Details
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Type:
Change Request
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Status: Deferred (View Workflow)
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Priority:
Highest
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Resolution: Considered for Future Use
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Specification:US CARIN Blue Button (FHIR)
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Raised in Version:0.1
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Work Group:Financial Mgmt
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Related Page(s):(NA)
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Related Section(s):NEW
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Grouping:
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Resolution Description:
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Resolution Vote:Mark Roberts/Pat Taylor: 18-0-5
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
Attachments
Issue Links
- is voted on by
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BALLOT-12251 Affirmative - Lenel James : 2020-Feb-BLUEBUTTON R1 STU
- Balloted