carin_for_blue_button_test_kit 0.15.0 → 0.15.1

This diff represents the content of publicly available package versions that have been released to one of the supported registries. The information contained in this diff is provided for informational purposes only and reflects changes between package versions as they appear in their respective public registries.
Files changed (322) hide show
  1. checksums.yaml +4 -4
  2. data/lib/carin_for_blue_button_test_kit/capability_statement/tests/instantiates_test.rb +1 -0
  3. data/lib/carin_for_blue_button_test_kit/capability_statement/tests/json_support_test.rb +1 -0
  4. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/c4bb_client_test_suite.rb +191 -126
  5. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/client_auth_smart_alca_group.rb +30 -0
  6. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/client_auth_smart_alcs_group.rb +30 -0
  7. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/client_auth_smart_alp_group.rb +30 -0
  8. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/client_auth_udap_group.rb +29 -0
  9. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/client_options.rb +25 -0
  10. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/client_registration/configuration_display_smart_test.rb +36 -0
  11. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/client_registration/configuration_display_udap_test.rb +36 -0
  12. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/client_registration_group.rb +65 -0
  13. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/client_validation_test.rb +1 -1
  14. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/endpoints/authorization_endpoint.rb +51 -0
  15. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/endpoints/next_page_endpoint.rb +4 -3
  16. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/endpoints/resource_api_endpoint.rb +4 -3
  17. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/endpoints/resource_id_endpoint.rb +4 -3
  18. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/endpoints/token_endpoint.rb +60 -62
  19. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/initial_wait_test.rb +33 -33
  20. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/metadata/mock_capability_statement.json.erb +3 -4
  21. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/mock_server.rb +12 -30
  22. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/required_searches_tests/coverage_required_searches.rb +6 -0
  23. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/required_searches_tests/eob_required_searches.rb +6 -0
  24. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/required_searches_tests/organization_required_searches.rb +6 -0
  25. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/required_searches_tests/patient_required_searches.rb +6 -0
  26. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/required_searches_tests/practitioner_required_searches.rb +6 -0
  27. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/required_searches_tests/relatedperson_required_searches.rb +6 -0
  28. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/tags.rb +2 -5
  29. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/urls.rb +11 -7
  30. data/lib/carin_for_blue_button_test_kit/custom_groups/v2.0.0/c4bb_smart_launch_group.rb +9 -0
  31. data/lib/carin_for_blue_button_test_kit/docs/carin_for_blue_button_v2.0.0_client_suite_description.md +136 -30
  32. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/coverage/metadata.yml +12 -4
  33. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/coverage/must_support_test.rb +4 -2
  34. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob/metadata.yml +6 -0
  35. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob/patient_search_test.rb +6 -2
  36. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob_inpatient_institutional/metadata.yml +155 -91
  37. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob_inpatient_institutional/must_support_test.rb +23 -9
  38. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob_inpatient_institutional/patient_search_test.rb +6 -2
  39. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob_outpatient_institutional/metadata.yml +155 -91
  40. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob_outpatient_institutional/must_support_test.rb +21 -10
  41. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob_outpatient_institutional/patient_search_test.rb +6 -2
  42. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob_pharmacy/metadata.yml +114 -68
  43. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob_pharmacy/must_support_test.rb +22 -7
  44. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob_pharmacy/patient_search_test.rb +6 -2
  45. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob_professional_non_clinician/metadata.yml +103 -60
  46. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob_professional_non_clinician/must_support_test.rb +13 -6
  47. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/eob_professional_non_clinician/patient_search_test.rb +6 -2
  48. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/metadata.yml +568 -314
  49. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/organization/metadata.yml +8 -4
  50. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/patient/metadata.yml +11 -2
  51. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/patient/must_support_test.rb +4 -0
  52. data/lib/carin_for_blue_button_test_kit/generated/v1.1.0/practitioner/metadata.yml +4 -2
  53. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/coverage/id_search_test.rb +11 -6
  54. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/coverage/lastupdated_search_test.rb +1 -0
  55. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/coverage/metadata.yml +12 -4
  56. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/coverage/must_support_test.rb +5 -2
  57. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/coverage/validation_test.rb +1 -0
  58. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/coverage_group.rb +1 -0
  59. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob/billable_period_start_search_test.rb +1 -0
  60. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob/id_search_test.rb +1 -0
  61. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob/identifier_search_test.rb +1 -0
  62. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob/lastupdated_search_test.rb +1 -0
  63. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob/metadata.yml +9 -2
  64. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob/must_support_test.rb +2 -1
  65. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob/patient_search_test.rb +7 -2
  66. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob/service_date_search_test.rb +1 -0
  67. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob/service_start_date_search_test.rb +1 -0
  68. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob/type_search_test.rb +1 -0
  69. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob/validation_test.rb +2 -0
  70. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_group.rb +1 -0
  71. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_inpatient_institutional/billable_period_start_search_test.rb +1 -0
  72. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_inpatient_institutional/id_search_test.rb +1 -0
  73. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_inpatient_institutional/identifier_search_test.rb +1 -0
  74. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_inpatient_institutional/lastupdated_search_test.rb +1 -0
  75. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_inpatient_institutional/metadata.yml +164 -94
  76. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_inpatient_institutional/must_support_test.rb +25 -10
  77. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_inpatient_institutional/patient_search_test.rb +7 -2
  78. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_inpatient_institutional/service_date_search_test.rb +1 -0
  79. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_inpatient_institutional/service_start_date_search_test.rb +1 -0
  80. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_inpatient_institutional/type_search_test.rb +1 -0
  81. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_inpatient_institutional/validation_test.rb +3 -0
  82. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_oral/billable_period_start_search_test.rb +1 -0
  83. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_oral/id_search_test.rb +1 -0
  84. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_oral/identifier_search_test.rb +1 -0
  85. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_oral/lastupdated_search_test.rb +1 -0
  86. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_oral/metadata.yml +129 -77
  87. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_oral/must_support_test.rb +24 -10
  88. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_oral/patient_search_test.rb +7 -2
  89. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_oral/service_date_search_test.rb +1 -0
  90. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_oral/service_start_date_search_test.rb +1 -0
  91. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_oral/type_search_test.rb +1 -0
  92. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_oral/validation_test.rb +1 -0
  93. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_outpatient_institutional/billable_period_start_search_test.rb +1 -0
  94. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_outpatient_institutional/id_search_test.rb +1 -0
  95. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_outpatient_institutional/identifier_search_test.rb +1 -0
  96. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_outpatient_institutional/lastupdated_search_test.rb +1 -0
  97. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_outpatient_institutional/metadata.yml +164 -94
  98. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_outpatient_institutional/must_support_test.rb +23 -11
  99. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_outpatient_institutional/patient_search_test.rb +7 -2
  100. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_outpatient_institutional/service_date_search_test.rb +1 -0
  101. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_outpatient_institutional/service_start_date_search_test.rb +1 -0
  102. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_outpatient_institutional/type_search_test.rb +1 -0
  103. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_outpatient_institutional/validation_test.rb +1 -0
  104. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_pharmacy/billable_period_start_search_test.rb +1 -0
  105. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_pharmacy/id_search_test.rb +1 -0
  106. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_pharmacy/identifier_search_test.rb +1 -0
  107. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_pharmacy/lastupdated_search_test.rb +1 -0
  108. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_pharmacy/metadata.yml +128 -78
  109. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_pharmacy/must_support_test.rb +25 -9
  110. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_pharmacy/patient_search_test.rb +7 -2
  111. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_pharmacy/service_date_search_test.rb +1 -0
  112. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_pharmacy/service_start_date_search_test.rb +1 -0
  113. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_pharmacy/type_search_test.rb +1 -0
  114. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_pharmacy/validation_test.rb +1 -0
  115. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_professional_non_clinician/billable_period_start_search_test.rb +1 -0
  116. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_professional_non_clinician/id_search_test.rb +1 -0
  117. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_professional_non_clinician/identifier_search_test.rb +1 -0
  118. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_professional_non_clinician/lastupdated_search_test.rb +1 -0
  119. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_professional_non_clinician/metadata.yml +121 -68
  120. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_professional_non_clinician/must_support_test.rb +14 -7
  121. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_professional_non_clinician/patient_search_test.rb +7 -2
  122. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_professional_non_clinician/service_date_search_test.rb +1 -0
  123. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_professional_non_clinician/service_start_date_search_test.rb +1 -0
  124. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_professional_non_clinician/type_search_test.rb +1 -0
  125. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/eob_professional_non_clinician/validation_test.rb +1 -0
  126. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/metadata.yml +752 -415
  127. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/organization/id_search_test.rb +11 -6
  128. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/organization/lastupdated_search_test.rb +1 -0
  129. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/organization/metadata.yml +8 -4
  130. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/organization/must_support_test.rb +1 -0
  131. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/organization/validation_test.rb +1 -0
  132. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/organization_group.rb +1 -0
  133. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/patient/id_search_test.rb +7 -2
  134. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/patient/lastupdated_search_test.rb +1 -0
  135. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/patient/metadata.yml +11 -2
  136. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/patient/must_support_test.rb +5 -0
  137. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/patient/validation_test.rb +1 -0
  138. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/patient_group.rb +1 -0
  139. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/practitioner/id_search_test.rb +11 -6
  140. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/practitioner/lastupdated_search_test.rb +1 -0
  141. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/practitioner/metadata.yml +4 -2
  142. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/practitioner/must_support_test.rb +1 -0
  143. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/practitioner/validation_test.rb +1 -0
  144. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/practitioner_group.rb +1 -0
  145. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/related_person/id_search_test.rb +11 -6
  146. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/related_person/lastupdated_search_test.rb +1 -0
  147. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/related_person/metadata.yml +2 -0
  148. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/related_person/must_support_test.rb +1 -0
  149. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/related_person/validation_test.rb +1 -0
  150. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0/related_person_group.rb +1 -0
  151. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/coverage/id_search_test.rb +11 -6
  152. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/coverage/lastupdated_search_test.rb +1 -0
  153. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/coverage/metadata.yml +12 -4
  154. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/coverage/must_support_test.rb +5 -2
  155. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/coverage/validation_test.rb +1 -0
  156. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/coverage_group.rb +1 -0
  157. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob/billable_period_start_search_test.rb +1 -0
  158. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob/id_search_test.rb +1 -0
  159. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob/identifier_search_test.rb +1 -0
  160. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob/lastupdated_search_test.rb +1 -0
  161. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob/metadata.yml +9 -2
  162. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob/must_support_test.rb +2 -1
  163. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob/patient_search_test.rb +7 -2
  164. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob/service_date_search_test.rb +1 -0
  165. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob/service_start_date_search_test.rb +1 -0
  166. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob/type_search_test.rb +1 -0
  167. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob/validation_test.rb +1 -0
  168. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob_group.rb +1 -0
  169. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob_inpatient_institutional/billable_period_start_search_test.rb +1 -0
  170. data/lib/carin_for_blue_button_test_kit/generated/v2.0.0-dev-nonfinancial/eob_inpatient_institutional/id_search_test.rb +1 -0
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  314. data/lib/carin_for_blue_button_test_kit/requirements/carin-for-blue-button-test-kit_out_of_scope_requirements.csv +15 -0
  315. data/lib/carin_for_blue_button_test_kit/requirements/carin-for-blue-button-test-kit_requirements.csv +80 -85
  316. data/lib/carin_for_blue_button_test_kit/requirements/generated/carin-for-blue-button-test-kit_requirements_coverage.csv +183 -240
  317. data/lib/carin_for_blue_button_test_kit/version.rb +2 -2
  318. data/lib/requirements_config.yaml +3 -0
  319. metadata +29 -9
  320. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/endpoints/authorize_endpoint.rb +0 -32
  321. data/lib/carin_for_blue_button_test_kit/client/v2.0.0/mock_authorization.rb +0 -35
  322. data/lib/carin_for_blue_button_test_kit/generator/must_support_metadata_extractor.rb +0 -326
@@ -1,335 +1,278 @@
1
- Req Set,ID,URL,Requirement,Conformance,Actor,Sub-Requirement(s),Conditionality,CARIN IG for Blue Button® v2.0.0 Client Test Suite Short ID(s),CARIN IG for Blue Button® v2.0.0 Client Test Suite Full ID(s)
2
- hl7.fhir.us.carin-bb_2.0.0,1,https://hl7.org/fhir/us/carin-bb/STU2/Background.html,The CARIN IG for Blue Button® requires the use of the SMART App Launch Framework’s standalone launch sequence,SHALL,Health Plan,,false,NA,NA
1
+ Req Set,ID,URL,Requirement,Conformance,Actor,Sub-Requirement(s),Conditionality,CARIN IG for Blue Button® v2.0.0 Client Test Suite Short ID(s),CARIN IG for Blue Button® v2.0.0 Client Test Suite Full ID(s),CARIN IG for Blue Button® v2.0.0 Short ID(s),CARIN IG for Blue Button® v2.0.0 Full ID(s)
2
+ hl7.fhir.us.carin-bb_2.0.0,1,https://hl7.org/fhir/us/carin-bb/STU2/Background.html#smart-application-launch,The CARIN IG for Blue Button® requires the use of the SMART App Launch Framework’s standalone launch sequence as it will clarify that applications maintain a patient context for the duration of the connection.,SHALL,Health Plan/Consumer,,false,"","",1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
3
3
  hl7.fhir.us.carin-bb_2.0.0,2,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#must-support,"When querying and reading CARIN IG for Blue Button® Profiles, *Must Support* on any profile data element SHALL be interpreted as follows: ...
4
4
 
5
- Health Plan API actors SHALL be capable of populating all data elements the payer maintains as part of the query results as specified by the CARINBlueButtonHealthPlanAPICapabilityStatement.",SHALL,Health Plan,,false,NA,NA
6
- hl7.fhir.us.carin-bb_2.0.0,3,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#must-support,"When querying and reading CARIN IG for Blue Button® Profiles, *Must Support* on any profile data element SHALL be interpreted as follows: ...
7
-
8
- Consumer App actors SHALL be capable of processing resource instances containing the data elements without generating an error or causing the application to fail.",SHALL,Consumer,,false,8.01,c4bb_v200_client-Group08-client_claims_data_attestation
9
- hl7.fhir.us.carin-bb_2.0.0,4,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#must-support,"When querying and reading CARIN IG for Blue Button® Profiles, *Must Support* on any profile data element SHALL be interpreted as follows:…
10
-
11
- Consumer App actors SHALL be capable of displaying the data elements for human use.",SHALL,Consumer,,false,,
5
+ Health Plan API actors SHALL be capable of populating all data elements the payer maintains as part of the query results as specified by the CARINBlueButtonHealthPlanAPICapabilityStatement.",SHALL,Health Plan,,false,NA,NA,,
6
+ hl7.fhir.us.carin-bb_2.0.0,3,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#must-support,[*Must Support* on profile data elements means] Consumer App actors SHALL be capable of processing resource instances containing the data elements without generating an error or causing the application to fail.,SHALL,Consumer,,false,8.01,c4bb_v200_client-c4bb_client_attestation_test_group-client_claims_data_attestation,NA,NA
7
+ hl7.fhir.us.carin-bb_2.0.0,4,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#must-support,[*Must Support* on profile data elements means] Consumer App actors SHALL be capable of displaying the data elements for human use.,SHALL,Consumer,,false,,,NA,NA
12
8
  hl7.fhir.us.carin-bb_2.0.0,5,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#must-support,"When querying and reading CARIN IG for Blue Button® Profiles, *Must Support* on any profile data element SHALL be interpreted as follows:...
13
9
 
14
- In situations where information on a particular data element is not present and the reason for absence is unknown, Health Plan API actors SHALL NOT include the data elements in the resource instance returned as part of the query results.",SHALL NOT,Health Plan,,true,NA,NA
15
- hl7.fhir.us.carin-bb_2.0.0,6,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#must-support,"When querying and reading CARIN IG for Blue Button® Profiles, *Must Support* on any profile data element SHALL be interpreted as follows: ...
16
-
17
- When querying Health Plan API actors, Consumer App actors SHALL interpret missing data elements within resource instances as data not present in the Health Plan API actors system.",SHALL,Consumer,,false,,
10
+ In situations where information on a particular data element is not present and the reason for absence is unknown, Health Plan API actors SHALL NOT include the data elements in the resource instance returned as part of the query results.",SHALL NOT,Health Plan,,true,NA,NA,,
11
+ hl7.fhir.us.carin-bb_2.0.0,6,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#must-support,"[*Must Support* on profile data elements means w]hen querying Health Plan API actors, Consumer App actors SHALL interpret missing data elements within resource instances as data not present in the Health Plan API actors system.",SHALL,Consumer,,false,,,NA,NA
18
12
  hl7.fhir.us.carin-bb_2.0.0,7,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#must-support,"When querying and reading CARIN IG for Blue Button® Profiles, *Must Support* on any profile data element SHALL be interpreted as follows: ...
19
13
 
20
- In situations where information on a particular data element is missing and the Health Plan API actor knows the precise reason for the absence of data, Health Plan API actors SHALL send the reason for the missing information using values (such as nullFlavors) from the value set where they exist or use the dataAbsentReason extension.",SHALL,Health Plan,,true,NA,NA
21
- hl7.fhir.us.carin-bb_2.0.0,8,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#must-support,"When querying and reading CARIN IG for Blue Button® Profiles, *Must Support* on any profile data element SHALL be interpreted as follows: ...
22
-
23
- Consumer App actors SHALL be able to process resource instances containing data elements asserting missing information.",SHALL,Consumer,,false,,
24
- hl7.fhir.us.carin-bb_2.0.0,9,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#missing-data,"If the source system does not have data for a *Must Support* data element with minimum cardinality = 0, the data element is omitted from the resource.",SHALL,Health Plan,,true,NA,NA
25
- hl7.fhir.us.carin-bb_2.0.0,10,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#missing-data,"If the source system does not have data for a required data element (in other words, where the minimum cardinality is > 0), follow guidance defined in the core FHIR specification and summarized in the US Core.",SHALL,Health Plan,,true,NA,NA
14
+ In situations where information on a particular data element is missing and the Health Plan API actor knows the precise reason for the absence of data, Health Plan API actors SHALL send the reason for the missing information using values (such as nullFlavors) from the value set where they exist or use the dataAbsentReason extension.",SHALL,Health Plan,,true,NA,NA,Not Tested,Not Tested
15
+ hl7.fhir.us.carin-bb_2.0.0,8,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#must-support,[*Must Support* on profile data elements means] Consumer App actors SHALL be able to process resource instances containing data elements asserting missing information.,SHALL,Consumer,,false,,,NA,NA
16
+ hl7.fhir.us.carin-bb_2.0.0,9,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#missing-data,"If the source system does not have data for a *Must Support* data element with minimum cardinality = 0, the data element is omitted from the resource.",SHALL,Health Plan,,true,NA,NA,,
17
+ hl7.fhir.us.carin-bb_2.0.0,10,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#missing-data,"If the source system does not have data for a required data element (in other words, where the minimum cardinality is > 0), follow guidance defined in the core FHIR specification and summarized in the US Core.",SHALL,Health Plan,"hl7.fhir.us.core_7.0.0,hl7.fhir_4.0.1",true,NA,NA,,
26
18
  hl7.fhir.us.carin-bb_2.0.0,11,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#conformance-to-us-core-profiles,"Any actor acting as a Health Plan API actor in this IG SHALL:…
27
19
 
28
- Be able to populate all profile data elements that have a minimum cardinality >= 1 and/or flagged as *Must Support* as defined by that profiles StructureDefinition.",SHALL,Health Plan,,false,NA,NA
20
+ Be able to populate all profile data elements that have a minimum cardinality >= 1 and/or flagged as *Must Support* as defined by that profiles StructureDefinition.",SHALL,Health Plan,,false,NA,NA,"2.2.05, 2.3.18, 2.3.20, 2.3.22, 2.3.24, 2.3.26, 2.3.28, 2.4.06, 2.5.05, 2.6.05, 2.7.05","c4bb_v200-Group02-c4bb_v200_patient-c4bb_v200_patient_must_support_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_must_support_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_inpatient_institutional_must_support_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_outpatient_institutional_must_support_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_oral_must_support_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_pharmacy_must_support_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_professional_non_clinician_must_support_test, c4bb_v200-Group02-c4bb_v200_coverage-c4bb_v200_coverage_must_support_test, c4bb_v200-Group02-c4bb_v200_organization-c4bb_v200_organization_must_support_test, c4bb_v200-Group02-c4bb_v200_practitioner-c4bb_v200_practitioner_must_support_test, c4bb_v200-Group02-c4bb_v200_related_person-c4bb_v200_related_person_must_support_test"
29
21
  hl7.fhir.us.carin-bb_2.0.0,12,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#conformance-to-us-core-profiles,"Any actor acting as a Health Plan API actor in this IG SHALL:…
30
22
 
31
- Conform to the US Core Health Plan Capability Statement expectations for that profile's type.",SHALL,Health Plan,,false,NA,NA
32
- hl7.fhir.us.carin-bb_2.0.0,13,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#conformance-to-us-core-profiles,"Any actor acting a FHIR Client in this IG SHALL:…
33
-
34
- Be able to process and retain all profile data elements that have a minimum cardinality >= 1 and/or flagged as Must Support as defined by that profiles StructureDefinition.",SHALL,Consumer,,false,8.01,c4bb_v200_client-Group08-client_claims_data_attestation
35
- hl7.fhir.us.carin-bb_2.0.0,14,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html,"Any actor acting a FHIR Client in this IG SHALL:…
36
-
37
- Conform to the US Core Client Capability Statement expectations for that profiles type.",SHALL,Consumer,,false,"2.02, 3.02, 4.02, 5.02, 6.02, 7.06","c4bb_v200_client-Group02-patient_required_searches, c4bb_v200_client-Group03-coverage_required_searches, c4bb_v200_client-Group04-organization_required_searches, c4bb_v200_client-Group05-practitioner_required_searches, c4bb_v200_client-Group06-relatedperson_required_searches, c4bb_v200_client-Group07-eob_required_searches"
38
- hl7.fhir.us.carin-bb_2.0.0,15,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#profiling-constraints,"Data element that are not part of this scope have not been constrained out, and as such, may be included by the Health Plan API.",MAY,Health Plan,,false,NA,NA
39
- hl7.fhir.us.carin-bb_2.0.0,16,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#profiling-constraints,"If a Health Plan API includes additional information, there SHALL be no expectation that client applications support the data in any way in order to be conformant with this specification.",SHALL NOT,Consumer,,true,Not Tested,Not Tested
40
- hl7.fhir.us.carin-bb_2.0.0,17,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#capabilitystatement-Health Plan-requirement,Health Plans claiming conformance to this guide SHALL include a CapabilityStatement that has a CapabilityStatement.instantiates with a URL of http://hl7.org/fhir/us/carin-bb/CapabilityStatement/c4bb or a URL to the appropriate version of the CapabilityStatement.,SHALL,Health Plan,,false,NA,NA
41
- hl7.fhir.us.carin-bb_2.0.0,18,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,payers **MAY** choose to provide a concept text `[CodeableConcept].text` or the coding display `[CodeableConcept].coding.display.`,MAY,Health Plan,,false,NA,NA
42
- hl7.fhir.us.carin-bb_2.0.0,19,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,"If the ‘display’ element is populated, the string used in `display` **SHALL** be one of the display strings defined for that code by the code system (code systems may define multiple display strings for a single code).",SHALL,Health Plan,,true,NA,NA
43
- hl7.fhir.us.carin-bb_2.0.0,20,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,"If the code description available is not known to be an exact match of a display string defined by the code system, the `[CodeableConcept].text` should be used in place of the `[CodeableConcept].coding.display`.",SHOULD,Health Plan,,true,NA,NA
44
- hl7.fhir.us.carin-bb_2.0.0,21,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,Payers **MAY** choose to also provide resource level text to enable consumers apps to render resources in a manner that the payer would like to have the data presented. ,MAY,Health Plan,,false,NA,NA
45
- hl7.fhir.us.carin-bb_2.0.0,22,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,The `[Resource].text` is a Narrative datatype that has a `div` element that is an xhtml datatype. This element **MAY** be used to provide an easily renderable version of the resource that is meant for human viewing.,MAY,Health Plan,,false,NA,NA
46
- hl7.fhir.us.carin-bb_2.0.0,23,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,Payers may also provide additional data elements beyond what is in this guide. ,MAY,Health Plan,,false,NA,NA
47
- hl7.fhir.us.carin-bb_2.0.0,24,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,"Payers SHOULD include descriptions of the data elements they provide, particularly for data elements not covered in this guide",SHOULD,Health Plan,,false,NA,NA
48
- hl7.fhir.us.carin-bb_2.0.0,25,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,"As part of their API documentation, Payers may consider providing a display mapping like can be found in the [Example Printed Explanation Of Benefit Mapping](http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#example-printed-eob-mapping) section of this implementation guide.",MAY,Health Plan,,false,NA,NA
49
- hl7.fhir.us.carin-bb_2.0.0,26,http://hl7.org/fhir/us/carin-bb/STU2/Common_Payer_Consumer_Data_Set.html#common-payer-consumer-data-set-cpcds,The Common Payer Consumer Data Set (CPCDS)… The CPCDS data elements can be stored and queried as profiled FHIR resources. ,MAY,Health Plan,,false,NA,NA
50
- hl7.fhir.us.carin-bb_2.0.0,27,http://hl7.org/fhir/us/carin-bb/STU2/Common_Payer_Consumer_Data_Set.html, The Common Payer Consumer Data Set (CPCDS)… [The CPCDS data elements] define key payer financial health data that SHALL be accessible and available to through standards-based APIs.,SHALL,Health Plan,,false,NA,NA
51
- hl7.fhir.us.carin-bb_2.0.0,28,http://hl7.org/fhir/us/carin-bb/STU2/Common_Payer_Consumer_Data_Set.html#common-payer-consumer-data-set-cpcds,"The Common Payer Consumer Data Set (CPCDS)… Data SHALL conform to specified profiles, vocabulary standards and code sets. ",SHALL,Health Plan,,false,NA,NA
52
- hl7.fhir.us.carin-bb_2.0.0,29,http://hl7.org/fhir/us/carin-bb/STU2/Common_Payer_Consumer_Data_Set.html,"Based on CPCDS, the mappings define the minimum mandatory elements, extensions and terminology requirements that must be present in the FHIR resource. Additional business rules are also specified.",SHALL,Health Plan,,false,NA,NA
53
- hl7.fhir.us.carin-bb_2.0.0,30,http://hl7.org/fhir/us/carin-bb/STU2/Terminology_Licensure.html#access-to-licensed-code-systems,Implementers ... of this specification SHALL abide by the license requirements for each terminology content artifact utilized within a functioning implementation. ,SHALL,Health Plan,,false,NA,NA
54
- hl7.fhir.us.carin-bb_2.0.0,31,http://hl7.org/fhir/us/carin-bb/STU2/Terminology_Licensure.html#access-to-licensed-code-systems,Terminology licenses SHALL be obtained from the Third Party IP owner for each code system and/or other specified artifact used. ,SHALL,Health Plan,,false,NA,NA
55
- hl7.fhir.us.carin-bb_2.0.0,32,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html,"Search Parameters Required By This Implementation Guide…
56
-
57
- ExplanationOfBenefit _id token GET [base]/ExplanationOfBenefit?_id=[id]",SHALL,Health Plan,,false,NA,NA
58
- hl7.fhir.us.carin-bb_2.0.0,33,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#search-parameters-required-by-this-implementation-guide,"Search Parameters Required By This Implementation Guide…
59
-
60
- ExplanationOfBenefit _lastUpdated date GET [base]/ExplanationOfBenefit?_lastUpdated=[_lastUpdated]",SHALL,Health Plan,,false,NA,NA
61
- hl7.fhir.us.carin-bb_2.0.0,34,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#search-parameters-required-by-this-implementation-guide,"Search Parameters Required By This Implementation Guide…
62
-
63
- ExplanationOfBenefit identifier token GET [base]/ExplanationOfBenefit?identifier=[system]|[code]",SHALL,Health Plan,,false,NA,NA
64
- hl7.fhir.us.carin-bb_2.0.0,35,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#search-parameters-required-by-this-implementation-guide,"Search Parameters Required By This Implementation Guide…
65
-
66
- ExplanationOfBenefit patient reference GET [base]/ExplanationOfBenefit?patient=[patient]",SHALL,Health Plan,,false,NA,NA
67
- hl7.fhir.us.carin-bb_2.0.0,36,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#search-parameters-required-by-this-implementation-guide,"Search Parameters Required By This Implementation Guide…
68
-
69
- ExplanationOfBenefit type token GET [base]/ExplanationOfBenefit?type=[system]|[code]",SHALL,Health Plan,,false,NA,NA
70
- hl7.fhir.us.carin-bb_2.0.0,37,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#search-parameters-required-by-this-implementation-guide,"Search Parameters Required By This Implementation Guide…
71
-
72
- ExplanationOfBenefit service-date date GET [base]/ExplanationOfBenefit?service-date=[service-date]",SHALL,Health Plan,,false,NA,NA
73
- hl7.fhir.us.carin-bb_2.0.0,38,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#search-parameters-required-by-this-implementation-guide,"Search Parameters Required By This Implementation Guide…
74
-
75
- ExplanationOfBenefit service-start-date date GET [base]/ExplanationOfBenefit?service-start-date=[service-start-date]",SHALL,Health Plan,,false,NA,NA
76
- hl7.fhir.us.carin-bb_2.0.0,39,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#search-parameters-required-by-this-implementation-guide,"Search Parameters Required By This Implementation Guide…
77
-
78
- ExplanationOfBenefit billable-period-start date GET [base]/ExplanationOfBenefit?billable-period-start=[billable-period-start]",SHALL,Health Plan,,false,NA,NA
79
- hl7.fhir.us.carin-bb_2.0.0,40,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#coverage,"A Server SHALL be capable of supporting the following _includes:…
80
-
81
- Coverage:payor - GET [base]/Coverage?_include=Coverage:payor",SHALL,Health Plan,,false,NA,NA
82
- hl7.fhir.us.carin-bb_2.0.0,41,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#explanationofbenefit,"A Server SHALL be capable of supporting the following _includes:…
83
-
84
- ExplanationOfBenefit:patient - GET [base]/ExplanationOfBenefit?[parameter=value]&_include=ExplanationOfBenefit:patient",SHALL,Health Plan,,false,NA,NA
85
- hl7.fhir.us.carin-bb_2.0.0,42,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#explanationofbenefit,"A Server SHALL be capable of supporting the following _includes:…
86
-
87
- ExplanationOfBenefit:provider - GET [base]/ExplanationOfBenefit?[parameter=value]&_include=ExplanationOfBenefit:provider",SHALL,Health Plan,,false,NA,NA
88
- hl7.fhir.us.carin-bb_2.0.0,43,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#explanationofbenefit,"A Server SHALL be capable of supporting the following _includes:…
89
-
90
- ExplanationOfBenefit:care-team - GET [base]/ExplanationOfBenefit?[parameter=value]&_include=ExplanationOfBenefit:care-team",SHALL,Health Plan,,false,NA,NA
91
- hl7.fhir.us.carin-bb_2.0.0,44,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#explanationofbenefit,"A Server SHALL be capable of supporting the following _includes:…
92
-
93
- ExplanationOfBenefit:coverage - GET [base]/ExplanationOfBenefit?[parameter=value]&_include=ExplanationOfBenefit:coverage",SHALL,Health Plan,,false,NA,NA
94
- hl7.fhir.us.carin-bb_2.0.0,45,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#explanationofbenefit,"A Server SHALL be capable of supporting the following _includes:…
95
-
96
- ExplanationOfBenefit:insurer - GET [base]/ExplanationOfBenefit?[parameter=value]&_include=ExplanationOfBenefit:insurer",SHALL,Health Plan,,false,NA,NA
97
- hl7.fhir.us.carin-bb_2.0.0,46,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#explanationofbenefit,"A Server SHALL be capable of supporting the following _includes:…
98
-
99
- ExplanationOfBenefit:payee - GET [base]/ExplanationOfBenefit?[parameter=value]&_include=ExplanationOfBenefit:payee",SHALL,Health Plan,,false,NA,NA
100
- hl7.fhir.us.carin-bb_2.0.0,47,http://hl7.org/fhir/us/carin-bb/STU2/searchparameters.html#explanationofbenefit,"A Server SHALL be capable of supporting the following _includes:…
101
-
102
- ExplanationOfBenefit:* - GET [base]/ExplanationOfBenefit?[parameter=value]&_include=ExplanationOfBenefit:*
103
-
104
- Note: _include=ExplanationOfBenefit:* means, at minimum, the resources that are included as reference type search parameters for the ExplanationOfBenefit resource on the Health Plan. Health Plans claiming compliance to this guide will, at minimum, support the include of patient, provider, care-team, coverage, and insurer, and will support returning all of them in support ExplanationOfBenefit:*. This guide does not require all of these as search parameters, but are defined as part of the _include requirement. For example, the insurer search parameter is not required because in the context of the use case, it is anticipated there will ever be one insurer. It however must be returned in the _include=ExplanationOfBenefit:* results. The means in which this is done (including defining all of the _include as search parameters) is not defined by this guide.",SHALL,Health Plan,,false,NA,NA
105
- hl7.fhir.us.carin-bb_2.0.0,48,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#general-considerations,"Members need to be able to direct the communication of this information through authenticated, authorized, and secure channels.",SHALL,Health Plan/Consumer,,false,,
106
- hl7.fhir.us.carin-bb_2.0.0,49,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html,Exchange of this information needs to be protected with proper security and privacy protections to avoid malicious or unintentional exposure of such information. ,SHALL,Health Plan/Consumer,,false,Not Tested,Not Tested
107
- hl7.fhir.us.carin-bb_2.0.0,50,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#general-considerations,All consumer-directed payer data exchanges must be appropriately secured in transit and access limited only to authorized individuals.,SHALL,Health Plan/Consumer,,false,Not Tested,Not Tested
108
- hl7.fhir.us.carin-bb_2.0.0,51,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#legal-and-regulatory-requirements,"Implementers must ensure that APIs fully and successfully implement privacy and security features such as, but not limited to, those required to comply with HIPAA privacy and security requirements and other applicable law protecting the privacy and security of protected health information.",SHALL,Health Plan,,false,NA,NA
109
- hl7.fhir.us.carin-bb_2.0.0,52,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#securityprivacy-related-technologies-including-explicit-consent-and-security-labels,"
110
- 1. While past ONC regulations did have optional rules for data labeling and consent directives, as of May 2020, ONC has elected to not establish rules for either data labeling and consent directives as part of the Final Rule for the 21st Century Cures Act.
23
