Claims
The Claims and Claims amend process is a follow on to the Dispensing API. The Claims process can only start when a prescription is fully dispensed and no outstanding items are awaiting to be dispensed. The endorsement codes are captured within the Dispensing system and are attached to the message within Claims, this follows on to capture the charge status of the patient and finally is submitted to NHSBSA via EPS for validation and verification.
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contain the message defintiion for Claims.
The two messages differ only on the eventCoding in the MessageHeader dispense-claim and dispense-claim-update respectively, and the Extension-replacementOf is mandatory in the MessageHeader for dispense-claim-update, this is an indentifier reference to the replaced dispense-claim.
The number of Claim resource will be equal to the number of MedicationRequest resources in the original prescription-order.
| Claim | Claim.item | Claim.item.detail |
|---|---|---|
| Contains general eClaim information. This links to the original prescription-order via the prescription element which links to both the MedicationRequest identifier and groupIdentifier | Details of the Medication that was ordered/prescribed, including the originally prescribed medication. This will also include endorements made by the prescriber. | Details of the Medication that was dispensed, including the originally prescribed medication. This will also include endorements made by the dispenser and patient. |