Implementation Guide
23.1.0 - R4 APIs
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Active as of 2023-03-01 |
Definitions for the athena-claim-profile logical model.
Guidance on how to interpret the contents of this table can be found here
0. athena-claim-profile | |
Logical Model | Instances of this logical model are not marked to be the target of a Reference |
2. athena-claim-profile.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Short | Logical id of this artifact |
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
Control | 1..1 |
Type | id |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
4. athena-claim-profile.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
Short | Metadata about the resource |
Comments | Unique Id for this particular athena-claim-profile. |
Control | 0..1 |
Type | Meta |
Is Modifier | false |
Must Support | false |
6. athena-claim-profile.pid | |
Definition | Who/What Claimed |
Short | PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource. |
Comments | PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource. |
Control | 1..1 |
Type | integer |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
8. athena-claim-profile.patient | |
Definition | Who or what the athena-claim-profile is about. The athena-claim-profile can be about a person. |
Short | Who/what is the patient of claim |
Control | 1..1 |
Type | Reference(Patient) |
10. athena-claim-profile.patient.reference | |
Definition | Who or what the athena-claim-profile is about. The athena-claim-profile can be about a person. |
Short | Reference to the Patient |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
12. athena-claim-profile.patient.display | |
Definition | Patient name for the athena-claim-profile is about. |
Short | Patient name |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
14. athena-claim-profile.patientProfileId | |
Definition | Internal ID of patient used in non-clinical practice management data. |
Short | Patient specific id for practice management data including financial information |
Comments | Patient profile ID |
Control | 1..1 |
Type | unsignedInt |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
16. athena-claim-profile.batchNumber | |
Definition | Batch no specific to the patient visit |
Short | Batch containing this claim |
Comments | The batch number of the batch containing this athena-claim-profile |
Control | 0..1 |
Type | unsignedInt |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
18. athena-claim-profile.charges | |
Definition | batch no specific to the patient visit |
Short | The sum of the charges to be claimed. |
Comments | The sum of the charges for this electronic athena-claim-profile. |
Control | 0..1 |
Type | Money |
20. athena-claim-profile.charges.value | |
Definition | Charged value of the athena-claim-profile |
Short | Amount of money |
Comments | The sum of the charges for this electronic athena-claim-profile. |
Control | 0..1 |
Type | decimal |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
22. athena-claim-profile.charges.currency | |
Definition | Name of the the Currency |
Short | Currency |
Comments | The sum of the charges for this electronic athena-claim-profile. |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
24. athena-claim-profile.filingMethod | |
Definition | Claim filing type |
Short | The ID of the filing method for ths electronic athena-claim-profile. This column should be linked to the MedLists table MedListsId column with a TableName of FilingMethods. |
Comments | The ID of the filing method for ths electronic athena-claim-profile. This column should be linked to the MedLists table MedListsId column with a TableName of FilingMethods. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
26. athena-claim-profile.claimFileId | |
Definition | Claim associated filed id |
Short | The ID of the EDICLaim. |
Comments | The ID of the EDIClaim that contains this electronic athena-claim-profile. |
Control | 0..1 |
Type | unsignedInt |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
28. athena-claim-profile.fileName | |
Definition | athena-claim-profileed file name |
Short | EDI Claim file name |
Comments | Edi Claim file name |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
30. athena-claim-profile.fileCreated | |
Definition | Claim file created date |
Short | Date that claim file was created. |
Comments | The date that this electronic athena-claim-profile file was created. |
Control | 0..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
32. athena-claim-profile.filedBy | |
Definition | Person name who filed claim |
Short | Person name who filed claim |
Comments | The name of the user who filed this electronic athena-claim-profile. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
34. athena-claim-profile.fileTransmitted | |
Definition | Claim file transmission date |
Short | Claim file transmission date |
Comments | Claim file transmission date |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
36. athena-claim-profile.submissionNumber | |
Definition | Electronic claim submission Number |
Short | Electronic claim submission Number |
Comments | The reference number for a given claim |
Control | 0..1 |
Type | integer |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
38. athena-claim-profile.transmissionStatus | |
Definition | Status of claim |
Short | The transmission status of this electronic claim file (i.e. 'Ready To Transmit', 'Transmission Failed', 'Transmitted') |
Comments | The transmission status of this electronic athena-claim-profile file (i.e. 'Ready To Transmit', 'Transmission Failed', 'Transmitted') |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
40. athena-claim-profile.failureReason | |
Definition | Transmission status failure reason |
Short | A description of the reason for the unsuccessful transmission of this electronic claim (applies only to files with TransmissionStatus = 'Transmission Failed')) |
Comments | A description of the reason for the unsuccessful transmission of this electronic athena-claim-profile file (applies only to files with TransmissionStatus = 'Transmission Failed') |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
42. athena-claim-profile.claimData | |
