Claim

A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.

Properties

Name	Card	Type	Description
id	0..1	string	Logical id of this artifact
meta	0..1	Meta	Metadata about the resource
implicitRules	0..1	uri	A set of rules under which this content was created
language	0..1	code	Language of the resource content
text	0..1	Narrative	Text summary of the resource, for human interpretation
contained	0..*	Resource	Contained, inline Resources
extension	0..*	Extension	Additional content defined by implementations
modifierExtension	0..*	Extension	Extensions that cannot be ignored
identifier	0..*	Identifier	Business Identifier for claim
status	1..1	code	active | cancelled | draft | entered-in-error
type	1..1	CodeableConcept	Category or discipline
subType	0..1	CodeableConcept	More granular claim type
use	1..1	code	claim | preauthorization | predetermination
patient	1..1	Reference	The recipient of the products and services
billablePeriod	0..1	Period	Relevant time frame for the claim
created	1..1	dateTime	Resource creation date
enterer	0..1	Reference	Author of the claim
insurer	0..1	Reference	Target
provider	1..1	Reference	Party responsible for the claim
priority	1..1	CodeableConcept	Desired processing ugency
fundsReserve	0..1	CodeableConcept	For whom to reserve funds
related	0..*	BackboneElement	Prior or corollary claims
prescription	0..1	Reference	Prescription authorizing services and products
originalPrescription	0..1	Reference	Original prescription if superseded by fulfiller
payee	0..1	BackboneElement	Recipient of benefits payable
referral	0..1	Reference	Treatment referral
facility	0..1	Reference	Servicing facility
careTeam	0..*	BackboneElement	Members of the care team
supportingInfo	0..*	BackboneElement	Supporting information
diagnosis	0..*	BackboneElement	Pertinent diagnosis information
procedure	0..*	BackboneElement	Clinical procedures performed
insurance	1..*	BackboneElement	Patient insurance information
accident	0..1	BackboneElement	Details of the event
item	0..*	BackboneElement	Product or service provided
total	0..1	Money	Total claim cost

Search Parameters

Name	Type	Description	Expression
care-team	reference	Member of the CareTeam	Claim.careTeam.provider
created	date	The creation date for the Claim	Claim.created
detail-udi	reference	UDI associated with a line item, detail product or service	Claim.item.detail.udi
encounter	reference	Encounters associated with a billed line item	Claim.item.encounter
enterer	reference	The party responsible for the entry of the Claim	Claim.enterer
facility	reference	Facility where the products or services have been or will be provided	Claim.facility
identifier	token	The primary identifier of the financial resource	Claim.identifier
insurer	reference	The target payor/insurer for the Claim	Claim.insurer
item-udi	reference	UDI associated with a line item product or service	Claim.item.udi
patient	reference	Patient receiving the products or services	Claim.patient
payee	reference	The party receiving any payment for the Claim	Claim.payee.party
priority	token	Processing priority requested	Claim.priority
procedure-udi	reference	UDI associated with a procedure	Claim.procedure.udi
provider	reference	Provider responsible for the Claim	Claim.provider
status	token	The status of the Claim instance.	Claim.status
subdetail-udi	reference	UDI associated with a line item, detail, subdetail product or service	Claim.item.detail.subDetail.udi
use	token	The kind of financial resource	Claim.use