Claim

A Claim represents a list of services given to an insurance company for recovering payment.

Overview

See the FHIR documentation for more information about Claim resources.

Mapped Concepts in HIEBus

  • Claim
  • Medication

Supported Interactions

Claim resources support the following interactions.

Search Parameters

When searching for Claim resources, the following search parameters are supported.

Name Type Prefixes
Modifiers
Can be Chained? Description
_id Token Resource id.
_lastUpdated Date lt  le  gt  ge  When the resource last changed.
_source Uri :missing  Where the resource comes from.
created Date ne  lt  le  gt  ge  sa  eb  ap  :missing  The creation date for the Claim.
encounter Reference :missing  yes Encounters associated with a billed line item.
enddate Date ne  lt  le  gt  ge  sa  eb  ap  :missing  Searches for claims by end date-time.
identifier Token :missing  The primary identifier of the financial resource.
patient Reference :missing  yes Patient receiving the products or services.
provenance-agent Reference :missing  yes Search by provenance, specified by its author (aka originator) Organization.
provider Reference :missing  yes Searches for claims by practitioner (caregiver), considering all possible references: provider, payee.provider and the http://careevolution.com/fhirextensions#claim-providers extension.
startdate Date ne  lt  le  gt  ge  sa  eb  ap  :missing  Searches for claims by start date-time.
status Token :not  :in  :notin  :missing  The status of the Claim instance.
type Token :missing  See the HL7 FHIR documentation.

Sortable Parameters

When searching Claim resources, it is possible to sort the returned values by the following search parameters.

  • created
  • identifier
  • _id

Only one sort parameter may be specified.

Supported Includes

When searching Claim resources, it is possible to include the resources referenced by the following field names.

  • Encounter
  • Patient
  • Provenance Agent
  • Provider

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