Package | ihe.iti.fais |
Type | CapabilityStatement |
Id | IHE.FAIS.ClaimsRequestor |
FHIR Version | R4 |
Source | https://profiles.ihe.net/ITI/FAIS/https://build.fhir.org/ig/IHE/ITI.Finance/CapabilityStatement-IHE.FAIS.ClaimsRequestor.html |
URL | https://profiles.ihe.net/ITI/FAIS/CapabilityStatement/IHE.FAIS.ClaimsRequestor |
Version | 1.0.1-current |
Status | active |
Date | 2024-07-17 |
Name | IHE_FAIS_ClaimsRequestor |
Title | IHE FAIS Claims Requestor |
Realm | uv |
Authority | ihe |
Description | CapabilityStatement for [Claims Requestor Actor](volume-1.html#claims-requestor). The Claims Requestor files a pre-determination, pre-authorization, or claim for a patient, as well as cancel and re-process claims, and can query for responses when the result is queued. |
Kind | requirements |
No resources found
OperationDefinition | |
IHE.FAIS.Claim.Cancel | FAIS Claim $cancel |
IHE.FAIS.Claim.Reprocess | FAIS Claim $reprocess |
IHE.FAIS.Claim.Submit | FAIS Claim $submit |
StructureDefinition | |
IHE.FAIS.Claim | FAIS Claim Profile |
IHE.FAIS.ClaimResponse | FAIS ClaimResponse Profile |
Note: links and images are rebased to the (stated) source
Generated Narrative: CapabilityStatement IHE.FAIS.ClaimsRequestor
application/fhir+xml
, application/fhir+json
Note to Implementers: FHIR Capabilities
Any FHIR capability may be 'allowed' by the system unless explicitly marked as 'SHALL NOT'. A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.
client
FAIS Claims Requestor provides capability to submit claim requests and query for claim responses.
Recommend ATNA, encouraged IHE-IUA or SMART-app-launch
search-system
interaction.The summary table lists the resources that are part of this configuration, and for each resource it lists:
_include
_revinclude
Resource Type | Profile | R | S | U | C | Searches | _include | _revinclude | Operations |
---|---|---|---|---|---|---|---|---|---|
Claim | Supported Profiles FAIS Claim Profile | $submit , $cancel , $reprocess | |||||||
ClaimResponse | Supported Profiles FAIS ClaimResponse Profile | y | y | _lastUpdated, _id, status, request, patient, requestor |
Supports these transactions:
FAIS Track Claim transaction [ITI-129]
Conformance | Parameter | Type | Documentation |
---|---|---|---|
MAY | _lastUpdated | date | When the resource version last changed. The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb. |
MAY | _id | token | Logical id of this artifact |
MAY | status | token | The status of the response |
MAY | request | reference | The coverage eligiblity request |
MAY | patient | reference | The beneficiary |
MAY | requestor | reference | The provider making the request |
{ "resourceType": "CapabilityStatement", "id": "IHE.FAIS.ClaimsRequestor", "text": { "status": "extensions", "div": "<!-- snip (see above) -->" }, "url": "https://profiles.ihe.net/ITI/FAIS/CapabilityStatement/IHE.FAIS.ClaimsRequestor", "version": "1.0.1-current", "name": "IHE_FAIS_ClaimsRequestor", "title": "IHE FAIS Claims Requestor", "status": "active", "experimental": false, "date": "2024-07-17", "publisher": "IHE IT Infrastructure Technical Committee", "contact": [ { "telecom": [ { "system": "url", "value": "https://www.ihe.net/ihe_domains/it_infrastructure/" } ] }, { "telecom": [ { "system": "email", "value": "iti@ihe.net" } ] }, { "name": "IHE IT Infrastructure Technical Committee", "telecom": [ { "system": "email", "value": "iti@ihe.net" } ] } ], "description": "CapabilityStatement for [Claims Requestor Actor](volume-1.html#claims-requestor).\n\nThe Claims Requestor files a pre-determination, pre-authorization, or claim for a patient, as well as cancel and re-process claims, and can query for responses when the result is queued.", "jurisdiction": [ { "coding": [ { "system": "http://unstats.un.org/unsd/methods/m49/m49.htm", "code": "001" } ] } ], "kind": "requirements", "fhirVersion": "4.0.1", "format": [ "application/fhir+xml", "application/fhir+json" ], "rest": [ { "mode": "client", "documentation": "FAIS Claims Requestor provides capability to submit claim requests and query for claim responses.", "security": { "description": "Recommend [ATNA](https://profiles.ihe.net/ITI/TF/Volume1/ch-9.html), encouraged [IHE-IUA](https://profiles.ihe.net/ITI/IUA/index.html) or [SMART-app-launch](http://www.hl7.org/fhir/smart-app-launch/)" }, "resource": [ { "type": "Claim", "supportedProfile": [ "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.Claim" ], "documentation": "Supports these transactions:\n* [Submit Claim [ITI-126]](ITI-126.html)\n* [Cancel Claim [ITI-127]](ITI-127.html)\n* [Re-process Claim [ITI-128]](ITI-128.html)", "operation": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", "valueCode": "SHALL" } ], "name": "submit", "definition": "https://profiles.ihe.net/ITI/FAIS/OperationDefinition/IHE.FAIS.Claim.Submit", "documentation": "Submits a claim. FAIS Submit Claim transaction [[ITI-126]](ITI-126.html)." }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", "valueCode": "SHALL" } ], "name": "cancel", "definition": "https://profiles.ihe.net/ITI/FAIS/OperationDefinition/IHE.FAIS.Claim.Cancel", "documentation": "Cancels a claim. FAIS Cancel Claim transaction [[ITI-127]](ITI-127.html)." }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", "valueCode": "SHALL" } ], "name": "reprocess", "definition": "https://profiles.ihe.net/ITI/FAIS/OperationDefinition/IHE.FAIS.Claim.Reprocess", "documentation": "Re-processes a claim. FAIS Re-process Claim transaction [[ITI-128]](ITI-128.html)." } ] }, { "type": "ClaimResponse", "supportedProfile": [ "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.ClaimResponse" ], "documentation": "FAIS Track Claim transaction [[ITI-129]](ITI-129.html)", "interaction": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", "valueCode": "MAY" } ], "code": "read" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", "valueCode": "MAY" } ], "code": "search-type" } ], "searchParam": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", "valueCode": "MAY" } ], "name": "_lastUpdated", "type": "date", "documentation": "When the resource version last changed. The values for this shall support these prefixes: gt, lt, ge, le, sa, and eb." }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", "valueCode": "MAY" } ], "name": "_id", "type": "token", "documentation": "Logical id of this artifact" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", "valueCode": "MAY" } ], "name": "status", "type": "token", "documentation": "The status of the response" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", "valueCode": "MAY" } ], "name": "request", "type": "reference", "documentation": "The coverage eligiblity request" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", "valueCode": "MAY" } ], "name": "patient", "type": "reference", "documentation": "The beneficiary" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", "valueCode": "MAY" } ], "name": "requestor", "type": "reference", "documentation": "The provider making the request" } ] } ], "interaction": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation", "valueCode": "MAY" } ], "code": "search-system" } ] } ] }