+ Conform to the US Core Health Plan Capability Statement expectations for that profile's type.",SHALL,Health Plan,,false,NA,NA,"2.2.04, 2.3.17, 2.3.19, 2.3.21, 2.3.23, 2.3.25, 2.3.27, 2.4.05, 2.5.04, 2.6.04, 2.7.04","c4bb_v200-Group02-c4bb_v200_patient-c4bb_v200_patient_validation_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_validation_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_inpatient_institutional_validation_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_outpatient_institutional_validation_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_oral_validation_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_pharmacy_validation_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_professional_non_clinician_validation_test, c4bb_v200-Group02-c4bb_v200_coverage-c4bb_v200_coverage_validation_test, c4bb_v200-Group02-c4bb_v200_organization-c4bb_v200_organization_validation_test, c4bb_v200-Group02-c4bb_v200_practitioner-c4bb_v200_practitioner_validation_test, c4bb_v200-Group02-c4bb_v200_related_person-c4bb_v200_related_person_validation_test"
24
+ hl7.fhir.us.carin-bb_2.0.0,13,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#conformance-to-us-core-profiles,Any actor acting [as] a FHIR Client in this IG SHALL … [b]e able to process and retain all profile data elements that have a minimum cardinality >= 1 and/or flagged as Must Support as defined by that profiles StructureDefinition.,SHALL,Consumer,,false,8.01,c4bb_v200_client-c4bb_client_attestation_test_group-client_claims_data_attestation,NA,NA
25
+ hl7.fhir.us.carin-bb_2.0.0,14,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#conformance-to-us-core-profiles,Any actor acting [as] a FHIR Client in this IG SHALL … [c]onform to the US Core Client Capability Statement expectations for that profiles type.,SHALL,Consumer,,false,"2.02, 3.02, 4.02, 5.02, 6.02, 7.06","c4bb_v200_client-c4bb_patient_profile_test_group-patient_required_searches, c4bb_v200_client-c4bb_coverage_profile_test_group-coverage_required_searches, c4bb_v200_client-c4bb_organization_profile_test_group-organization_required_searches, c4bb_v200_client-c4bb_practitioner_profile_test_group-practitioner_required_searches, c4bb_v200_client-c4bb_relatedperson_profile_test_group-relatedperson_required_searches, c4bb_v200_client-c4bb_explanationofbenefit_profiles_test_group-eob_required_searches",NA,NA
26
+ hl7.fhir.us.carin-bb_2.0.0,15,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#profiling-constraints,"Data element that are not part of this scope have not been constrained out, and as such, may be included by the Health Plan API.",MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
27
+ hl7.fhir.us.carin-bb_2.0.0,16,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#profiling-constraints,"If a Health Plan API includes additional information, there SHALL be no expectation that client applications support the data in any way in order to be conformant with this specification.",SHALL NOT,Consumer,,true,Not Tested,Not Tested,NA,NA
28
+ hl7.fhir.us.carin-bb_2.0.0,17,http://hl7.org/fhir/us/carin-bb/STU2/Conformance_Requirements.html#capabilitystatement-Health Plan-requirement,Health Plans claiming conformance to this guide SHALL include a CapabilityStatement that has a CapabilityStatement.instantiates with a URL of http://hl7.org/fhir/us/carin-bb/CapabilityStatement/c4bb or a URL to the appropriate version of the CapabilityStatement.,SHALL,Health Plan,,false,NA,NA,2.1.04,c4bb_v200-Group02-capability_statement_group-carin_bb_instantiate
29
+ hl7.fhir.us.carin-bb_2.0.0,18,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,payers **MAY** choose to provide a concept text `[CodeableConcept].text` or the coding display `[CodeableConcept].coding.display.`,MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
30
+ hl7.fhir.us.carin-bb_2.0.0,19,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,"If the ‘display’ element is populated, the string used in `display` **SHALL** be one of the display strings defined for that code by the code system (code systems may define multiple display strings for a single code).",SHALL,Health Plan,,true,NA,NA,,
31
+ hl7.fhir.us.carin-bb_2.0.0,20,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,"If the code description available is not known to be an exact match of a display string defined by the code system, the `[CodeableConcept].text` should be used in place of the `[CodeableConcept].coding.display`.",SHOULD,Health Plan,,true,NA,NA,Not Tested,Not Tested
32
+ hl7.fhir.us.carin-bb_2.0.0,21,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,Payers **MAY** choose to also provide resource level text to enable consumers apps to render resources in a manner that the payer would like to have the data presented.,MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
33
+ hl7.fhir.us.carin-bb_2.0.0,22,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,The `[Resource].text` is a Narrative datatype that has a `div` element that is an xhtml datatype. This element **MAY** be used to provide an easily renderable version of the resource that is meant for human viewing.,MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
34
+ hl7.fhir.us.carin-bb_2.0.0,23,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,Payers may also provide additional data elements beyond what is in this guide.,MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
35
+ hl7.fhir.us.carin-bb_2.0.0,24,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,"Payers SHOULD include descriptions of the data elements they provide, particularly for data elements not covered in this guide",SHOULD,Health Plan,,false,NA,NA,Not Tested,Not Tested
36
+ hl7.fhir.us.carin-bb_2.0.0,25,http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#considerations-for-improving-interoperability,"As part of their API documentation, Payers may consider providing a display mapping like can be found in the [Example Printed Explanation Of Benefit Mapping](http://hl7.org/fhir/us/carin-bb/STU2/General_Guidance.html#example-printed-eob-mapping) section of this implementation guide.",MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
37
+ hl7.fhir.us.carin-bb_2.0.0,27,http://hl7.org/fhir/us/carin-bb/STU2/Common_Payer_Consumer_Data_Set.html#common-payer-consumer-data-set-cpcds,The Common Payer Consumer Data Set (CPCDS)… [The CPCDS data elements] define key payer financial health data that SHALL be accessible and available to through standards-based APIs.,SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
38
+ hl7.fhir.us.carin-bb_2.0.0,28,http://hl7.org/fhir/us/carin-bb/STU2/Common_Payer_Consumer_Data_Set.html#common-payer-consumer-data-set-cpcds,"The Common Payer Consumer Data Set (CPCDS)… Data SHALL conform to specified profiles, vocabulary standards and code sets.",SHALL,Health Plan,,false,NA,NA,,
39
+ hl7.fhir.us.carin-bb_2.0.0,30,http://hl7.org/fhir/us/carin-bb/STU2/Terminology_Licensure.html#access-to-licensed-code-systems,Implementers ... of this specification SHALL abide by the license requirements for each terminology content artifact utilized within a functioning implementation.,SHALL,Health Plan,,false,NA,NA,,
40
+ hl7.fhir.us.carin-bb_2.0.0,31,http://hl7.org/fhir/us/carin-bb/STU2/Terminology_Licensure.html#access-to-licensed-code-systems,Terminology licenses SHALL be obtained from the Third Party IP owner for each code system and/or other specified artifact used.,SHALL,Health Plan,,false,NA,NA,,
41
+ hl7.fhir.us.carin-bb_2.0.0,48,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#general-considerations,"Members need to be able to direct the communication of this information through authenticated, authorized, and secure channels.",SHALL,Health Plan/Consumer,,false,,,,
42
+ hl7.fhir.us.carin-bb_2.0.0,49,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#general-considerations,Exchange of this information needs to be protected with proper security and privacy protections to avoid malicious or unintentional exposure of such information.,SHALL,Health Plan/Consumer,,false,Not Tested,Not Tested,Not Tested,Not Tested
43
+ hl7.fhir.us.carin-bb_2.0.0,50,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#general-considerations,All consumer-directed payer data exchanges must be appropriately secured in transit and access limited only to authorized individuals.,SHALL,Health Plan/Consumer,,false,Not Tested,Not Tested,Not Tested,Not Tested
44
+ hl7.fhir.us.carin-bb_2.0.0,51,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#legal-and-regulatory-requirements,"Implementers must ensure that APIs fully and successfully implement privacy and security features such as, but not limited to, those required to comply with HIPAA privacy and security requirements and other applicable law protecting the privacy and security of protected health information.",SHALL,Health Plan,,false,NA,NA,,
45
+ hl7.fhir.us.carin-bb_2.0.0,52,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#securityprivacy-related-technologies-including-explicit-consent-and-security-labels,"1. While past ONC regulations did have optional rules for data labeling and consent directives, as of May 2020, ONC has elected to not establish rules for either data labeling and consent directives as part of the Final Rule for the 21st Century Cures Act.
111
46
  2. At present there is no explicit regulatory requirement for the use of these technologies in conjunction with this guide.
112
47
  3. However, to meet the statutes, regulations, and guiding principles above, consent directives and security labels MAY be considered and used.
113
- 4. Organizations which plan to take advantage of these additional capabilities are responsible for negotiating support for these mechanisms between trading partners. The FHIR implementation guide defining the recommended standard is the FHIR Data Segmentation for Privacy IG.",MAY,Health Plan/Consumer,,false,Not Tested,Not Tested
114
- hl7.fhir.us.carin-bb_2.0.0,53,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#security-considerations-and-guidance,"All implementers of the CARIN Consumer-Directed Payer Data Exchange Implementation Guide (IG) should follow the FHIR Security guidance, Security and Privacy Module, and the FHIR Implementer’s Safety Checklist guidance as defined in the FHIR standard where applicable and not otherwise superseded by this section of the IG.",SHOULD,Health Plan/Consumer,,false,,
115
- hl7.fhir.us.carin-bb_2.0.0,54,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#exchange-security,The exchange of information SHOULD use the current version...of Transport Level Security (TLS) as specified by the current release of NIST guidelines (SP 800-52). ,SHOULD,Health Plan/Consumer,,false,,
116
- hl7.fhir.us.carin-bb_2.0.0,55,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#exchange-security,The exchange of information … SHALL use either current or the immediately prior release of Transport Level Security (TLS) as specified by the current release of NIST guidelines (SP 800-52).,SHALL,Health Plan,,false,NA,NA
117
- hl7.fhir.us.carin-bb_2.0.0,56,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#exchange-security,Implementers of this Implementation Guide SHOULD support SMART on FHIR Authorization best practices Transport Security section.,SHOULD,Health Plan/Consumer,,false,,
118
- hl7.fhir.us.carin-bb_2.0.0,57,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Implementations SHALL support the FHIR US Core [Patient Privacy and Security requirements](https://www.hl7.org/fhir/us/core/security.html),SHALL,Health Plan,,false,NA,NA
119
- hl7.fhir.us.carin-bb_2.0.0,58,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server systems SHALL publish their authorization and token endpoints for discovery in accordance with the SMART App Launch framework and publicly publish the Well-Known Uniform Resource Identifiers (URIs) JSON file with scopes defined in the scopes_supported property.,SHALL,Health Plan,,false,NA,NA
120
- hl7.fhir.us.carin-bb_2.0.0,59,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Implementations SHOULD consider the SMART on FHIR Best Practices in Authorization found [here](https://docs.smarthealthit.org/authorization/best-practices/).,SHOULD,Health Plan/Consumer,,false,Not Tested,Not Tested
48
+ 4. Organizations which plan to take advantage of these additional capabilities are responsible for negotiating support for these mechanisms between trading partners. The FHIR implementation guide defining the recommended standard is the FHIR Data Segmentation for Privacy IG.",MAY,Health Plan/Consumer,,false,Not Tested,Not Tested,Not Tested,Not Tested
49
+ hl7.fhir.us.carin-bb_2.0.0,53,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#security-considerations-and-guidance,"All implementers of the CARIN Consumer-Directed Payer Data Exchange Implementation Guide (IG) should follow the FHIR Security guidance, Security and Privacy Module, and the FHIR Implementer’s Safety Checklist guidance as defined in the FHIR standard where applicable and not otherwise superseded by this section of the IG.",SHOULD,Health Plan/Consumer,,false,,,,
50
+ hl7.fhir.us.carin-bb_2.0.0,54,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#exchange-security,The exchange of information SHOULD use the current version...of Transport Level Security (TLS) as specified by the current release of NIST guidelines (SP 800-52).,SHOULD,Health Plan/Consumer,,false,,,,
51
+ hl7.fhir.us.carin-bb_2.0.0,55,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#exchange-security,The exchange of information … SHALL use either current or the immediately prior release of Transport Level Security (TLS) as specified by the current release of NIST guidelines (SP 800-52).,SHALL,Health Plan,,false,NA,NA,,
52
+ hl7.fhir.us.carin-bb_2.0.0,56,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#exchange-security,Implementers of this Implementation Guide SHOULD support SMART on FHIR Authorization best practices Transport Security section.,SHOULD,Health Plan/Consumer,,false,,,,
53
+ hl7.fhir.us.carin-bb_2.0.0,57,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Implementations SHALL support the FHIR US Core [Patient Privacy and Security requirements](https://www.hl7.org/fhir/us/core/security.html),SHALL,Health Plan,hl7.fhir.us.core_7.0.0,false,NA,NA,,
54
+ hl7.fhir.us.carin-bb_2.0.0,58,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server systems SHALL publish their authorization and token endpoints for discovery in accordance with the SMART App Launch framework and publicly publish the Well-Known Uniform Resource Identifiers (URIs) JSON file with scopes defined in the scopes_supported property.,SHALL,Health Plan,,false,NA,NA,1.1,c4bb_v200-c4bb_v200_smart_launch-smart_discovery
55
+ hl7.fhir.us.carin-bb_2.0.0,59,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Implementations SHOULD consider the SMART on FHIR Best Practices in Authorization found [here](https://docs.smarthealthit.org/authorization/best-practices/).,SHOULD,Health Plan/Consumer,,false,Not Tested,Not Tested,Not Tested,Not Tested
121
56
  hl7.fhir.us.carin-bb_2.0.0,60,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,"Server implementation SHALL support the following [“SMART Core Capabilities”](http://hl7.org/fhir/smart-app-launch/conformance/index.html#core-capabilities)...
122
57
 
