API end point: https://fhir.careevolution.com/Master.Adapter1.WebClient/api/fhir.

Resource Claim (DSTU2)

Maps CareEvolution Claim concepts

Supported interactions

Search parameters

Name Type Modifiers , prefixes Multiple values Can be chained Description
_id Token Yes See here
_lastUpdated Date lt le gt ge See here
created Date eq ne lt le gt ge sa eb ap

Searches for claims by start date-time

date Date eq ne lt le gt ge sa eb ap See here
encounter Reference :missing Yes Yes

Searches for claims by their associated encounter

identifier Token Yes See here
patient Reference :missing Yes Yes See here
provenance-agent Reference Yes Yes

Search by provenance, specified by its author (aka originator) Organization

provider Reference :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 Yes

Searches for claims by status

type Token Yes See here

Sorts

Supports multiple sorts

Includes

Operations

To FHIR mappings

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/PointOfOrigin-NewBorn
AdmitType
Domain: AdmissionType
extension('http://careevolution.com/fhirextensions#claim-admitType')
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set
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
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
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/claim-adjustment-reason-codes  https://x12.org/codes/remittance-advice-remark-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://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm/diagnosis  http://snomed.info/sct
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
Services.Modifier1
Domain: BillingModifier
item.modifier
Bindings:  http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier2
Domain: BillingModifier
item.modifier
Bindings:  http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier3
Domain: BillingModifier
item.modifier
Bindings:  http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier4
Domain: BillingModifier
item.modifier
Bindings:  http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier5
Domain: BillingModifier
item.modifier
Bindings:  http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
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.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://hl7.org/fhir/sid/cvx  http://www.icd10data.com/icd10pcs  http://hl7.org/fhir/sid/icd-9-cm/procedure  http://snomed.info/sct
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')

From FHIR mappings

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/PointOfOrigin-NewBorn
AdmitType
Domain: AdmissionType
extension('http://careevolution.com/fhirextensions#claim-admitType')
Bindings:  https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit  https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set
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
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
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/claim-adjustment-reason-codes  https://x12.org/codes/remittance-advice-remark-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://hl7.org/fhir/sid/icd-10-cm  http://hl7.org/fhir/sid/icd-9-cm/diagnosis  http://snomed.info/sct
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
Services.Modifier1
Domain: BillingModifier
item.modifier
Bindings:  http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier2
Domain: BillingModifier
item.modifier
Bindings:  http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier3
Domain: BillingModifier
item.modifier
Bindings:  http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier4
Domain: BillingModifier
item.modifier
Bindings:  http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
Services.Modifier5
Domain: BillingModifier
item.modifier
Bindings:  http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://snomed.info/sct
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.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets  http://hl7.org/fhir/sid/cvx  http://www.icd10data.com/icd10pcs  http://hl7.org/fhir/sid/icd-9-cm/procedure  http://snomed.info/sct
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')