Package | pharmacyeclaim.two |
Resource Type | StructureDefinition |
Id | profile-parameters-daily-totals-OUT |
FHIR Version | R4 |
Source | https://simplifier.net/resolve?scope=pharmacyeclaim.two@1.0.2-preview&canonical=http://pharmacyeclaims.ca/FHIR/v1.0/StructureDefinition/profile-parameters-daily-totals-OUT |
URL | http://pharmacyeclaims.ca/FHIR/v1.0/StructureDefinition/profile-parameters-daily-totals-OUT |
Status | draft |
Name | DailyTotalsParametersOUT |
Title | DailyTotalsOUTParameters |
Description | DailyTotalsParametersOUT is used to return the result set from an adjudicator for daily totals over a period of time |
Purpose | DailyTotalsParametersOUT is used to return the result set from an adjudicator for daily totals over a period of time |
Type | Parameters |
Kind | resource |
No resources found
No resources found
No narrative content found in resource
{ "resourceType": "StructureDefinition", "id": "profile-parameters-daily-totals-OUT", "url": "http://pharmacyeclaims.ca/FHIR/v1.0/StructureDefinition/profile-parameters-daily-totals-OUT", "name": "DailyTotalsParametersOUT", "title": "DailyTotalsOUTParameters", "status": "draft", "description": "DailyTotalsParametersOUT is used to return the result set from an adjudicator for daily totals over a period of time", "purpose": "DailyTotalsParametersOUT is used to return the result set from an adjudicator for daily totals over a period of time", "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "Parameters", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Parameters", "derivation": "constraint", "differential": { "element": [ { "id": "Parameters.parameter", "path": "Parameters.parameter", "slicing": { "discriminator": [ { "type": "value", "path": "name" } ], "rules": "open" }, "mustSupport": true }, { "id": "Parameters.parameter.id", "path": "Parameters.parameter.id", "mustSupport": true }, { "id": "Parameters.parameter.name", "path": "Parameters.parameter.name", "mustSupport": true }, { "id": "Parameters.parameter.value[x]", "path": "Parameters.parameter.value[x]", "comment": "Usage Note: Limited to 6N\r\nCPHA: Trace Number", "min": 1, "mustSupport": true }, { "id": "Parameters.parameter:TraceNumber", "path": "Parameters.parameter", "sliceName": "TraceNumber", "comment": "Usage Note: Identifier assigned to this transaction; limited to 6N for backward compatibility. Note; we have a message identifier which is unrestricted in size. The number assigned, by the provider, to the transaction to which this response applies\r\nCPHA Map: B.23.03 Trace Number 6N", "min": 1, "max": "1" }, { "id": "Parameters.parameter:TraceNumber.name", "path": "Parameters.parameter.name", "fixedString": "TraceNumber" }, { "id": "Parameters.parameter:TraceNumber.value[x]", "path": "Parameters.parameter.value[x]", "type": [ { "code": "Identifier" } ] }, { "id": "Parameters.parameter:TraceNumber.value[x].system", "path": "Parameters.parameter.value[x].system", "mustSupport": true }, { "id": "Parameters.parameter:TraceNumber.value[x].value", "path": "Parameters.parameter.value[x].value", "min": 1, "mustSupport": true }, { "id": "Parameters.parameter:Date", "path": "Parameters.parameter", "sliceName": "Date", "comment": "Usage Note: Specifies the date associated with the results and is therefore mandatory. This repeats for each date specified in the request.\r\nCPHA Map: F.90.03 Adjudication Date", "max": "1" }, { "id": "Parameters.parameter:Date.name", "path": "Parameters.parameter.name", "fixedString": "StartDate" }, { "id": "Parameters.parameter:Date.value[x]", "path": "Parameters.parameter.value[x]", "type": [ { "code": "dateTime" } ] }, { "id": "Parameters.parameter:Date.part", "path": "Parameters.parameter.part", "slicing": { "discriminator": [ { "type": "value", "path": "name" } ], "rules": "open" }, "comment": "CPHA Mapping: When mapping, all known parts should be populated in accordance with the request message.\r\n\r\nOnly one level of nested parameters is allowed." }, { "id": "Parameters.parameter:Date.part:ClaimTotalPaid", "path": "Parameters.parameter.part", "sliceName": "ClaimTotalPaid", "comment": "CPHA Map: Total Payable by Carrier G.42.03 \r\n\r\nOnly one level of nested parameters is allowed.", "max": "1" }, { "id": "Parameters.parameter:Date.part:ClaimTotalPaid.name", "path": "Parameters.parameter.part.name", "fixedString": "ClaimTotalPaid" }, { "id": "Parameters.parameter:Date.part:ClaimTotalPaid.value[x]", "path": "Parameters.parameter.part.value[x]", "min": 1, "type": [ { "code": "Money" } ] }, { "id": "Parameters.parameter:Date.part:ClaimTotalPaidPatient", "path": "Parameters.parameter.part", "sliceName": "ClaimTotalPaidPatient", "comment": "CPHA Mapping: Not directly mappable; Set value = blank when not applicable, eg during MVP phase. Post MVP this must be populated properly\r\n\r\nOnly one level of nested parameters is allowed.", "max": "1" }, { "id": "Parameters.parameter:Date.part:ClaimTotalPaidPatient.name", "path": "Parameters.parameter.part.name", "fixedString": "ClaimTotalPaidPatient" }, { "id": "Parameters.parameter:Date.part:ClaimTotalPaidPatient.value[x]", "path": "Parameters.parameter.part.value[x]", "min": 1, "type": [ { "code": "Money" } ] }, { "id": "Parameters.parameter:Date.part:ReversalTotal", "path": "Parameters.parameter.part", "sliceName": "ReversalTotal", "comment": "CPHA Map: Total Value of Reversals G.44.03\r\n\r\nOnly one level of nested parameters is allowed.", "max": "1" }, { "id": "Parameters.parameter:Date.part:ReversalTotal.name", "path": "Parameters.parameter.part.name", "fixedString": "ReversalTotal" }, { "id": "Parameters.parameter:Date.part:ReversalTotal.value[x]", "path": "Parameters.parameter.part.value[x]", "type": [ { "code": "Money" } ] }, { "id": "Parameters.parameter:Date.part:ReversalTotalPatient", "path": "Parameters.parameter.part", "sliceName": "ReversalTotalPatient", "comment": "CPHA Mapping: Not directly mappable; Set value = blank when not applicable, eg during MVP phase. Post MVP this must be populated properly\r\n\r\nOnly one level of nested parameters is allowed.", "max": "1" }, { "id": "Parameters.parameter:Date.part:ReversalTotalPatient.name", "path": "Parameters.parameter.part.name", "fixedString": "ReversalTotalPatient" }, { "id": "Parameters.parameter:Date.part:ReversalTotalPatient.value[x]", "path": "Parameters.parameter.part.value[x]", "type": [ { "code": "Money" } ] }, { "id": "Parameters.parameter:Date.part:PriorDayReversals", "path": "Parameters.parameter.part", "sliceName": "PriorDayReversals", "comment": "CPHA Mapping: Total Value of Prior Reversals G.46.03\r\n\r\nOnly one level of nested parameters is allowed.", "max": "1" }, { "id": "Parameters.parameter:Date.part:PriorDayReversals.name", "path": "Parameters.parameter.part.name", "fixedString": "PriorDayReversals" }, { "id": "Parameters.parameter:Date.part:PriorDayReversals.value[x]", "path": "Parameters.parameter.part.value[x]", "min": 1, "type": [ { "code": "Money" } ] }, { "id": "Parameters.parameter:Date.part:PriorDayReversalsPatient", "path": "Parameters.parameter.part", "sliceName": "PriorDayReversalsPatient", "comment": "CPHA Mapping: Not directly mappable; Set value = blank when not applicable, eg during MVP phase. Post MVP this must be populated properly\r\n\r\nOnly one level of nested parameters is allowed." }, { "id": "Parameters.parameter:Date.part:PriorDayReversalsPatient.name", "path": "Parameters.parameter.part.name", "fixedString": "PriorDayReversalsPatient" }, { "id": "Parameters.parameter:Date.part:PriorDayReversalsPatient.value[x]", "path": "Parameters.parameter.part.value[x]", "type": [ { "code": "Money" } ] }, { "id": "Parameters.parameter:Date.part:TotalClaimsApproved", "path": "Parameters.parameter.part", "sliceName": "TotalClaimsApproved", "comment": "CPHA Mapping Total Claims Approved G.41.03 \r\n\r\nOnly one level of nested parameters is allowed." }, { "id": "Parameters.parameter:Date.part:TotalClaimsApproved.name", "path": "Parameters.parameter.part.name", "fixedString": "TotalClaimsApprovedCount" }, { "id": "Parameters.parameter:Date.part:TotalClaimsApproved.value[x]", "path": "Parameters.parameter.part.value[x]", "type": [ { "code": "positiveInt" } ] }, { "id": "Parameters.parameter:Date.part:TotalReversals", "path": "Parameters.parameter.part", "sliceName": "TotalReversals", "comment": "CPHA Map: Map: Total Reversals G.43.03\r\n\r\nOnly one level of nested parameters is allowed." }, { "id": "Parameters.parameter:Date.part:TotalReversals.name", "path": "Parameters.parameter.part.name", "fixedString": "TotalReversalsCount" }, { "id": "Parameters.parameter:Date.part:TotalReversals.value[x]", "path": "Parameters.parameter.part.value[x]", "type": [ { "code": "positiveInt" } ] }, { "id": "Parameters.parameter:Date.part:TotalPriorReversals", "path": "Parameters.parameter.part", "sliceName": "TotalPriorReversals", "comment": "CPHA Map: Total Prior Reversals G.45.03\r\n\r\nOnly one level of nested parameters is allowed." }, { "id": "Parameters.parameter:Date.part:TotalPriorReversals.name", "path": "Parameters.parameter.part.name", "fixedString": "TotalPriorReversalsCount" }, { "id": "Parameters.parameter:TotalTrxnsDateRange", "path": "Parameters.parameter", "sliceName": "TotalTrxnsDateRange", "comment": "Usage Note: The total number of transactions for the date range requested.", "max": "1" }, { "id": "Parameters.parameter:TotalTrxnsDateRange.name", "path": "Parameters.parameter.name", "fixedString": "TotalTrxnsDateRange" }, { "id": "Parameters.parameter:TotalTrxnsDateRange.value[x]", "path": "Parameters.parameter.value[x]", "min": 1, "type": [ { "code": "positiveInt" } ] }, { "id": "Parameters.parameter:ReferenceNumber", "path": "Parameters.parameter", "sliceName": "ReferenceNumber", "comment": "Usage Note: This is the internal reference number assigned, by the processor to the request for daily totals\r\nCPHA Map: E.04.03", "min": 1, "max": "1" }, { "id": "Parameters.parameter:ReferenceNumber.name", "path": "Parameters.parameter.name", "fixedString": "ReferenceNumber", "mustSupport": true }, { "id": "Parameters.parameter:ReferenceNumber.value[x]", "path": "Parameters.parameter.value[x]", "type": [ { "code": "string" } ], "mustSupport": true }, { "id": "Parameters.parameter:ResponseStatus", "path": "Parameters.parameter", "sliceName": "ResponseStatus", "comment": "Usage: This indicates the status of the request this responds to \r\nZ=detailed record as requested\r\nR=request rejected\r\nCPHA Map: E.05.03 Response Status", "min": 1, "max": "1" }, { "id": "Parameters.parameter:ResponseStatus.name", "path": "Parameters.parameter.name", "fixedString": "ResponseStatus" }, { "id": "Parameters.parameter:ResponseStatus.value[x]", "path": "Parameters.parameter.value[x]", "type": [ { "code": "code" } ] }, { "id": "Parameters.parameter:ResponseCodes", "path": "Parameters.parameter", "sliceName": "ResponseCodes", "comment": "Usage: Codes to define responses that identify errors and other reasons that may cause the request to be rejected or the response to be incomplete. Field length of 10 will accommodate 5 response codes per request\r\nCPHA Map: E.06.03 Response Codes\r\n01=IIN error\r\n02=version number error\r\n03=transaction code error\r\n04=provider software ID error\r\n05=provider software version error\r\n07=active device ID error\r\n21=pharmacy ID code error\r\n22=provider transaction date error\r\n23=trace number error\r\n30=carrier ID error\r\n31=group # error\r\n90=adjudication date error\r\nD9=call adjudicator" }, { "id": "Parameters.parameter:ResponseCodes.name", "path": "Parameters.parameter.name", "fixedString": "ResponseCodes" }, { "id": "Parameters.parameter:ResponseCodes.value[x]", "path": "Parameters.parameter.value[x]", "type": [ { "code": "code" } ] }, { "id": "Parameters.parameter:DailyTotalsByDate", "path": "Parameters.parameter", "sliceName": "DailyTotalsByDate", "comment": "Usage Note: This will specify the date and for each date, the totals. If carrier/group is specified, the totals provided are specific to that carrier/group. This is mandatory for all successful responses" }, { "id": "Parameters.parameter:DailyTotalsByDate.name", "path": "Parameters.parameter.name", "fixedString": "Date" }, { "id": "Parameters.parameter:DailyTotalsByDate.value[x]", "path": "Parameters.parameter.value[x]", "comment": "Usage Note: Only a date is required though this allows for a timezone is desired", "min": 1, "type": [ { "code": "dateTime" } ] }, { "id": "Parameters.parameter:DailyTotalsByDate.part", "path": "Parameters.parameter.part", "slicing": { "discriminator": [ { "type": "value", "path": "name" } ], "rules": "open" }, "comment": "Usage note: This repeats for every day within the requested time period (start and end date)\r\n\r\nOnly one level of nested parameters is allowed.", "min": 1 }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalNumberPayProvider", "path": "Parameters.parameter.part", "sliceName": "TotalNumberPayProvider", "comment": "Usage Note: Total number of pay provider claims accepted for payment for the requested adjudication date\r\nCPHA Map: Total Claims Approved G.41.03\rOnly one level of nested parameters is allowed.", "max": "1", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalNumberPayProvider.name", "path": "Parameters.parameter.part.name", "fixedString": "TotalNumberPayProvider", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalNumberPayProvider.value[x]", "path": "Parameters.parameter.part.value[x]", "min": 1, "type": [ { "code": "positiveInt" } ] }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalAmtPayProvider", "path": "Parameters.parameter.part", "sliceName": "TotalAmtPayProvider", "comment": "Usage Note: Total number of pay provider claims accepted for payment for the requested adjudication date\r\nCPHA Map: Total Claims Approved G.41.03\r\n\r\nOnly one level of nested parameters is allowed.", "min": 1, "max": "1", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalAmtPayProvider.name", "path": "Parameters.parameter.part.name", "fixedString": "Total$AmtPayProvider" }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalAmtPayProvider.value[x]", "path": "Parameters.parameter.part.value[x]", "min": 1, "type": [ { "code": "Money" } ], "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalNumberReversalsPayProvider", "path": "Parameters.parameter.part", "sliceName": "TotalNumberReversalsPayProvider", "comment": "Usage: The total number of reversals processed against pay provider claims approved on the adjudication date to which the response refers\r\nCPHA Map: Total Reversals G.43.03 \r\n\r\nOnly one level of nested parameters is allowed.", "max": "1", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalNumberReversalsPayProvider.name", "path": "Parameters.parameter.part.name", "fixedString": "TotalNumberReversalsPayProvider", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalNumberReversalsPayProvider.value[x]", "path": "Parameters.parameter.part.value[x]", "min": 1, "type": [ { "code": "positiveInt" } ], "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalAmtReversalsPayProvider", "path": "Parameters.parameter.part", "sliceName": "TotalAmtReversalsPayProvider", "comment": "Usage Note: The total value of reversals processed against pay provider claims approved on the adjudication date to which this response refers\r\nCPHA Map: Total Value of Reversals G.44.03\r\n\r\nOnly one level of nested parameters is allowed.", "max": "1", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalAmtReversalsPayProvider.name", "path": "Parameters.parameter.part.name", "fixedString": "Total$AmtReversalsPayProvider", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalAmtReversalsPayProvider.value[x]", "path": "Parameters.parameter.part.value[x]", "min": 1, "type": [ { "code": "positiveInt" } ], "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalNumberPayCardholder", "path": "Parameters.parameter.part", "sliceName": "TotalNumberPayCardholder", "comment": "Usage Note: Total number of claims captured by the adjudicator for reimbursement to cardholders on the requested adjudication date\r\nCPHA Map: Total Claims Captured for Reimbursement to Card Holder G.53.03\r\r\n\r\n\r\nOnly one level of nested parameters is allowed.", "max": "1", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalNumberPayCardholder.name", "path": "Parameters.parameter.part.name", "fixedString": "TotalNumberPayCardholder" }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalNumberPayCardholder.value[x]", "path": "Parameters.parameter.part.value[x]", "min": 1, "type": [ { "code": "positiveInt" } ], "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalAmtPayCardholder", "path": "Parameters.parameter.part", "sliceName": "TotalAmtPayCardholder", "comment": "Usage Note: The total amount paid to cardholders on the requested adjudication date. Must be populated when known; optional for backward compatibility\r\nCPHA Map: None - new field\r\nOnly one level of nested parameters is allowed.", "max": "1", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalAmtPayCardholder.name", "path": "Parameters.parameter.part.name", "fixedString": "Total$AmtPayCardholder", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TotalAmtPayCardholder.value[x]", "path": "Parameters.parameter.part.value[x]", "min": 1, "type": [ { "code": "Money" } ], "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:CarrierNumber", "path": "Parameters.parameter.part", "sliceName": "CarrierNumber", "comment": "Usage Note: When present, the daily totals provided are broken down by carrier and/or group. When group is also present, the daily totals apply to the carrier and group. If not populated, the daily totals provided are based on the criteria in the query parameters.\r\n \r\nUsage Note: If adjudicators wish to provide daily totals by carrier/group this part is specified. This may be populated when one or more carriers/groups are present in the request message and when the Results Rule Parameter on the query has indicated \"include\". Include = Return only carrier/groups that are specifed in the list. May be repeated for each carrier/group in the request if a breakdown by carrier/group is desired. \r\nCPHA Map: None\r\n\r\nOnly one level of nested parameters is allowed.", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:CarrierNumber.name", "path": "Parameters.parameter.part.name", "fixedString": "Carrier", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:CarrierNumber.value[x]", "path": "Parameters.parameter.part.value[x]", "comment": "Usage Note: This must be populated with the carrier number and where applicable the carrier+group.", "min": 1, "type": [ { "code": "string" } ], "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:CarrierNumber.part", "path": "Parameters.parameter.part.part", "slicing": { "discriminator": [ { "type": "value", "path": "name" } ], "rules": "open" }, "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:CarrierNumber.part:GroupNumber", "path": "Parameters.parameter.part.part", "sliceName": "GroupNumber", "comment": "Usage Note: Identified if the totals provided apply to one or more groups \r\n\r\nOnly one level of nested parameters is allowed." }, { "id": "Parameters.parameter:DailyTotalsByDate.part:CarrierNumber.part:GroupNumber.name", "path": "Parameters.parameter.part.part.name", "fixedString": "Group" }, { "id": "Parameters.parameter:DailyTotalsByDate.part:CarrierNumber.part:GroupNumber.value[x]", "path": "Parameters.parameter.part.part.value[x]", "type": [ { "code": "string" } ] }, { "id": "Parameters.parameter:DailyTotalsByDate.part:DateOfDeposit", "path": "Parameters.parameter.part", "sliceName": "DateOfDeposit", "comment": "Usage Note: Date upon which the banking institution is expected to post the deposit to the providers account\r\nCPHA Map: G.49.03 Date of Deposit\r\n\r\nOnly one level of nested parameters is allowed.", "max": "1", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:DateOfDeposit.name", "path": "Parameters.parameter.part.name", "fixedString": "DateOfDeposit", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:DateOfDeposit.value[x]", "path": "Parameters.parameter.part.value[x]", "type": [ { "code": "dateTime" } ], "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TransactionFees", "path": "Parameters.parameter.part", "sliceName": "TransactionFees", "comment": "Usage Note: Total Value of Transaction Fees\r\nCPHA Map: Transaction Fees G.50.03\r\nOnly one level of nested parameters is allowed.", "max": "1", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TransactionFees.name", "path": "Parameters.parameter.part.name", "fixedString": "TransactionFees", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:TransactionFees.value[x]", "path": "Parameters.parameter.part.value[x]", "type": [ { "code": "Money" } ], "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:GSTTransactionFees", "path": "Parameters.parameter.part", "sliceName": "GSTTransactionFees", "comment": "Ugage Note: The applicable amount of GST for the transaction fee charged\r\nCPHA Map: GST charged on Transaction Fees G.51.03\r\r\nOnly one level of nested parameters is allowed.", "max": "1", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:GSTTransactionFees.name", "path": "Parameters.parameter.part.name", "fixedString": "GSTTransactionFees", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:GSTTransactionFees.value[x]", "path": "Parameters.parameter.part.value[x]", "type": [ { "code": "Money" } ], "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:AmountOfDeposit", "path": "Parameters.parameter.part", "sliceName": "AmountOfDeposit", "comment": "Usage Note: The amount of the EFT deposit for the adjudication date concerned\r\nCPHA Map: Amount of Deposit G.52.03\r\r\n\r\nOnly one level of nested parameters is allowed.", "max": "1", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:AmountOfDeposit.name", "path": "Parameters.parameter.part.name", "fixedString": "AmountOfDeposit", "mustSupport": true }, { "id": "Parameters.parameter:DailyTotalsByDate.part:AmountOfDeposit.value[x]", "path": "Parameters.parameter.part.value[x]", "type": [ { "code": "Money" } ] } ] } }