123
- `launch-standalone`: support for SMART’s Standalone Launch mode",SHALL,Health Plan,,false,NA,NA
58
+ `launch-standalone`: support for SMART’s Standalone Launch mode",SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
124
59
  hl7.fhir.us.carin-bb_2.0.0,61,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,"Server implementation SHALL support the following [“SMART Core Capabilities”](http://hl7.org/fhir/smart-app-launch/conformance/index.html#core-capabilities)…
125
60
 
126
- `client-public`: support for SMART’s public Consumer profile (no Consumer authentication)",SHALL,Health Plan,,false,NA,NA
61
+ `client-public`: support for SMART’s public Consumer profile (no Consumer authentication)",SHALL,Health Plan,,false,NA,NA,,
127
62
  hl7.fhir.us.carin-bb_2.0.0,62,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,"Server implementation SHALL support the following “SMART Core Capabilities”
128
63
  ...
129
- client-confidential-symmetric: support for SMART’s confidential client profile",SHALL,Health Plan,,false,NA,NA
64
+ client-confidential-symmetric: support for SMART’s confidential client profile",SHALL,Health Plan,,false,NA,NA,,
130
65
  hl7.fhir.us.carin-bb_2.0.0,63,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,"Server implementation SHALL support the following [“SMART Core Capabilities”](http://hl7.org/fhir/smart-app-launch/conformance/index.html#core-capabilities)...
131
66
 
132
- `sso-openid-connect`: support for SMART’s OpenID Connect profile",SHALL,Health Plan,,false,NA,NA
67
+ `sso-openid-connect`: support for SMART’s OpenID Connect profile",SHALL,Health Plan,,false,NA,NA,,
133
68
  hl7.fhir.us.carin-bb_2.0.0,64,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,"Server implementation SHALL support the following [“SMART Core Capabilities”](http://hl7.org/fhir/smart-app-launch/conformance/index.html#core-capabilities)...
134
69
 
135
- `context-standalone-patient`: support for patient-level launch context (requested by launch/patient scope, conveyed via patient token parameter)",SHALL,Health Plan,,false,NA,NA
70
+ `context-standalone-patient`: support for patient-level launch context (requested by launch/patient scope, conveyed via patient token parameter)",SHALL,Health Plan,,false,NA,NA,,
136
71
  hl7.fhir.us.carin-bb_2.0.0,65,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,"Server implementation SHALL support the following [“SMART Core Capabilities”](http://hl7.org/fhir/smart-app-launch/conformance/index.html#core-capabilities)…
137
72
 
138
- `permission-offline`: support for refresh tokens (requested by offline_access scope)",SHALL,Health Plan,,false,NA,NA
73
+ `permission-offline`: support for refresh tokens (requested by offline_access scope)",SHALL,Health Plan,,false,NA,NA,,
139
74
  hl7.fhir.us.carin-bb_2.0.0,66,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,"Server implementation SHALL support the following [“SMART Core Capabilities”](http://hl7.org/fhir/smart-app-launch/conformance/index.html#core-capabilities)…
140
75
 
141
- `permission-patient`: support for patient-level scopes (e.g. patient Observation.read)",SHALL,Health Plan,,false,NA,NA
76
+ `permission-patient`: support for patient-level scopes (e.g. patient Observation.read)",SHALL,Health Plan,,false,NA,NA,,
142
77
  hl7.fhir.us.carin-bb_2.0.0,67,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,"Server implementation SHALL support the following [“SMART Core Capabilities”](http://hl7.org/fhir/smart-app-launch/conformance/index.html#core-capabilities)…
143
78
 
