Profiles

Structures: Resource Profiles

These define constraints on Healthcare interoperable resources for systems conforming to this implementation guide

Profile Name Description
DXP Patient This profile builds upon the US Core Patient profile. Demographics and other administrative information about an individual receiving care or other health-related services. It is used to convey information about the patient who received the services described on the claim.
DXP Claim This profile builds upon the R4 Claim profile. The Claim is used by providers and payors, insurers, to exchange the financial information, and supporting clinical information, regarding the provision of health care services with payors and for reporting to regulatory bodies and firms which provide data analytics. The primary uses of this resource is to support eClaims, the exchange of information relating to the proposed or actual provision of healthcare-related goods and services for patients to their benefit payors, insurers and national health programs, for treatment payment planning and reimbursement.
DXP Coverage The Coverage resource is intended to provide the high-level identifiers and descriptors of an insurance plan, typically the information which would appear on an insurance card, which may be used to pay, in part or in whole, for the provision of health care products and services.
DXP ExplanationofBenefit The profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for inpatient services, which may include the use of equipment and supplies, laboratory services, radiology services and other charges. Inpatient claims are submitted for services rendered at an institution as part of an overnight stay.
DXP Organization A formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc.
DXP Practitioner Practitioner covers all individuals who are engaged in the healthcare process and healthcare-related services as part of their formal responsibilities and this Resource is used for attribution of activities and responsibilities to these individuals.
DXP PractitionerRole The role, specialty, Location telecom and HealthcareService properties can be repeated if required in other instances of the PractitionerRole. Some systems record a collection of service values for a single location, others record the single service and the list of locations it is available.