Union of https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementclaim-logo and https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementclaim-logo

This is the set of resources that conform to either of the profiles MyCareNet eAgreement Claim Logo BE profile (https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementclaim-logo) and MyCareNet eAgreement Claim Logo BE profile (https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementclaim-logo). E.g. what you have to deal with if you get resources conforming to one of them

Structure

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim C0..*Claim, Pre-determination or Pre-authorization
Constraints: be-rule-eagreementclaim-1, be-rule-eagreementclaim-2, be-rule-eagreementclaim-3
... meta SΣ1..1MetaMetadata about the resource
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ0..1instantWhen the resource version last changed
.... source Σ0..1uriIdentifies where the resource comes from
.... profile Σ1..1canonical(StructureDefinition)Profiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
.... tag Σ0..*CodingTags applied to this resource
Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: ?? (preferred): A human language.
... text 0..1NarrativeText summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
Constraints: ext-1
... identifier 0..*IdentifierBusiness Identifier for claim
... status ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
Binding: ?? (required): A code specifying the state of the resource instance.
... type SΣ1..1CodeableConceptCategory or discipline
Binding: ?? (extensible): The type or discipline-style of the claim.
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... coding Σ1..1CodingCode defined by a terminology system
..... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
..... system Σ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subType S1..1CodeableConceptMore granular claim type
Binding: ?? (example): A more granular claim typecode.
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... coding Σ1..1CodingCode defined by a terminology system
..... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
..... system Σ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... use SΣ1..1codeclaim | preauthorization | predetermination
Binding: ?? (required): The purpose of the Claim: predetermination, preauthorization, claim.
... patient SΣ1..1Reference(BePatient(2.1.2))The recipient of the products and services
... billablePeriod SΣ0..1PeriodRelevant time frame for the claim
... created SΣ1..1dateTimeResource creation date
... enterer S1..1Reference(BePractitionerRole(2.1.2))Author of the claim
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... reference Σ1..1stringLiteral reference, Relative, internal or absolute URL
.... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
.... display Σ0..1stringText alternative for the resource
... insurer Σ0..1Reference(Organization)Target
... provider SΣ1..1Reference(BeOrganization(2.1.2) | BePractitionerRole(2.1.2))Party responsible for the claim
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... reference Σ1..1stringLiteral reference, Relative, internal or absolute URL
.... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
.... display Σ0..1stringText alternative for the resource
... priority SΣ1..1CodeableConceptDesired processing ugency
Binding: ?? (example): The timeliness with which processing is required: stat, normal, deferred.
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... coding Σ1..1CodingCode defined by a terminology system
..... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
..... system Σ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... fundsReserve 0..1CodeableConceptFor whom to reserve funds
Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None).
... related 0..*BackboneElementPrior or corollary claims
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... claim 0..1Reference(Claim)Reference to the related claim
.... relationship 0..1CodeableConceptHow the reference claim is related
Binding: ?? (example): Relationship of this claim to a related Claim.
.... reference 0..1IdentifierFile or case reference
... prescription 0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Prescription authorizing services and products
... originalPrescription 0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Original prescription if superseded by fulfiller
... payee 0..1BackboneElementRecipient of benefits payable
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... type 1..1CodeableConceptCategory of recipient
Binding: ?? (example): A code for the party to be reimbursed.
.... party 0..1Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)Recipient reference
... referral S0..1Reference(ServiceRequest)Treatment referral
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... reference Σ1..1stringLiteral reference, Relative, internal or absolute URL
.... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
.... display Σ0..1stringText alternative for the resource
... facility 0..1Reference(Location)Servicing facility
... careTeam 0..*BackboneElementMembers of the care team
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1positiveIntOrder of care team
.... provider 1..1Reference(Practitioner | PractitionerRole | Organization)Practitioner or organization
.... responsible 0..1booleanIndicator of the lead practitioner
.... role 0..1CodeableConceptFunction within the team
Binding: ?? (example): The role codes for the care team members.
.... qualification 0..1CodeableConceptPractitioner credential or specialization
Binding: ?? (example): Provider professional qualifications.
... supportingInfo S0..*BackboneElementSupporting information
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1positiveIntInformation instance identifier
.... category S1..1CodeableConceptClassification of the supplied information
Binding: ?? (example): The valuset used for additional information category codes.
..... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
..... coding Σ1..1CodingCode defined by a terminology system
...... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... code 0..1CodeableConceptType of information
Binding: ?? (example): The valuset used for additional information codes.
..... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
..... coding Σ1..1CodingCode defined by a terminology system
...... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... timing[x] 0..1When it occurred
..... timingDatedate
..... timingPeriodPeriod
.... value[x] 0..1Data to be provided
..... valueBooleanboolean
..... valueStringstring
..... valueQuantityQuantity
..... valueAttachmentAttachment
..... valueReferenceReference(Resource)
.... reason 0..1CodeableConceptExplanation for the information
Binding: ?? (example): Reason codes for the missing teeth.
... diagnosis 0..*BackboneElementPertinent diagnosis information
