C4BBExplanationOfBenefitOutpatientInstitutional

C4BB ExplanationOfBenefit Outpatient Institutional

activeCARIN Blue Button2.2.0resource8 key elements

This profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for outpatient services, which may include including the use of equipment and supplies, laboratory services, radiology services and other charges. Outpatient claims are submitted for services rendered at an institution that are not part of an overnight stay. The claims data is based on the institutional claim form UB-04, submission standards adopted by the Department of Health and Human Services. The profile has requirements for financial data.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-ExplanationOfBenefit-Outpatient-Institutional
ID
C4BB-ExplanationOfBenefit-Outpatient-Institutional
Type
Base Definition
C4BB-ExplanationOfBenefit-Outpatient-Institutional-Basis
Derivation
constraint
Mandatory and Must-Support Elements

Elements with cardinality > 0 or marked as Must Support (S)

PathCard.TypeFlagsDescription
:adjudicationamounttype0..*
S
Line level adjudication type and amount
item.adjudication.amount
S1+
:adjudicationamounttype0..*
S
Claim level adjudication type and amount
adjudication.amount
S1+
total
S1+
total.category
S
:adjudicationamounttype1..*
S1+
Total adjudication type and amount
total.amount
S