Patient Cost Transparency Implementation Guide
2.0.0 - STU 2 United States of America flag

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

Resource Profile: PCTAdvancedEOBSummary - Mappings

Page standards status: Trial-use Maturity Level: 1

Mappings for the davinci-pct-aeob-summary resource profile.

Mappings to Structures in this Implementation Guide

No Mappings Found

Mappings to other Structures

No Mappings Found

Other Mappings

NameWorkflow PatternFiveWs Pattern MappingHL7 v2 MappingRIM Mappingdoco
.. ExplanationOfBenefit
Event
  • Entity. Role
  • or Act
... id
... meta
... implicitRules
... language
... text
Act.text?
... contained
N/A
... Slices for extension
.... extension:serviceDescription
.... extension:outOfNetworkProviderInfo
... modifierExtension
N/A
... identifier
Event.identifier
FiveWs.identifier
... status
Event.status
FiveWs.status
... type
Event.code
FiveWs.class
... subType
FiveWs.class
... use
FiveWs.class
... patient
Event.subject
FiveWs.subject
... billablePeriod
FiveWs.done[x]
... created
Event.occurrence[x]
FiveWs.recorded
... enterer
Event.performer.agent
FiveWs.author
... insurer
Event.performer.agent
FiveWs.author
... provider
FiveWs.source
.... id
n/a
.... Slices for extension
..... extension:dataAbsentReason
ANY.nullFlavor
...... id
n/a
...... extension
...... url
N/A
...... value[x]
N/A
.... reference
N/A
.... type
N/A
.... identifier
.identifier
.... display
N/A
... priority
Request.priority
... fundsReserveRequested
... fundsReserve
... related
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... claim
.... relationship
.... reference
... prescription
... originalPrescription
... payee
... referral
FiveWs.cause
... facility
Event.performer.location
FiveWs.where[x]
... claim
FiveWs.why[x]
... claimResponse
... outcome
... disposition
... preAuthRef
... preAuthRefPeriod
... careTeam
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... sequence
.... provider
FiveWs.actor
.... responsible
.... role
.... qualification
... supportingInfo
... diagnosis
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... sequence
.... diagnosis[x]
.... type
.... onAdmission
.... packageCode
... procedure
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... sequence
.... type
.... date
.... procedure[x]
.... udi
... precedence
... insurance
Coverage
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... focal
.... coverage
.... preAuthRef
... accident
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... date
.... type
.... location[x]
... item
... addItem
... adjudication
... Slices for total
.... total:All Slices
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... category
..... amount
.... total:submitted
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... category
..... amount
.... total:memberliability
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... category
..... amount
.... total:eligible
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... category
..... amount
.... total:innetwork
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... category
..... amount
.... total:outofnetwork
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... category
..... amount
.... total:noncovered
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... category
..... amount
.... total:negotiated
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... category
..... amount
.... total:benefit
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... category
..... amount
... payment
... formCode
... form
... processNote
.... id
n/a
.... Slices for extension
..... extension:processNoteClass
.... modifierExtension
N/A
.... number
.... type
.... text
.... language
... benefitPeriod
... benefitBalance
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... category
..... id
n/a
..... extension
n/a
..... coding
  • C*E.1-8
  • C*E.10-22
  • union(.
  • ./translation)
..... text
C*E.9. But note many systems use C*E.2 for this
./originalText[mediaType/code="text/plain"]/data
.... excluded
.... name
.... description
.... network
.... unit
.... term
.... financial
..... id
n/a
..... Slices for extension
...... extension:remaining
..... modifierExtension
N/A
..... type
..... Slices for allowed[x]
...... allowed[x]:allowedMoney
..... Slices for used[x]
...... used[x]:usedMoney

doco Documentation for this format