Definition | Claim file data |
Short | The actual contents of this electronic claim file. |
Comments | The actual contents of this electronic claim file. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
44. athena-claim-profile.lineDelimiter | |
Short | The line delimiter used when this electronic claim file was created by the plug-in. |
Comments | The record delimiter used when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
46. athena-claim-profile.fieldDelimiter | |
Short | The field delimiter used when this electronic claim file was created by the plug-in. |
Comments | The record delimiter used when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
48. athena-claim-profile.recordDelimiter | |
Short | The record delimiter used when this electronic claim file was created by the plug-in. |
Comments | The record delimiter used when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
50. athena-claim-profile.lineLength | |
Short | The maximum line length allowed when this electronic claim file was created by the plug-in. |
Comments | The maximum line length allowed when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
52. athena-claim-profile.recordLength | |
Short | The maximum record length allowed when this electronic claim file was created by the plug-in. |
Comments | The maximum record length allowed when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
54. athena-claim-profile.clearinghouseName | |
Definition | name of clearing house |
Short | Clearinghouse for the electronic claim file. |
Comments | clearinghouse for this electronic claim file |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
56. athena-claim-profile.insuranceCarrier | |
Definition | Reference to Organization |
Short | Insurance carrier for the electronic claim. |
Control | 0..1 |
Type | Reference(Organization) |
58. athena-claim-profile.insuranceCarrier.reference | |
Definition | Reference to Organization |
Short | Insurance Carrier Id refering to Organization |
Comments | Insurance Carrier Id refering to Organization |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
60. athena-claim-profile.insuranceCarrier.display | |
Definition | Name of the the insurance Carrier |
Short | Insurance carrier Name |
Comments | Insurance carrier Name |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Guidance on how to interpret the contents of this table can be found here
0. athena-claim-profile | |
Control | 0..* |
Is Modifier | false |
Logical Model | Instances of this logical model are not marked to be the target of a Reference |
2. athena-claim-profile.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Short | Logical id of this artifact |
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
Control | 1..1 |
Type | id |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | true |
4. athena-claim-profile.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
Short | Metadata about the resource |
Comments | Unique Id for this particular athena-claim-profile. |
Control | 0..1 |
Type | Meta |
Is Modifier | false |
Must Support | false |
Summary | true |
6. athena-claim-profile.pid | |
Definition | Who/What Claimed |
Short | PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource. |
Comments | PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource. |
Control | 1..1 |
Type | integer |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
8. athena-claim-profile.patient | |
Definition | Who or what the athena-claim-profile is about. The athena-claim-profile can be about a person. |
Short | Who/what is the patient of claim |
Control | 1..1 |
Type | Reference(Patient) |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) |
10. athena-claim-profile.patient.reference | |
Definition | Who or what the athena-claim-profile is about. The athena-claim-profile can be about a person. A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. |
Short | Reference to the PatientLiteral reference, Relative, internal or absolute URL |
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. |
Control | 0..1 This element is affected by the following invariants: ref-1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
12. athena-claim-profile.patient.display | |
Definition | Patient name for the athena-claim-profile is about. Plain text narrative that identifies the resource in addition to the resource reference. |
Short | Patient nameText alternative for the resource |
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. |
Control | 0..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
14. athena-claim-profile.patientProfileId | |
Definition | Internal ID of patient used in non-clinical practice management data. |
Short | Patient specific id for practice management data including financial information |
Comments | Patient profile ID |
Control | 1..1 |
Type | unsignedInt |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | true |
16. athena-claim-profile.batchNumber | |
Definition | Batch no specific to the patient visit |
Short | Batch containing this claim |
Comments | The batch number of the batch containing this athena-claim-profile |
Control | 0..1 |
Type | unsignedInt |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
18. athena-claim-profile.charges | |
Definition | batch no specific to the patient visit |
Short | The sum of the charges to be claimed. |
Comments | The sum of the charges for this electronic athena-claim-profile. |
Control | 0..1 |
Type | Money |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
20. athena-claim-profile.charges.value | |
Definition | Charged value of the athena-claim-profile Numerical value (with implicit precision). |
Short | Amount of moneyNumerical value (with implicit precision) |
Comments | The sum of the charges for this electronic athena-claim-profile. Monetary values have their own rules for handling precision (refer to standard accounting text books). |
Control | 0..1 |
Type | decimal |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | The amount of the currency. The value includes an implicit precision in the presentation of the value. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
22. athena-claim-profile.charges.currency | |
