Stream: implementers
Topic: Benefits definition
AHMAD ABU RJEILA (Mar 14 2020 at 04:31):
Hi, i need help in the best way of representing insurance Benefits (Dental, Maternity, ... etc) since usually Benefit has multiple details linked to it (drugs, procedures, diagnosis, ... etc). To be more clear suppose that i want to select Dental benefit if i receive diagnosis X, how to represent this relation in FHIR ?
Lloyd McKenzie (Mar 14 2020 at 14:55):
@Paul Knapp
Paul Knapp (Mar 19 2020 at 00:50):
@AHMAD ABU RJEILA See the examples of CoverageEligibilityResponse (and ExplanationOfBenefit) where the benefit details can be expressed in the response from the payor.
I don't understand your 'I want to select Dental benefit...' comment. If you receive Dental services then you may Claim for them against any Coverages which include Dental benefits.
Last updated: Apr 12 2022 at 19:14 UTC
