Stream: financial
Topic: External charges
AHMAD ABU RJEILA (Mar 10 2020 at 05:26):
Hi, from insurance side in-order to check patient consumption i can query patient claims and accumulate approved/payed amounts is it the right way ? also if i have external charges (not throw claims) what is the proper way to represent them in FHIR?
Lloyd McKenzie (Mar 10 2020 at 14:44):
@Paul Knapp
Paul Knapp (Mar 10 2020 at 17:31):
@AHMAD ABU RJEILA I'm not sure I understand your question, are you an insurer wanting to query your own data store? The Financial Management Work Group meeting on Tuesdays at 11AM eastern - this can be a good place to rise your questions and discuss appropriate solutions with other insurers/providers/etc.
AHMAD ABU RJEILA (Mar 10 2020 at 17:46):
Thanks for your reply.
I have two sources of patient consumption, one of them is claims & authorizations which is clear but i need confirmation that its the right way to calculated member consumption just i need to apply query on patient claims & authorizations and accumulate.
The other source of patient consumption came out of my claims(external application for areas that i don't cover suppose i only cover drugs & i receive lab cost). I receive just the cost & on which benefit and i need to store this external consumption in my datastore (fhir), is there any resource i can use to store such external consumption ? chargeitem for example ?
Regards
Last updated: Apr 12 2022 at 19:14 UTC