144
- `permission-user`: support for user-level scopes (e.g. user/Appointment.read)",SHALL,Health Plan,,false,NA,NA
145
- hl7.fhir.us.carin-bb_2.0.0,68,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … openid,SHALL,Health Plan,,false,NA,NA
146
- hl7.fhir.us.carin-bb_2.0.0,69,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … fhirUser,SHALL,Health Plan,,false,NA,NA
147
- hl7.fhir.us.carin-bb_2.0.0,70,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … launch/patient,SHALL,Health Plan,,false,NA,NA
148
- hl7.fhir.us.carin-bb_2.0.0,71,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … patient/ExplanationOfBenefit.read,SHALL,Health Plan,,false,NA,NA
149
- hl7.fhir.us.carin-bb_2.0.0,72,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … patient/Coverage.read,SHALL,Health Plan,,false,NA,NA
150
- hl7.fhir.us.carin-bb_2.0.0,73,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … patient/Patient.read,SHALL,Health Plan,,false,NA,NA
151
- hl7.fhir.us.carin-bb_2.0.0,74,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … patient/Organization.read,SHALL,Health Plan,,false,NA,NA
152
- hl7.fhir.us.carin-bb_2.0.0,75,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … patient/Practitioner.read,SHALL,Health Plan,,false,NA,NA
153
- hl7.fhir.us.carin-bb_2.0.0,76,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … patient/Coverage.read,SHALL,Health Plan,,false,NA,NA
154
- hl7.fhir.us.carin-bb_2.0.0,77,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … user/ExplanationOfBenefit.read,SHALL,Health Plan,,false,NA,NA
155
- hl7.fhir.us.carin-bb_2.0.0,78,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … user/Coverage.read,SHALL,Health Plan,,false,NA,NA
156
- hl7.fhir.us.carin-bb_2.0.0,79,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … user/Patient.read,SHALL,Health Plan,,false,NA,NA
157
- hl7.fhir.us.carin-bb_2.0.0,80,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … user/Organization.read,SHALL,Health Plan,,false,NA,NA
158
- hl7.fhir.us.carin-bb_2.0.0,81,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … user/Practitioner.read,SHALL,Health Plan,,false,NA,NA
159
- hl7.fhir.us.carin-bb_2.0.0,82,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,"MAY support the [Security for Scalable Registration, Authentication, and Authorization 0.1.0](http://hl7.org/fhir/us/udap-security/2021Sep/) or later for registration of client applications and (authentication and authorization of client applications or users)",MAY,Health Plan,,false,NA,NA
160
- hl7.fhir.us.carin-bb_2.0.0,83,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements," If UDAP is supported, then all Server systems and Client applications that can protect private cryptographic keys and all systems of record SHOULD support UDAP JWT-Based Consumer Authentication for the authentication of client applications using asymmetric cryptography.",SHOULD,Health Plan/Consumer,,true,,
161
- hl7.fhir.us.carin-bb_2.0.0,84,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html,Relevant audit and provenance events SHALL be recorded.,SHALL,Health Plan,,false,NA,NA
162
- hl7.fhir.us.carin-bb_2.0.0,85,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#audit-logging-and-provenance,Server implementations SHOULD record IG related data access using the [AuditEvent](http://hl7.org/fhir/R4/auditevent.html) resource.,SHOULD,Health Plan,,false,NA,NA
163
- hl7.fhir.us.carin-bb_2.0.0,86,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#audit-logging-and-provenance,Server implementations SHOULD support the ability to directly record and/or enable Clients to assert (store) provenance associated with advance directive information using the [Provenance](http://hl7.org/fhir/R4/provenance.html) resource.,SHOULD,Health Plan,,false,NA,NA
164
- hl7.fhir.us.carin-bb_2.0.0,87,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#root,"The Coverage Reference Resource SHALL be returned with data that was effective as of the date of service of the claim; for example, the data will reflect the employer name in effect at that time. ",SHALL,Health Plan,,false,NA,NA
165
- hl7.fhir.us.carin-bb_2.0.0,88,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#root,"However, for other reference resources [than Coverage Reference Resource], payers MAY decide to provide either the data that was in effect as of the date of service or the current data. ",MAY,Health Plan,,false,NA,NA
166
- hl7.fhir.us.carin-bb_2.0.0,89,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#root,"Payers SHALL provide the last time the data was updated or the date of creation in the payers system of record, whichever comes last.",SHALL,Health Plan,,false,NA,NA
167
- hl7.fhir.us.carin-bb_2.0.0,90,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#root,Apps will use the meta.lastUpdated values to determine if the reference resources are as of the current date or date of service.,SHALL,Consumer,,false,,
168
- hl7.fhir.us.carin-bb_2.0.0,91,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#title,"The Coverage Reference Resource SHALL be returned with data that was effective as of the date of service of the claim; for example, the data will reflect the employer name in effect at that time. ",SHALL,Health Plan,,false,NA,NA
169
- hl7.fhir.us.carin-bb_2.0.0,92,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#title,"However, for other reference resources [than Coverage Reference Resource], payers MAY decide to provide either the data that was in effect as of the date of service or the current data. ",MAY,Health Plan,,false,NA,NA
170
- hl7.fhir.us.carin-bb_2.0.0,93,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#title,"Payers SHALL provide the last time the data was updated or the date of creation in the payers system of record, whichever comes last.",SHALL,Health Plan,,false,NA,NA
171
- hl7.fhir.us.carin-bb_2.0.0,94,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#title,Apps will use the meta.lastUpdated values to determine if the reference resources are as of the current date or date of service.,SHALL,Consumer,,false,Not Tested,Not Tested
172
- hl7.fhir.us.carin-bb_2.0.0,95,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,The C4BB Server SHALL: … Support all profiles defined in this Implementation Guide.,SHALL,Health Plan,,false,NA,NA
173
- hl7.fhir.us.carin-bb_2.0.0,96,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,The C4BB Server SHALL: … Implement the RESTful behavior according to the FHIR specification.,SHALL,Health Plan,,false,NA,NA
79
+ `permission-user`: support for user-level scopes (e.g. user/Appointment.read)",SHALL,Health Plan,,false,NA,NA,,
80
+ hl7.fhir.us.carin-bb_2.0.0,68,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … openid,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
81
+ hl7.fhir.us.carin-bb_2.0.0,69,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … fhirUser,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
82
+ hl7.fhir.us.carin-bb_2.0.0,70,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … launch/patient,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
83
+ hl7.fhir.us.carin-bb_2.0.0,71,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … patient/ExplanationOfBenefit.read,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
84
+ hl7.fhir.us.carin-bb_2.0.0,72,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … patient/Coverage.read,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
85
+ hl7.fhir.us.carin-bb_2.0.0,73,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … patient/Patient.read,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
86
+ hl7.fhir.us.carin-bb_2.0.0,74,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … patient/Organization.read,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
87
+ hl7.fhir.us.carin-bb_2.0.0,75,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … patient/Practitioner.read,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
88
+ hl7.fhir.us.carin-bb_2.0.0,76,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … patient/Coverage.read,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
89
+ hl7.fhir.us.carin-bb_2.0.0,77,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … user/ExplanationOfBenefit.read,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
90
+ hl7.fhir.us.carin-bb_2.0.0,78,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … user/Coverage.read,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
91
+ hl7.fhir.us.carin-bb_2.0.0,79,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … user/Patient.read,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
92
+ hl7.fhir.us.carin-bb_2.0.0,80,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … user/Organization.read,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
93
+ hl7.fhir.us.carin-bb_2.0.0,81,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,Server implementations of this Implementation Guide SHALL support … the requested authorization scopes: … user/Practitioner.read,SHALL,Health Plan,,false,NA,NA,1.2,c4bb_v200-c4bb_v200_smart_launch-smart_standalone_launch
94
+ hl7.fhir.us.carin-bb_2.0.0,82,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,"MAY support the [Security for Scalable Registration, Authentication, and Authorization 0.1.0](http://hl7.org/fhir/us/udap-security/2021Sep/) or later for registration of client applications and (authentication and authorization of client applications or users)",MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
95
+ hl7.fhir.us.carin-bb_2.0.0,83,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#authentication-and-authorization-requirements,"If UDAP is supported, then all Server systems and Client applications that can protect private cryptographic keys and all systems of record SHOULD support UDAP JWT-Based Consumer Authentication for the authentication of client applications using asymmetric cryptography.",SHOULD,Health Plan/Consumer,,true,,,,
96
+ hl7.fhir.us.carin-bb_2.0.0,84,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#audit-logging-and-provenance,Relevant audit and provenance events SHALL be recorded.,SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
97
+ hl7.fhir.us.carin-bb_2.0.0,85,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#audit-logging-and-provenance,Server implementations SHOULD record IG related data access using the [AuditEvent](http://hl7.org/fhir/R4/auditevent.html) resource.,SHOULD,Health Plan,,false,NA,NA,Not Tested,Not Tested
98
+ hl7.fhir.us.carin-bb_2.0.0,86,http://hl7.org/fhir/us/carin-bb/STU2/Security_And_Privacy_Considerations.html#audit-logging-and-provenance,Server implementations SHOULD support the ability to directly record and/or enable Clients to assert (store) provenance associated with advance directive information using the [Provenance](http://hl7.org/fhir/R4/provenance.html) resource.,SHOULD,Health Plan,,false,NA,NA,,
99
+ hl7.fhir.us.carin-bb_2.0.0,87,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#root,"The Coverage Reference Resource SHALL be returned with data that was effective as of the date of service of the claim; for example, the data will reflect the employer name in effect at that time.",SHALL,Health Plan,,false,NA,NA,,
100
+ hl7.fhir.us.carin-bb_2.0.0,88,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#root,"However, for other reference resources [than Coverage Reference Resource], payers MAY decide to provide either the data that was in effect as of the date of service or the current data.",MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
101
+ hl7.fhir.us.carin-bb_2.0.0,89,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#root,"Payers SHALL provide the last time the data was updated or the date of creation in the payers system of record, whichever comes last.",SHALL,Health Plan,,false,NA,NA,,
102
+ hl7.fhir.us.carin-bb_2.0.0,90,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#root,Apps will use the meta.lastUpdated values to determine if the reference resources are as of the current date or date of service.,SHALL,Consumer,,false,,,NA,NA
103
+ hl7.fhir.us.carin-bb_2.0.0,91,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#title,"The Coverage Reference Resource SHALL be returned with data that was effective as of the date of service of the claim; for example, the data will reflect the employer name in effect at that time.",SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
104
+ hl7.fhir.us.carin-bb_2.0.0,92,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#title,"However, for other reference resources [than Coverage Reference Resource], payers MAY decide to provide either the data that was in effect as of the date of service or the current data.",MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
105
+ hl7.fhir.us.carin-bb_2.0.0,93,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#title,"Payers SHALL provide the last time the data was updated or the date of creation in the payers system of record, whichever comes last.",SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
106
+ hl7.fhir.us.carin-bb_2.0.0,94,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#title,Apps will use the meta.lastUpdated values to determine if the reference resources are as of the current date or date of service.,SHALL,Consumer,,false,Not Tested,Not Tested,NA,NA
107
+ hl7.fhir.us.carin-bb_2.0.0,95,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,The C4BB Server SHALL: … Support all profiles defined in this Implementation Guide.,SHALL,Health Plan,,false,NA,NA,"2.2, 2.3, 2.4, 2.5, 2.6, 2.7","c4bb_v200-Group02-c4bb_v200_patient, c4bb_v200-Group02-c4bb_v200_eob, c4bb_v200-Group02-c4bb_v200_coverage, c4bb_v200-Group02-c4bb_v200_organization, c4bb_v200-Group02-c4bb_v200_practitioner, c4bb_v200-Group02-c4bb_v200_related_person"
108
+ hl7.fhir.us.carin-bb_2.0.0,96,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,The C4BB Server SHALL: … Implement the RESTful behavior according to the FHIR specification.,SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
174
109
  hl7.fhir.us.carin-bb_2.0.0,97,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,"The C4BB Server SHALL: … Return the following response classes:
175
110
  - (Status 400): invalid parameter
176
111
  - (Status 401/4xx): unauthorized request
177
112
  - (Status 403): insufficient scope
178
113
  - (Status 404): unknown resource
179
- - (Status 410): deleted resource.",SHALL,Health Plan,,false,NA,NA
180
- hl7.fhir.us.carin-bb_2.0.0,98,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,The C4BB Server SHALL: … Support json source formats for all CARIN-BB interactions.,SHALL,Health Plan,,false,NA,NA
181
- hl7.fhir.us.carin-bb_2.0.0,99,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,The C4BB Server SHALL: … Identify the CARIN-BB profiles supported as part of the FHIR meta.profile attribute for each instance.,SHALL,Health Plan,,false,NA,NA
182
- hl7.fhir.us.carin-bb_2.0.0,100,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,The C4BB Server SHALL: … Support the searchParameters on each profile individually and in combination.,SHALL,Health Plan,,false,NA,NA
183
- hl7.fhir.us.carin-bb_2.0.0,101,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,The C4BB Server SHOULD: Support xml source formats for all C4BB interactions.,SHOULD,Health Plan,,false,NA,NA
184
- hl7.fhir.us.carin-bb_2.0.0,102,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,"A Server SHALL reject any unauthorized requests by returning an HTTP 401 ""Unauthorized"", HTTP 403 ""Forbidden"", or HTTP 404 ""Not Found"" .",SHALL,Health Plan,,false,NA,NA
185
- hl7.fhir.us.carin-bb_2.0.0,103,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,Explanation of Benefits: Conformance Expectation SHALL,SHALL,Health Plan,,false,NA,NA
186
- hl7.fhir.us.carin-bb_2.0.0,104,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,"When an EOB references another resource (e.g., Patient or Practitioner), the reference may be versioned or versionless.",MAY,Health Plan,,false,NA,NA
187
- hl7.fhir.us.carin-bb_2.0.0,105,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,"Payers SHALL use versioned references whenever they maintain point-in-time data (data that was effective as of the date of service or date of admission on the claim), ",SHALL,Health Plan,,false,NA,NA
188
- hl7.fhir.us.carin-bb_2.0.0,106,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,Payers... MAY use versionless references when they do not maintain versioned data.,MAY,Health Plan,,false,NA,NA
189
- hl7.fhir.us.carin-bb_2.0.0,107,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,Clients MAY request referenced resources as part of an EOB search (by supplying the _include parameter) or directly using read or vread.,MAY,Consumer,,false,Not Tested,Not Tested
190
- hl7.fhir.us.carin-bb_2.0.0,108,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,"Payers SHALL support both approaches, and SHALL return the same content for referenced resources in either case. ",SHALL,Health Plan,,false,NA,NA
191
- hl7.fhir.us.carin-bb_2.0.0,109,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,"“:iterate"" should be used if you request to include Coverage:payor in the EOB response bundle, e.g. GET [base]/ExplanationOfBenefit?_id[parameter=value]&_include=ExplanationOfBenefit:coverage&_include:iterate=Coverage:payor.",SHOULD,Consumer,,false,,
192
- hl7.fhir.us.carin-bb_2.0.0,110,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#root,"All EOB instances should be from one of the four concrete EOB profiles defined in this Implementation Guide: Inpatient, Outpatient, Pharmacy, and Professional/NonClinician",SHOULD,Health Plan,,false,NA,NA
193
- hl7.fhir.us.carin-bb_2.0.0,111,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#other-payer,CPCDS modified the concept of primary payer to other payer to accommodate situations when multiple prior payers are involved. Each amount paid by the other payer should be listed separately.,SHOULD,Health Plan,,false,NA,NA
194
- hl7.fhir.us.carin-bb_2.0.0,112,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html,".meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last.",SHALL,Health Plan,,false,NA,NA
195
- hl7.fhir.us.carin-bb_2.0.0,113,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".status: value =Expected values are active or cancelled. To comply with the CMS rule, draft EOBs are not required. ",SHOULD,Health Plan,,false,NA,NA
196
- hl7.fhir.us.carin-bb_2.0.0,114,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,.type Defines the Claims profiles. Values from Claim Type Codes are required; ,SHALL,Health Plan,,false,NA,NA
197
- hl7.fhir.us.carin-bb_2.0.0,115,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,.type Defines the Claims profiles…. .type SHALL NOT use a data absent reason.,SHALL NOT,Health Plan,,false,NA,NA
198
- hl7.fhir.us.carin-bb_2.0.0,116,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,.insurer Same as insurance.coverage.organization. Party responsible for reimbursing the provider,SHALL,Health Plan,,false,NA,NA
199
- hl7.fhir.us.carin-bb_2.0.0,117,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,.outcome: value = complete,SHALL,Health Plan,,false,NA,NA
200
- hl7.fhir.us.carin-bb_2.0.0,118,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields," .related:
201
-
202
- If the current adjusts a prior ExplanationOfBenefit, .related.reference = the prior ExplanationOfBenefit identifier and related.relationship value = 'prior'.",SHALL,Health Plan,,true,NA,NA
114
+ - (Status 410): deleted resource.",SHALL,Health Plan,,false,NA,NA,,
115
+ hl7.fhir.us.carin-bb_2.0.0,98,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,The C4BB Server SHALL: … Support json source formats for all CARIN-BB interactions.,SHALL,Health Plan,,false,NA,NA,2.1.03,c4bb_v200-Group02-capability_statement_group-carin_bb_json_support
116
+ hl7.fhir.us.carin-bb_2.0.0,99,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,The C4BB Server SHALL: … Identify the CARIN-BB profiles supported as part of the FHIR meta.profile attribute for each instance.,SHALL,Health Plan,,false,NA,NA,,
117
+ hl7.fhir.us.carin-bb_2.0.0,100,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,The C4BB Server SHALL: … Support the searchParameters on each profile individually and in combination.,SHALL,Health Plan,,false,NA,NA,"2.2.01, 2.2.02, 2.3.01, 2.3.02, 2.3.03, 2.3.04, 2.3.05, 2.3.06, 2.3.07, 2.3.08, 2.4.01, 2.4.02, 2.5.01, 2.5.02, 2.6.01, 2.6.02, 2.7.01, 2.7.02","c4bb_v200-Group02-c4bb_v200_patient-c4bb_v200_patient__id_search_test, c4bb_v200-Group02-c4bb_v200_patient-c4bb_v200_patient__lastUpdated_search_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_patient_search_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob__id_search_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob__lastUpdated_search_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_type_search_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_identifier_search_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_service_date_search_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_service_start_date_search_test, c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_billable_period_start_search_test, c4bb_v200-Group02-c4bb_v200_coverage-c4bb_v200_coverage__id_search_test, c4bb_v200-Group02-c4bb_v200_coverage-c4bb_v200_coverage__lastUpdated_search_test, c4bb_v200-Group02-c4bb_v200_organization-c4bb_v200_organization__id_search_test, c4bb_v200-Group02-c4bb_v200_organization-c4bb_v200_organization__lastUpdated_search_test, c4bb_v200-Group02-c4bb_v200_practitioner-c4bb_v200_practitioner__id_search_test, c4bb_v200-Group02-c4bb_v200_practitioner-c4bb_v200_practitioner__lastUpdated_search_test, c4bb_v200-Group02-c4bb_v200_related_person-c4bb_v200_related_person__id_search_test, c4bb_v200-Group02-c4bb_v200_related_person-c4bb_v200_related_person__lastUpdated_search_test"
118
+ hl7.fhir.us.carin-bb_2.0.0,101,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,The C4BB Server SHOULD: Support xml source formats for all C4BB interactions.,SHOULD,Health Plan,,false,NA,NA,,
119
+ hl7.fhir.us.carin-bb_2.0.0,102,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#behavior,"A Server SHALL reject any unauthorized requests by returning an HTTP 401 ""Unauthorized"", HTTP 403 ""Forbidden"", or HTTP 404 ""Not Found"" .",SHALL,Health Plan,,false,NA,NA,,
120
+ hl7.fhir.us.carin-bb_2.0.0,103,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,Explanation of Benefits: Conformance Expectation SHALL,SHALL,Health Plan,,false,NA,NA,2.3,c4bb_v200-Group02-c4bb_v200_eob
121
+ hl7.fhir.us.carin-bb_2.0.0,104,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,"When an EOB references another resource (e.g., Patient or Practitioner), the reference may be versioned or versionless.",MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
122
+ hl7.fhir.us.carin-bb_2.0.0,105,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,"Payers SHALL use versioned references whenever they maintain point-in-time data (data that was effective as of the date of service or date of admission on the claim),",SHALL,Health Plan,,false,NA,NA,,
123
+ hl7.fhir.us.carin-bb_2.0.0,106,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,Payers... MAY use versionless references when they do not maintain versioned data.,MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
124
+ hl7.fhir.us.carin-bb_2.0.0,107,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,Clients MAY request referenced resources as part of an EOB search (by supplying the _include parameter) or directly using read or vread.,MAY,Consumer,,false,Not Tested,Not Tested,NA,NA
125
+ hl7.fhir.us.carin-bb_2.0.0,108,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,"Payers SHALL support both approaches, and SHALL return the same content for referenced resources in either case.",SHALL,Health Plan,,false,NA,NA,,
126
+ hl7.fhir.us.carin-bb_2.0.0,109,http://hl7.org/fhir/us/carin-bb/STU2/CapabilityStatement-c4bb.html#explanationofbenefit,"“:iterate"" should be used if you request to include Coverage:payor in the EOB response bundle, e.g. GET [base]/ExplanationOfBenefit?_id[parameter=value]&_include=ExplanationOfBenefit:coverage&_include:iterate=Coverage:payor.",SHOULD,Consumer,,false,,,NA,NA
127
+ hl7.fhir.us.carin-bb_2.0.0,110,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#root,"All EOB instances should be from one of the four concrete EOB profiles defined in this Implementation Guide: Inpatient, Outpatient, Pharmacy, and Professional/NonClinician",SHOULD,Health Plan,,false,NA,NA,,
128
+ hl7.fhir.us.carin-bb_2.0.0,111,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#other-payer,CPCDS modified the concept of primary payer to other payer to accommodate situations when multiple prior payers are involved. Each amount paid by the other payer should be listed separately.,SHOULD,Health Plan,,false,NA,NA,,
129
+ hl7.fhir.us.carin-bb_2.0.0,112,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last.",SHALL,Health Plan,,false,NA,NA,2.3.17,c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_validation_test
130
+ hl7.fhir.us.carin-bb_2.0.0,113,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".status: value =Expected values are active or cancelled. To comply with the CMS rule, draft EOBs are not required.",SHOULD,Health Plan,,false,NA,NA,,
131
+ hl7.fhir.us.carin-bb_2.0.0,114,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,.type Defines the Claims profiles. Values from Claim Type Codes are required;,SHALL,Health Plan,,false,NA,NA,2.3.17,c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_validation_test
132
+ hl7.fhir.us.carin-bb_2.0.0,115,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,.type Defines the Claims profiles…. .type SHALL NOT use a data absent reason.,SHALL NOT,Health Plan,,false,NA,NA,,
133
+ hl7.fhir.us.carin-bb_2.0.0,116,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,.insurer Same as insurance.coverage.organization. Party responsible for reimbursing the provider,SHALL,Health Plan,,false,NA,NA,,
134
+ hl7.fhir.us.carin-bb_2.0.0,117,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,.outcome: value = complete,SHALL,Health Plan,,false,NA,NA,,
135
+ hl7.fhir.us.carin-bb_2.0.0,118,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".related:
136
+
137
+ If the current adjusts a prior ExplanationOfBenefit, .related.reference = the prior ExplanationOfBenefit identifier and related.relationship value = 'prior'.",SHALL,Health Plan,,true,NA,NA,Not Tested,Not Tested
203
138
  hl7.fhir.us.carin-bb_2.0.0,119,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".related:
204
139
 