Definition | Name of the the Currency ISO 4217 Currency Code. |
Short | CurrencyISO 4217 Currency Code |
Comments | The sum of the charges for this electronic athena-claim-profile. |
Control | 0..1 |
Binding | The codes SHALL be taken from Currencieshttp://hl7.org/fhir/ValueSet/currencies|4.0.1 (required to http://hl7.org/fhir/ValueSet/currencies|4.0.1 )A code indicating the currency, taken from ISO 4217. |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | A code indicating the currency, taken from ISO 4217. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
24. athena-claim-profile.filingMethod | |
Definition | Claim filing type |
Short | The ID of the filing method for ths electronic athena-claim-profile. This column should be linked to the MedLists table MedListsId column with a TableName of FilingMethods. |
Comments | The ID of the filing method for ths electronic athena-claim-profile. This column should be linked to the MedLists table MedListsId column with a TableName of FilingMethods. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
26. athena-claim-profile.claimFileId | |
Definition | Claim associated filed id |
Short | The ID of the EDICLaim. |
Comments | The ID of the EDIClaim that contains this electronic athena-claim-profile. |
Control | 0..1 |
Type | unsignedInt |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
28. athena-claim-profile.fileName | |
Definition | athena-claim-profileed file name |
Short | EDI Claim file name |
Comments | Edi Claim file name |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
30. athena-claim-profile.fileCreated | |
Definition | Claim file created date |
Short | Date that claim file was created. |
Comments | The date that this electronic athena-claim-profile file was created. |
Control | 0..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
32. athena-claim-profile.filedBy | |
Definition | Person name who filed claim |
Short | Person name who filed claim |
Comments | The name of the user who filed this electronic athena-claim-profile. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
34. athena-claim-profile.fileTransmitted | |
Definition | Claim file transmission date |
Short | Claim file transmission date |
Comments | Claim file transmission date |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
36. athena-claim-profile.submissionNumber | |
Definition | Electronic claim submission Number |
Short | Electronic claim submission Number |
Comments | The reference number for a given claim |
Control | 0..1 |
Type | integer |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
38. athena-claim-profile.transmissionStatus | |
Definition | Status of claim |
Short | The transmission status of this electronic claim file (i.e. 'Ready To Transmit', 'Transmission Failed', 'Transmitted') |
Comments | The transmission status of this electronic athena-claim-profile file (i.e. 'Ready To Transmit', 'Transmission Failed', 'Transmitted') |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
40. athena-claim-profile.failureReason | |
Definition | Transmission status failure reason |
Short | A description of the reason for the unsuccessful transmission of this electronic claim (applies only to files with TransmissionStatus = 'Transmission Failed')) |
Comments | A description of the reason for the unsuccessful transmission of this electronic athena-claim-profile file (applies only to files with TransmissionStatus = 'Transmission Failed') |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
42. athena-claim-profile.claimData | |
Definition | Claim file data |
Short | The actual contents of this electronic claim file. |
Comments | The actual contents of this electronic claim file. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
44. athena-claim-profile.lineDelimiter | |
Short | The line delimiter used when this electronic claim file was created by the plug-in. |
Comments | The record delimiter used when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
46. athena-claim-profile.fieldDelimiter | |
Short | The field delimiter used when this electronic claim file was created by the plug-in. |
Comments | The record delimiter used when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
48. athena-claim-profile.recordDelimiter | |
Short | The record delimiter used when this electronic claim file was created by the plug-in. |
Comments | The record delimiter used when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
50. athena-claim-profile.lineLength | |
Short | The maximum line length allowed when this electronic claim file was created by the plug-in. |
Comments | The maximum line length allowed when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
52. athena-claim-profile.recordLength | |
Short | The maximum record length allowed when this electronic claim file was created by the plug-in. |
Comments | The maximum record length allowed when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
54. athena-claim-profile.clearinghouseName | |
Definition | name of clearing house |
Short | Clearinghouse for the electronic claim file. |
Comments | clearinghouse for this electronic claim file |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
56. athena-claim-profile.insuranceCarrier | |
Definition | Reference to Organization |
Short | Insurance carrier for the electronic claim. |
Control | 0..1 |
Type | Reference(Organization) |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) |
58. athena-claim-profile.insuranceCarrier.reference | |
Definition | Reference to Organization A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. |
Short | Insurance Carrier Id refering to OrganizationLiteral reference, Relative, internal or absolute URL |
Comments | Insurance Carrier Id refering to Organization Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. |
Control | 0..1 This element is affected by the following invariants: ref-1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
60. athena-claim-profile.insuranceCarrier.display | |
Definition | Name of the the insurance Carrier Plain text narrative that identifies the resource in addition to the resource reference. |
Short | Insurance carrier NameText alternative for the resource |
Comments | Insurance carrier Name This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. |
Control | 0..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be found here
0. athena-claim-profile | |
Control | 0..* |
Is Modifier | false |
Logical Model | Instances of this logical model are not marked to be the target of a Reference |
2. athena-claim-profile.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Short | Logical id of this artifact |
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
Control | 1..1 |
Type | id |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | true |
4. athena-claim-profile.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
Short | Metadata about the resource |
Comments | Unique Id for this particular athena-claim-profile. |
Control | 0..1 |
Type | Meta |
Is Modifier | false |
Must Support | false |
Summary | true |
6. athena-claim-profile.pid | |
Definition | Who/What Claimed |
Short | PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource. |
Comments | PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource. |
Control | 1..1 |
Type | integer |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | false |
Summary | true |
8. athena-claim-profile.patient | |
Definition | Who or what the athena-claim-profile is about. The athena-claim-profile can be about a person. |
Short | Who/what is the patient of claim |
Control | 1..1 |
Type | Reference(Patient) |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) |
10. athena-claim-profile.patient.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
12. athena-claim-profile.patient.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Short | Additional content defined by implementations |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) |
Slicing | This element introduces a set of slices on athena-claim-profile.patient.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
14. athena-claim-profile.patient.reference | |
Definition | Who or what the athena-claim-profile is about. The athena-claim-profile can be about a person. |
Short | Reference to the Patient |
Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. |
Control | 0..1 This element is affected by the following invariants: ref-1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
16. athena-claim-profile.patient.type | |
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). |
Short | Type the reference refers to (e.g. "Patient") |
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. |
Control | 0..1 |
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to http://hl7.org/fhir/ValueSet/resource-types )Aa resource (or, for logical models, the URI of the logical model). |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
18. athena-claim-profile.patient.identifier | |
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. |
Short | Logical reference, when literal reference is not known |
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..1 |
Type | Identifier |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
20. athena-claim-profile.patient.display | |
Definition | Patient name for the athena-claim-profile is about. |
Short | Patient name |
Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. |
Control | 0..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
22. athena-claim-profile.patientProfileId | |
Definition | Internal ID of patient used in non-clinical practice management data. |
Short | Patient specific id for practice management data including financial information |
Comments | Patient profile ID |
Control | 1..1 |
Type | unsignedInt |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | true |
24. athena-claim-profile.batchNumber | |
Definition | Batch no specific to the patient visit |
Short | Batch containing this claim |
Comments | The batch number of the batch containing this athena-claim-profile |
Control | 0..1 |
Type | unsignedInt |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
26. athena-claim-profile.charges | |
Definition | batch no specific to the patient visit |
Short | The sum of the charges to be claimed. |
Comments | The sum of the charges for this electronic athena-claim-profile. |
Control | 0..1 |
Type | Money |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
28. athena-claim-profile.charges.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
30. athena-claim-profile.charges.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Short | Additional content defined by implementations |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) |
Slicing | This element introduces a set of slices on athena-claim-profile.charges.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
32. athena-claim-profile.charges.value | |
Definition | Charged value of the athena-claim-profile |
Short | Amount of money |
Comments | The sum of the charges for this electronic athena-claim-profile. |
Control | 0..1 |
Type | decimal |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | The amount of the currency. The value includes an implicit precision in the presentation of the value. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
34. athena-claim-profile.charges.currency | |
Definition | Name of the the Currency |
Short | Currency |
Comments | The sum of the charges for this electronic athena-claim-profile. |
Control | 0..1 |
Binding | The codes SHALL be taken from Currencies (required to http://hl7.org/fhir/ValueSet/currencies|4.0.1 )A code indicating the currency, taken from ISO 4217. |
Type | code |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | A code indicating the currency, taken from ISO 4217. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
36. athena-claim-profile.filingMethod | |
Definition | Claim filing type |
Short | The ID of the filing method for ths electronic athena-claim-profile. This column should be linked to the MedLists table MedListsId column with a TableName of FilingMethods. |
Comments | The ID of the filing method for ths electronic athena-claim-profile. This column should be linked to the MedLists table MedListsId column with a TableName of FilingMethods. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
38. athena-claim-profile.claimFileId | |
Definition | Claim associated filed id |
Short | The ID of the EDICLaim. |
Comments | The ID of the EDIClaim that contains this electronic athena-claim-profile. |
Control | 0..1 |
Type | unsignedInt |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
40. athena-claim-profile.fileName | |
Definition | athena-claim-profileed file name |
Short | EDI Claim file name |
Comments | Edi Claim file name |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
42. athena-claim-profile.fileCreated | |
Definition | Claim file created date |
Short | Date that claim file was created. |
Comments | The date that this electronic athena-claim-profile file was created. |
Control | 0..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
44. athena-claim-profile.filedBy | |
Definition | Person name who filed claim |
Short | Person name who filed claim |
Comments | The name of the user who filed this electronic athena-claim-profile. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
46. athena-claim-profile.fileTransmitted | |
Definition | Claim file transmission date |
Short | Claim file transmission date |
Comments | Claim file transmission date |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
48. athena-claim-profile.submissionNumber | |
Definition | Electronic claim submission Number |
Short | Electronic claim submission Number |
Comments | The reference number for a given claim |
Control | 0..1 |
Type | integer |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
50. athena-claim-profile.transmissionStatus | |
Definition | Status of claim |
Short | The transmission status of this electronic claim file (i.e. 'Ready To Transmit', 'Transmission Failed', 'Transmitted') |
Comments | The transmission status of this electronic athena-claim-profile file (i.e. 'Ready To Transmit', 'Transmission Failed', 'Transmitted') |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
52. athena-claim-profile.failureReason | |
Definition | Transmission status failure reason |
Short | A description of the reason for the unsuccessful transmission of this electronic claim (applies only to files with TransmissionStatus = 'Transmission Failed')) |
Comments | A description of the reason for the unsuccessful transmission of this electronic athena-claim-profile file (applies only to files with TransmissionStatus = 'Transmission Failed') |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
54. athena-claim-profile.claimData | |
Definition | Claim file data |
Short | The actual contents of this electronic claim file. |
Comments | The actual contents of this electronic claim file. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
56. athena-claim-profile.lineDelimiter | |
Short | The line delimiter used when this electronic claim file was created by the plug-in. |
Comments | The record delimiter used when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
58. athena-claim-profile.fieldDelimiter | |
Short | The field delimiter used when this electronic claim file was created by the plug-in. |
Comments | The record delimiter used when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
60. athena-claim-profile.recordDelimiter | |
Short | The record delimiter used when this electronic claim file was created by the plug-in. |
Comments | The record delimiter used when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
62. athena-claim-profile.lineLength | |
Short | The maximum line length allowed when this electronic claim file was created by the plug-in. |
Comments | The maximum line length allowed when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
64. athena-claim-profile.recordLength | |
Short | The maximum record length allowed when this electronic claim file was created by the plug-in. |
Comments | The maximum record length allowed when this electronic claim file was created by the plug-in. |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
66. athena-claim-profile.clearinghouseName | |
Definition | name of clearing house |
Short | Clearinghouse for the electronic claim file. |
Comments | clearinghouse for this electronic claim file |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
68. athena-claim-profile.insuranceCarrier | |
Definition | Reference to Organization |
Short | Insurance carrier for the electronic claim. |
Control | 0..1 |
Type | Reference(Organization) |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ref-1: SHALL have a contained resource if a local reference is provided ( reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) ) |
70. athena-claim-profile.insuranceCarrier.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
72. athena-claim-profile.insuranceCarrier.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Short | Additional content defined by implementations |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) |
Slicing | This element introduces a set of slices on athena-claim-profile.insuranceCarrier.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
74. athena-claim-profile.insuranceCarrier.reference | |
Definition | Reference to Organization |
Short | Insurance Carrier Id refering to Organization |
Comments | Insurance Carrier Id refering to Organization |
Control | 0..1 This element is affected by the following invariants: ref-1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
76. athena-claim-profile.insuranceCarrier.type | |
Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). |
Short | Type the reference refers to (e.g. "Patient") |
Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. |
Control | 0..1 |
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to http://hl7.org/fhir/ValueSet/resource-types )Aa resource (or, for logical models, the URI of the logical model). |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
78. athena-claim-profile.insuranceCarrier.identifier | |
Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. |
Short | Logical reference, when literal reference is not known |
Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..1 |
Type | Identifier |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
80. athena-claim-profile.insuranceCarrier.display | |
Definition | Name of the the insurance Carrier |
Short | Insurance carrier Name |
Comments | Insurance carrier Name |
Control | 0..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |