API end point: https://fhir.careevolution.com/Master.Adapter1.WebClient/api/fhir.
Maps CareEvolution Claim concepts
| Name | Type | Modifiers , prefixes | Multiple values | Can be chained | Description |
|---|---|---|---|---|---|
| _id | Token | Yes |
Resource id |
||
| _lastUpdated | Date | lt le gt ge |
When the resource last changed |
||
| _source | Uri | :missing | Yes |
Where the resource comes from |
|
| created | Date | :missing eq ne lt le gt ge sa eb ap |
Searches for claims by start date-time |
||
| date | Date | :missing eq ne lt le gt ge sa eb ap | See here | ||
| encounter | Reference (Encounter) | :missing | Yes | Yes |
Searches for claims by their associated encounter |
| identifier | Token | :missing | Yes |
The primary identifier of the financial resource |
|
| patient | Reference (Patient) | :missing | Yes | Yes |
The patient the Claim is about |
| provenance-agent | Reference (Organization) | :missing | Yes | Yes |
Search by provenance, specified by its author (aka originator) Organization |
| provider | Reference (Practitioner) | :missing | Yes | Yes |
Searches for claims by practitioner (caregiver), considering all possible references: provider, payee.provider and the http://careevolution.com/fhirextensions#claim-providers extension |
| status | Token | :not :in :not-in :missing | Yes |
Searches for claims by status |
|
| type | Token | :missing | Yes | See here |
Supports multiple sorts
| CareEvolution | FHIR | |
|---|---|---|
| AdjudicationDate | extension('http://careevolution.com/fhirextensions#claim-adjudicationDate') | |
| AdmitDate | extension('http://careevolution.com/fhirextensions#claim-admitDate') | |
| AdmitSource
Domain: AdmitSource |
extension('http://careevolution.com/fhirextensions#claim-admitSource')
Bindings: https://www.nubc.org/CodeSystem/PointOfOrigin https://www.nubc.org/CodeSystem/PointOfOriginNewBorn |
|
| AdmitType
Domain: AdmissionType |
extension('http://careevolution.com/fhirextensions#claim-admitType')
Bindings: https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit http://hl7.org/fhir/v3/ActCode https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set https://rosetta.careevolution.com/UBFacilityType |
|
| AlternateIdentifier | identifier | |
| BillClass
Domain: BillClass |
extension('http://careevolution.com/fhirextensions#claim-billClass')
Bindings: https://www.nubc.org/CodeSystem/TypeOfBill |
|
| CaregiverRelationships | provider | Maps CaregiverRelationships with RelationshipType=ClaimProvider |
| payee | Maps CaregiverRelationships with RelationshipType=PayToProvider | |
| extension('http://careevolution.com/fhirextensions#claim-providers') | ||
| ClaimType
Domain: ClaimType |
type
Bindings: valueset-claim-type |
|
| Comment | text | |
| ControlNumber | extension('http://careevolution.com/fhirextensions#claim-controlNumber') | |
| DataSource | extension('http://careevolution.com/fhirextensions#dataSource') | |
| DischargeDate | extension('http://careevolution.com/fhirextensions#claim-dischargeDate') | |
| Disposition
Domain: ClaimDisposition |
extension('http://careevolution.com/fhirextensions#claim-disposition') | |
| Drg
Domain: ClaimDrg |
extension('http://careevolution.com/fhirextensions#claim-drg')
Bindings: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software |
|
| Encounter.EncounterLocations | facility | |
| EncounterID | extension('http://careevolution.com/fhirextensions#claim-encounterID') | |
| EndDate | extension('http://careevolution.com/fhirextensions#claim-endDate') | |
| FacilityType
Domain: FacilityType |
extension('http://careevolution.com/fhirextensions#claim-facilityType')
Bindings: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set http://hl7.org/fhir/v3/ActCode https://rosetta.careevolution.com/UBFacilityType |
|
| Identifier | identifier | |
| InNetwork
Domain: ClaimInNetwork |
extension('http://careevolution.com/fhirextensions#claim-innetwork') | |
| InsuranceID | coverage | |
| Mrn | extension('http://careevolution.com/fhirextensions#claim-mrn') | |
| NonPaymentReason
Domain: NonPaymentReason |
extension('http://careevolution.com/fhirextensions#claim-nonPaymentReason')
Bindings: https://x12.org/codes/remittance-advice-remark-codes https://x12.org/codes/claim-adjustment-reason-codes |
|
| PaidDate | extension('http://careevolution.com/fhirextensions#claim-paidDate') | |
| PatientID | patient | |
| PatientStatus
Domain: PatientStatus |
extension('http://careevolution.com/fhirextensions#claim-patientStatus') | |
| Problems.Date | diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') | |
| Problems.Sequence | diagnosis.sequence | |
| Problems.Term
Domain: DiagnosisCode |
diagnosis.diagnosis
Bindings: http://snomed.info/sct http://hl7.org/fhir/sid/icd-10-cm http://hl7.org/fhir/sid/icd-9-cm/diagnosis |
|
| Problems.Type
Domain: DiagnosisType |
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemType') | |
| Properties | extension('http://careevolution.com/fhirextensions#properties') | |
| ReferralID | referral | |
| Services.AllowedAmount | item.extension('http://careevolution.com/fhirextensions#claimService-allowedamount') | |
| Services.AmountClaimed | item.unitPrice | |
| Services.AmountPaid | item.net | |
| Services.CaregiverRelationships | extension('http://careevolution.com/fhirextensions#claim-providers') | |
| Services.CoinsuranceAmount | item.extension('http://careevolution.com/fhirextensions#claimService-coinsuranceamount') | |
| Services.CopayAmount | item.extension('http://careevolution.com/fhirextensions#claimService-copayamount') | |
| Services.DeductibleAmount | item.extension('http://careevolution.com/fhirextensions#claimService-deductibleamount') | |
| Services.EndDate | item.extension('http://careevolution.com/fhirextensions#claim-endDate') | |
| Services.HsaPaidAmount | item.extension('http://careevolution.com/fhirextensions#claimService-hsapaidamount') | |
| Services.LocationType
Domain: ServiceLocation |
item.extension('http://careevolution.com/fhirextensions#claim-locationType')
Bindings: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set http://hl7.org/fhir/v3/ActCode https://rosetta.careevolution.com/UBFacilityType |
|
| Services.Modifier1
Domain: BillingModifier |
item.modifier
Bindings: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets http://snomed.info/sct |
|
| Services.Modifier2
Domain: BillingModifier |
item.modifier
Bindings: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets http://snomed.info/sct |
|
| Services.Modifier3
Domain: BillingModifier |
item.modifier
Bindings: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets http://snomed.info/sct |
|
| Services.Modifier4
Domain: BillingModifier |
item.modifier
Bindings: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets http://snomed.info/sct |
|
| Services.Modifier5
Domain: BillingModifier |
item.modifier
Bindings: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets http://snomed.info/sct |
|
| Services.NonPaymentReason
Domain: NonPaymentReason |
item.extension('http://careevolution.com/fhirextensions#claimService-nonPaymentReason')
Bindings: https://x12.org/codes/remittance-advice-remark-codes https://x12.org/codes/claim-adjustment-reason-codes |
|
| Services.NotCoveredAmount | item.extension('http://careevolution.com/fhirextensions#claimService-notcoveredamount') | |
| Services.PatientPaid | item.extension('http://careevolution.com/fhirextensions#claim-patientPaid') | |
| Services.PatientResponsibleAmount | item.extension('http://careevolution.com/fhirextensions#claimService-patientresponsibleamount') | |
| Services.RevenueCode
Domain: RevenueCode |
item.extension('http://careevolution.com/fhirextensions#claim-revenueCode')
Bindings: https://www.nubc.org/CodeSystem/RevenueCodes |
|
| Services.Sequence | item.sequence | |
| Services.ServiceCode
Domain: ServiceCode |
item.service
Bindings: http://www.ada.org/cdt http://snomed.info/sct https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets http://www.icd10data.com/icd10pcs http://hl7.org/fhir/sid/icd-9-cm/procedure |
|
| Services.StartDate | item.serviceDate | |
| Services.Status
Domain: ClaimServiceStatus |
item.extension('http://careevolution.com/fhirextensions#claim-status') | |
| Services.Units | item.quantity | |
| StartDate | created | |
| Status
Domain: ClaimStatus |
extension('http://careevolution.com/fhirextensions#claim-status') | |
| TotalAllowed | extension('http://careevolution.com/fhirextensions#claim-totalAllowed') | |
| TotalCharges | extension('http://careevolution.com/fhirextensions#claim-totalCharges') | |
| TotalCoinsuranceAmount | extension('http://careevolution.com/fhirextensions#claim-totalcoinsuranceamount') | |
| TotalCopayAmount | extension('http://careevolution.com/fhirextensions#claim-totalcopayamount') | |
| TotalDeductibleAmount | extension('http://careevolution.com/fhirextensions#claim-totaldeductibleamount') | |
| TotalHsaPaidAmount | extension('http://careevolution.com/fhirextensions#claim-totalhsapaidamount') | |
| TotalNotCoveredAmount | extension('http://careevolution.com/fhirextensions#claim-totalnotcoveredamount') | |
| TotalPaid | extension('http://careevolution.com/fhirextensions#claim-totalPaid') | |
| TotalPatientPaid | extension('http://careevolution.com/fhirextensions#claim-totalPatientPaid') | |
| TotalPatientResponsibleAmount | extension('http://careevolution.com/fhirextensions#claim-totalpatientresponsibleamount') |
| CareEvolution | FHIR | |
|---|---|---|
| AdjudicationDate | extension('http://careevolution.com/fhirextensions#claim-adjudicationDate') | |
| AdmitDate | extension('http://careevolution.com/fhirextensions#claim-admitDate') | |
| AdmitSource
Domain: AdmitSource |
extension('http://careevolution.com/fhirextensions#claim-admitSource')
Bindings: https://www.nubc.org/CodeSystem/PointOfOrigin https://www.nubc.org/CodeSystem/PointOfOriginNewBorn |
|
| AdmitType
Domain: AdmissionType |
extension('http://careevolution.com/fhirextensions#claim-admitType')
Bindings: https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit http://hl7.org/fhir/v3/ActCode https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set https://rosetta.careevolution.com/UBFacilityType |
|
| AlternateIdentifier | identifier | |
| BillClass
Domain: BillClass |
extension('http://careevolution.com/fhirextensions#claim-billClass')
Bindings: https://www.nubc.org/CodeSystem/TypeOfBill |
|
| CaregiverRelationships | provider | Maps CaregiverRelationships with RelationshipType=ClaimProvider |
| payee | Maps CaregiverRelationships with RelationshipType=PayToProvider | |
| extension('http://careevolution.com/fhirextensions#claim-providers') | ||
| ClaimType
Domain: ClaimType |
type
Bindings: valueset-claim-type |
|
| Comment | text | |
| ControlNumber | extension('http://careevolution.com/fhirextensions#claim-controlNumber') | |
| DataSource | extension('http://careevolution.com/fhirextensions#dataSource') | |
| DischargeDate | extension('http://careevolution.com/fhirextensions#claim-dischargeDate') | |
| Disposition
Domain: ClaimDisposition |
extension('http://careevolution.com/fhirextensions#claim-disposition') | |
| Drg
Domain: ClaimDrg |
extension('http://careevolution.com/fhirextensions#claim-drg')
Bindings: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software |
|
| EncounterID | extension('http://careevolution.com/fhirextensions#claim-encounterID') | |
| EndDate | extension('http://careevolution.com/fhirextensions#claim-endDate') | |
| FacilityType
Domain: FacilityType |
extension('http://careevolution.com/fhirextensions#claim-facilityType')
Bindings: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set http://hl7.org/fhir/v3/ActCode https://rosetta.careevolution.com/UBFacilityType |
|
| Identifier | identifier | |
| id | ||
| InNetwork
Domain: ClaimInNetwork |
extension('http://careevolution.com/fhirextensions#claim-innetwork') | |
| InsuranceID | coverage | |
| Mrn | extension('http://careevolution.com/fhirextensions#claim-mrn') | |
| NonPaymentReason
Domain: NonPaymentReason |
extension('http://careevolution.com/fhirextensions#claim-nonPaymentReason')
Bindings: https://x12.org/codes/remittance-advice-remark-codes https://x12.org/codes/claim-adjustment-reason-codes |
|
| PaidDate | extension('http://careevolution.com/fhirextensions#claim-paidDate') | |
| PatientID | patient | |
| PatientStatus
Domain: PatientStatus |
extension('http://careevolution.com/fhirextensions#claim-patientStatus') | |
| Problems.Date | diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemDate') | |
| Problems.Sequence | diagnosis.sequence | |
| Problems.Term
Domain: DiagnosisCode |
diagnosis.diagnosis
Bindings: http://snomed.info/sct http://hl7.org/fhir/sid/icd-10-cm http://hl7.org/fhir/sid/icd-9-cm/diagnosis |
|
| Problems.Type
Domain: DiagnosisType |
diagnosis.extension('http://careevolution.com/fhirextensions#claim-problemType') | |
| Properties | extension('http://careevolution.com/fhirextensions#properties') | |
| ReferralID | referral | |
| Services.AllowedAmount | item.extension('http://careevolution.com/fhirextensions#claimService-allowedamount') | |
| Services.AmountClaimed | item.unitPrice | |
| Services.AmountPaid | item.net | |
| Services.CaregiverRelationships | extension('http://careevolution.com/fhirextensions#claim-providers') | |
| Services.CoinsuranceAmount | item.extension('http://careevolution.com/fhirextensions#claimService-coinsuranceamount') | |
| Services.CopayAmount | item.extension('http://careevolution.com/fhirextensions#claimService-copayamount') | |
| Services.DeductibleAmount | item.extension('http://careevolution.com/fhirextensions#claimService-deductibleamount') | |
| Services.EndDate | item.extension('http://careevolution.com/fhirextensions#claim-endDate') | |
| Services.HsaPaidAmount | item.extension('http://careevolution.com/fhirextensions#claimService-hsapaidamount') | |
| Services.LocationType
Domain: ServiceLocation |
item.extension('http://careevolution.com/fhirextensions#claim-locationType')
Bindings: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set http://hl7.org/fhir/v3/ActCode https://rosetta.careevolution.com/UBFacilityType |
|
| Services.Modifier1
Domain: BillingModifier |
item.modifier
Bindings: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets http://snomed.info/sct |
|
| Services.Modifier2
Domain: BillingModifier |
item.modifier
Bindings: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets http://snomed.info/sct |
|
| Services.Modifier3
Domain: BillingModifier |
item.modifier
Bindings: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets http://snomed.info/sct |
|
| Services.Modifier4
Domain: BillingModifier |
item.modifier
Bindings: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets http://snomed.info/sct |
|
| Services.Modifier5
Domain: BillingModifier |
item.modifier
Bindings: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets http://snomed.info/sct |
|
| Services.NonPaymentReason
Domain: NonPaymentReason |
item.extension('http://careevolution.com/fhirextensions#claimService-nonPaymentReason')
Bindings: https://x12.org/codes/remittance-advice-remark-codes https://x12.org/codes/claim-adjustment-reason-codes |
|
| Services.NotCoveredAmount | item.extension('http://careevolution.com/fhirextensions#claimService-notcoveredamount') | |
| Services.PatientPaid | item.extension('http://careevolution.com/fhirextensions#claim-patientPaid') | |
| Services.PatientResponsibleAmount | item.extension('http://careevolution.com/fhirextensions#claimService-patientresponsibleamount') | |
| Services.RevenueCode
Domain: RevenueCode |
item.extension('http://careevolution.com/fhirextensions#claim-revenueCode')
Bindings: https://www.nubc.org/CodeSystem/RevenueCodes |
|
| Services.Sequence | item.sequence | |
| Services.ServiceCode
Domain: ServiceCode |
item.service
Bindings: http://www.ada.org/cdt http://snomed.info/sct https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets http://www.icd10data.com/icd10pcs http://hl7.org/fhir/sid/icd-9-cm/procedure |
|
| Services.StartDate | item.serviceDate | |
| Services.Status
Domain: ClaimServiceStatus |
item.extension('http://careevolution.com/fhirextensions#claim-status') | |
| Services.Units | item.quantity | |
| StartDate | created | |
| Status
Domain: ClaimStatus |
extension('http://careevolution.com/fhirextensions#claim-status') | |
| TotalAllowed | extension('http://careevolution.com/fhirextensions#claim-totalAllowed') | |
| TotalCharges | extension('http://careevolution.com/fhirextensions#claim-totalCharges') | |
| TotalCoinsuranceAmount | extension('http://careevolution.com/fhirextensions#claim-totalcoinsuranceamount') | |
| TotalCopayAmount | extension('http://careevolution.com/fhirextensions#claim-totalcopayamount') | |
| TotalDeductibleAmount | extension('http://careevolution.com/fhirextensions#claim-totaldeductibleamount') | |
| TotalHsaPaidAmount | extension('http://careevolution.com/fhirextensions#claim-totalhsapaidamount') | |
| TotalNotCoveredAmount | extension('http://careevolution.com/fhirextensions#claim-totalnotcoveredamount') | |
| TotalPaid | extension('http://careevolution.com/fhirextensions#claim-totalPaid') | |
| TotalPatientPaid | extension('http://careevolution.com/fhirextensions#claim-totalPatientPaid') | |
| TotalPatientResponsibleAmount | extension('http://careevolution.com/fhirextensions#claim-totalpatientresponsibleamount') |
