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    • Type: Change Request
    • Status: Resolved - change required (View Workflow)
    • Priority: Medium
    • Resolution: Not Persuasive with Modification
    • Specification:
      US CARIN Blue Button (FHIR)
    • Raised in Version:
      0.1
    • Work Group:
      Financial Mgmt
    • Related Page(s):
      (profiles)
    • Resolution Description:
      Hide

      The base R4 EOB,  EOB.provider is a reference to (Practitioner | PractitionerRole | Organization). The base CARIN ExplanationofBenefit profile has Reference(CARIN_Blue_Button_Organization_Profile. 

       

      The CarinBBEOB profile will constrain the reference to (CarinBBPractitioner || CarinBBPractitionerRole || CarinBBOrganization).

       

      In the mapping that drove the CarinBB IG, the EOB.provider is the 'Party responsible for the claim'.   This varies for the different EOB subtypes, as follows:

      For Facility (Inpatient and Outpatient) Claims), this must be an Organization.
      For Professional/Non-Clinician and Pharmacy claims, this may be an Organization, Practitioner, or PractitionerRole.

      The Inpatient/Outpatient Facilitiy EOBs will constrain provider to CarinBBOrganization.

      Show
      The base R4 EOB,  EOB.provider is a reference to (Practitioner | PractitionerRole | Organization). The base CARIN ExplanationofBenefit profile has Reference(CARIN_Blue_Button_Organization_Profile.    The CarinBBEOB profile will constrain the reference to (CarinBBPractitioner || CarinBBPractitionerRole || CarinBBOrganization).   In the mapping that drove the CarinBB IG, the EOB.provider is the 'Party responsible for the claim'.   This varies for the different EOB subtypes, as follows: For Facility (Inpatient and Outpatient) Claims), this must be an Organization. For Professional/Non-Clinician and Pharmacy claims, this may be an Organization, Practitioner, or PractitionerRole. The Inpatient/Outpatient Facilitiy EOBs will constrain provider to CarinBBOrganization.
    • Resolution Vote:
      Mark Roberts/Pat Taylor: 18-0-5
    • Change Category:
      Correction
    • Change Impact:
      Compatible, substantive

      Description

      Relax EOB.provider to be a reference to Org or Practitioner

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              Assignee:
              Unassigned
              Reporter:
              mark_roberts Mark Roberts
              Watchers:
              3 Start watching this issue

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                Created:
                Updated:
                Resolved:
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