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Type:
Change Request
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Resolution: Persuasive with Modification
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Priority:
Medium
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FHIR Core (FHIR)
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R4
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Financial Mgmt
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(NA)
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Rachel Foerster / Gail Kocher: 6-0-0
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Enhancement
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Non-substantive
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R5
Definitions of the Claim Type codes do not align with industry claims submissions standards.
Replace the definitions of the following codes in Code System http://terminology.hl7.org/CodeSystem/claim-type with the following:
– institutional: Claims submitted by clinics, hospitals, skilled nursing facilities, and other institutional providers
– professional: Claims submitted by physicians, suppliers, and other non-institutional providers
– pharmacy: Claims submitted by retail pharmacies
The updates do not change the meaning of the codes but add clarity to their content.
- relates to
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FHIR-22661 Claim.type has an extensible binding and is a limited value set
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- Triaged
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FHIR-27118 Update claim-type valueset to reflect industry practice
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- Resolved - No Change
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- mentioned in
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