Stream: CARIN IG for Blue Button®
Topic: EOB Profiles
SSM (Jul 20 2020 at 20:17):
Hi, On top of CARIN BB EOB Profile, in CARIN IG we have 4 different EOB profiles inpatientFacility, outpatientFacility, Pharmacy, ProfNonClinician. How this is envisioned to be implemented? If the payer supports the base CARIN BB EOB profile, is that enough to get compliance or do the payer need to support base CARIN EOB and 4 others using _Profile?
Michele Mottini (Jul 20 2020 at 21:10):
You do not need to use _profile, but you need to make that data available
Paul Church (Jul 20 2020 at 21:17):
These are not separate things. The EOB profile is an abstract parent that includes constraints common to all EOB profiles. Each of the four specific profiles is for one of the claim types (I believe there are two more coming for vision and dental) so in practice any EOB you make available will conform to exactly one of these concrete types.
SSM (Jul 20 2020 at 21:38):
@Michele Mottini @Paul Church - If _profile is not needed, then can i keep search option for example member id and cliam type and it response it will display the appropriate data elements based on claim type.
Paul Church (Jul 20 2020 at 21:40):
Yes
Josh Lamb (Jul 22 2020 at 19:38):
EOB.Meta.Profile is required as per: https://build.fhir.org/ig/HL7/carin-bb/StructureDefinition-CARIN-BB-ExplanationOfBenefit-definitions.html#ExplanationOfBenefit.meta.profile. We are not allowing reference to the abstract base profile. If you want to present a non-CARIN BB EOB you can omit profile, as Paul stated.
Last updated: Apr 12 2022 at 19:14 UTC
