{
  "resourceType": "StructureDefinition",
  "id": "spark1646",
  "meta": {
    "versionId": "spark1998",
    "lastUpdated": "2015-11-18T16:38:16.272+00:00"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 0
    }
  ],
  "url": "http://mais.org.ar/fhir/StructureDefinition/AutorizacionRecibida",
  "name": "AutorizacionRecibida",
  "status": "draft",
  "date": "2015-09-22T10:02:49+00:00",
  "description": "Base StructureDefinition for ClaimResponse Resource",
  "fhirVersion": "1.0.1",
  "mapping": [
    {
      "identity": "w5",
      "uri": "http://hl7.org/fhir/w5",
      "name": "W5 Mapping"
    },
    {
      "identity": "cdanetv4",
      "uri": "http://www.cda-adc.ca/en/services/cdanet/",
      "name": "Canadian Dental Association eclaims standard"
    },
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM"
    }
  ],
  "kind": "resource",
  "constrainedType": "ClaimResponse",
  "abstract": false,
  "base": "http://hl7.org/fhir/StructureDefinition/ClaimResponse",
  "differential": {
    "element": [
      {
        "path": "ClaimResponse",
        "short": "Remittance resource",
        "definition": "This resource provides the adjudication details from the processing of a Claim resource.",
        "alias": [
          "Remittance Advice"
        ],
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "ClaimResponse",
            "aggregation": [
              "contained"
            ]
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "w5",
            "map": "financial.billing"
          }
        ]
      },
      {
        "path": "ClaimResponse.identifier",
        "short": "Response  number",
        "definition": "The Response business identifier.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.identifier.use",
        "short": "usual | official | temp | secondary (If known)",
        "definition": "The purpose of this identifier.",
        "comments": "This is labeled as \"Is Modifier\" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.",
        "requirements": "Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "code"
          }
        ],
        "isModifier": true,
        "isSummary": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "N/A"
          },
          {
            "identity": "rim",
            "map": "Role.code or implied by context"
          }
        ]
      },
      {
        "path": "ClaimResponse.identifier.type",
        "short": "Description of identifier",
        "definition": "A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.",
        "comments": "This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.",
        "requirements": "Allows users to make use of identifiers when the identifier system is not known.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "CX.5"
          },
          {
            "identity": "rim",
            "map": "Role.code or implied by context"
          }
        ]
      },
      {
        "path": "ClaimResponse.identifier.system",
        "short": "The namespace for the identifier",
        "definition": "Establishes the namespace in which set of possible id values is unique.",
        "requirements": "There are many sequences of identifiers.  To perform matching, we need to know what sequence we're dealing with. The system identifies a particular sequence or set of unique identifiers.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "uri"
          }
        ],
        "exampleUri": "http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri",
        "isSummary": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "CX.4 / EI-2-4"
          },
          {
            "identity": "rim",
            "map": "II.root or Role.id.root"
          },
          {
            "identity": "servd",
            "map": "./IdentifierType"
          }
        ]
      },
      {
        "path": "ClaimResponse.identifier.value",
        "short": "The value that is unique",
        "definition": "The portion of the identifier typically displayed to the user and which is unique within the context of the system.",
        "comments": "If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "string"
          }
        ],
        "exampleString": "123456",
        "isSummary": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "CX.1 / EI.1"
          },
          {
            "identity": "rim",
            "map": "II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"
          },
          {
            "identity": "servd",
            "map": "./Value"
          }
        ]
      },
      {
        "path": "ClaimResponse.identifier.period",
        "short": "Time period when id is/was valid for use",
        "definition": "Time period during which identifier is/was valid for use.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Period"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "CX.7 + CX.8"
          },
          {
            "identity": "rim",
            "map": "Role.effectiveTime or implied by context"
          },
          {
            "identity": "servd",
            "map": "./StartDate and ./EndDate"
          }
        ]
      },
      {
        "path": "ClaimResponse.identifier.assigner",
        "short": "Organization that issued id (may be just text)",
        "definition": "Organization that issued/manages the identifier.",
        "comments": "The reference may be just a text description of the assigner.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ]
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "v2",
            "map": "CX.4 / (CX.4,CX.9,CX.10)"
          },
          {
            "identity": "rim",
            "map": "II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"
          },
          {
            "identity": "servd",
            "map": "./IdentifierIssuingAuthority"
          }
        ]
      },
      {
        "path": "ClaimResponse.request",
        "short": "Id of resource triggering adjudication",
        "definition": "Original request resource referrence.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Claim"
            ]
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "cdanetv4",
            "map": "A02|G01"
          }
        ]
      },
      {
        "path": "ClaimResponse.ruleset",
        "short": "Resource version",
        "definition": "The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Coding"
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.originalRuleset",
        "short": "Original version",
        "definition": "The style (standard) and version of the original material which was converted into this resource.",
        "requirements": "Knowledge of the original version can inform the processing of this instance so that information which is processable by the originating system may be generated.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Coding"
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.created",
        "short": "Creation date",
        "definition": "The date when the enclosed suite of services were performed or completed.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "dateTime"
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.organization",
        "short": "Insurer",
        "definition": "The Insurer who produced this adjudicated response.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ]
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.requestProvider",
        "short": "Responsible practitioner",
        "definition": "The practitioner who is responsible for the services rendered to the patient.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Practitioner"
            ]
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "cdanetv4",
            "map": "B01"
          }
        ]
      },
      {
        "path": "ClaimResponse.requestOrganization",
        "short": "Responsible organization",
        "definition": "The organization which is responsible for the services rendered to the patient.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Reference",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ]
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.outcome",
        "short": "complete | error",
        "definition": "Transaction status: error, complete.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "code"
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.disposition",
        "short": "Disposition Message",
        "definition": "A description of the status of the adjudication.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "string"
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.payeeType",
        "short": "Party to be paid any benefits payable",
        "definition": "Party to be reimbursed: Subscriber, provider, other.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Coding"
          }
        ],
        "isSummary": true
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
            "valueString": "Items"
          }
        ],
        "path": "ClaimResponse.item",
        "short": "Line items",
        "definition": "The first tier service adjudications for submitted services.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "isSummary": true
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
            "valueString": "AddedItem"
          }
        ],
        "path": "ClaimResponse.addItem",
        "short": "Insurer added line items",
        "definition": "The first tier service adjudications for payor added services.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "isSummary": true
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
            "valueString": "Errors"
          }
        ],
        "path": "ClaimResponse.error",
        "short": "Processing errors",
        "definition": "Mutually exclusive with Services Provided (Item).",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.totalCost",
        "short": "Total Cost of service from the Claim",
        "definition": "The total cost of the services reported.",
        "requirements": "This is a check value that the receiver calculates and returns.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Money"
            ]
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.unallocDeductable",
        "short": "Unallocated deductible",
        "definition": "The amount of deductible applied which was not allocated to any particular service line.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Money"
            ]
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.totalBenefit",
        "short": "Total benefit payable for the Claim",
        "definition": "Total amount of benefit payable (Equal to sum of the Benefit amounts from all detail lines and additions less the Unallocated Deductible).",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Money"
            ]
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.paymentAdjustment",
        "short": "Payment adjustment for non-Claim issues",
        "definition": "Adjustment to the payment of this transaction which is not related to adjudication of this transaction.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Money"
            ]
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.paymentAdjustmentReason",
        "short": "Reason for Payment adjustment",
        "definition": "Reason for the payment adjustment.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Coding"
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.paymentDate",
        "short": "Expected data of Payment",
        "definition": "Estimated payment data.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "date"
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.paymentAmount",
        "short": "Payment amount",
        "definition": "Payable less any payment adjustment.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Quantity",
            "profile": [
              "http://hl7.org/fhir/StructureDefinition/Money"
            ]
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.paymentRef",
        "short": "Payment identifier",
        "definition": "Payment identifier.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Identifier"
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.reserved",
        "short": "Funds reserved status",
        "definition": "Status of funds reservation (For provider, for Patient, None).",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Coding"
          }
        ],
        "isSummary": true
      },
      {
        "path": "ClaimResponse.form",
        "short": "Printed Form Identifier",
        "definition": "The form to be used for printing the content.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "Coding"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "cdanetv4",
            "map": "G42"
          }
        ]
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
            "valueString": "Notes"
          }
        ],
        "path": "ClaimResponse.note",
        "short": "Processing notes",
        "definition": "Note text.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "isSummary": true
      },
      {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
            "valueString": "Coverage"
          }
        ],
        "path": "ClaimResponse.coverage",
        "short": "Insurance or medical plan",
        "definition": "Financial instrument by which payment information for health care.",
        "requirements": "Health care programs and insurers are significant payors of health service costs.",
        "min": 0,
        "max": "0",
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "isSummary": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "Coverage"
          }
        ]
      }
    ]
  }
}