SIL HIE Implementation Guide, published by Kathurima Kimathi. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/savannahghi/hie-fhir-ig-profile/ and changes regularly. See the Directory of published versions

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Resource Profile: HIEClaim - Mappings

Mappings for the claim resource profile.

Mappings to Structures in this Implementation Guide

No Mappings Found

Mappings to other Structures

No Mappings Found

Other Mappings

Name	Workflow Pattern	FiveWs Pattern Mapping	RIM Mapping
Claim	Request	financial.billing	Entity. Role or Act
Claim / id
Claim / meta
Claim / implicitRules
Claim / language
Claim / text			Act.text?
Claim / contained			N/A
Claim / extension			N/A
Claim / modifierExtension			N/A
Claim / identifier	Request.identifier	FiveWs.identifier
Claim / identifier / id			n/a
Claim / identifier / extension			n/a
Claim / identifier / use			Role.code or implied by context
Claim / identifier / type			Role.code or implied by context
Claim / identifier / system			II.root or Role.id.root
Claim / identifier / value			II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
Claim / identifier / period			Role.effectiveTime or implied by context
Claim / identifier / assigner			II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
Claim / status	Request.status	FiveWs.status
Claim / type		FiveWs.class
Claim / subType		FiveWs.class
Claim / use		FiveWs.class
Claim / patient	Request.subject	FiveWs.subject
Claim / billablePeriod		FiveWs.done[x]
Claim / created	Request.authoredOn	FiveWs.recorded
Claim / enterer		FiveWs.author
Claim / insurer	Request.performer
Claim / provider	Request.requester	FiveWs.source
Claim / priority	Request.priority
Claim / fundsReserve
Claim / related
Claim / related / id			n/a
Claim / related / extension			n/a
Claim / related / modifierExtension			N/A
Claim / related / claim	Request.replaces
Claim / related / relationship
Claim / related / reference
Claim / prescription
Claim / originalPrescription
Claim / payee
Claim / payee / id			n/a
Claim / payee / extension			n/a
Claim / payee / modifierExtension			N/A
Claim / payee / type
Claim / payee / party
Claim / referral		FiveWs.cause
Claim / facility		FiveWs.where[x]
Claim / careTeam
Claim / careTeam / id			n/a
Claim / careTeam / extension			n/a
Claim / careTeam / modifierExtension			N/A
Claim / careTeam / sequence
Claim / careTeam / provider		FiveWs.actor
Claim / careTeam / responsible
Claim / careTeam / role
Claim / careTeam / qualification
Claim / supportingInfo	Request.supportingInfo
Claim / supportingInfo / id			n/a
Claim / supportingInfo / extension			n/a
Claim / supportingInfo / modifierExtension			N/A
Claim / supportingInfo / sequence
Claim / supportingInfo / category
Claim / supportingInfo / code
Claim / supportingInfo / timing[x]
Claim / supportingInfo / Slices for value[x]
Claim / supportingInfo / Slices for value[x] / value[x]:valueReference
Claim / supportingInfo / reason
Claim / diagnosis	Request.reasonReference
Claim / diagnosis / id			n/a
Claim / diagnosis / extension			n/a
Claim / diagnosis / modifierExtension			N/A
Claim / diagnosis / sequence
Claim / diagnosis / Slices for diagnosis[x]
Claim / diagnosis / Slices for diagnosis[x] / diagnosis[x]:diagnosisCodeableConcept
Claim / diagnosis / Slices for diagnosis[x] / diagnosis[x]:diagnosisReference
Claim / diagnosis / type
Claim / diagnosis / onAdmission
Claim / diagnosis / packageCode
Claim / procedure
Claim / procedure / id			n/a
Claim / procedure / extension			n/a
Claim / procedure / modifierExtension			N/A
Claim / procedure / sequence
Claim / procedure / type
Claim / procedure / date
Claim / procedure / Slices for procedure[x]
Claim / procedure / Slices for procedure[x] / procedure[x]:procedureCodeableConcept
Claim / procedure / Slices for procedure[x] / procedure[x]:procedureReference
Claim / procedure / udi
Claim / insurance			Coverage
Claim / insurance / id			n/a
Claim / insurance / extension			n/a
Claim / insurance / modifierExtension			N/A
Claim / insurance / sequence
Claim / insurance / focal
Claim / insurance / identifier	Request.identifier	FiveWs.identifier
Claim / insurance / coverage
Claim / insurance / businessArrangement
Claim / insurance / preAuthRef
Claim / insurance / claimResponse
Claim / accident
Claim / accident / id			n/a
Claim / accident / extension			n/a
Claim / accident / modifierExtension			N/A
Claim / accident / date
Claim / accident / type
Claim / accident / location[x]
Claim / item
Claim / item / id			n/a
Claim / item / extension			n/a
Claim / item / modifierExtension			N/A
Claim / item / sequence
Claim / item / careTeamSequence
Claim / item / diagnosisSequence
Claim / item / procedureSequence
Claim / item / informationSequence
Claim / item / revenue
Claim / item / category
Claim / item / productOrService
Claim / item / modifier
Claim / item / programCode
Claim / item / serviced[x]		FiveWs.done[x]
Claim / item / location[x]		FiveWs.where[x]
Claim / item / quantity
Claim / item / unitPrice
Claim / item / factor
Claim / item / net
Claim / item / udi
Claim / item / bodySite
Claim / item / subSite
Claim / item / encounter	Request.context
Claim / item / detail
Claim / item / detail / id			n/a
Claim / item / detail / extension			n/a
Claim / item / detail / modifierExtension			N/A
Claim / item / detail / sequence
Claim / item / detail / revenue
Claim / item / detail / category
Claim / item / detail / productOrService
Claim / item / detail / modifier
Claim / item / detail / programCode
Claim / item / detail / quantity
Claim / item / detail / unitPrice
Claim / item / detail / factor
Claim / item / detail / net
Claim / item / detail / udi
Claim / item / detail / subDetail
Claim / item / detail / subDetail / id			n/a
Claim / item / detail / subDetail / extension			n/a
Claim / item / detail / subDetail / modifierExtension			N/A
Claim / item / detail / subDetail / sequence
Claim / item / detail / subDetail / revenue
Claim / item / detail / subDetail / category
Claim / item / detail / subDetail / productOrService
Claim / item / detail / subDetail / modifier
Claim / item / detail / subDetail / programCode
Claim / item / detail / subDetail / quantity
Claim / item / detail / subDetail / unitPrice
Claim / item / detail / subDetail / factor
Claim / item / detail / subDetail / net
Claim / item / detail / subDetail / udi
Claim / total
Documentation for this format