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1positiveIntDiagnosis instance identifier
.... diagnosis[x] 1..1Nature of illness or problem
Binding: ?? (example): Example ICD10 Diagnostic codes.
..... diagnosisCodeableConceptCodeableConcept
..... diagnosisReferenceReference(Condition)
.... type 0..*CodeableConceptTiming or nature of the diagnosis
Binding: ?? (example): The type of the diagnosis: admitting, principal, discharge.
.... onAdmission 0..1CodeableConceptPresent on admission
Binding: ?? (example): Present on admission.
.... packageCode 0..1CodeableConceptPackage billing code
Binding: ?? (example): The DRG codes associated with the diagnosis.
... procedure 0..*BackboneElementClinical procedures performed
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1positiveIntProcedure instance identifier
.... type 0..*CodeableConceptCategory of Procedure
Binding: ?? (example): Example procedure type codes.
.... date S1..1dateTimeWhen the procedure was performed
.... procedure[x] 1..1Specific clinical procedure
Binding: ?? (example): Example ICD10 Procedure codes.
..... procedureCodeableConceptCodeableConcept
..... procedureReferenceReference(Procedure)
.... udi 0..*Reference(Device)Unique device identifier
... insurance SΣ1..1BackboneElementPatient insurance information
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence Σ1..1positiveIntInsurance instance identifier
.... focal Σ1..1booleanCoverage to be used for adjudication
.... identifier 0..1IdentifierPre-assigned Claim number
.... coverage Σ1..1Reference(Coverage)Insurance information
..... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
..... reference Σ0..1stringLiteral reference, Relative, internal or absolute URL
..... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).
..... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
..... display Σ1..1stringText alternative for the resource
.... businessArrangement 0..1stringAdditional provider contract number
.... preAuthRef 0..*stringPrior authorization reference number
.... claimResponse 0..1Reference(ClaimResponse)Adjudication results
... accident 0..1BackboneElementDetails of the event
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... date 1..1dateWhen the incident occurred
.... type 0..1CodeableConceptThe nature of the accident
Binding: ?? (extensible): Type of accident: work place, auto, etc.
.... location[x] 0..1Where the event occurred
..... locationAddressAddress
..... locationReferenceReference(Location)
... item S0..*BackboneElementProduct or service provided
.... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1positiveIntItem instance identifier
.... careTeamSequence 0..*positiveIntApplicable careTeam members
.... diagnosisSequence 0..*positiveIntApplicable diagnoses
.... procedureSequence 0..*positiveIntApplicable procedures
.... informationSequence 0..*positiveIntApplicable exception and supporting information
.... revenue 0..1CodeableConceptRevenue or cost center code
Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.
.... category 0..1CodeableConceptBenefit classification
Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.
.... productOrService 1..1CodeableConceptBilling, service, product, or drug code
Binding: ?? (example): Allowable service and product codes.
..... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
..... coding Σ1..1CodingCode defined by a terminology system
Binding: ?? (required)
...... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... modifier 0..*CodeableConceptProduct or service billing modifiers
Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
.... programCode 0..*CodeableConceptProgram the product or service is provided under
Binding: ?? (example): Program specific reason codes.
.... serviced[x] 0..1dateDate or dates of service or product delivery
.... location[x] 0..1Place of service or where product was supplied
Binding: ?? (example): Place of service: pharmacy, school, prison, etc.
..... locationCodeableConceptCodeableConcept
..... locationAddressAddress
..... locationReferenceReference(Location)
.... quantity 0..1??Count of products or services
.... unitPrice 0..1MoneyFee, charge or cost per item
.... factor 0..1decimalPrice scaling factor
.... net 0..1MoneyTotal item cost
.... udi 0..*Reference(Device)Unique device identifier
.... bodySite 0..1CodeableConceptAnatomical location
Binding: ?? (example): The code for the teeth, quadrant, sextant and arch.
.... subSite 0..*CodeableConceptAnatomical sub-location
Binding: ?? (example): The code for the tooth surface and surface combinations.
.... encounter 0..*Reference(Encounter)Encounters related to this billed item
.... detail 0..*BackboneElementProduct or service provided
..... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
Constraints: ext-1
..... sequence 1..1positiveIntItem instance identifier
..... revenue 0..1CodeableConceptRevenue or cost center code
Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.
..... category 0..1CodeableConceptBenefit classification
Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.
..... productOrService 1..1CodeableConceptBilling, service, product, or drug code
Binding: ?? (example): Allowable service and product codes.
..... modifier 0..*CodeableConceptService/Product billing modifiers
Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
..... programCode 0..*CodeableConceptProgram the product or service is provided under
Binding: ?? (example): Program specific reason codes.
..... quantity 0..1??Count of products or services
..... unitPrice 0..1MoneyFee, charge or cost per item
..... factor 0..1decimalPrice scaling factor
..... net 0..1MoneyTotal item cost
..... udi 0..*Reference(Device)Unique device identifier
..... subDetail 0..*BackboneElementProduct or service provided
...... extension 0..*ExtensionAdditional content defined by implementations
Constraints: ext-1
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
Constraints: ext-1
...... sequence 1..1positiveIntItem instance identifier
...... revenue 0..1CodeableConceptRevenue or cost center code
Binding: ?? (example): Codes for the revenue or cost centers supplying the service and/or products.
...... category 0..1CodeableConceptBenefit classification
Binding: ?? (example): Benefit categories such as: oral-basic, major, glasses.
...... productOrService 1..1CodeableConceptBilling, service, product, or drug code
Binding: ?? (example): Allowable service and product codes.
...... modifier 0..*CodeableConceptService/Product billing modifiers
Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
...... programCode 0..*CodeableConceptProgram the product or service is provided under
Binding: ?? (example): Program specific reason codes.
...... quantity 0..1??Count of products or services
...... unitPrice 0..1MoneyFee, charge or cost per item
...... factor 0..1decimalPrice scaling factor
...... net 0..1MoneyTotal item cost
...... udi 0..*Reference(Device)Unique device identifier
... total 0..1MoneyTotal claim cost

doco Documentation for this format