Health Cloud Financial System API - Implementation Template

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Field mappings

MemberPlan

See src/main/resources/dw/CoverageEligibilityResponseLib.dwl for a mapping example.

FHIR FieldFieldNotes
statusStatus
servicedPeriod.start or servicedDateEffectiveFrom
servicedPeriod.endEffectiveTo
insurance[x].subscriberSubscriber
insurance[x].payor[x]Payer
requestorPrimaryCarePhysician
identifier.valueSourceSystemIdentifier
identifier.systemSourceSystem

CoverageBenefit

See src/main/resources/dw/CoverageEligibilityResponseLib.dwl for a mapping example.

FHIR FieldFieldNotes
item.category[x].coding[x].codeCoverageType
insurance[x].item[x].benefit[x].allowedMoney.valueIndividualInNetworkDeductibleLimit
insurance[x].item[x].benefit[x].usedMoney.valueIndividualInNetworkDeductibleApplied
insurance[x].item[x].benefit[x].allowedMoney.value - insurance[x].item[x].benefit[x].usedMoney.valueIndividualInNetworkDeductibleRemaining
insurance[x].item[x].benefit[x].allowedMoney.valueIndividualOutofNetworkDeductibleLimit
insurance[x].item[x].benefit[x].usedMoney.valueIndividualOutofNetworkDeductibleApplied
insurance[x].item[x].benefit[x].allowedMoney.value - insurance[x].item[x].benefit[x].usedMoney.valueIndividualOutofNetworkDeductibleRemaining
insurance[x].item[x].benefit[x].allowedMoney.valueFamilyInNetworkDeductibleLimit
insurance[x].item[x].benefit[x].usedMoney.valueFamilyInNetworkDeductibleApplied
insurance[x].item[x].benefit[x].allowedMoney.value - insurance[x].item[x].benefit[x].usedMoney.valueFamilyInNetworkDeductibleRemaining
insurance[x].item[x].benefit[x].allowedMoney.valueFamilyOutofNetworkDeductibleLimit
insurance[x].item[x].benefit[x].usedMoney.valueFamilyOutofNetworkDeductibleApplied
insurance[x].item[x].benefit[x].allowedMoney.value - insurance[x].item[x].benefit[x].usedMoney.valueFamilyOutofNetworkDeductibleRemaining
insurance[x].item[x].benefit[x].allowedMoney.valueIndividualInNetworkOutofPocketLimit
insurance[x].item[x].benefit[x].usedMoney.valueIndividualInNetworkOutofPocketApplied
insurance[x].item[x].benefit[x].allowedMoney.value - insurance[x].item[x].benefit[x].usedMoney.valueIndividualInNetworkOutofPocketRemaining
insurance[x].item[x].benefit[x].allowedMoney.valueIndividualOutofNetworkOutofPocketLimit
insurance[x].item[x].benefit[x].usedMoney.valueIndividualOutofNetworkOutofPocketApplied
insurance[x].item[x].benefit[x].allowedMoney.value - insurance[x].item[x].benefit[x].usedMoney.valueIndividualOutofNetworkOutofPocketRemaining
insurance[x].item[x].benefit[x].allowedMoney.valueFamilyInNetworkOutofPocketLimit
insurance[x].item[x].benefit[x].usedMoney.valueFamilyInNetworkOutofPocketApplied
insurance[x].item[x].benefit[x].allowedMoney.value - insurance[x].item[x].benefit[x].usedMoney.valueFamilyInNetworkOutofPocketRemaining
insurance[x].item[x].benefit[x].allowedMoney.valueFamilyOutofNetworkOutofPocketLimit
insurance[x].item[x].benefit[x].usedMoney.valueFamilyOutofNetworkOutofPocketApplied
insurance[x].item[x].benefit[x].allowedMoney.value - insurance[x].item[x].benefit[x].usedMoney.valueFamilyOutofNetworkOutofPocketRemaining
insurance[x].item[x].benefit[x].allowedMoney.valueInNetworkLifetimeMaximum
insurance[x].item[x].benefit[x].allowedMoney.valueOutofNetworkLifetimeMaximum
insurance[x].item[x].benefit[x].allowedUnsignedIntInNetworkCoinsurancePercentage
insurance[x].item[x].benefit[x].allowedUnsignedIntOutofNetworkCoinsurancePercentage

Reviews

TypeTemplate
OrganizationMulesoft
Published by
MuleSoft Organization
Published onDec 14, 2022
Asset overview

Asset versions for 1.0.x

Asset versions
VersionActions
1.0.2