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Financial Management Work Group Maturity Level: 2Trial Use Compartments: N/A

This operation is used to submit an ProcessRequest for assessment either as a single ProcessRequest resource instance or as a Bundle containing the ProcessRequest and other referenced resources, or Bundle containing a batch of ProcessRequest resources, either as single ProcessRequests resources or Bundle resources, for processing. The only input parameter is the single ProcessRequest or Bundle resource and the only output is a single ProcessResponse or other single resource, Bundle of resources or Bundles or an OperationOutcome resource.

The official URL for this operation definition is

 http://hl7.org/fhir/OperationDefinition/ProcessRequest-submit

Formal Definition (as a OperationDefinition).

URL: [base]/ProcessRequest/$submit

This is not an idempotent operation

In Parameters:
NameCardinalityTypeBindingProfileDocumentation
resource1..1Resource

An ProcessRequest resource or Bundle of ProcessRequests, either as individual ProcessRequest resources or as Bundles each containing a single ProcessRequest plus referenced resources.

Out Parameters:
NameCardinalityTypeBindingProfileDocumentation
return1..1Resource

A resource or Bundle of responses, either as individual resources or as Bundles each containing a single focal resource plus referenced resources.

Note: as this is the only out parameter, it is a resource, and it has the name 'return', the result of this operation is returned directly as a resource

Request:

POST [baseurl]/ProcessRequest/$submit
[headers]

<?xml version="1.0" encoding="UTF-8"?>
<ProcessRequest xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../schema/remittance.xsd">
 <id value="1115"/>

 <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Poll ProcessRequest</div>
  </text>

  <identifier>
    <system value="http://www.phr.com/patient/12345/processrequest"/>
    <value value="115"/>
  </identifier>
  
  <status value="active"/>
  
  <action value="poll"/>
 
  <created value="2014-08-16"/>

  <include value="ExplanationOfBenefit"/>
  
 </ProcessRequest>

Response:

HTTP/1.1 200 OK
[headers]

<?xml version="1.0" encoding="UTF-8"?>
<ExplanationOfBenefit xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" >
	<id value="EB3500"/>

	<text>
		<status value="generated"/>
		<div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the ExplanationOfBenefit</div>
	</text>

	<identifier>
		<system value="http://www.BenefitsInc.com/fhir/explanationofbenefit"/>
		<value value="987654321"/>
	</identifier>

	<status value="active"/>

	<type>
		<coding>
			<system value="http://hl7.org/fhir/ex-claimtype"/>
			<code value="oral"/>
		</coding>
	</type>

	<patient>
		<reference value="Patient/pat1"/>
	</patient>

	<created value="2014-08-16"/>

	<enterer>
		<reference value="Practitioner/1"/>
	</enterer>

	<provider>
		<reference value="Practitioner/1"/>
	</provider>

	<organization>
		<reference value="Organization/2"/>
	</organization>

	<facility>
		<reference value="Location/1"/>
	</facility>

	<claim>
		<reference value="Claim/100150"/>
	</claim>

	<claimResponse>
		<reference value="ClaimResponse/R3500"/>
	</claimResponse> 

	<outcome value="complete" />

	<disposition value="Claim settled as per contract."/>

	<payee>
		<type>
			<coding>
				<system value="http://hl7.org/fhir/payeetype"/>
				<code value="provider"/>
			</coding>
		</type>
		<resource>
			<system value="http://hl7.org/fhir/resource-type-link"/>
			<code value="organization"/>
		</resource>
		<party>
			<reference value="Organization/2"/>
		</party>
	</payee>

	<careTeam>
		<sequence value="1"/>
		<provider>
			<reference value="Practitioner/example"/>
		</provider>
	</careTeam>

	<insurance>
		<coverage>
			<reference value="Coverage/9876B1"/>
		</coverage>
	</insurance>

	<item>
		<sequence value="1"/>
		<careTeamSequence value="1"/>
		<service>
			<coding>
				<system value="http://hl7.org/fhir/service-uscls"/>
				<code value="1200"/>
			</coding>
		</service>
		<servicedDate value="2014-08-16"/>
		<unitPrice>
			<value value="135.57"/>
			<system value="urn:iso:std:iso:4217"/>
			<code value="USD"/> 
		</unitPrice> 
		<net>
			<value value="135.57"/>
			<system value="urn:iso:std:iso:4217"/>
			<code value="USD"/> 
		</net> 
		<encounter>
			<reference value="Encounter/example"/>
		</encounter>
		<adjudication>
			<category>
				<coding>
					<code value="eligible"/>
				</coding>
			</category>
			<amount>
				<value value="120.00"/>
				<system value="urn:iso:std:iso:4217"/>
				<code value="USD"/> 
			</amount> 
		</adjudication>
		<adjudication>
			<category>
				<coding>
					<code value="eligpercent"/>
				</coding>
			</category>
			<value value="0.80"/>
		</adjudication>
		<adjudication>
			<category>
				<coding>
					<code value="benefit"/>
				</coding>
			</category>
			<amount>
				<value value="96.00"/>
				<system value="urn:iso:std:iso:4217"/>
				<code value="USD"/> 
			</amount> 
		</adjudication>
	</item>

	<totalCost>
		<value value="135.57"/>
		<system value="urn:iso:std:iso:4217"/>
		<code value="USD"/> 
	</totalCost>

	<totalBenefit>
		<value value="96.00"/>
		<system value="urn:iso:std:iso:4217"/>
		<code value="USD"/> 
	</totalBenefit>

</ExplanationOfBenefit>

 

For more information about operations, including how they are invoked, see Operations.