QI-Core Implementation Guide
6.0.0 - STU6 United States of America flag

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Example ClaimResponse: ClaimResponse example

Generated Narrative: ClaimResponse

Resource ClaimResponse "example"

Profile: QICore ClaimResponse

status: active

type: Vision (Claim Type Codes#vision)

use: preauthorization

patient: Patient/example " CHALMERS"

created: 2018-02-24

insurer: Organization/example "Health Level Seven International"

requestor: Practitioner/example " CAREFUL"

request: Claim/example

outcome: queued

item

itemSequence: 1

adjudication

category: Submitted Amount (Adjudication Value Codes#submitted)

Amounts

-ValueCurrency
*235.40USD