205
- If the current ExplanationOfBenefit has been adjusted; related.reference = the ExplanationOfBenefit.identifier of the adjusting ExplanationOfBenefit and related.relationship value = 'replacedby'. ",SHALL,Health Plan,,true,NA,NA
140
+ If the current ExplanationOfBenefit has been adjusted; related.reference = the ExplanationOfBenefit.identifier of the adjusting ExplanationOfBenefit and related.relationship value = 'replacedby'.",SHALL,Health Plan,,true,NA,NA,Not Tested,Not Tested
206
141
  hl7.fhir.us.carin-bb_2.0.0,120,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".related:
207
142
 
208
- The .related.reference contains the identifier of the immediately preceding or following ExplanationOfBenefit, not the first or last.",SHALL,Health Plan,,false,NA,NA
209
- hl7.fhir.us.carin-bb_2.0.0,121,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,.supportinginfo.sequence rule: client app implementations should look-up supportingInfo elements based on category values instead of sequence values,SHOULD,Consumer,,false,Not Tested,Not Tested
143
+ The .related.reference contains the identifier of the immediately preceding or following ExplanationOfBenefit, not the first or last.",SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
144
+ hl7.fhir.us.carin-bb_2.0.0,121,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,.supportinginfo.sequence rule: client app implementations should look-up supportingInfo elements based on category values instead of sequence values,SHOULD,Consumer,,false,Not Tested,Not Tested,NA,NA
210
145
  hl7.fhir.us.carin-bb_2.0.0,122,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".careTeam.sequence rule:
211
146
 
212
- Client app implementations SHOULD NOT assign any significance to the sequence values. ",SHOULD NOT,Consumer,,false,Not Tested,Not Tested
147
+ Client app implementations SHOULD NOT assign any significance to the sequence values.",SHOULD NOT,Consumer,,false,Not Tested,Not Tested,NA,NA
213
148
  hl7.fhir.us.carin-bb_2.0.0,123,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".insurance:
214
149
 
215
- ExplanationOfBenefit.insurer MAY have a boolean value = 'True'",MAY,Health Plan,,false,NA,NA
150
+ ExplanationOfBenefit.insurer MAY have a boolean value = 'True'",MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
216
151
  hl7.fhir.us.carin-bb_2.0.0,124,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".insurance:
217
152
 
218
- .insurance occurring other than ExplanationOfBenefit.insurer SHALL NOT have a boolean value = 'True'",SHALL NOT,Health Plan,,false,NA,NA
153
+ .insurance occurring other than ExplanationOfBenefit.insurer SHALL NOT have a boolean value = 'True'",SHALL NOT,Health Plan,,false,NA,NA,,
219
154
  hl7.fhir.us.carin-bb_2.0.0,125,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".insurance.focal:
220
155
 
221
- If there is an occurrence, with focal = true, EOB.insurance.coverage.payor = EOB.insurer",SHALL,Health Plan,,true,NA,NA
156
+ If there is an occurrence, with focal = true, EOB.insurance.coverage.payor = EOB.insurer",SHALL,Health Plan,,true,NA,NA,,
222
157
  hl7.fhir.us.carin-bb_2.0.0,126,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".insurance.focal:
223
158
 
224
- There can be 0 or * occurrences with focal = false",MAY,Health Plan,,false,NA,NA
159
+ There can be 0 or * occurrences with focal = false",MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
225
160
  hl7.fhir.us.carin-bb_2.0.0,127,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".insurance.coverage:
226
161
 
227
- When focal = true, Coverage.payer--> Organization.identifier.",SHALL,Health Plan,,true,NA,NA
162
+ When focal = true, Coverage.payer--> Organization.identifier.",SHALL,Health Plan,,true,NA,NA,,
228
163
  hl7.fhir.us.carin-bb_2.0.0,128,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,".insurance.coverage:
229
164
 
230
- When focal = false, EOB.insurance.coverage.display = [name of other carrier] ",SHALL,Health Plan,,true,NA,NA
231
- hl7.fhir.us.carin-bb_2.0.0,129,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,insurance.coverage: Same as insurance.coverage.organization.,SHALL,Health Plan,,false,NA,NA
165
+ When focal = false, EOB.insurance.coverage.display = [name of other carrier]",SHALL,Health Plan,,true,NA,NA,,
166
+ hl7.fhir.us.carin-bb_2.0.0,129,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit.html#notes-on-fields,insurance.coverage: Same as insurance.coverage.organization.,SHALL,Health Plan,,false,NA,NA,,
232
167
  hl7.fhir.us.carin-bb_2.0.0,130,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,"CPCDS data elements
233
168
 
234
- If a Payer does not have line item amounts, provide the claim amounts and amount types in the EOB header data elements.",SHALL,Health Plan,,true,NA,NA
169
+ If a Payer does not have line item amounts, provide the claim amounts and amount types in the EOB header data elements.",SHALL,Health Plan,,true,NA,NA,Not Tested,Not Tested
235
170
  hl7.fhir.us.carin-bb_2.0.0,131,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,"CPCDS data elements
236
171
 
237
- Total amounts and amount types of the claim are to be provided in EOB.total.",SHALL,Health Plan,,false,NA,NA
172
+ Total amounts and amount types of the claim are to be provided in EOB.total.",SHALL,Health Plan,,false,NA,NA,2.3.17,c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_validation_test
238
173
  hl7.fhir.us.carin-bb_2.0.0,132,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,"CPCDS data elements
239
174
 
240
- The in network or out of network payment status of the claim are to be provided in EOB.supportingInfo.",SHALL,Health Plan,,false,NA,NA
175
+ The in network or out of network payment status of the claim are to be provided in EOB.supportingInfo.",SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
241
176
  hl7.fhir.us.carin-bb_2.0.0,133,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,"A CPT / HCPCS code may not be available
242
177
 
243
- The cardinality of the HL7 base EOB Resource for item.productOrService is 1..1 if .item is provided.",SHALL,Health Plan,,false,NA,NA
178
+ The cardinality of the HL7 base EOB Resource for item.productOrService is 1..1 if .item is provided.",SHALL,Health Plan,,false,NA,NA,2.3.19,c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_inpatient_institutional_validation_test
244
179
  hl7.fhir.us.carin-bb_2.0.0,134,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,"A CPT / HCPCS code may not be available
245
180
 
246
- item.productOrService must be populated. ",SHALL,Health Plan,,false,NA,NA
181
+ item.productOrService must be populated.",SHALL,Health Plan,,false,NA,NA,2.3.19,c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_inpatient_institutional_validation_test
247
182
  hl7.fhir.us.carin-bb_2.0.0,135,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,"A CPT / HCPCS code may not be available
248
183
 
249
- it is recommended payers provide a data absent reason when a CPT / HCPCS code is not available.",SHOULD,Health Plan,,false,NA,NA
250
- hl7.fhir.us.carin-bb_2.0.0,136,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,.diagnosis: ICD-10 / ICD-9 diagnosis codes are defined as CodeableConcepts,SHALL,Health Plan,,false,NA,NA
184
+ it is recommended payers provide a data absent reason when a CPT / HCPCS code is not available.",SHOULD,Health Plan,,false,NA,NA,,
185
+ hl7.fhir.us.carin-bb_2.0.0,136,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,.diagnosis: ICD-10 / ICD-9 diagnosis codes are defined as CodeableConcepts,SHALL,Health Plan,,false,NA,NA,2.3.19,c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_inpatient_institutional_validation_test
251
186
  hl7.fhir.us.carin-bb_2.0.0,137,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,".diagnosis.sequence rule:
252
187
 
