Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.1 - STU 2.2 United States of America flag

Da Vinci Prior Authorization Support (PAS) FHIR IG, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.2.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions

Resource Profile: PAS Claim Response Base - Mappings

Page standards status: Trial-use Maturity Level: 4

Mappings for the profile-claimresponse-base resource profile.

Mappings to Structures in this Implementation Guide

No Mappings Found

Mappings to other Structures

No Mappings Found

Other Mappings

NameWorkflow PatternFiveWs Pattern MappingRIM Mappingdoco
ClaimResponse
Event
  • Entity. Role
  • or Act
ClaimResponse / id
ClaimResponse / meta
ClaimResponse / implicitRules
ClaimResponse / language
ClaimResponse / text
Act.text?
ClaimResponse / contained
N/A
ClaimResponse / Slices for extension
ClaimResponse / Slices for extension / extension:transmissionIdentifiers
ClaimResponse / Slices for extension / extension:claimResponseReviewer
ClaimResponse / Slices for extension / extension:authorizedProvider
ClaimResponse / modifierExtension
N/A
ClaimResponse / identifier
Event.identifier
FiveWs.identifier
ClaimResponse / identifier / id
n/a
ClaimResponse / identifier / Slices for extension
n/a
ClaimResponse / identifier / Slices for extension / extension:subDepartment
ClaimResponse / identifier / Slices for extension / extension:jurisdiction
ClaimResponse / identifier / use
Role.code or implied by context
ClaimResponse / identifier / type
Role.code or implied by context
ClaimResponse / identifier / system
II.root or Role.id.root
ClaimResponse / identifier / value
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
ClaimResponse / identifier / period
Role.effectiveTime or implied by context
ClaimResponse / identifier / assigner
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
ClaimResponse / status
Event.status
FiveWs.status
ClaimResponse / type
FiveWs.class
ClaimResponse / subType
FiveWs.class
ClaimResponse / use
FiveWs.class
ClaimResponse / patient
FiveWs.subject
ClaimResponse / created
Event.occurrence[x]
FiveWs.recorded
ClaimResponse / insurer
Event.performer
ClaimResponse / requestor
FiveWs.source
ClaimResponse / request
Event.basedOn
FiveWs.why[x]
ClaimResponse / request / id
n/a
ClaimResponse / request / Slices for extension
n/a
ClaimResponse / request / Slices for extension / extension:DataAbsentReason
ANY.nullFlavor
ClaimResponse / request / reference
N/A
ClaimResponse / request / type
N/A
ClaimResponse / request / identifier
.identifier
ClaimResponse / request / display
N/A
ClaimResponse / outcome
ClaimResponse / disposition
Event.note
ClaimResponse / preAuthRef
ClaimResponse / preAuthPeriod
ClaimResponse / payeeType
ClaimResponse / item
ClaimResponse / item / id
n/a
ClaimResponse / item / Slices for extension
ClaimResponse / item / Slices for extension / extension:itemTraceNumber
ClaimResponse / item / Slices for extension / extension:preAuthIssueDate
ClaimResponse / item / Slices for extension / extension:preAuthPeriod
ClaimResponse / item / Slices for extension / extension:previousAuthorizationNumber
ClaimResponse / item / Slices for extension / extension:administrationReferenceNumber
ClaimResponse / item / Slices for extension / extension:requestedServiceDate
ClaimResponse / item / Slices for extension / extension:authorizedProvider
ClaimResponse / item / Slices for extension / extension:authorizedItemDetail
ClaimResponse / item / Slices for extension / extension:admissionDates
ClaimResponse / item / Slices for extension / extension:dischargeDate
ClaimResponse / item / modifierExtension
N/A
ClaimResponse / item / itemSequence
ClaimResponse / item / noteNumber
ClaimResponse / item / adjudication
ClaimResponse / item / adjudication / id
n/a
ClaimResponse / item / adjudication / Slices for extension
ClaimResponse / item / adjudication / Slices for extension / extension:reviewAction
ClaimResponse / item / adjudication / modifierExtension
N/A
ClaimResponse / item / adjudication / category
ClaimResponse / item / adjudication / reason
ClaimResponse / item / adjudication / amount
ClaimResponse / item / adjudication / value
ClaimResponse / item / detail
ClaimResponse / item / detail / id
n/a
ClaimResponse / item / detail / extension
n/a
ClaimResponse / item / detail / modifierExtension
N/A
ClaimResponse / item / detail / detailSequence
ClaimResponse / item / detail / noteNumber
ClaimResponse / item / detail / adjudication
ClaimResponse / item / detail / subDetail
ClaimResponse / item / detail / subDetail / id
n/a
ClaimResponse / item / detail / subDetail / extension
n/a
ClaimResponse / item / detail / subDetail / modifierExtension
N/A
ClaimResponse / item / detail / subDetail / subDetailSequence
ClaimResponse / item / detail / subDetail / noteNumber
ClaimResponse / item / detail / subDetail / adjudication
ClaimResponse / addItem
ClaimResponse / addItem / id
n/a
ClaimResponse / addItem / Slices for extension
ClaimResponse / addItem / Slices for extension / extension:itemTraceNumber
ClaimResponse / addItem / Slices for extension / extension:preAuthIssueDate
ClaimResponse / addItem / Slices for extension / extension:preAuthPeriod
ClaimResponse / addItem / Slices for extension / extension:previousAuthorizationNumber
ClaimResponse / addItem / Slices for extension / extension:administrationReferenceNumber
ClaimResponse / addItem / Slices for extension / extension:epsdtIndicator
ClaimResponse / addItem / Slices for extension / extension:nursingHomeResidentialStatus
ClaimResponse / addItem / Slices for extension / extension:nursingHomeLevelOfCare
ClaimResponse / addItem / Slices for extension / extension:productOrServiceCodeEnd
ClaimResponse / addItem / Slices for extension / extension:revenue
ClaimResponse / addItem / Slices for extension / extension:revenueUnitRateLimit
ClaimResponse / addItem / Slices for extension / extension:requestedService
ClaimResponse / addItem / Slices for extension / extension:requestType
ClaimResponse / addItem / Slices for extension / extension:certificationType
ClaimResponse / addItem / Slices for extension / extension:category
ClaimResponse / addItem / Slices for extension / extension:admissionDates
ClaimResponse / addItem / Slices for extension / extension:dischargeDate
ClaimResponse / addItem / modifierExtension
N/A
ClaimResponse / addItem / itemSequence
ClaimResponse / addItem / detailSequence
ClaimResponse / addItem / subdetailSequence
ClaimResponse / addItem / provider
FiveWs.source
ClaimResponse / addItem / provider / id
n/a
ClaimResponse / addItem / provider / Slices for extension
n/a
ClaimResponse / addItem / provider / Slices for extension / extension:providerType
ClaimResponse / addItem / provider / reference
N/A
ClaimResponse / addItem / provider / type
N/A
ClaimResponse / addItem / provider / identifier
.identifier
ClaimResponse / addItem / provider / display
N/A
ClaimResponse / addItem / productOrService
ClaimResponse / addItem / modifier
  • 24.C
  • 24.D mods
ClaimResponse / addItem / programCode
24.H
ClaimResponse / addItem / serviced[x]
FiveWs.done[x]
24.A
ClaimResponse / addItem / location[x]
FiveWs.where[x]
24.B
ClaimResponse / addItem / quantity
24.G
ClaimResponse / addItem / unitPrice
ClaimResponse / addItem / factor
ClaimResponse / addItem / net
24.F
ClaimResponse / addItem / bodySite
ClaimResponse / addItem / subSite
ClaimResponse / addItem / noteNumber
ClaimResponse / addItem / adjudication
ClaimResponse / addItem / adjudication / id
n/a
ClaimResponse / addItem / adjudication / Slices for extension
ClaimResponse / addItem / adjudication / Slices for extension / extension:reviewAction
