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ClaimResponse

This resource provides the adjudication details from the processing of a Claim resource.

Properties

NameCardTypeDescription
id0..1stringLogical id of this artifact
meta0..1MetaMetadata about the resource
implicitRules0..1uriA set of rules under which this content was created
language0..1codeLanguage of the resource content
text0..1NarrativeText summary of the resource, for human interpretation
contained0..*ResourceContained, inline Resources
extension0..*ExtensionAdditional content defined by implementations
modifierExtension0..*ExtensionExtensions that cannot be ignored
identifier0..*IdentifierBusiness Identifier for a claim response
status1..1codeactive | cancelled | draft | entered-in-error
type1..1CodeableConceptMore granular claim type
subType0..1CodeableConceptMore granular claim type
use1..1codeclaim | preauthorization | predetermination
patient1..1ReferenceThe recipient of the products and services
created1..1dateTimeResponse creation date
insurer1..1ReferenceParty responsible for reimbursement
requestor0..1ReferenceParty responsible for the claim
request0..1ReferenceId of resource triggering adjudication
outcome1..1codequeued | complete | error | partial
disposition0..1stringDisposition Message
preAuthRef0..1stringPreauthorization reference
preAuthPeriod0..1PeriodPreauthorization reference effective period
payeeType0..1CodeableConceptParty to be paid any benefits payable
item0..*BackboneElementAdjudication for claim line items
addItem0..*BackboneElementInsurer added line items
adjudication0..*Header-level adjudication
total0..*BackboneElementAdjudication totals
payment0..1BackboneElementPayment Details
fundsReserve0..1CodeableConceptFunds reserved status
formCode0..1CodeableConceptPrinted form identifier
form0..1AttachmentPrinted reference or actual form
processNote0..*BackboneElementNote concerning adjudication
communicationRequest0..*ReferenceRequest for additional information
insurance0..*BackboneElementPatient insurance information
error0..*BackboneElementProcessing errors

Search Parameters

NameTypeDescriptionExpression
createddateThe creation dateClaimResponse.created
dispositionstringThe contents of the disposition messageClaimResponse.disposition
identifiertokenThe identity of the ClaimResponseClaimResponse.identifier
insurerreferenceThe organization which generated this resourceClaimResponse.insurer
outcometokenThe processing outcomeClaimResponse.outcome
patientreferenceThe subject of careClaimResponse.patient
payment-datedateThe expected payment dateClaimResponse.payment.date
requestreferenceThe claim referenceClaimResponse.request
requestorreferenceThe Provider of the claimClaimResponse.requestor
statustokenThe status of the ClaimResponseClaimResponse.status
usetokenThe type of claimClaimResponse.use