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  1. FHIR Specification Feedback
  2. FHIR-31699

Base EOB payee.party has a 1..1 cardinality but the reference type available are not sufficient

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    • Type: Change Request
    • Status: Resolved - change required (View Workflow)
    • Priority: Medium
    • Resolution: Persuasive with Modification
    • Specification:
      US CARIN Blue Button (FHIR)
    • Raised in Version:
      1.0.0
    • Work Group:
      Financial Mgmt
    • Related Artifact(s):
      C4BB Explanation Of Benefit
    • Grouping:
    • Resolution Description:
      Hide

      Add relatedPerson profile (Optional in Capability Statement) and as a reference type for payee.party

      Change payee.party cardinality to 0..1

      Add invariant that requires payee.party be present if payee.type = other.

      Show
      Add relatedPerson profile (Optional in Capability Statement) and as a reference type for payee.party Change payee.party cardinality to 0..1 Add invariant that requires payee.party be present if payee.type = other.
    • Resolution Vote:
      Corey Spears / Pat Taylor: 10-0-0
    • Change Category:
      Enhancement
    • Change Impact:
      Non-compatible

      Description

      EOB.party.type can be "subscriber", "beneficiary" (Patient), "provider", or "other". If payee is present, the party reference has a cardinality of 1..1. This reference type is limited to only Organization, Practitioner, or Patient. That is not sufficient for the type of subscriber (which may not be a patient or organization) or other, which may be some other related person.

       

      The CARIN BB IG does not specify further requirements of the party Reference data type, so the payee.party.reference is not required. Short term the IG could provide some guidance on how an EOB may be specified without a payee.party.reference.

      Longer term (possibly STU2),  this could be fixed by providing additional reference types (such as relatedPerson).

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            Assignee:
            Unassigned Unassigned
            Reporter:
            corey_spears Corey Spears
            Watchers:
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              Updated:
              Resolved:
              Vote Date: