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{
  "resourceType": "StructureDefinition",
  "id": "profile-parameters-reversal-OUT",
  "url": "http://pharmacyeclaims.ca/FHIR/v1.0/StructureDefinition/profile-parameters-reversal-OUT",
  "name": "ReversalParametersOUT",
  "title": "Reversal Parameters OUT profile",
  "status": "draft",
  "description": "Reversal Parameters OUT profile",
  "purpose": "Reversal Parameters profile OUT",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Parameters",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Parameters",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Parameters.parameter",
        "path": "Parameters.parameter",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "name"
            }
          ],
          "rules": "open"
        },
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:AdjudicationDate",
        "path": "Parameters.parameter",
        "sliceName": "AdjudicationDate",
        "comment": "Usage:  The date, as determined by the processor, on which the claim, transaction or request being responded to has been adjudicated.   This date is found in the ClaimResponse.created data element.   This must be present when reversal a claim that has been adjudicated.\r\nCPHA Map:  D.77.03 Adjudication Date",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:AdjudicationDate.name",
        "path": "Parameters.parameter.name",
        "fixedString": "AdjudicationDate",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:AdjudicationDate.value[x]",
        "path": "Parameters.parameter.value[x]",
        "min": 1,
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:TraceNumber",
        "path": "Parameters.parameter",
        "sliceName": "TraceNumber",
        "comment": "Usage Note:  Trace number from the claim which is echoed back in the response\r\nCPHA map:  E.02.03 Trace Number.",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:TraceNumber.name",
        "path": "Parameters.parameter.name",
        "fixedString": "TraceNumber",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:TraceNumber.value[x]",
        "path": "Parameters.parameter.value[x]",
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:TraceNumber.value[x].system",
        "path": "Parameters.parameter.value[x].system",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:TraceNumber.value[x].value",
        "path": "Parameters.parameter.value[x].value",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ReferenceNumber",
        "path": "Parameters.parameter",
        "sliceName": "ReferenceNumber",
        "comment": "Usage Note:  This is an internal reference number assigned to each claim by the processor.   This is optional as Pharmacies may reverse a claim when no adjudication response has been received.\r\nCPHA map:  E.04. 03 Reference Number",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ReferenceNumber.name",
        "path": "Parameters.parameter.name",
        "fixedString": "ReferenceNumber",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ReferenceNumber.value[x]",
        "path": "Parameters.parameter.value[x]",
        "comment": "Usage Note:   The system should be included when known.",
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ReferenceNumber.value[x].system",
        "path": "Parameters.parameter.value[x].system",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ReferenceNumber.value[x].value",
        "path": "Parameters.parameter.value[x].value",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ClaimOrCurrentRXNumber",
        "path": "Parameters.parameter",
        "sliceName": "ClaimOrCurrentRXNumber",
        "comment": "Usage Note:  Prescription Number appearing on the label of the dispensed prescription or on the record of the \r\nservice provided.       In FHIR this is found in the MedicationDispense.identifier for dispenses or in the claim.identifier for professional services claims\r\nCPHA Map: D.55.03",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ClaimOrCurrentRXNumber.name",
        "path": "Parameters.parameter.name",
        "fixedString": "ClaimOrCurrentRXNumber",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ClaimOrCurrentRXNumber.value[x]",
        "path": "Parameters.parameter.value[x]",
        "comment": "Usage Note:   In FHIR, the system is known and must be present when known.   It is optional for backward compatibility to CPHA3.",
        "min": 1,
        "type": [
          {
            "code": "Identifier"
          }
        ]
      },
      {
        "id": "Parameters.parameter:ClaimOrCurrentRXNumber.value[x].system",
        "path": "Parameters.parameter.value[x].system",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ClaimOrCurrentRXNumber.value[x].value",
        "path": "Parameters.parameter.value[x].value",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ResponseStatus",
        "path": "Parameters.parameter",
        "sliceName": "ResponseStatus",
        "comment": "Usage Note:   Set Value = R = rejected OR V - reversal accepted\r\nCPHA Map:  E.05.03 Response Status",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ResponseStatus.name",
        "path": "Parameters.parameter.name",
        "fixedString": "ResponseStatus",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ResponseStatus.value[x]",
        "path": "Parameters.parameter.value[x]",
        "min": 1,
        "type": [
          {
            "code": "code"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ResponseCodes",
        "path": "Parameters.parameter",
        "sliceName": "ResponseCodes",
        "comment": "Usage Note:  Only used when Response Status = R\r\nExamples are: \r\nA7-submit manual reversal\r\nA8 - no reversal made-orig. claim missing\r\nA9-reversal processed previously",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ResponseCodes.name",
        "path": "Parameters.parameter.name",
        "fixedString": "ResponseCodes"
      },
      {
        "id": "Parameters.parameter:ResponseCodes.value[x]",
        "path": "Parameters.parameter.value[x]",
        "type": [
          {
            "code": "code"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ReversalAmount",
        "path": "Parameters.parameter",
        "sliceName": "ReversalAmount",
        "comment": "Usage Note:  Must be present when the reversal is successful.  \r\nCPHA Mapping:",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ReversalAmount.name",
        "path": "Parameters.parameter.name",
        "fixedString": "ReversalAmount",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ReversalAmount.value[x]",
        "path": "Parameters.parameter.value[x]",
        "comment": "Usage Note:   Canadian Dollars is assumed and therefore currency is not required",
        "type": [
          {
            "code": "Money"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ReversalAmount.value[x].value",
        "path": "Parameters.parameter.value[x].value",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:PayeeType",
        "path": "Parameters.parameter",
        "sliceName": "PayeeType",
        "comment": "Usage Note:   This is the payee type from the reversed claim.   Set value = \"Patient\" or \"Provider\".   This is found in the payee field of the claim response and request.    This value must be present.\r\nCPHA Map:   This is not on the claim reversal today and is therefore optional.   Value must be present",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:PayeeType.name",
        "path": "Parameters.parameter.name",
        "fixedString": "PayeeType",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:PayeeType.value[x]",
        "path": "Parameters.parameter.value[x]",
        "min": 1,
        "type": [
          {
            "code": "string"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ReversalRefusalReason",
        "path": "Parameters.parameter",
        "sliceName": "ReversalRefusalReason",
        "comment": "Usage Note:  Used when adjudicators need to provide a textual description of reasons that a claim reversal was not accepted.    \r\nCPHA Map:  E.20.03 Message Data Line",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ReversalRefusalReason.name",
        "path": "Parameters.parameter.name",
        "fixedString": "ReversalRefusalReason",
        "mustSupport": true
      },
      {
        "id": "Parameters.parameter:ReversalRefusalReason.value[x]",
        "path": "Parameters.parameter.value[x]",
        "min": 1,
        "type": [
          {
            "code": "string"
          }
        ],
        "mustSupport": true
      }
    ]
  }
}

name : ReversalParametersOUT

{

}