### ----------------------------------------------------
### -- FHIR
### -- Licenses: Artistic-2.0
### -- Authors: Hugh Simpson
### -- File: t/resources/structureDefinition/ClaimResponse.json
### ----------------------------------------------------
### -- Chunk 24 of 26
" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
      "alias" : ["extensions",
      "user content",
      "modifiers"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "BackboneElement.modifierExtension",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Extension"
      }],
      "isModifier" : true,
      "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary" : true,
      "mapping" : [{
        "identity" : "rim",
        "map" : "N/A"
      }]
    },
    {
      "id" : "ClaimResponse.processNote.number",
      "path" : "ClaimResponse.processNote.number",
      "short" : "Note instance identifier",
      "definition" : "A number to uniquely identify a note entry.",
      "requirements" : "Necessary to provide a mechanism to link from adjudications.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.processNote.number",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "positiveInt"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "ClaimResponse.processNote.type",
      "path" : "ClaimResponse.processNote.type",
      "short" : "display | print | printoper",
      "definition" : "The business purpose of the note text.",
      "requirements" : "To convey the expectation for when the text is used.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.processNote.type",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "code"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "NoteType"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean" : true
        }],
        "strength" : "required",
        "description" : "The presentation types of notes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/note-type|4.0.0"
      }
    },
    {
      "id" : "ClaimResponse.processNote.text",
      "path" : "ClaimResponse.processNote.text",
      "short" : "Note explanatory text",
      "definition" : "The explanation or description associated with the processing.",
      "requirements" : "Required to provide human readable explanation.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.processNote.text",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "string"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "ClaimResponse.processNote.language",
      "path" : "ClaimResponse.processNote.language",
      "short" : "Language of the text",
      "definition" : "A code to define the language used in the text of the note.",
      "comment" : "Only required if the language is different from the resource language.",
      "requirements" : "Note text may vary from the resource defined language.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.processNote.language",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueCanonical" : "http://hl7.org/fhir/ValueSet/all-languages"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Language"
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean" : true
        }],
        "strength" : "preferred",
        "description" : "A human language.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/languages"
      }
    },
    {
      "id" : "ClaimResponse.communicationRequest",
      "path" : "ClaimResponse.communicationRequest",
      "short" : "Request for additional information",
      "definition" : "Request for additional supporting or authorizing information.",
      "comment" : "For example: professional reports, documents, images, clinical resources, or accident reports.",
      "requirements" : "Need to communicate insurer request for additional information required to support the adjudication.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "ClaimResponse.communicationRequest",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/CommunicationRequest"]
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "ClaimResponse.insurance",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Insurance"
      }],
      "path" : "ClaimResponse.insurance",
      "short" : "Patient insurance information",
      "definition" : "Financial instruments for reimbursement for the health care products and services specified on the claim.",
      "comment" : "All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.",
      "requirements" : "At least one insurer is required for a claim to be a claim.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "ClaimResponse.insurance",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "BackboneElement"
      }],
      "constraint" : [{
        "key" : "ele-1",
        "severity" : "error",
        "human" : "All FHIR elements must have a @value or children",
        "expression" : "hasValue() or (children().count() > id.count())",
        "xpath" : "@value|f:*|h:div",
        "source" : "Element"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "Coverage"
      }]
    },
    {
      "id" : "ClaimResponse.insurance.id",
      "path" : "ClaimResponse.insurance.id",
      "representation" : ["xmlAttr"],
      "short" : "Unique id for inter-element referencing",
      "definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Element.id",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "string"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "n/a"
      }]
    },
    {
      "id" : "ClaimResponse.insurance.extension",
      "path" : "ClaimResponse.insurance.extension",
      "short" : "Additional content defined by implementations",
      "definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "alias" : ["extensions",
      "user content"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "Element.extension",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Extension"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "n/a"
      }]
    },
    {
      "id" : "ClaimResponse.insurance.modifierExtension",
      "path" : "ClaimResponse.insurance.modifierExtension",
      "short" : "Extensions that cannot be ignored even if unrecognized",
      "definition" : "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
      "alias" : ["extensions",
      "user content",
      "modifiers"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "BackboneElement.modifierExtension",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Extension"
      }],
      "isModifier" : true,
      "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary" : true,
      "mapping" : [{
        "identity" : "rim",
        "map" : "N/A"
      }]
    },
    {
      "id" : "ClaimResponse.insurance.sequence",
      "path" : "ClaimResponse.insurance.sequence",
      "short" : "Insurance instance identifier",
      "definition" : "A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order.",
      "requirements" : "To maintain order of the coverages.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.insurance.sequence",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "positiveInt"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "ClaimResponse.insurance.focal",
      "path" : "ClaimResponse.insurance.focal",
      "short" : "Coverage to be used for adjudication",
      "definition" : "A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.",
      "comment" : "A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies.",
      "requirements" : "To identify which coverage in the list is being used to adjudicate this claim.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.insurance.focal",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "boolean"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "ClaimResponse.insurance.coverage",
      "path" : "ClaimResponse.insurance.coverage",
      "short" : "Insurance information",
      "definition" : "Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.",
      "requirements" : "Required to allow the adjudicator to locate the correct policy and history within their information system.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.insurance.coverage",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Coverage"]
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "ClaimResponse.insurance.businessArrangement",
      "path" : "ClaimResponse.insurance.businessArrangement",
      "short" : "Additional provider contract number",
      "definition" : "A business agreement number established between the provider and the insurer for special business processing purposes.",
      "requirements" : "Providers may have multiple business arrangements with a given insurer and must supply the specific contract number for adjudication.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.insurance.businessArrangement",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "string"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "ClaimResponse.insurance.claimResponse",
      "path" : "ClaimResponse.insurance.claimResponse",
      "short" : "Adjudication results",
      "definition" : "The result of the adjudication of the line items for the Coverage specified in this insurance.",
      "comment" : "Must not be specified when 'focal=true' for this insurance.",
      "requirements" : "An insurer need the adjudication results from prior insurers to determine the outstanding balance remaining by item for the items in the curent claim.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.insurance.claimResponse",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/ClaimResponse"]
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "ClaimResponse.error",
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
        "valueString" : "Error"
      }],
      "path" : "ClaimResponse.error",
      "short" : "Processing errors",
      "definition" : "Errors encountered during the processing of the adjudication.",
      "comment" : "If the request contains errors then an error element should be provided and no adjudication related sections (item, addItem, or payment) should be present.",
      "requirements" : "Need to communicate processing issues to the requestor.",
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "ClaimResponse.error",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "BackboneElement"
      }],
      "constraint" : [{
        "key" : "ele-1",
        "severity" : "error",
        "human" : "All FHIR elements must have a @value or children",
        "expression" : "hasValue() or (children().count() > id.count())",
        "xpath" : "@value|f:*|h:div",
        "source" : "Element"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "ClaimResponse.error.id",
      "path" : "ClaimResponse.error.id",
      "representation" : ["xmlAttr"],
      "short" : "Unique id for inter-element referencing",
      "definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "Element.id",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "string"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "n/a"
      }]
    },
    {
      "id" : "ClaimResponse.error.extension",
      "path" : "ClaimResponse.error.extension",
      "short" : "Additional content defined by implementations",
      "definition" : "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "alias" : ["extensions",
      "user content"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "Element.extension",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Extension"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "mapping" : [{
        "identity" : "rim",
        "map" : "n/a"
      }]
    },
    {
      "id" : "ClaimResponse.error.modifierExtension",
      "path" : "ClaimResponse.error.modifierExtension",
      "short" : "Extensions that cannot be ignored even if unrecognized",
      "definition" : "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "requirements" : "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
      "alias" : ["extensions",
      "user content",
      "modifiers"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "BackboneElement.modifierExtension",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Extension"
      }],
      "isModifier" : true,
      "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary" : true,
      "mapping" : [{
        "identity" : "rim",
        "map" : "N/A"
      }]
    },
    {
      "id" : "ClaimResponse.error.itemSequence",
      "path" : "ClaimResponse.error.itemSequence",
      "short" : "Item sequence number",
      "definition" : "The sequence number of the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure.",
      "requirements" : "Provides references to the claim items.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.error.itemSequence",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "positiveInt"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "ClaimResponse.error.detailSequence",
      "path" : "ClaimResponse.error.detailSequence",
      "short" : "Detail sequence number",
      "definition" : "The sequence number of the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure.",
      "requirements" : "Provides references to the claim details within the claim item.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.error.detailSequence",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "positiveInt"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "ClaimResponse.error.subDetailSequence",
      "path" : "ClaimResponse.error.subDetailSequence",
      "short" : "Subdetail sequence number",
      "definition" : "The sequence number of the sub-detail within the detail within the line item submitted which contains the error. This value is omitted when the error occurs outside of the item structure.",
      "requirements" : "Provides references to the claim sub-details within the claim detail.",
      "min" : 0,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.error.subDetailSequence",
        "min" : 0,
        "max" : "1"
      },
      "type" : [{
        "code" : "positiveInt"
      }],
      "isModifier" : false,
      "isSummary" : false
    },
    {
      "id" : "ClaimResponse.error.code",
      "path" : "ClaimResponse.error.code",
      "short" : "Error code detailing processing issues",
      "definition" : "An error code, from a specified code system, which details why the claim could not be adjudicated.",
      "requirements" : "Required to convey processing errors.",
      "min" : 1,
      "max" : "1",
      "base" : {
        "path" : "ClaimResponse.error.code",
        "min" : 1,
        "max" : "1"
      },
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isModifier" : false,
      "isSummary" : false,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "AdjudicationError"
        }],
        "strength" : "example",
        "description" : "The adjudication error codes.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/adjudication-error"
      }
    }]
  },
  "differential" : {
    "element" : [{
      "id" : "ClaimResponse",
      "path" : "ClaimResponse",
      "short" : "Response to a claim predetermination or preauthorization",
      "definition" : "This resource provides the adjudication details from the processing of a Claim resource.",
      "alias" : ["Remittance Advice"],
      "min" : 0,
      "max" : "*",
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event"
      }]
    },
    {
      "id" : "ClaimResponse.identifier",
      "path" : "ClaimResponse.identifier",
      "short" : "Business Identifier for a claim response",
      "definition" : "A unique identifier assigned to this claim response.",
      "requirements" : "Allows claim responses to be distinguished and referenced.",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Identifier"
      }],
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.identifier"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.identifier"
      }]
    },
    {
      "id" : "ClaimResponse.status",
      "path" : "ClaimResponse.status",
      "short" : "active | cancelled | draft | entered-in-error",
      "definition" : "The status of the resource instance.",
      "comment" : "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
      "requirements" : "Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "code"
      }],
      "isModifier" : true,
      "isModifierReason" : "This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ClaimResponseStatus"
        }],
        "strength" : "required",
        "description" : "A code specifying the state of the resource instance.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/fm-status|4.0.0"
      },
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.status"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.status"
      }]
    },
    {
      "id" : "ClaimResponse.type",
      "path" : "ClaimResponse.type",
      "short" : "More granular claim type",
      "definition" : "A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.",
      "comment" : "This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type.",
      "requirements" : "Some jurisdictions need a finer grained claim type for routing and adjudication.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ClaimType"
        }],
        "strength" : "extensible",
        "description" : "The type or discipline-style of the claim.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/claim-type"
      },
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.class"
      }]
    },
    {
      "id" : "ClaimResponse.subType",
      "path" : "ClaimResponse.subType",
      "short" : "More granular claim type",
      "definition" : "A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.",
      "comment" : "This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type.",
      "requirements" : "Some jurisdictions need a finer grained claim type for routing and adjudication.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "ClaimSubType"
        }],
        "strength" : "example",
        "description" : "A more granular claim typecode.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/claim-subtype"
      },
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.class"
      }]
    },
    {
      "id" : "ClaimResponse.use",
      "path" : "ClaimResponse.use",
      "short" : "claim | preauthorization | predetermination",
      "definition" : "A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.",
      "requirements" : "This element is required to understand the nature of the request for adjudication.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "code"
      }],
      "isSummary" : true,
      "binding" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString" : "Use"
        }],
        "strength" : "required",
        "description" : "Claim, preauthorization, predetermination.",
        "valueSet" : "http://hl7.org/fhir/ValueSet/claim-use|4.0.0"
      },
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.class"
      }]
    },
    {
      "id" : "ClaimResponse.patient",
      "path" : "ClaimResponse.patient",
      "short" : "The recipient of the products and services",
      "definition" : "The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought.",
      "requirements" : "The patient must be supplied to the insurer so that confirmation of coverage and service hstory may be considered as part of the authorization and/or adjudiction.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Patient"]
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.subject[x]"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.subject"
      }]
    },
    {
      "id" : "ClaimResponse.created",
      "path" : "ClaimResponse.created",
      "short" : "Response creation date",
      "definition" : "The date this resource was created.",
      "requirements" : "Need to record a timestamp for use by both the recipient and the issuer.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "dateTime"
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.occurrence[x]"
      },
      {
        "identity" : "w5",
        "map" : "FiveWs.recorded"
      }]
    },
    {
      "id" : "ClaimResponse.insurer",
      "path" : "ClaimResponse.insurer",
      "short" : "Party responsible for reimbursement",
      "definition" : "The party responsible for authorization, adjudication and reimbursement.",
      "requirements" : "To be a valid claim, preauthorization or predetermination there must be a party who is responsible for adjudicating the contents against a policy which provides benefits for the patient.",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Organization"]
      }],
      "isSummary" : true,
      "mapping" : [{
        "identity" : "workflow",
        "map" : "Event.performer"
      }]
    },
    {
      "id" : "ClaimResponse.requestor",
      "path" : "ClaimResponse.requestor",
      "short" : "Party responsible for the claim",
      "definition" : "The provider which is responsible for the claim, predetermination or preauthorization.",
      "comment" : "Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/StructureDefinition/Practitioner",
        "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
        "http://hl7.org/fhir/StructureDefinition/Organization"]
      }],
      "mapping" : [{
        "identity" : "w5",
        "map" : "FiveWs.source"
      }]
    },
    {
      "id" : "ClaimResponse.request",
      "path" : "