Stream: CARIN IG for Blue Button®
Topic: EOB.total:inoutnetwork
Josh Lamb (Oct 08 2020 at 17:48):
@Pat Taylor @Amol Vyas @Saul Kravitz , can anyone help me figure out how to populate the ExplanationOfBenefit.Total:InOutNetwork slice, since it is required. We are already providing the contracting status of the providers as part of supporting info.
If this slice is appropriate, what should we put for the amount, since it is required?
Saul Kravitz (Oct 08 2020 at 18:05):
Amount is required by EOB R4...we can't change that (1..1).
I think the payload is the in or out of network characterization, which is passed through the category, but @Pat Taylor should comment on that.
{
"category" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBPayerAdjudicationStatus",
"code" : "innetwork"
}
]
},
"amount" : {
"value" : 0,
"currency" : "USD"
}
}
Josh Lamb (Oct 08 2020 at 18:18):
This seems more appropriate as a supporting info. The inclusion of an amount, and this being part of "Total" implies this is conveying an in network or out of network amount of some type (Is It?).
Since this is not flagged as must support are we okay with just always setting the amount to zero for STU1?
Last updated: Apr 12 2022 at 19:14 UTC
