醫療保險理賠實作指引 - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: ClaimiClaim - Mappings

Active as of 2024-07-23

Mappings for the claim-iclaim resource profile.

Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

ClaimiClaim
Claim	Request
identifier	Request.identifier
status	Request.status
patient	Request.subject
created	Request.authoredOn
insurer	Request.performer
provider	Request.requester
priority	Request.priority
related
claim	Request.replaces
supportingInfo	Request.supportingInfo
diagnosis	Request.reasonReference
insurance
identifier	Request.identifier
item
encounter	Request.context

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

ClaimiClaim
Claim
identifier	FiveWs.identifier
status	FiveWs.status
type	FiveWs.class
subType	FiveWs.class
use	FiveWs.class
patient	FiveWs.subject[x], FiveWs.subject
billablePeriod	FiveWs.done[x]
created	FiveWs.recorded
enterer	FiveWs.author
provider	FiveWs.source
referral	FiveWs.cause
facility	FiveWs.where[x]
careTeam
provider	FiveWs.actor
insurance
identifier	FiveWs.identifier
item
serviced[x]	FiveWs.done[x]
location[x]	FiveWs.where[x]

Mappings for RIM Mapping (http://hl7.org/v3)

ClaimiClaim
Claim	Entity. Role, or Act
text	Act.text?
contained	N/A
extension	N/A
modifierExtension	N/A
related
id	n/a
extension	n/a
modifierExtension	N/A
payee
id	n/a
extension	n/a
modifierExtension	N/A
careTeam
id	n/a
extension	n/a
modifierExtension	N/A
supportingInfo
id	n/a
extension	n/a
modifierExtension	N/A
diagnosis
id	n/a
extension	n/a
modifierExtension	N/A
procedure
id	n/a
extension	n/a
modifierExtension	N/A
insurance	Coverage
id	n/a
extension	n/a
modifierExtension	N/A
accident
id	n/a
extension	n/a
modifierExtension	N/A
item
id	n/a
extension	n/a
modifierExtension	N/A
detail
id	n/a
extension	n/a
modifierExtension	N/A
subDetail
id	n/a
extension	n/a
modifierExtension	N/A