ClaimResponse / addItem / adjudication / modifierExtension
N/A
ClaimResponse / addItem / adjudication / category
ClaimResponse / addItem / adjudication / reason
ClaimResponse / addItem / adjudication / amount
ClaimResponse / addItem / adjudication / value
ClaimResponse / addItem / detail
ClaimResponse / addItem / detail / id
n/a
ClaimResponse / addItem / detail / extension
n/a
ClaimResponse / addItem / detail / modifierExtension
N/A
ClaimResponse / addItem / detail / productOrService
ClaimResponse / addItem / detail / modifier
  • 24.C
  • 24.D mods
ClaimResponse / addItem / detail / quantity
24.G
ClaimResponse / addItem / detail / unitPrice
ClaimResponse / addItem / detail / factor
ClaimResponse / addItem / detail / net
24.F
ClaimResponse / addItem / detail / noteNumber
ClaimResponse / addItem / detail / adjudication
ClaimResponse / addItem / detail / subDetail
ClaimResponse / addItem / detail / subDetail / id
n/a
ClaimResponse / addItem / detail / subDetail / extension
n/a
ClaimResponse / addItem / detail / subDetail / modifierExtension
N/A
ClaimResponse / addItem / detail / subDetail / productOrService
ClaimResponse / addItem / detail / subDetail / modifier
  • 24.C
  • 24.D mods
ClaimResponse / addItem / detail / subDetail / quantity
24.G
ClaimResponse / addItem / detail / subDetail / unitPrice
ClaimResponse / addItem / detail / subDetail / factor
ClaimResponse / addItem / detail / subDetail / net
24.F
ClaimResponse / addItem / detail / subDetail / noteNumber
ClaimResponse / addItem / detail / subDetail / adjudication
ClaimResponse / adjudication
ClaimResponse / adjudication / id
n/a
ClaimResponse / adjudication / Slices for extension
ClaimResponse / adjudication / Slices for extension / extension:reviewAction
ClaimResponse / adjudication / modifierExtension
N/A
ClaimResponse / adjudication / category
ClaimResponse / adjudication / reason
ClaimResponse / adjudication / amount
ClaimResponse / adjudication / value
ClaimResponse / total
ClaimResponse / total / id
n/a
ClaimResponse / total / extension
n/a
ClaimResponse / total / modifierExtension
N/A
ClaimResponse / total / category
ClaimResponse / total / amount
ClaimResponse / payment
ClaimResponse / payment / id
n/a
ClaimResponse / payment / extension
n/a
ClaimResponse / payment / modifierExtension
N/A
ClaimResponse / payment / type
ClaimResponse / payment / adjustment
ClaimResponse / payment / adjustmentReason
ClaimResponse / payment / date
ClaimResponse / payment / amount
ClaimResponse / payment / identifier
ClaimResponse / fundsReserve
ClaimResponse / formCode
ClaimResponse / form
ClaimResponse / processNote
ClaimResponse / processNote / id
n/a
ClaimResponse / processNote / extension
n/a
ClaimResponse / processNote / modifierExtension
N/A
ClaimResponse / processNote / number
ClaimResponse / processNote / type
ClaimResponse / processNote / text
ClaimResponse / processNote / language
ClaimResponse / communicationRequest
ClaimResponse / insurance
Coverage
ClaimResponse / insurance / id
n/a
ClaimResponse / insurance / extension
n/a
ClaimResponse / insurance / modifierExtension
N/A
ClaimResponse / insurance / sequence
ClaimResponse / insurance / focal
ClaimResponse / insurance / coverage
ClaimResponse / insurance / businessArrangement
ClaimResponse / insurance / claimResponse
ClaimResponse / error
ClaimResponse / error / id
n/a
ClaimResponse / error / Slices for extension
ClaimResponse / error / Slices for extension / extension:followupAction
ClaimResponse / error / Slices for extension / extension:errorElement
ClaimResponse / error / Slices for extension / extension:errorPath
ClaimResponse / error / modifierExtension
N/A
ClaimResponse / error / itemSequence
ClaimResponse / error / detailSequence
ClaimResponse / error / subDetailSequence
ClaimResponse / error / code

doco Documentation for this format