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  1. FHIR Specification Feedback
  2. FHIR-26721

Define the various payer adjudication amount fields in the EOB adjudication section

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    • Icon: Change Request Change Request
    • Resolution: Unresolved
    • Icon: Highest Highest
    • US CARIN Blue Button (FHIR)
    • 0.1 [deprecated]
    • Financial Mgmt
    • (NA)
    • NEW

    Description

      H.Resources (Claim / ClaimResponse / ExplanationOfBenefits). I.HTML Page Names (https://www.hl7.org/fhir/claim.html
      https://www.hl7.org/fhir/claimresponse.html

      https://www.hl7.org/fhir/explanationofbenefit.html). Description: Describes the various amount fields used when payers receive and adjudicate a claim.
      Values are submitted | eligible | deductible |coinsurance | copay | noncovered | priorpayerpaid | benefit | paidbypatient | paidtoprovider | paidtopatient | memberliability | discount | drugcost
      The data element resides in all claims.

      Existing Wording:

      The IG defines the Adjudication Amount Category as supporting.info

      Proposed Wording:

      Define these data elements within the adjudication section

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            Unassigned Unassigned
            taylorpatriciab Patricia Taylor
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            Dates

              Created:
              Updated: