Stream: implementers
Topic: EOB.created
Brendan Keeler (Nov 19 2021 at 00:30):
Brendan Keeler (Nov 19 2021 at 00:31):
I'm a little confused by the documentation on EOB.created. If I receive a claims file and convert it to FHIR, is EOB.created the date I created the resource, the date of the claim was paid, or something else?
Lloyd McKenzie (Nov 19 2021 at 04:20):
@Paul Knapp
Daniel Venton (Nov 19 2021 at 13:12):
I feel like when you receive a claims file you aren't creating EoB resources. You are creating Claim resources, at some point in the future you create a ClaimResponse. After all the processing is done (typically the claim is adjudicated) at that time the EoB is created. The EoB doesn't exist until all processing is done.
Brendan Keeler (Nov 19 2021 at 20:15):
In this case, this is a bunch of EOB summary data. We are not getting a response to a claims we've sent. Sorta seems to fit this:
This resource combines the information from the Claim and the ClaimResponse, stripping out any provider or payor proprietary information, into a unified information model suitable for use for: patient reporting; transferring information to a Patient Health Record system; and, supporting complete claim and adjudication information exchange with regulatory and analytics organizations and other parts of the provider's organization.
MaryKay McDaniel (Nov 30 2021 at 17:25):
@Brendan Keeler
The FMWG reviewed your question today. Are you looking at the R4 Resource or another specific profile?
For the CARIN4BB this is the date the claim was adjudicated as an example.
Please feel free to join our calls if you have additional questions.
(Tuesday's 11-1pmET.)
Last updated: Apr 12 2022 at 19:14 UTC
