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  1. FHIR Specification Feedback
  2. FHIR-37740

EOB.payee needs additional Referenced Resource type

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US CARIN Blue Button (FHIR)
    • current
    • Financial Mgmt
    • C4BB ExplanationOfBenefit Inpatient Institutional
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      As Per voted on in the resolution of FHIR-31699:

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

      This splits out the concepts out from Patient so the Patient resource is not required for non-patient payees.

       

      Additionally, definition for the relatedPerson Profile (matching the element constraints of US Core 5.0.1 RelatedPerson)

      Profile: C4BBRelatedPerson

      id: C4BB-RelatedPerson

      Title: C4BB Related Person

      Description: This profile is used to convey basic demographic information about a person related to the claim.

      meta.profile slice 1..1 MS

      active 1..1 MS

      patient 1..1 MS Reference(C4BB Patient)

      relationship 0..* MS

      name 0..* MS

      telecom 0..* MS

      address 0..* MS

       

      Add Invariant per FHIR-34223

       

      Add to CapabilityStatement as SHOULD. No search parameters, read (GET by id only)

       

      Add the following Invariant on the root of C4BBRelatedPerson

      Invariant: RelatedPerson-name-or-relationship

      Description: Either a name or a relationship SHALL be provided (or both)

      Expression: name.exists() or relationship.exists()

      Severity: error

       

      Show
      As Per voted on in the resolution of FHIR-31699 : Add relatedPerson profile (SHOULD in Capability Statement) and as a reference type for payee.party This splits out the concepts out from Patient so the Patient resource is not required for non-patient payees.   Additionally, definition for the relatedPerson Profile (matching the element constraints of US Core 5.0.1 RelatedPerson) Profile: C4BBRelatedPerson id: C4BB-RelatedPerson Title: C4BB Related Person Description: This profile is used to convey basic demographic information about a person related to the claim. meta.profile slice 1..1 MS active 1..1 MS patient 1..1 MS Reference(C4BB Patient) relationship 0..* MS name 0..* MS telecom 0..* MS address 0..* MS   Add Invariant per FHIR-34223   Add to CapabilityStatement as SHOULD. No search parameters, read (GET by id only)   Add the following Invariant on the root of C4BBRelatedPerson Invariant: RelatedPerson-name-or-relationship Description: Either a name or a relationship SHALL be provided (or both) Expression: name.exists() or relationship.exists() Severity: error  
    • Corey Spears / Jeff Brown : 13-0-0
    • Correction
    • Compatible, substantive

    Description

      Should the claim.payee also support a Reference to RelatedPerson?

      It seems like the payee could be the subscriber or some other related person and might not be the patient all the time, especially in the case where the patient is a child and one of the parents (might be the subscriber, might not be) pays for some services and then submits the claim afterwards.

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            Unassigned Unassigned
            LisaRNelson Lisa R. Nelson
            Lisa R. Nelson
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              Updated:
              Resolved: