| Package | hl7.fhir.us.carin-bb |
| Type | ImplementationGuide |
| Id | Id |
| FHIR Version | R4 |
| Source | http://hl7.org/fhir/us/carin-bb/https://build.fhir.org/ig/HL7/carin-bb/index.html |
| Url | http://hl7.org/fhir/us/carin-bb/ImplementationGuide/hl7.fhir.us.carin-bb |
| Version | 2.1.0 |
| Status | active |
| Date | 2024-12-12T20:01:15+00:00 |
| Name | CARINConsumerDirectedPayerDataExchange |
| Title | CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®) |
| Experimental | False |
| Realm | us |
| Authority | hl7 |
| Description | CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®) |
| CapabilityStatement | |
c4bb  | C4BB CapabilityStatement |
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: ImplementationGuide hl7.fhir.us.carin-bb
The official URL for this implementation guide is:
http://hl7.org/fhir/us/carin-bb/ImplementationGuide/hl7.fhir.us.carin-bb
CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
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{
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"valueString" : "true"
}
],
"url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
},
{
"extension" : [
{
"url" : "code",
"valueCode" : "fmm-definition"
},
{
"url" : "value",
"valueString" : "http://hl7.org/fhir/versions.html#maturity"
}
],
"url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
},
{
"extension" : [
{
"url" : "code",
"valueCode" : "propagate-status"
},
{
"url" : "value",
"valueString" : "true"
}
],
"url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
},
{
"extension" : [
{
"url" : "code",
"valueCode" : "excludelogbinaryformat"
},
{
"url" : "value",
"valueString" : "true"
}
],
"url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
},
{
"extension" : [
{
"url" : "code",
"valueCode" : "tabbed-snapshots"
},
{
"url" : "value",
"valueString" : "true"
}
],
"url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-parameter"
}
],
"grouping" : [
{
"id" : "capability",
"name" : "Behavior: Capability Statements",
"description" : "The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements."
},
{
"id" : "search",
"name" : "Behavior: Search Parameters",
"description" : "These define the properties by which a RESTful server can be searched. They can also be used for sorting and including related resources."
},
{
"id" : "abstract",
"name" : "Structures: Abstract Profiles",
"description" : "These are profiles on resources or data types that describe patterns used by other profiles, but cannot be instantiated directly. I.e. instances can conform to profiles based on these abstract profiles, but do not declare conformance to the abstract profiles themselves."
},
{
"id" : "basis",
"name" : "Structures: Explanation of Benefits Basis Profiles",
"description" : "Basis profiles that define all non-financial element requirements for ExplanationOfBenefit types. These profiles are not expected to be implemented directly within the context of the consumer directed data exchange use case defined by this guide, but rather from within the context in which external guides may define (e.g. Provider Access API of PDEX)."
},
{
"id" : "profiles",
"name" : "Structures: Resource Profiles",
"description" : "These define constraints on FHIR resources for systems conforming to this implementation guide."
}
],
"resource" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/ADADentalProcedureCode"
},
"name" : "ADA Code on Dental Procedures and Nomenclature Value Set",
"description" : "The purpose of the CDT Code is to achieve uniformity, consistency and specificity in accurately documenting dental treatment. One use of the CDT Code is to provide for the efficient processing of dental claims, and another is to populate an Electronic Health Record.\n\nOn August 17, 2000 the CDT Code was named as a HIPAA standard code set. Any claim submitted on a HIPAA standard electronic dental claim must use dental procedure codes from the version of the CDT Code in effect on the date of service. The CDT Code is also used on paper dental claims, and the ADA's paper claim form data content reflects the HIPAA electronic standard.\n\nCDT is published Annually. Versions should refect the YYYY of the release.\n\nThe Council on Dental Benefit Programs (CDBP) has ADA Bylaws responsibility for CDT Code maintenance. To fulfill this obligation CDBP established its Code Maintenance Committee (CMC), a body that includes representatives from various sectors of the dental community (e.g., ADA; dental specialty organizations; third-party payers). CMC members, by their votes, determine which of the requested actions are incorporated into the CDT Code.\n\nPlease see Code Maintenance Committee (CMC) page for information about the CMC's members and activities.\n\nTo obtain the underlying code systems, please see information [here](https://www.nubc.org/subscription-information)",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/ADAUniversalNumberingSystem"
},
"name" : "American Dental Association Universal Numbering Value Set",
"description" : "The American Dental Association Universal Numbering System is a tooth notation system primarily used in the United States.\n\nTeeth are numbered from the viewpoint of the dental practitioner looking into the open mouth, clockwise starting from the distalmost right maxillary teeth.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/BB-EOBOral1-nonfinancial"
},
"name" : "BB-EOBOral1-nonfinancial",
"description" : "EOB Oral Example 1 - Nonfinancial",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Oral-Basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/BB-EOBOral2-nonfinancial"
},
"name" : "BB-EOBOral2-nonfinancial",
"description" : "EOB Oral Example 2 - Nonfinancial",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Oral-Basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/BB-EOBPharmacy1-nonfinancial"
},
"name" : "BB-EOBPharmacy1-nonfinancial",
"description" : "EOB Pharmacy Example 1 - Nonfinancial",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Pharmacy-Basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBAdjudicationCategoryDiscriminator"
},
"name" : "C4BB Adjudication Category Discriminator Value Set",
"description" : "Used as the discriminator for adjudication.category and item.adjudication.category for the CARIN IG for Blue Button®",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CodeSystem"
}
],
"reference" : {
"reference" : "CodeSystem/C4BBAdjudication"
},
"name" : "C4BB Adjudication Code System",
"description" : "Describes the various amount fields used when payers receive and adjudicate a claim. It complements the values defined in http://terminology.hl7.org/CodeSystem/adjudication.\n\nThis is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CodeSystem"
}
],
"reference" : {
"reference" : "CodeSystem/C4BBAdjudicationDiscriminator"
},
"name" : "C4BB Adjudication Discriminator Code System",
"description" : "Used as the discriminator for the data elements in adjudication and item.adjudication.\n\nThis is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBAdjudication"
},
"name" : "C4BB Adjudication Value Set",
"description" : "Describes the various amount fields used when payers receive and adjudicate a claim. It includes the values \ndefined in http://terminology.hl7.org/CodeSystem/adjudication, as well as those defined in the C4BB Adjudication CodeSystem.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBAmbulanceTransportReasonCodes"
},
"name" : "C4BB Ambulance Transport Reasons Value Set",
"description" : "Transportation Services Ambulatory Transport Reason Codes",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CapabilityStatement"
}
],
"reference" : {
"reference" : "CapabilityStatement/c4bb"
},
"name" : "C4BB CapabilityStatement",
"description" : "This Section describes the expected capabilities of the C4BB Server actor which is responsible for providing responses to the queries submitted by the C4BB Requestors. \n\nThe EOB Resource is the focal Consumer-Directed Payer Data Exchange (CDPDE) Resource. Several Reference Resources are defined directly/indirectly from the EOB: Coverage, Patient, Organization (Payer ID), Practioner, and Organization (Facility).\n\nThe Coverage Reference Resource SHALL be returned with data that was effective as of the date of service of the claim; for example, the data will reflect the employer name in effect at that time. However, for other reference resources, payers MAY decide to provide either the data that was in effect as of the date of service or the current data. All reference resources within the EOB will have meta.lastUpdated flagged as must support. Payers SHALL provide the last time the data was updated or the date of creation in the payers system of record, whichever comes last. Apps will use the meta.lastUpdated values to determine if the reference resources are as of the current date or date of service.",
"exampleBoolean" : false,
"groupingId" : "capability"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CodeSystem"
}
],
"reference" : {
"reference" : "CodeSystem/C4BBClaimCareTeamRole"
},
"name" : "C4BB Claim Care Team Role Code System",
"description" : "Describes functional roles of the care team members. Complements http://terminology.hl7.org/CodeSystem/claimcareteamrole.\n\nThis is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CodeSystem"
}
],
"reference" : {
"reference" : "CodeSystem/C4BBClaimDiagnosisType"
},
"name" : "C4BB Claim Diagnosis Type Code System",
"description" : "Indicates if the institutional diagnosis is admitting, principal, secondary, other, an external cause of injury or a patient reason for visit. Complements http://terminology.hl7.org/CodeSystem/ex-diagnosistype.\n\nThis is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBClaimIdentifierType"
},
"name" : "C4BB Claim Identifier Type Value Set",
"description" : "Indicates that the claim identifier is that assigned by a payer for a claim received from a provider or subscriber",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBClaimInpatientInstitutionalDiagnosisType"
},
"name" : "C4BB Claim Inpatient Institutional Diagnosis Type Value Set",
"description" : "Indicates if the inpatient institutional diagnosis is admitting, principal, other or an external cause of injury.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBClaimInstitutionalCareTeamRole"
},
"name" : "C4BB Claim Institutional Care Team Role Value Set",
"description" : "Describes functional roles of the care team members.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBClaimOutpatientInstitutionalDiagnosisType"
},
"name" : "C4BB Claim Outpatient Institutional Diagnosis Type Value Set",
"description" : "Indicates if the outpatient institutional diagnosis is principal, other, an external cause of injury or a patient reason for visit.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBClaimPharmacyTeamRole"
},
"name" : "C4BB Claim Pharmacy CareTeam Role Value Set",
"description" : "Describes functional roles of the care team members",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CodeSystem"
}
],
"reference" : {
"reference" : "CodeSystem/C4BBClaimProcedureType"
},
"name" : "C4BB Claim Procedure Type Code System",
"description" : "Indicates if the inpatient institutional procedure (ICD-PCS) is the principal procedure or another procedure.\n\nThis is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBClaimProcedureType"
},
"name" : "C4BB Claim Procedure Type Value Set",
"description" : "Indicates if the inpatient institutional procedure (ICD-PCS) is the principal procedure or another procedure",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBClaimProfessionalAndNonClinicianCareTeamRole"
},
"name" : "C4BB Claim Professional And Non Clinician Care Team Role Value Set",
"description" : "Describes functional roles of the care team members",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBClaimProfessionalAndNonClinicianDiagnosisType"
},
"name" : "C4BB Claim Professional And Non Clinician Diagnosis Type Value Set",
"description" : "Indicates if the professional and non-clinician diagnosis is principal or secondary",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CodeSystem"
}
],
"reference" : {
"reference" : "CodeSystem/C4BBCompoundLiteral"
},
"name" : "C4BB Compound Literal Code System",
"description" : "CodeSystem for a Literal 'compound' value.\n\nThis is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-Coverage"
},
"name" : "C4BB Coverage",
"description" : "Data that reflect a payer’s coverage that was effective as of the date of service or the date of admission of the claim.",
"exampleBoolean" : false,
"groupingId" : "profiles"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource:abstract"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-ExplanationOfBenefit"
},
"name" : "C4BB Explanation Of Benefit",
"description" : "Abstract parent profile that includes constraints that are common to the four specific ExplanationOfBenefit (EOB) profiles defined in this Implementation Guide.\nAll EOB instances should be from one of the four concrete EOB profiles defined in this Implementation Guide: Inpatient, Outpatient, Pharmacy, and Professional/NonClinician",
"exampleBoolean" : false,
"groupingId" : "abstract"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
},
"name" : "C4BB ExplanationOfBenefit Inpatient Institutional",
"description" : "The profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for inpatient services, which may include the use of equipment and supplies, laboratory services, radiology services and other charges. Inpatient claims are submitted for services rendered at an institution as part of an overnight stay.\nThe claims data is based on the institutional claim format UB-04, submission standards adopted by the Department of Health and Human\nServices.\nThe profile has requirements for financial data.",
"exampleBoolean" : false,
"groupingId" : "profiles"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional-Basis"
},
"name" : "C4BB ExplanationOfBenefit Inpatient Institutional Basis",
"description" : "The basis profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for inpatient services, which may include the use of equipment and supplies, laboratory services, radiology services and other charges. Inpatient claims are submitted for services rendered at an institution as part of an overnight stay.\nThe claims data is based on the institutional claim format UB-04, submission standards adopted by the Department of Health and Human\nServices.\nThe basis profile does not have requirements for financial data.",
"exampleBoolean" : false,
"groupingId" : "basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-ExplanationOfBenefit-Oral"
},
"name" : "C4BB ExplanationOfBenefit Oral",
"description" : "This profile is used for Explanation of Benefits (EOBs) based on claims submitted by providers of oral services including Dental, Denture and Hygiene. The ADA Dental Claim Form provides a common format for reporting dental services to a patient's dental benefit plan.\nThe profile has requirements for financial data.",
"exampleBoolean" : false,
"groupingId" : "profiles"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-ExplanationOfBenefit-Oral-Basis"
},
"name" : "C4BB ExplanationOfBenefit Oral Basis",
"description" : "This profile is used for Explanation of Benefits (EOBs) based on claims submitted by providers of oral services including Dental, Denture and Hygiene. The ADA Dental Claim Form provides a common format for reporting dental services to a patient's dental benefit plan.\nThe basis profile does not have requirements for financial data.",
"exampleBoolean" : false,
"groupingId" : "basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
},
"name" : "C4BB ExplanationOfBenefit Outpatient Institutional",
"description" : "This profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for outpatient services, which may include including the use of equipment and supplies, laboratory services, radiology services and other charges. Outpatient claims are submitted for services rendered at an institution that are not part of an overnight stay.\nThe claims data is based on the institutional claim form UB-04, submission standards adopted by the Department of Health and Human Services.\nThe profile has requirements for financial data.",
"exampleBoolean" : false,
"groupingId" : "profiles"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional-Basis"
},
"name" : "C4BB ExplanationOfBenefit Outpatient Institutional Basis",
"description" : "This profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for outpatient services, which may include including the use of equipment and supplies, laboratory services, radiology services and other charges. Outpatient claims are submitted for services rendered at an institution that are not part of an overnight stay.\nThe claims data is based on the institutional claim form UB-04, submission standards adopted by the Department of Health and Human Services.\nThe basis profile does not have requirements for financial data.",
"exampleBoolean" : false,
"groupingId" : "basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-ExplanationOfBenefit-Pharmacy"
},
"name" : "C4BB ExplanationOfBenefit Pharmacy",
"description" : "This profile is used for Explanation of Benefits (EOBs) based on claims submitted by retail pharmacies.\nThe claims data is based on submission standards adopted by the Department of Health and Human Services defined by NCPDP (National Council for Prescription Drug Program)\nThe profile has requirements for financial data.",
"exampleBoolean" : false,
"groupingId" : "profiles"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-ExplanationOfBenefit-Pharmacy-Basis"
},
"name" : "C4BB ExplanationOfBenefit Pharmacy Basis",
"description" : "This profile is used for Explanation of Benefits (EOBs) based on claims submitted by retail pharmacies.\nThe claims data is based on submission standards adopted by the Department of Health and Human Services defined by NCPDP (National Council for Prescription Drug Program)\nThe basis profile does not have requirements for financial data.",
"exampleBoolean" : false,
"groupingId" : "basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician"
},
"name" : "C4BB ExplanationOfBenefit Professional NonClinician",
"description" : "This profile is used for Explanation of Benefits (EOBs) based on claims submitted by physicians, suppliers and other non-institutional providers for professional and vision services. These services may be rendered in inpatient or outpatient, including office locations. The claims data is based on the professional claim form 1500, submission standards adopted by the Department of Health and Human Services as form CMS-1500.\nThe profile has requirements for financial data.",
"exampleBoolean" : false,
"groupingId" : "profiles"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician-Basis"
},
"name" : "C4BB ExplanationOfBenefit Professional NonClinician Basis",
"description" : "This profile is used for Explanation of Benefits (EOBs) based on claims submitted by physicians, suppliers and other non-institutional providers for professional and vision services. These services may be rendered in inpatient or outpatient, including office locations. The claims data is based on the professional claim form 1500, submission standards adopted by the Department of Health and Human Services as form CMS-1500.\nThe basis profile does not have requirements for financial data.",
"exampleBoolean" : false,
"groupingId" : "basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CodeSystem"
}
],
"reference" : {
"reference" : "CodeSystem/C4BBIdentifierType"
},
"name" : "C4BB Identifier Type Code System",
"description" : "Identifier Type codes that extend those defined in http://terminology.hl7.org/CodeSystem/v2-0203 to define the type of identifier payers and providers assign to claims and patients.\n\nThis is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CodeSystem"
}
],
"reference" : {
"reference" : "CodeSystem/C4BBInstitutionalClaimSubType"
},
"name" : "C4BB Institutional Claim SubType Code System",
"description" : "Indicates if institutional ExplanationOfBenefit is inpatient or outpatient.\n\nThis is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBInstitutionalClaimSubType"
},
"name" : "C4BB Institutional Claim SubType Value Set",
"description" : "Indicates if institutional ExplanationOfBenefit is inpatient or outpatient.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-Organization"
},
"name" : "C4BB Organization",
"description" : "This profile builds upon the US Core Organization profile. It is used to convey a payer, provider, payee or service facility organization.",
"exampleBoolean" : false,
"groupingId" : "profiles"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBOrganizationIdentifierType"
},
"name" : "C4BB Organization Identifier Type Value Set",
"description" : "Identifies the type of identifiers for organizations",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-Patient"
},
"name" : "C4BB Patient",
"description" : "This profile builds upon the US Core Patient profile. It is used to convey information about the patient who received the services described on the claim.",
"exampleBoolean" : false,
"groupingId" : "profiles"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBPatientIdentifierType"
},
"name" : "C4BB Patient Identifier Type Value Set",
"description" : "Identifies the type of identifier payers and providers assign to patients",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CodeSystem"
}
],
"reference" : {
"reference" : "CodeSystem/C4BBPayeeType"
},
"name" : "C4BB Payee Type Code System",
"description" : "Indicates that a payee type may be a beneficiary.\n\nThis is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBPayeeType"
},
"name" : "C4BB Payee Type Value Set",
"description" : "Identifies the type of recipient of the adjudication amount; i.e., provider, subscriber, beneficiary or another recipient.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CodeSystem"
}
],
"reference" : {
"reference" : "CodeSystem/C4BBPayerAdjudicationStatus"
},
"name" : "C4BB Payer Adjudication Status Code System",
"description" : "Describes the various status fields used when payers adjudicate a claim, such as whether the claim was adjudicated in or out of network, if the provider was in or not in network for the service.\n\nThis is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBPayerBenefitPaymentStatus"
},
"name" : "C4BB Payer Benefit Payment Status Value Set",
"description" : "Indicates the in network or out of network payment status of the claim.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBPayerClaimPaymentStatusCode"
},
"name" : "C4BB Payer Claim Payment Status Code Value Set",
"description" : "Indicates whether the claim / item was paid or denied.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBPayerProviderNetworkStatus"
},
"name" : "C4BB Payer Provider Network Status Value Set",
"description" : "Indicates the provider network status in relation to a patient's coverage as of the effective date of service or admission.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-Practitioner"
},
"name" : "C4BB Practitioner",
"description" : "This profile builds upon the US Core Practitioner profile. It is used to convey information about the practitioner who provided to the patient services described on the claim.",
"exampleBoolean" : false,
"groupingId" : "profiles"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBPractitionerIdentifierType"
},
"name" : "C4BB Practitioner Identifier Type Value Set",
"description" : "Identifies the type of identifiers for practitioners",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBProfessionalAndNonClinicianClaimSubType"
},
"name" : "C4BB Professional And Non Clinician Claim SubType Value Set",
"description" : "This value set includes Professional and Non Clinician Claim SubType codes.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBProfessionalAndNonClinicianClaimType"
},
"name" : "C4BB Professional And Non Clinician Claim Type Value Set",
"description" : "This value set includes Professional and Non Clinician Claim Type codes.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CodeSystem"
}
],
"reference" : {
"reference" : "CodeSystem/C4BBRelatedClaimRelationshipCodes"
},
"name" : "C4BB Related Claim Relationship Code System",
"description" : "Identifies if the current claim represents a claim that has been adjusted and was given a prior claim number or if the current claim has been adjusted; i.e., replaced by or merged to another claim number.\n\nThis is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBRelatedClaimRelationshipCodes"
},
"name" : "C4BB Related Claim Relationship Codes Value Set",
"description" : "Identifies if the current claim represents a claim that has been adjusted and was given a prior claim number or if the current claim has been adjusted; i.e., replaced by or merged to another claim number.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "StructureDefinition:resource"
}
],
"reference" : {
"reference" : "StructureDefinition/C4BB-RelatedPerson"
},
"name" : "C4BB RelatedPerson",
"description" : "This profile is used to convey basic demographic information about a person related to the claim.",
"exampleBoolean" : false,
"groupingId" : "profiles"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "CodeSystem"
}
],
"reference" : {
"reference" : "CodeSystem/C4BBSupportingInfoType"
},
"name" : "C4BB Supporting Info Type Code System",
"description" : "Claim Information Category - Used as the discriminator for supportingInfo.\n\nThis is a code system defined locally by the CARIN BlueButton IG. As this IG matures, it is expected that this CodeSystem will be migrated to THO (terminology.hl7.org). The current CodeSystem url should be considered temporary and subject to change in a future version.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBSupportingInfoType"
},
"name" : "C4BB SupportingInfo Type Value Set",
"description" : "Used as the discriminator for the types of supporting information for the CARIN IG for Blue Button� Implementation Guide.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBTotalCategoryDiscriminator"
},
"name" : "C4BB Total Category Discriminator Value Set",
"description" : "Used as the discriminator for total.category for the CARIN IG for Blue Button®",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/C4BBTransportationServiceCategories"
},
"name" : "C4BB Transportation Services Categories Value Set",
"description" : "Transportation Services Supporting Info Category Codes",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/CMSPlaceofServiceCodes"
},
"name" : "CMS Place of Service Codes (POS) Value Set",
"description" : "Place of Service Codes are two-digit codes placed on health care professional claims to indicate the setting in which a service was provided. The Centers for Medicare & Medicaid Services (CMS) maintain POS codes used throughout the health care industry.\n\nThis code set is required for use in the implementation guide adopted as the national standard for electronic transmission of professional health care claims under the provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA directed the Secretary of HHS to adopt national standards for electronic transactions. These standard transactions require all health plans and providers to use standard code sets to populate data elements in each transaction. The Transaction and Code Set Rule adopted the ASC X12N-837 Health Care Claim: Professional, volumes 1 and 2, as the standard for electronic submission of professional claims. This standard names the POS code set currently maintained by CMS as the code set to be used for describing sites of service in such claims. POS information is often needed to determine the acceptability of direct billing of Medicare, Medicaid and private insurance services provided by a given provider.\n\nCurrent codes can be obtained [here](https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set)",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/CMSPresentOnAdmissionIndicator"
},
"name" : "CMS Present On Admission Indicator Codes Value Set",
"description" : "This code system consists of Present on Admission (POA) indicators which are assigned to the principal and secondary diagnoses (as defined in Section II of the Official Guidelines for Coding and Reporting) and the external cause of injury codes to indicate the presence or absence of the diagnosis at the time of inpatient admission.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "Coverage"
}
],
"reference" : {
"reference" : "Coverage/Coverage1"
},
"name" : "Coverage Example 1",
"description" : "Coverage Example1",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "Coverage"
}
],
"reference" : {
"reference" : "Coverage/Coverage2"
},
"name" : "Coverage Example 2",
"description" : "Coverage Example 2",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "Coverage"
}
],
"reference" : {
"reference" : "Coverage/Coverage3"
},
"name" : "Coverage Example 3",
"description" : "Coverage Example 3",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/coverage-payor"
},
"name" : "Coverage_Payor",
"description" : "The identity of the insurer or party paying for services",
"exampleBoolean" : false,
"groupingId" : "search"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "Coverage"
}
],
"reference" : {
"reference" : "Coverage/CoverageDental1"
},
"name" : "Dental Coverage Example1",
"description" : "Dental Coverage Example1",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "Organization"
}
],
"reference" : {
"reference" : "Organization/DentalPayer1"
},
"name" : "Dental Payer1",
"description" : "Dental Payer1",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Organization"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "Practitioner"
}
],
"reference" : {
"reference" : "Practitioner/PractitionerDentalProvider1"
},
"name" : "Dental Provider 1",
"description" : "Dental Provider 1",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Practitioner"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ValueSet"
}
],
"reference" : {
"reference" : "ValueSet/CDCICD910CMDiagnosisCodes"
},
"name" : "Diagnosis Codes - International Classification of Diseases, Clinical Modification (ICD-9-CM, ICD-10-CM) Value Set",
"description" : "The Value Set is a combination of values from volume 1 and volume 2 from the Code System International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and values in the Code System International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)\n\nThe International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) is based on the World Health Organization’s Ninth Revision, International Classification of Diseases (ICD-9). ICD-9-CM was the official system of assigning codes to diagnoses and procedures associated with hospital utilization in the United States.\n\nThe ICD-9-CM consists of:\n\n* a tabular list containing a numerical list of the disease code numbers in tabular form;\n* an alphabetical index to the disease entries; and\n* a classification system for surgical, diagnostic, and therapeutic procedures (alphabetic index and tabular list).\n\nThe National Center for Health Statistics (NCHS) and the [Centers for Medicare and Medicaid Services](http://www.cms.hhs.gov/) are the U.S. governmental agencies responsible for overseeing all changes and modifications to the ICD-9-CM.\n\n[ICD-10-CM](https://confluence.hl7.org/pages/viewpage.action?pageId=97453674) is the replacement for ICD-9-CM, volumes 1 and 2, effective October 1, 2015.\n\nThe National Center for Health Statistics (NCHS), the Federal agency responsible for use of the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) in the United States, has developed a clinical modification of the classification for morbidity purposes. The ICD-10 is used to code and classify mortality data from death certificates, having replaced ICD-9 for this purpose as of January 1, 1999.\n\nThe clinical modification represents a significant improvement over ICD-9-CM and ICD-10. Specific improvements include: the addition of information relevant to ambulatory and managed care encounters; expanded injury codes; the creation of combination diagnosis/symptom codes to reduce the number of codes needed to fully describe a condition; the addition of sixth and seventh characters; incorporation of common 4th and 5th digit subclassifications; laterality; and greater specificity in code assignment. The new structure will allow further expansion than was possible with ICD-9-CM.\n\nCurrent and previous releases of ICD-9-CM are available here: [https://www.cdc.gov/nchs/icd/icd9cm.htm](https://www.cdc.gov/nchs/icd/icd9cm.htm)\n\nCurrent and previous releases of ICD-10-CM are available in PDF and XML format here: [https://www.cdc.gov/nchs/icd/icd10cm.htm](https://www.cdc.gov/nchs/icd/icd10cm.htm)\n\nMost files are provided in compressed zip format for ease in downloading. These files have been created by the National Center for Health Statistics (NCHS), under authorization by the World Health Organization. Any questions regarding typographical or other errors noted on this release may be reported to nchsicd10cm@cdc.gov.",
"exampleBoolean" : false
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/EOBInpatient2"
},
"name" : "EOB Inpatient Example 2",
"description" : "EOB Inpatient Example 2",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/EOBInpatient1"
},
"name" : "EOB Inpatient Example1",
"description" : "EOB Inpatient Example 1",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/BB-EOBInpatient1-nonfinancial"
},
"name" : "EOB Inpatient Institutional - Example 1 - Nonfinancial",
"description" : "EOB Inpatient Institutional - Example 1 - Nonfinancial",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional-Basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/BB-EOBInpatient2-nonfinancial"
},
"name" : "EOB Inpatient Institutional - Example 2 - Nonfinancial",
"description" : "EOB Inpatient Institutional - Example 2 - Nonfinancial",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Inpatient-Institutional-Basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/EOBOral1"
},
"name" : "EOB Oral Example 1",
"description" : "EOB Oral Example 1",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Oral"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/EOBOral2"
},
"name" : "EOB Oral Example 2",
"description" : "EOB Oral Example 2",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Oral"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/EOBOutpatient1"
},
"name" : "EOB Outpatient Institutional - Example 1",
"description" : "EOB Outpatient Institutional - Example 1",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/BB-EOBOutpatient1-nonfinancial"
},
"name" : "EOB Outpatient Institutional - Example 1 - Nonfinancial",
"description" : "EOB Outpatient Institutional - Example 1 - Nonfinancial",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional-Basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/EOBOutpatient2"
},
"name" : "EOB Outpatient Institutional - Example 2",
"description" : "EOB Outpatient Institutional - Example 2",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/BB-EOBOutpatient2-nonfinancial"
},
"name" : "EOB Outpatient Institutional - Example 2 - Nonfinancial",
"description" : "EOB Outpatient Institutional - Example 2 - Nonfinancial",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional-Basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/EOBPharmacy1"
},
"name" : "EOB Pharmacy Example1",
"description" : "EOB Pharmacy Example1",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Pharmacy"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/EOBProfessional1"
},
"name" : "EOB Professional - Example 1",
"description" : "EOB Professional - Example 1",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/BB-EOBProfessional1-nonfinancial"
},
"name" : "EOB Professional - Example 1 - Nonfinancial",
"description" : "EOB Professional Example 1 - Nonfinancial",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician-Basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/EOBProfessional2"
},
"name" : "EOB Professional - Example 2",
"description" : "EOB Professional - Example 2",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/BB-EOBProfessional2-nonfinancial"
},
"name" : "EOB Professional - Example 2 - Nonfinancial",
"description" : "EOB Professional - Example 2 - Nonfinancial",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician-Basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/EOBProfessionalTransportation1"
},
"name" : "EOB Professional - Transportation 1",
"description" : "EOB Professional - Transportation 1",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "ExplanationOfBenefit"
}
],
"reference" : {
"reference" : "ExplanationOfBenefit/BB-EOBProfessionalTransportation1-nonfinancial"
},
"name" : "EOB Professional - Transportation 1 - Nonfinancial",
"description" : "EOB Professional - Transportation Services Example 1 - Nonfinancial",
"exampleCanonical" : "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Professional-NonClinician-Basis"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/explanationofbenefit-billable-period-start"
},
"name" : "ExplanationOfBenefit_BillablePeriodStart",
"description" : "Starting Date of the service for the EOB using billablePeriod.period.start. The billable-period-start search parameter using the billablePeriod.period.start provides results with the earliest billablePeriod.start from a professional and non-clinician EOB or an oral EOB.",
"exampleBoolean" : false,
"groupingId" : "search"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/explanationofbenefit-care-team"
},
"name" : "ExplanationOfBenefit_Careteam",
"description" : "Member of the CareTeam",
"exampleBoolean" : false,
"groupingId" : "search"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/explanationofbenefit-coverage"
},
"name" : "ExplanationOfBenefit_Coverage",
"description" : "The plan under which the claim was adjudicated",
"exampleBoolean" : false,
"groupingId" : "search"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/explanationofbenefit-identifier"
},
"name" : "ExplanationOfBenefit_Identifier",
"description" : "The business/claim identifier of the Explanation of Benefit",
"exampleBoolean" : false,
"groupingId" : "search"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/explanationofbenefit-insurer"
},
"name" : "ExplanationOfBenefit_Insurer",
"description" : "The party responsible for the claim",
"exampleBoolean" : false,
"groupingId" : "search"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/practitionerrole-organization"
},
"name" : "ExplanationOfBenefit_Organization",
"description" : "The identity of the organization the practitioner represents / acts on behalf of",
"exampleBoolean" : false,
"groupingId" : "search"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/explanationofbenefit-patient"
},
"name" : "ExplanationOfBenefit_Patient",
"description" : "The reference to the patient",
"exampleBoolean" : false,
"groupingId" : "search"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/practitionerrole-practitioner"
},
"name" : "ExplanationOfBenefit_Practitioner",
"description" : "Practitioner that is able to provide the defined services for the organization",
"exampleBoolean" : false,
"groupingId" : "search"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/explanationofbenefit-provider"
},
"name" : "ExplanationOfBenefit_Provider",
"description" : "The reference to the provider",
"exampleBoolean" : false,
"groupingId" : "search"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/explanationofbenefit-service-date"
},
"name" : "ExplanationOfBenefit_ServiceDate",
"description" : "The service-date search parameter is meant to simplify the search for the client enabling them to use one search parameter across EoB types for the service date. With this parameter. the client doesn't need to know that for inpatient and outpatient institutional EOB dates they need to search by billablePeriod, for a pharmacy EOB by item.servicedDate, for a professional and non-clinician EOB - by item.servicedPeriod and for an oral EOB – by item.servicedPeriod.",
"exampleBoolean" : false,
"groupingId" : "search"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/explanationofbenefit-service-start-date"
},
"name" : "ExplanationOfBenefit_ServiceStartDate",
"description" : "Starting Date of the service for the EOB. The service-start-date search parameter simplifies search, since a client doesn't need to know that for inpatient and outpatient institutional EOB dates they need to search by billablePeriod.start, for a pharmacy EOB by item.servicedDate, for a professional and non-clinician EOB - by item.servicedPeriod.start and for an oral EOB – by item.servicedPeriod.start.",
"exampleBoolean" : false,
"groupingId" : "search"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString" : "SearchParameter"
}
],
"reference" : {
"reference" : "SearchParameter/explanationofbenefit-type"
},
"name" : "ExplanationOfBenefit_Type",
"description" : "The type of the ExplanationOfBenefit",
"exampleBoolean" : false,
& : "artifacts.html"
}
],
"nameUrl" : "artifacts.html",
"title" : "Artifacts Summary",
"generation" : "html"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "informative"
},
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl" : "searchparameters.html"
}
],
"nameUrl" : "searchparameters.html",
"title" : "Search Parameters",
"generation" : "markdown"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "informative"
},
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl" : "Security_And_Privacy_Considerations.html"
}
],
"nameUrl" : "Security_And_Privacy_Considerations.html",
"title" : "Security and Privacy Considerations",
"generation" : "markdown"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "informative"
},
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl" : "downloads.html"
}
],
"nameUrl" : "downloads.html",
"title" : "Downloads",
"generation" : "markdown"
},
{
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "informative"
},
{
"url" : "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl" : "change_notes.html"
}
],
"nameUrl" : "change_notes.html",
"title" : "Change Notes",
"generation" : "markdown"
}
]
},
"parameter" : [
{
"code" : "path-resource",
"value" : "input/capabilities"
},
{
"code" : "path-resource",
"value" : "input/examples"
},
{
"code" : "path-resource",
"value" : "input/extensions"
},
{
"code" : "path-resource",
"value" : "input/models"
},
{
"code" : "path-resource",
"value" : "input/operations"
},
{
"code" : "path-resource",
"value" : "input/profiles"
},
{
"code" : "path-resource",
"value" : "input/resources"
},
{
"code" : "path-resource",
"value" : "input/vocabulary"
},
{
"code" : "path-resource",
"value" : "input/maps"
},
{
"code" : "path-resource",
"value" : "input/testing"
},
{
"code" : "path-resource",
"value" : "input/history"
},
{
"code" : "path-resource",
"value" : "fsh-generated/resources"
},
{
"code" : "path-pages",
"value" : "template/config"
},
{
"code" : "path-pages",
"value" : "input/images"
},
{
"code" : "path-tx-cache",
"value" : "input-cache/txcache"
}
]
}
}
XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.