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Readjudicate FHIR Resource Proposal
Revision as of 01:35, 22 October 2014 by Paul Knapp (talk | contribs) (Created page with "=Readjudicate= <!-- Resource names should meet the following characteristics: * Lower camel case * U.S. English * Domain-friendly * Short * Clear * Unique * Avoid non-univers...")
Contents
- 1 Readjudicate
- 1.1 Owning committee name
- 1.2 Contributing or Reviewing Work Groups
- 1.3 FHIR Resource Development Project Insight ID
- 1.4 Scope of coverage
- 1.5 RIM scope
- 1.6 Resource appropriateness
- 1.7 Expected implementations
- 1.8 Content sources
- 1.9 Example Scenarios
- 1.10 Resource Relationships
- 1.11 Timelines
- 1.12 gForge Users
Readjudicate
Owning committee name
Contributing or Reviewing Work Groups
- Claims with Attachments
- Patient Administration
FHIR Resource Development Project Insight ID
994
Scope of coverage
The Readjudicate resource indicates the claim which is to be reversed and provides both supporting information for the reversal and the goods and services which are to be readjudicated.
RIM scope
InvoiceElementGroup (classCode=INVE,moodCode=RQO)
Resource appropriateness
This is necessary for the limited supporters who require the ability to formally request the readjudication of specified service subtrees from an already adjudicated Claim.
Expected implementations
This is a new resource to support this infrequently mandated ability to readjudicate claims.
Content sources
Saudi Arabia requirements.
Example Scenarios
Resource Relationships
Refers to a Claim resource and uses Organization, Practitioner. Is referred to by a ClaimResponse.
Timelines
Ready for DSTU 2
gForge Users
paulknapp
