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  1. FHIR Specification Feedback
  2. FHIR-31639

Tighter guidance requiring WHEN provenance needs to be included in the EOB profiles

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    Details

    • Type: Change Request
    • Status: Resolved - change required (View Workflow)
    • Priority: Medium
    • Resolution: Persuasive with Modification
    • Specification:
      US CARIN Blue Button (FHIR)
    • Raised in Version:
      current
    • Work Group:
      Financial Mgmt
    • Related Artifact(s):
      C4BB Explanation Of Benefit
    • Grouping:
    • Resolution Description:
      Hide

      We will change cardinality from 0..1 to 1..1 for Outpatient Institutional EOB.item.serviced [x].

      We will also change cardinality 0..1 to 1..1 for Professional Non Clinician EOB.billablePeriod and EOB.item.serviced [x]

      We will change cardinality from 0..1 to 1..1 for Pharmacy EOB.item.serviced [x].

       

      We add cardinality from 0..1 to 1..1 for Oral EOB.item.serviced [x].

      Show
      We will change cardinality from 0..1 to 1..1 for Outpatient Institutional EOB.item.serviced [x] . We will also change cardinality 0..1 to 1..1 for Professional Non Clinician EOB.billablePeriod and EOB.item.serviced [x] .  We will change cardinality from 0..1 to 1..1 for Pharmacy EOB.item.serviced [x] .   We add cardinality from 0..1 to 1..1 for Oral EOB.item.serviced [x] .
    • Resolution Vote:
      Corey Spears / Mark Roberts : 12-0-0
    • Change Category:
      Correction
    • Change Impact:
      Compatible, substantive

      Description

      Currently the Inpatient EOB profile requires WHEN provenance information to be included but the other EOB profiles do not have the same constraints. Consequently we are seeing EOBs being supplied that are missing the critical information for making the data meaningful.  

      The constraint for the relevant date of outpatient, professional services and pharmacy (and dental and vision) services needs to be tightened to 1..1 as it is in the inpatient EOB (even though the WHEN provenance information may be included in a different data element within the EOB modeling).

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            Assignee:
            Unassigned Unassigned
            Reporter:
            LisaRNelson Lisa R. Nelson
            Watchers:
            2 Start watching this issue

              Dates

              Created:
              Updated:
              Resolved:
              Vote Date: