Finance and Insurance Service (FAIS)
1.0.0-comment - ballot International flag

This page is part of the IHE ITI Finance and Insurance Services (v1.0.0-comment: Publication Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: FAIS ClaimResponse Bundle Profile

Official URL: https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.ClaimResponse.Bundle Version: 1.0.0-comment
Active as of 2024-08-07 Computable Name: FAISClaimResponseBundle

The FAIS ClaimResponse Bundle profile for a claim response bundle to be returned from the claim operations:

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Bundle

NameFlagsCard.TypeDescription & Constraintsdoco
.. Bundle 0..* Bundle Contains a collection of resources
... implicitRules 0..0
... type 1..1 code document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
Required Pattern: collection
... Slices for entry 1..* BackboneElement Entry in the bundle - will have a resource or information
Slice: Unordered, Open by type:resource
.... entry:FAISClaimResponse 1..1 BackboneElement Entry in the bundle - will have a resource or information
..... resource 0..1 FAISClaimResponse Response to a claim predetermination or preauthorization

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Bundle C 0..* Bundle Contains a collection of resources
bdl-1: total only when a search or history
bdl-2: entry.search only when a search
bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited
bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited
bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)
bdl-9: A document must have an identifier with a system and a value
bdl-10: A document must have a date
bdl-11: A document must have a Composition as the first resource
bdl-12: A message must have a MessageHeader as the first resource
... type Σ 1..1 code document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used.


Required Pattern: collection
... Slices for entry ΣC 1..* BackboneElement Entry in the bundle - will have a resource or information
Slice: Unordered, Open by type:resource
bdl-5: must be a resource unless there's a request or response
bdl-8: fullUrl cannot be a version specific reference
This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
.... entry:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... entry:FAISClaimResponse ΣC 1..1 BackboneElement Entry in the bundle - will have a resource or information
bdl-5: must be a resource unless there's a request or response
bdl-8: fullUrl cannot be a version specific reference
This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... resource 0..1 FAISClaimResponse Response to a claim predetermination or preauthorization

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Bundle.typerequiredPattern: collection
http://hl7.org/fhir/ValueSet/bundle-type|4.0.1
from the FHIR Standard
NameFlagsCard.TypeDescription & Constraintsdoco
.. Bundle C 0..* Bundle Contains a collection of resources
bdl-1: total only when a search or history
bdl-2: entry.search only when a search
bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited
bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited
bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)
bdl-9: A document must have an identifier with a system and a value
bdl-10: A document must have a date
bdl-11: A document must have a Composition as the first resource
bdl-12: A message must have a MessageHeader as the first resource
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... identifier Σ 0..1 Identifier Persistent identifier for the bundle
... type Σ 1..1 code document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used.


Required Pattern: collection
... timestamp Σ 0..1 instant When the bundle was assembled
... total ΣC 0..1 unsignedInt If search, the total number of matches
... link Σ 0..* BackboneElement Links related to this Bundle
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... relation Σ 1..1 string See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
.... url Σ 1..1 uri Reference details for the link
... Slices for entry ΣC 1..* BackboneElement Entry in the bundle - will have a resource or information
Slice: Unordered, Open by type:resource
bdl-5: must be a resource unless there's a request or response
bdl-8: fullUrl cannot be a version specific reference
This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
.... entry:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... link Σ 0..* See link (Bundle) Links related to this entry
..... fullUrl Σ 0..1 uri URI for resource (Absolute URL server address or URI for UUID/OID)
..... resource Σ 0..1 Resource A resource in the bundle
..... search ΣC 0..1 BackboneElement Search related information
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... mode Σ 0..1 code match | include | outcome - why this is in the result set
Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.

...... score Σ 0..1 decimal Search ranking (between 0 and 1)
..... request ΣC 0..1 BackboneElement Additional execution information (transaction/batch/history)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... method Σ 1..1 code GET | HEAD | POST | PUT | DELETE | PATCH
Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.

...... url Σ 1..1 uri URL for HTTP equivalent of this entry
...... ifNoneMatch Σ 0..1 string For managing cache currency
...... ifModifiedSince Σ 0..1 instant For managing cache currency
...... ifMatch Σ 0..1 string For managing update contention
...... ifNoneExist Σ 0..1 string For conditional creates
..... response ΣC 0..1 BackboneElement Results of execution (transaction/batch/history)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... status Σ 1..1 string Status response code (text optional)
...... location Σ 0..1 uri The location (if the operation returns a location)
...... etag Σ 0..1 string The Etag for the resource (if relevant)
...... lastModified Σ 0..1 instant Server's date time modified
...... outcome Σ 0..1 Resource OperationOutcome with hints and warnings (for batch/transaction)
.... entry:FAISClaimResponse ΣC 1..1 BackboneElement Entry in the bundle - will have a resource or information
bdl-5: must be a resource unless there's a request or response
bdl-8: fullUrl cannot be a version specific reference
This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... link Σ 0..* See link (Bundle) Links related to this entry
..... fullUrl Σ 0..1 uri URI for resource (Absolute URL server address or URI for UUID/OID)
..... resource 0..1 FAISClaimResponse Response to a claim predetermination or preauthorization
..... search ΣC 0..1 BackboneElement Search related information
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... mode Σ 0..1 code match | include | outcome - why this is in the result set
Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.

...... score Σ 0..1 decimal Search ranking (between 0 and 1)
..... request ΣC 0..1 BackboneElement Additional execution information (transaction/batch/history)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... method Σ 1..1 code GET | HEAD | POST | PUT | DELETE | PATCH
Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.

...... url Σ 1..1 uri URL for HTTP equivalent of this entry
...... ifNoneMatch Σ 0..1 string For managing cache currency
...... ifModifiedSince Σ 0..1 instant For managing cache currency
...... ifMatch Σ 0..1 string For managing update contention
...... ifNoneExist Σ 0..1 string For conditional creates
..... response ΣC 0..1 BackboneElement Results of execution (transaction/batch/history)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... status Σ 1..1 string Status response code (text optional)
...... location Σ 0..1 uri The location (if the operation returns a location)
...... etag Σ 0..1 string The Etag for the resource (if relevant)
...... lastModified Σ 0..1 instant Server's date time modified
...... outcome Σ 0..1 Resource OperationOutcome with hints and warnings (for batch/transaction)
... signature Σ 0..1 Signature Digital Signature

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Bundle.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Bundle.typerequiredPattern: collection
http://hl7.org/fhir/ValueSet/bundle-type|4.0.1
from the FHIR Standard
Bundle.entry.search.moderequiredSearchEntryMode
http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1
from the FHIR Standard
Bundle.entry.request.methodrequiredHTTPVerb
http://hl7.org/fhir/ValueSet/http-verb|4.0.1
from the FHIR Standard
Bundle.entry:FAISClaimResponse.search.moderequiredSearchEntryMode
http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1
from the FHIR Standard
Bundle.entry:FAISClaimResponse.request.methodrequiredHTTPVerb
http://hl7.org/fhir/ValueSet/http-verb|4.0.1
from the FHIR Standard

This structure is derived from Bundle

Summary

Mandatory: 2 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Bundle.entry

Differential View

This structure is derived from Bundle

NameFlagsCard.TypeDescription & Constraintsdoco
.. Bundle 0..* Bundle Contains a collection of resources
... implicitRules 0..0
... type 1..1 code document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
Required Pattern: collection
... Slices for entry 1..* BackboneElement Entry in the bundle - will have a resource or information
Slice: Unordered, Open by type:resource
.... entry:FAISClaimResponse 1..1 BackboneElement Entry in the bundle - will have a resource or information
..... resource 0..1 FAISClaimResponse Response to a claim predetermination or preauthorization

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Bundle C 0..* Bundle Contains a collection of resources
bdl-1: total only when a search or history
bdl-2: entry.search only when a search
bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited
bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited
bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)
bdl-9: A document must have an identifier with a system and a value
bdl-10: A document must have a date
bdl-11: A document must have a Composition as the first resource
bdl-12: A message must have a MessageHeader as the first resource
... type Σ 1..1 code document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used.


Required Pattern: collection
... Slices for entry ΣC 1..* BackboneElement Entry in the bundle - will have a resource or information
Slice: Unordered, Open by type:resource
bdl-5: must be a resource unless there's a request or response
bdl-8: fullUrl cannot be a version specific reference
This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
.... entry:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... entry:FAISClaimResponse ΣC 1..1 BackboneElement Entry in the bundle - will have a resource or information
bdl-5: must be a resource unless there's a request or response
bdl-8: fullUrl cannot be a version specific reference
This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... resource 0..1 FAISClaimResponse Response to a claim predetermination or preauthorization

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Bundle.typerequiredPattern: collection
http://hl7.org/fhir/ValueSet/bundle-type|4.0.1
from the FHIR Standard

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Bundle C 0..* Bundle Contains a collection of resources
bdl-1: total only when a search or history
bdl-2: entry.search only when a search
bdl-3: entry.request mandatory for batch/transaction/history, otherwise prohibited
bdl-4: entry.response mandatory for batch-response/transaction-response/history, otherwise prohibited
bdl-7: FullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)
bdl-9: A document must have an identifier with a system and a value
bdl-10: A document must have a date
bdl-11: A document must have a Composition as the first resource
bdl-12: A message must have a MessageHeader as the first resource
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... identifier Σ 0..1 Identifier Persistent identifier for the bundle
... type Σ 1..1 code document | message | transaction | transaction-response | batch | batch-response | history | searchset | collection
Binding: BundleType (required): Indicates the purpose of a bundle - how it is intended to be used.


Required Pattern: collection
... timestamp Σ 0..1 instant When the bundle was assembled
... total ΣC 0..1 unsignedInt If search, the total number of matches
... link Σ 0..* BackboneElement Links related to this Bundle
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... relation Σ 1..1 string See http://www.iana.org/assignments/link-relations/link-relations.xhtml#link-relations-1
.... url Σ 1..1 uri Reference details for the link
... Slices for entry ΣC 1..* BackboneElement Entry in the bundle - will have a resource or information
Slice: Unordered, Open by type:resource
bdl-5: must be a resource unless there's a request or response
bdl-8: fullUrl cannot be a version specific reference
This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
.... entry:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... link Σ 0..* See link (Bundle) Links related to this entry
..... fullUrl Σ 0..1 uri URI for resource (Absolute URL server address or URI for UUID/OID)
..... resource Σ 0..1 Resource A resource in the bundle
..... search ΣC 0..1 BackboneElement Search related information
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... mode Σ 0..1 code match | include | outcome - why this is in the result set
Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.

...... score Σ 0..1 decimal Search ranking (between 0 and 1)
..... request ΣC 0..1 BackboneElement Additional execution information (transaction/batch/history)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... method Σ 1..1 code GET | HEAD | POST | PUT | DELETE | PATCH
Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.

...... url Σ 1..1 uri URL for HTTP equivalent of this entry
...... ifNoneMatch Σ 0..1 string For managing cache currency
...... ifModifiedSince Σ 0..1 instant For managing cache currency
...... ifMatch Σ 0..1 string For managing update contention
...... ifNoneExist Σ 0..1 string For conditional creates
..... response ΣC 0..1 BackboneElement Results of execution (transaction/batch/history)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... status Σ 1..1 string Status response code (text optional)
...... location Σ 0..1 uri The location (if the operation returns a location)
...... etag Σ 0..1 string The Etag for the resource (if relevant)
...... lastModified Σ 0..1 instant Server's date time modified
...... outcome Σ 0..1 Resource OperationOutcome with hints and warnings (for batch/transaction)
.... entry:FAISClaimResponse ΣC 1..1 BackboneElement Entry in the bundle - will have a resource or information
bdl-5: must be a resource unless there's a request or response
bdl-8: fullUrl cannot be a version specific reference
This repeating element order: For bundles of type 'document' and 'message', the first resource is special (must be Composition or MessageHeader respectively). For all bundles, the meaning of the order of entries depends on the bundle type
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... link Σ 0..* See link (Bundle) Links related to this entry
..... fullUrl Σ 0..1 uri URI for resource (Absolute URL server address or URI for UUID/OID)
..... resource 0..1 FAISClaimResponse Response to a claim predetermination or preauthorization
..... search ΣC 0..1 BackboneElement Search related information
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... mode Σ 0..1 code match | include | outcome - why this is in the result set
Binding: SearchEntryMode (required): Why an entry is in the result set - whether it's included as a match or because of an _include requirement, or to convey information or warning information about the search process.

...... score Σ 0..1 decimal Search ranking (between 0 and 1)
..... request ΣC 0..1 BackboneElement Additional execution information (transaction/batch/history)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... method Σ 1..1 code GET | HEAD | POST | PUT | DELETE | PATCH
Binding: HTTPVerb (required): HTTP verbs (in the HTTP command line). See HTTP rfc for details.

...... url Σ 1..1 uri URL for HTTP equivalent of this entry
...... ifNoneMatch Σ 0..1 string For managing cache currency
...... ifModifiedSince Σ 0..1 instant For managing cache currency
...... ifMatch Σ 0..1 string For managing update contention
...... ifNoneExist Σ 0..1 string For conditional creates
..... response ΣC 0..1 BackboneElement Results of execution (transaction/batch/history)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... status Σ 1..1 string Status response code (text optional)
...... location Σ 0..1 uri The location (if the operation returns a location)
...... etag Σ 0..1 string The Etag for the resource (if relevant)
...... lastModified Σ 0..1 instant Server's date time modified
...... outcome Σ 0..1 Resource OperationOutcome with hints and warnings (for batch/transaction)
... signature Σ 0..1 Signature Digital Signature

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Bundle.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Bundle.typerequiredPattern: collection
http://hl7.org/fhir/ValueSet/bundle-type|4.0.1
from the FHIR Standard
Bundle.entry.search.moderequiredSearchEntryMode
http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1
from the FHIR Standard
Bundle.entry.request.methodrequiredHTTPVerb
http://hl7.org/fhir/ValueSet/http-verb|4.0.1
from the FHIR Standard
Bundle.entry:FAISClaimResponse.search.moderequiredSearchEntryMode
http://hl7.org/fhir/ValueSet/search-entry-mode|4.0.1
from the FHIR Standard
Bundle.entry:FAISClaimResponse.request.methodrequiredHTTPVerb
http://hl7.org/fhir/ValueSet/http-verb|4.0.1
from the FHIR Standard

This structure is derived from Bundle

Summary

Mandatory: 2 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Bundle.entry

 

Other representations of profile: CSV, Excel, Schematron