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Merge pull request #68 from Alvearie/HIWHC-2611-Add-Commercial,-Opt,-…
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…Eligibility

Hiwhc 2611 add commercial, opt, eligibility
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dmangum2 committed Nov 19, 2021
2 parents 7468046 + aa8d61d commit 335f7a0
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Showing 37 changed files with 1,419 additions and 195 deletions.
2 changes: 1 addition & 1 deletion data/config.yaml
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Expand Up @@ -11,7 +11,7 @@
# ╰────────────────────────────────────────────────────────────────────────────────────────────────╯
id: alvearie.fhir.ig
canonical: http://ibm.com/fhir/cdm
version: 4.0.0
version: 5.0.0
name: AlvearieFHIRImplementationGuide
title: Alvearie FHIR Implementation Guide
status: active
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4 changes: 3 additions & 1 deletion data/elements/CDMIdentifier.fsh
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Expand Up @@ -8,7 +8,9 @@ Profile: CDMIdentifier
Parent: Identifier
Id: cdm-identifier
Title: "CDM Identifier"
Description: "CDM identifier with support for encrypted value"
Description: "CDM identifier with extensions"

* extension contains EncryptedState named encryptedState 0..1

* extension[encryptedState] ^short = "Used to indicate whether the identifier value is encrypted"
* extension[encryptedState] ^definition = "Used to indicate whether the identifier value is encrypted"
18 changes: 18 additions & 0 deletions data/extensions/AddressExtensions.fsh
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Expand Up @@ -6,6 +6,12 @@ Description: "Address wtih common extensions"
* extension contains CountyCode named countyCode 0..1
* extension[countyCode] ^short = "The county code for the address"
* extension[countyCode] ^definition = "The county code for the address"
* extension contains Latitude named latitude 0..1
* extension[latitude] ^short = "Latitude for the address"
* extension[latitude] ^definition = "Latitude for the address"
* extension contains Longitude named longitude 0..1
* extension[longitude] ^short = "Longitude for the address"
* extension[longitude] ^definition = "Longitude for the address"
* extension contains RegionCode named regionCode 0..1
* extension[regionCode] ^short = "Customer-specific code for the geographic region of the address"
* extension[regionCode] ^definition = "Customer-specific code for the geographic region of the address"
Expand All @@ -16,6 +22,18 @@ Description: "The county code for the address"
Id: county-code
* value[x] only CodeableConcept

Extension: Latitude
Title: "Latitude"
Description: "Latitude for the address"
Id: latitude
* value[x] only string

Extension: Longitude
Title: "Longitude"
Description: "Longitude for the address"
Id: longitude
* value[x] only string

Extension: RegionCode
Title: "Region Code"
Description: "Customer-specific code for the geographic region of the address"
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20 changes: 10 additions & 10 deletions data/extensions/ClaimExtensions.fsh
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Expand Up @@ -12,7 +12,7 @@ Description: "Indicates whether this claim record is included in the adjustme

Extension: AverageWholesalePrice
Id: average-wholesale-price
Title: "Average wholesale price"
Title: "Average Wholesale Price"
Description: "The average wholesale price charged by wholesalers for the specific drug"
* value[x] only Money

Expand Down Expand Up @@ -75,7 +75,7 @@ Description: "Business unit of the subscriber as reported on the claim"
Extension: Employer
Id: employer
Title: "Employer"
Description: "Customer-specific code for the employer as reported on the claim record"
Description: "Code for the employer as reported on the claim record"
* value[x] only CodeableConcept

Extension: FinancialSystem
Expand Down Expand Up @@ -121,11 +121,11 @@ Title: "Nursing Home Indicator"
Description: "Indicates whether the claim was for a nursing home patient"
* value[x] only string

Extension: ProcedureGroup
Id: procedure-group
Title: "Procedure Group"
Description: "Code assigned to categorize related procedures"
* value[x] only CodeableConcept
Extension:      ProcedureGroup
Id:             procedure-group
Title:          "Procedure Group"
Description:    "Code assigned to categorize related procedures"
* value[x] only CodeableConcept 
* valueCodeableConcept from WHPayerProcedureGroupValueSet (extensible)

Extension: ParticipatingPlan
Expand All @@ -137,13 +137,13 @@ Description: "Customer-specific code for the participating plan"
Extension: PriorAuthorizationIndicator
Id: prior-authorization-indicator
Title: "Prior Authorization Indicator"
Description: "Indicator of prior authorization for the claim"
Description: "Indicates prior authorization for the claim"
* value[x] only string

Extension: ReferralIndicator
Id: referral-indicator
Title: "Referral Indicator"
Description: "Indicator signifying the service resulted from a referral"
Description: "Indicates whether the service resulted from a referral"
* value[x] only string

Extension: RxCount
Expand All @@ -161,7 +161,7 @@ Description: "Number of days between the date of service and the date the cla
Extension: WhPayerPcpResponsibilityIndicator
Id: wh-payer-pcp-responsibility-indicator
Title: "Health Data Connect PCP Responsibility Indicator"
Description: "Indicator signifying that the primary care physician is the physician considered either responsible or accountable for this claim"
Description: "Indicates whether the primary care physician is the physician considered either responsible or accountable for this claim"
* value[x] only string

// Extensions that are also used in ClaimResponse
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