CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
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CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®), published by HL7 Financial Management Working Group. This is not an authorized publication; it is the continuous build for version 2.0.0). This version is based on the current content of https://github.com/HL7/carin-bb/ and changes regularly. See the Directory of published versions

Resource Profile: C4BBExplanationOfBenefitProfessionalNonClinician - Mappings

Active as of 2023-08-02

Mappings for the C4BB-ExplanationOfBenefit-Professional-NonClinician resource profile.

Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

C4BBExplanationOfBenefitProfessionalNonClinician
ExplanationOfBenefitEvent
   identifierEvent.identifier
   identifier (uniqueclaimid)Event.identifier
   statusEvent.status
   typeEvent.code
   patientEvent.subject
   createdEvent.occurrence[x]
   entererEvent.performer.agent
   insurerEvent.performer.agent
   facilityEvent.performer.location

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

C4BBExplanationOfBenefitProfessionalNonClinician
ExplanationOfBenefit
   identifierFiveWs.identifier
   identifier (uniqueclaimid)FiveWs.identifier
   statusFiveWs.status
   typeFiveWs.class
   subTypeFiveWs.class
   useFiveWs.class
   patientFiveWs.subject[x], FiveWs.subject
   billablePeriodFiveWs.done[x]
   createdFiveWs.recorded
   entererFiveWs.author
   insurerFiveWs.author
   providerFiveWs.source
   referralFiveWs.cause
   facilityFiveWs.where[x]
   claimFiveWs.why[x]
   careTeam
      providerFiveWs.actor
   item
      serviced[x]FiveWs.done[x]
      location[x]FiveWs.where[x]
   addItem
      providerFiveWs.source
      serviced[x]FiveWs.done[x]
      location[x]FiveWs.where[x]

Mappings for HL7 v2 Mapping (http://hl7.org/v2)

C4BBExplanationOfBenefitProfessionalNonClinician
ExplanationOfBenefit
   identifier
      useN/A
      typeCX.5
      systemCX.4 / EI-2-4
      valueCX.1 / EI.1
      periodCX.7 + CX.8
      assignerCX.4 / (CX.4,CX.9,CX.10)
   identifier (uniqueclaimid)
      useN/A
      typeCX.5
      systemCX.4 / EI-2-4
      valueCX.1 / EI.1
      periodCX.7 + CX.8
      assignerCX.4 / (CX.4,CX.9,CX.10)
   billablePeriod
      startDR.1
      endDR.2
   priorityRequest.priority
   supportingInfo
      value[x]
   supportingInfo (clmrecvddate)
      value[x]
   supportingInfo (servicefacility)
      value[x]
      value[x] (valueReference)
   supportingInfo (medicalrecordnumber)
      value[x]
      value[x] (valueString)
   supportingInfo (patientaccountnumber)
      value[x]
      value[x] (valueString)
   supportingInfo (patientweight)
      value[x]
         valueSN.2 / CQ - N/A
         comparatorSN.1 / CQ.1
         unit(see OBX.6 etc.) / CQ.2
         system(see OBX.6 etc.) / CQ.2
         code(see OBX.6 etc.) / CQ.2
   supportingInfo (ambulancetransportreason)
      value[x]
   supportingInfo (transportationdistance)
      value[x]
         valueSN.2 / CQ - N/A
         comparatorSN.1 / CQ.1
         unit(see OBX.6 etc.) / CQ.2
         system(see OBX.6 etc.) / CQ.2
         code(see OBX.6 etc.) / CQ.2
   insuranceCoverage

Mappings for RIM Mapping (http://hl7.org/v3)

C4BBExplanationOfBenefitProfessionalNonClinician
ExplanationOfBenefitEntity. Role, or Act
   meta
      idn/a
      extensionn/a
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifier
      idn/a
      extensionn/a
      useRole.code or implied by context
      typeRole.code or implied by context
      systemII.root or Role.id.root
      valueII.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
      periodRole.effectiveTime or implied by context
      assignerII.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
   identifier (uniqueclaimid)
      idn/a
      extensionn/a
      useRole.code or implied by context
      typeRole.code or implied by context
      systemII.root or Role.id.root
      valueII.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
      periodRole.effectiveTime or implied by context
      assignerII.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
   billablePeriod
      idn/a
      extensionn/a
      start./low
      end./high
   related
      idn/a
      extensionn/a
      modifierExtensionN/A
   payee
      idn/a
      extensionn/a
      modifierExtensionN/A
   careTeam
      idn/a
      extensionn/a
      modifierExtensionN/A
   supportingInfo
      idn/a
      extensionn/a
      modifierExtensionN/A
      value[x]
   supportingInfo (clmrecvddate)
      idn/a
      extensionn/a
      modifierExtensionN/A
      value[x]
   supportingInfo (servicefacility)
      idn/a
      extensionn/a
      modifierExtensionN/A
      value[x]
      value[x] (valueReference)
   supportingInfo (medicalrecordnumber)
      idn/a
      extensionn/a
      modifierExtensionN/A
      value[x]
      value[x] (valueString)
   supportingInfo (patientaccountnumber)
      idn/a
      extensionn/a
      modifierExtensionN/A
      value[x]
      value[x] (valueString)
   supportingInfo (patientweight)
      idn/a
      extensionn/a
      modifierExtensionN/A
      value[x]
         idn/a
         extensionn/a
         valuePQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
         comparatorIVL properties
         unitPQ.unit
         systemCO.codeSystem, PQ.translation.codeSystem
         codePQ.code, MO.currency, PQ.translation.code
   supportingInfo (ambulancetransportreason)
      idn/a
      extensionn/a
      modifierExtensionN/A
      value[x]
   supportingInfo (transportationdistance)
      idn/a
      extensionn/a
      modifierExtensionN/A
      value[x]
         idn/a
         extensionn/a
         valuePQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
         comparatorIVL properties
         unitPQ.unit
         systemCO.codeSystem, PQ.translation.codeSystem
         codePQ.code, MO.currency, PQ.translation.code
   supportingInfo (roudtrippurpose)
      idn/a
      extensionn/a
      modifierExtensionN/A
   supportingInfo (stretcherpurpose)
      idn/a
      extensionn/a
      modifierExtensionN/A
   supportingInfo (pickuplocation)
      idn/a
      extensionn/a
      modifierExtensionN/A
   supportingInfo (dropofflocation)
      idn/a
      extensionn/a
      modifierExtensionN/A
   diagnosis
      idn/a
      extensionn/a
      modifierExtensionN/A
   procedure
      idn/a
      extensionn/a
      modifierExtensionN/A
   insurance
      idn/a
      extensionn/a
      modifierExtensionN/A
   accident
      idn/a
      extensionn/a
      modifierExtensionN/A
   item
      idn/a
      extensionn/a
      modifierExtensionN/A
      adjudication
         idn/a
         extensionn/a
         modifierExtensionN/A
      adjudication (adjudicationamounttype)
         idn/a
         extensionn/a
         modifierExtensionN/A
      adjudication (adjustmentreason)
         idn/a
         extensionn/a
         modifierExtensionN/A
      adjudication (benefitpaymentstatus)
         idn/a
         extensionn/a
         modifierExtensionN/A
      adjudication (allowedunits)
         idn/a
         extensionn/a
         modifierExtensionN/A
      detail
         idn/a
         extensionn/a
         modifierExtensionN/A
         subDetail
            idn/a
            extensionn/a
            modifierExtensionN/A
   addItem
      idn/a
      extensionn/a
      modifierExtensionN/A
      detail
         idn/a
         extensionn/a
         modifierExtensionN/A
         subDetail
            idn/a
            extensionn/a
            modifierExtensionN/A
   adjudication
      idn/a
      extensionn/a
      modifierExtensionN/A
   adjudication (billingnetworkstatus)
      idn/a
      extensionn/a
      modifierExtensionN/A
   adjudication (renderingnetworkstatus)
      idn/a
      extensionn/a
      modifierExtensionN/A
   total
      idn/a
      extensionn/a
      modifierExtensionN/A
   total (adjudicationamounttype)
      idn/a
      extensionn/a
      modifierExtensionN/A
   payment
      idn/a
      extensionn/a
      modifierExtensionN/A
   processNote
      idn/a
      extensionn/a
      modifierExtensionN/A
   benefitBalance
      idn/a
      extensionn/a
      modifierExtensionN/A
      financial
         idn/a
         extensionn/a
         modifierExtensionN/A