Claim
A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
http://hl7.org/fhir/R4/claim.html
Endpoints
Attributes
The status of the resource instance.
Supported codes for create interactions are: active
The category of claim.
Supported codes for create interactions are: professional with a system
of http://hl7.org/fhir/ValueSet/claim-type
A code to indicate the nature of the request
Supported codes for create interactions are: claim
The Canvas patient resource for the claim
The date this resource was created.
Canvas will use this as the date of service for the claims in this message.
Expected format is : YYYY-MM-DD
The Canvas provider resource for the staff responsible for the claim.
The provider-required urgency of processing the request.
Supported codes for create interactions are: normal with a system of http://hl7.org/fhir/ValueSet/process-priority
Additional information about the Claim
Canvas supports a single iteration for a reason for visit - the text in the valueString
will be used.
Information about diagnoses relevant to the claim items.
These diagnoses will create Assessments in Canvas.
The sequence
should be unique within the Claim message, usually starting at 1 and incrementing as needed.
Must be a diagnosisCodeableConcept
Codes are supported from the following systems: http://hl7.org/fhir/ValueSet/icd-10
FHIR resource for the coverage(s) to use when adjudicating the claim
sequence
should be unique for each insurance in the claim message.
focal
indicates whether this insurance should be used to adjudicate the claim in this message. Canvas will ignore any elements that are False.
coverage
is a Canvas coverage resource identifying the coverage for this iteration of insurance
Additional information on a Coverage can be obtained from the Coverage search endpoint
List of service charges to be used in the claim.
sequence
should be unique for each item in the message.
diagnosisSequence
should have one or more sequence
values from the diagnosis
section.
productOrService
is an object that specifies the coding of the service. Canvas uses the first coding where system is http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code.
modifier
specifies the list of charge modifier codings. Canvas accepts the first element where the coding’s system is http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSModifiers. Canvas uses the 2 character modifiers from this ValueSet.
Claim create
Create a Claim resource.
Attributes
The status of the resource instance.
Supported codes for create interactions are: active
The category of claim.
Supported codes for create interactions are: professional with a system
of http://hl7.org/fhir/ValueSet/claim-type
A code to indicate the nature of the request
Supported codes for create interactions are: claim
The Canvas patient resource for the claim
The date this resource was created.
Canvas will use this as the date of service for the claims in this message.
Expected format is : YYYY-MM-DD
The Canvas provider resource for the staff responsible for the claim.
The provider-required urgency of processing the request.
Supported codes for create interactions are: normal with a system of http://hl7.org/fhir/ValueSet/process-priority
Additional information about the Claim
Canvas supports a single iteration for a reason for visit - the text in the valueString
will be used.
Information about diagnoses relevant to the claim items.
These diagnoses will create Assessments in Canvas.
The sequence
should be unique within the Claim message, usually starting at 1 and incrementing as needed.
Must be a diagnosisCodeableConcept
Codes are supported from the following systems: http://hl7.org/fhir/ValueSet/icd-10
FHIR resource for the coverage(s) to use when adjudicating the claim
sequence
should be unique for each insurance in the claim message.
focal
indicates whether this insurance should be used to adjudicate the claim in this message. Canvas will ignore any elements that are False.
coverage
is a Canvas coverage resource identifying the coverage for this iteration of insurance
Additional information on a Coverage can be obtained from the Coverage search endpoint
List of service charges to be used in the claim.
sequence
should be unique for each item in the message.
diagnosisSequence
should have one or more sequence
values from the diagnosis
section.
productOrService
is an object that specifies the coding of the service. Canvas uses the first coding where system is http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code.
modifier
specifies the list of charge modifier codings. Canvas accepts the first element where the coding’s system is http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSModifiers. Canvas uses the 2 character modifiers from this ValueSet.
Responses
Errors
curl --request POST \ --url 'https://fumage-example.canvasmedical.com/Claim' \ --header 'Authorization: Bearer <token>' \ --header 'accept: application/json' \ --header 'content-type: application/json' \ --data ' { "resourceType": "Claim", "status": "active", "type": { "coding": [ { "system": "http://hl7.org/fhir/ValueSet/claim-type", "code": "professional" } ] }, "use": "claim", "patient": { "reference": "Patient/b3084f7e884e4af2b7e23b1dca494abd", "type": "Patient" }, "created": "2021-08-16", "provider": { "reference": "Practitioner/4150cd20de8a470aa570a852859ac87e", "type": "Practitioner" }, "priority": { "coding": [ { "code": "normal", "system": "http://hl7.org/fhir/ValueSet/process-priority" } ] }, "supportingInfo": [ { "sequence": 1, "category": { "coding": [ { "code": "patientreasonforvisit", "system": "http://hl7.org/fhir/ValueSet/claim-informationcategory", "display": "Patient Reason for Visit" } ] }, "valueString": "This is only...a test" } ], "diagnosis": [ { "sequence": 1, "diagnosisCodeableConcept": { "coding": [ { "code": "F41.1", "system": "http://hl7.org/fhir/ValueSet/icd-10", "display": "Generalized anxiety" } ] } } ], "insurance": [ { "sequence": 1, "focal": true, "coverage": { "reference": "Coverage/02d4f77a-ebaf-47d5-b162-6313244aed5f" } } ], "item": [ { "sequence": 1, "diagnosisSequence": [ 1 ], "productOrService": { "coding": [ { "system": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code", "code": "exam", "display": "Office visit" } ] }, "modifier": [ { "coding": [ { "system": "http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSModifiers", "code": "21" } ] } ], "quantity": { "value": 1 }, "unitPrice": { "value": 75 } } ] }'
import requests url = "https://fumage-example.canvasmedical.com/Claim" headers = { "accept": "application/json", "Authorization": "Bearer <token>", "content-type": "application/json" } payload = { "resourceType": "Claim", "status": "active", "type": { "coding": [ { "system": "http://hl7.org/fhir/ValueSet/claim-type", "code": "professional" } ] }, "use": "claim", "patient": { "reference": "Patient/b3084f7e884e4af2b7e23b1dca494abd", "type": "Patient" }, "created": "2021-08-16", "provider": { "reference": "Practitioner/4150cd20de8a470aa570a852859ac87e", "type": "Practitioner" }, "priority": { "coding": [ { "code": "normal", "system": "http://hl7.org/fhir/ValueSet/process-priority" } ] }, "supportingInfo": [ { "sequence": 1, "category": { "coding": [ { "code": "patientreasonforvisit", "system": "http://hl7.org/fhir/ValueSet/claim-informationcategory", "display": "Patient Reason for Visit" } ] }, "valueString": "This is only...a test" } ], "diagnosis": [ { "sequence": 1, "diagnosisCodeableConcept": { "coding": [ { "code": "F41.1", "system": "http://hl7.org/fhir/ValueSet/icd-10", "display": "Generalized anxiety" } ] } } ], "insurance": [ { "sequence": 1, "focal": True, "coverage": { "reference": "Coverage/02d4f77a-ebaf-47d5-b162-6313244aed5f" } } ], "item": [ { "sequence": 1, "diagnosisSequence": [ 1 ], "productOrService": { "coding": [ { "system": "http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code", "code": "exam", "display": "Office visit" } ] }, "modifier": [ { "coding": [ { "system": "http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSModifiers", "code": "21" } ] } ], "quantity": { "value": 1 }, "unitPrice": { "value": 75 } } ] } response = requests.post(url, json=payload, headers=headers) print(response.text)
null
{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "invalid", "details": { "text": "Bad request" } } ] }
{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "unknown", "details": { "text": "Authentication failed" } } ] }
{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "forbidden", "details": { "text": "Authorization failed" } } ] }
{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "not-supported", "details": { "text": "Operation is not supported" } } ] }
{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "business-rule", "details": { "text": "Unprocessable entity" } } ] }