi",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Device", "http://hl7.org/fhir/StructureDefinition/Device" ]
} ]
}, {
"id": "Claim.item.udi.identifier.assigner",
"path": "Claim.item.udi.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.item.encounter",
"path": "Claim.item.encounter",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Encounter", "http://hl7.org/fhir/StructureDefinition/Encounter" ]
} ]
}, {
"id": "Claim.item.encounter.identifier.assigner",
"path": "Claim.item.encounter.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.item.detail.udi",
"path": "Claim.item.detail.udi",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Device", "http://hl7.org/fhir/StructureDefinition/Device" ]
} ]
}, {
"id": "Claim.item.detail.udi.identifier.assigner",
"path": "Claim.item.detail.udi.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
}, {
"id": "Claim.item.detail.subDetail.udi",
"path": "Claim.item.detail.subDetail.udi",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Device", "http://hl7.org/fhir/StructureDefinition/Device" ]
} ]
}, {
"id": "Claim.item.detail.subDetail.udi.identifier.assigner",
"path": "Claim.item.detail.subDetail.udi.identifier.assigner",
"type": [ {
"code": "Reference",
"targetProfile": [ "https://www.spirehealthcare.com/fhir/StructureDefinition/SpireCore-Organization", "http://hl7.org/fhir/StructureDefinition/Organization" ]
} ]
} ]
},
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Claim"
}