Healthcare Financial Services IG Edition 1
0.3.0 - STU-Ballot
Healthcare Financial Services IG Edition 1
0.3.0 - STU-Ballot
Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
This page is not part of the normative specification of the implementation guide, but it provides usefull supporting information for implementer such as: links to content from the guide which may be downloaded and installed locally; usefull endpoints to obtain support or implementation materials; and, a suite of information guides which provides contextualized assistance for implementers.
The detailed information content of this IG may be downloaded in JSON (Javascript Object Notation), TTL: (Turtle) and XML (eXtensible Markup Language).
| Information | Description | JSON | TTL | XML |
|---|---|---|---|---|
| Definitions | The artifact definitions (profiles). | JSON | TTL | XML |
| Examples | The profile and message examples. | JSON | TTL | XML |
| Information | Description |
|---|---|
| Implementation Guide | This link allows the user to download this entire Implementation Guide, as a zip file, which may then be unzipped to their local drive to provide faster access to navigate the guide without requiring an internet connection. Note, do not delete, rename or move any of the files in the unzip directory as they may be referred to in the guide at their current name and relative location. |
| Package File | The package file and necessary materials for inclusion in another implementation Guide or project which refers to, has dependencies on, the artifacts defined in this guide. |
| Validation Pack | The standard FHIR validation pack. See the FHIR documentation for the contents and usage guidance. |
| Business and Validation Rules Spreadsheet | This spreadsheet contains the various business and validation rules which may be implemented by message validators and the associated error codes which may be returned in response messages. |
The nphies portal which provides education materials, downloadable terminology and implementer registration: https://portal.nphies.sa.
The table below lists a suite of downloadable contextualized information guides in PDF form which pull together information from this Implementation Guide to address common questions or implementation situations:
| Document Description | Document Link |
|---|---|
| Chief Complaint Process | Describes how to provide Chief Complaint information on Authorizations and Claims. |
| Episode Identifier Guide | Describes how to manage identifiers for Episodes of Care. |
| Claim Submission Guideline | Describes how to handle claim submissions. |
| Claim Re-submission Guide | Describes how to handle claim re-submissions. |
| Claims re-submission with supporting information guidance | Describes how to handle claim re-submissions when additional supporting information is required. |
| Communication and CommunicationRequest referring to ClaimItem | Describes how to request and respond to requests for supporting information for specified line items in an authorization or claim. |
| Error received by HCP - Guideline | Describes provider handling for errors identified in response messages. |
| Amending adn re-submitting Authorizations | Describes how to amend the services requested in an authorization. |
| Invoice Number for item Level Guide | Describes how to provide Patient Invoice numbers for Claim line items. |
| Newborn Handling | Describes the requirements and handling for Authorizations and Claims for Newborns. |
| Patient Transfer of Care | Describes the information handling for Patient Transfer of Care. |
| Payment Reconciliation and Payment Notice Guideline | Describes the processes and information exchange for payment from insurers to providers and the acknowledgement of receipt of the actual payment by the provider. |
| Requesting Additional Information Guideline | Describes how to request and supply additional information to support an Authorization or Claim. |
| Site Eligbility | Describes how to determine if a providers site is eligible to be reimbursed for care provided to a specified patient. |
| Transaction Statuses Guideline | Describes how to determine the processing status of a previously submitted transaction (message). |
| Beneficiary Discovery Insurance - Integration Guide | Describes the services available to assist in determining if a patient has insurance and with which insurers. |
| Definitions of Outcome and Adjudication | Describes the various states of authorization and claim processing and adjudication. |