253
- Client app implementations should not assign any significance to the sequence values.",SHOULD NOT,Consumer,,false,Not Tested,Not Tested
188
+ Client app implementations should not assign any significance to the sequence values.",SHOULD NOT,Consumer,,false,Not Tested,Not Tested,NA,NA
254
189
  hl7.fhir.us.carin-bb_2.0.0,138,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,".diagnosis.sequence rule:
255
190
 
256
- Client app implementations should use the values of diagnosis.type to identify primary, secondary, etc. ",SHOULD,Consumer,,false,Not Tested,Not Tested
191
+ Client app implementations should use the values of diagnosis.type to identify primary, secondary, etc.",SHOULD,Consumer,,false,Not Tested,Not Tested,NA,NA
257
192
  hl7.fhir.us.carin-bb_2.0.0,139,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,".procedure.sequence rule:
258
193
 
259
- Client app implementations should not assign any significance to the sequence values. ",SHOULD NOT,Consumer,,false,Not Tested,Not Tested
194
+ Client app implementations should not assign any significance to the sequence values.",SHOULD NOT,Consumer,,false,Not Tested,Not Tested,NA,NA
260
195
  hl7.fhir.us.carin-bb_2.0.0,140,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,".procedure.sequence rule:
261
196
 
262
- Client app implementations should use the values of procedure.type to identify primary and secondary procedures",SHOULD,Consumer,,false,Not Tested,Not Tested
263
- hl7.fhir.us.carin-bb_2.0.0,141,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,".supportingInfo[DRG]: DRGs require the DRG system; i.e., MS-DRG / AP-DRG / APR-DRG, the DRG version and the code value",SHALL,Health Plan,,false,NA,NA
264
- hl7.fhir.us.carin-bb_2.0.0,142,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,.adjudication.amount (populate only if item.adjudication is not available):,SHALL NOT,Health Plan,,true,NA,NA
265
- hl7.fhir.us.carin-bb_2.0.0,143,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,.total.amount: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA
197
+ Client app implementations should use the values of procedure.type to identify primary and secondary procedures",SHOULD,Consumer,,false,Not Tested,Not Tested,NA,NA
198
+ hl7.fhir.us.carin-bb_2.0.0,141,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,".supportingInfo[DRG]: DRGs require the DRG system; i.e., MS-DRG / AP-DRG / APR-DRG, the DRG version and the code value",SHALL,Health Plan,,false,NA,NA,2.3.19,c4bb_v200-Group02-c4bb_v200_eob-c4bb_v200_eob_inpatient_institutional_validation_test
199
+ hl7.fhir.us.carin-bb_2.0.0,142,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,.adjudication.amount (populate only if item.adjudication is not available):,SHALL NOT,Health Plan,,true,NA,NA,,
200
+ hl7.fhir.us.carin-bb_2.0.0,143,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,.total.amount: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
266
201
  hl7.fhir.us.carin-bb_2.0.0,144,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,"CPCDS data elements
267
202
 
268
- Line item amounts, amount types and the in network or out of network payment status of the line are to be provided in EOB.item. ",SHALL,Health Plan,,false,NA,NA
203
+ Line item amounts, amount types and the in network or out of network payment status of the line are to be provided in EOB.item.",SHALL,Health Plan,,false,NA,NA,,
269
204
  hl7.fhir.us.carin-bb_2.0.0,145,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,"CPCDS data elements
270
205
 
271
- Total amounts, amount types and the in network or out of network payment status of the claim are to be provided in EOB.total ",SHALL,Health Plan,,false,NA,NA
206
+ Total amounts, amount types and the in network or out of network payment status of the claim are to be provided in EOB.total",SHALL,Health Plan,,false,NA,NA,,
272
207
  hl7.fhir.us.carin-bb_2.0.0,146,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,"CPCDS data elements
273
208
 
274
- If there is a mix of lines paid in network and out of network on a claim, the value of C4BB Payer Benefit Payment Status is ‘Other’ ",SHALL,Health Plan,,true,NA,NA
275
- hl7.fhir.us.carin-bb_2.0.0,147,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,".diagnosis.sequence rule: diagnosis.sequence values do not necessarily indicate any order in which the diagnosis was reported or identified. Client app implementations should not assign any significance to the sequence values. Client app implementations should use the values of diagnosis.type to identify primary, secondary, etc. ",SHOULD NOT,Consumer,,false,Not Tested,Not Tested
276
- hl7.fhir.us.carin-bb_2.0.0,148,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,".supportingInfo[servicefacility]: Service Facility Location information conveys the name, full address and identifier of the facility where services were rendered when that is different from the Billing/Rendering Provider.",SHALL,Health Plan,,false,NA,NA
277
- hl7.fhir.us.carin-bb_2.0.0,149,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,.item. diagnosisSequence: References the sequence number of the associated diagnosis entered above,SHALL,Health Plan,,false,NA,NA
278
- hl7.fhir.us.carin-bb_2.0.0,150,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,.item.productOrService: CPT / HCPCS procedure codes are defined as CodeableConcepts: A revenue code will not be available on an oral claim,SHALL NOT,Health Plan,,false,NA,NA
279
- hl7.fhir.us.carin-bb_2.0.0,151,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,The line item primary body site (tooth or oral cavity) SHALL be specified in the .item.bodySite.,SHALL,Health Plan,,false,NA,NA
280
- hl7.fhir.us.carin-bb_2.0.0,152,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields, Additional body sites (tooth or oral cavity) SHALL be specified in supportingInfo[additionalbodysite] repetitions with supportingInfo[additionalbodysite].sequence matching the line items .item.informationSequence,SHALL,Health Plan,,false,NA,NA
281
- hl7.fhir.us.carin-bb_2.0.0,153,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,All Oral line item subsites (.item.subSite repetitions) apply to all the line item's associated tooth surfaces (item.bodySite and .supportingInfo[additionalbodysite] associated with the line item by referencing supportingInfo[additionalbodysite].sequence through .item.informationSequence),SHALL,Health Plan,,false,NA,NA
282
- hl7.fhir.us.carin-bb_2.0.0,154,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,.item.adjudication.amount: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA
283
- hl7.fhir.us.carin-bb_2.0.0,155,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,.total.amount: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA
284
- hl7.fhir.us.carin-bb_2.0.0,156,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.html#notes-on-fields,"CPCDS data elements are mapped to EOB header or EOB.item data elements in alignment with claims submission standards. ... If a Payer does not have line item amounts, provide the claim amounts and amount types in the EOB header data elements. ",SHALL,Health Plan,,false,NA,NA
285
- hl7.fhir.us.carin-bb_2.0.0,157,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.html#notes-on-fields,.item.productOrService: CPT / HCPCS procedure codes are defined as CodeableConcepts,SHALL,Health Plan,,false,NA,NA
209
+ If there is a mix of lines paid in network and out of network on a claim, the value of C4BB Payer Benefit Payment Status is ‘Other’",SHALL,Health Plan,,true,NA,NA,,
210
+ hl7.fhir.us.carin-bb_2.0.0,147,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,".diagnosis.sequence rule: diagnosis.sequence values do not necessarily indicate any order in which the diagnosis was reported or identified. Client app implementations should not assign any significance to the sequence values. Client app implementations should use the values of diagnosis.type to identify primary, secondary, etc.",SHOULD NOT,Consumer,,false,Not Tested,Not Tested,NA,NA
211
+ hl7.fhir.us.carin-bb_2.0.0,148,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,".supportingInfo[servicefacility]: Service Facility Location information conveys the name, full address and identifier of the facility where services were rendered when that is different from the Billing/Rendering Provider.",SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
212
+ hl7.fhir.us.carin-bb_2.0.0,149,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,.item. diagnosisSequence: References the sequence number of the associated diagnosis entered above,SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
213
+ hl7.fhir.us.carin-bb_2.0.0,150,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,.item.productOrService: CPT / HCPCS procedure codes are defined as CodeableConcepts: A revenue code will not be available on an oral claim,SHALL NOT,Health Plan,,false,NA,NA,,
214
+ hl7.fhir.us.carin-bb_2.0.0,151,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,The line item primary body site (tooth or oral cavity) SHALL be specified in the .item.bodySite.,SHALL,Health Plan,,false,NA,NA,,
215
+ hl7.fhir.us.carin-bb_2.0.0,152,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,Additional body sites (tooth or oral cavity) SHALL be specified in supportingInfo[additionalbodysite] repetitions with supportingInfo[additionalbodysite].sequence matching the line items .item.informationSequence,SHALL,Health Plan,,false,NA,NA,,
216
+ hl7.fhir.us.carin-bb_2.0.0,153,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,All Oral line item subsites (.item.subSite repetitions) apply to all the line item's associated tooth surfaces (item.bodySite and .supportingInfo[additionalbodysite] associated with the line item by referencing supportingInfo[additionalbodysite].sequence through .item.informationSequence),SHALL,Health Plan,,false,NA,NA,,
217
+ hl7.fhir.us.carin-bb_2.0.0,154,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,.item.adjudication.amount: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
218
+ hl7.fhir.us.carin-bb_2.0.0,155,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html#notes-on-fields,.total.amount: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
219
+ hl7.fhir.us.carin-bb_2.0.0,156,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.html#notes-on-fields,"CPCDS data elements are mapped to EOB header or EOB.item data elements in alignment with claims submission standards. ... If a Payer does not have line item amounts, provide the claim amounts and amount types in the EOB header data elements.",SHALL,Health Plan,,false,NA,NA,,
220
+ hl7.fhir.us.carin-bb_2.0.0,157,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.html#notes-on-fields,.item.productOrService: CPT / HCPCS procedure codes are defined as CodeableConcepts,SHALL,Health Plan,,false,NA,NA,,
286
221
  hl7.fhir.us.carin-bb_2.0.0,158,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.html#notes-on-fields,"A CPT / HCPCS or HIPPS code may not be available on an outpatient institutional claim.
287
222
 
288
- The cardinality of the HL7 base EOB Resource for item.productOrService is 1..1 if .item is provided.",SHALL,Health Plan,,false,NA,NA
223
+ The cardinality of the HL7 base EOB Resource for item.productOrService is 1..1 if .item is provided.",SHALL,Health Plan,,false,NA,NA,,
289
224
  hl7.fhir.us.carin-bb_2.0.0,159,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.html#notes-on-fields,"A CPT / HCPCS or HIPPS code may not be available on an outpatient institutional claim.
290
225
 
291
- item.productOrService must be populated. ",SHALL,Health Plan,,false,NA,NA
226
+ item.productOrService must be populated.",SHALL,Health Plan,,false,NA,NA,,
292
227
  hl7.fhir.us.carin-bb_2.0.0,160,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.html#notes-on-fields,"A CPT / HCPCS or HIPPS code may not be available on an outpatient institutional claim.
293
228
 
294
- it is recommended payers provide a data absent reason when a CPT / HCPCS or HIPPS code is not available.",SHOULD,Health Plan,,false,NA,NA
229
+ it is recommended payers provide a data absent reason when a CPT / HCPCS or HIPPS code is not available.",SHOULD,Health Plan,,false,NA,NA,,
295
230
  hl7.fhir.us.carin-bb_2.0.0,161,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Pharmacy.html,"ExplanationOfBenefit.item.productOrService:
296
231
 
297
- values are NDC Codes when Compound Code (MapID 78) = 0 or 1. ",SHALL,Health Plan,,true,NA,NA
232
+ values are NDC Codes when Compound Code (MapID 78) = 0 or 1.",SHALL,Health Plan,,true,NA,NA,,
298
233
  hl7.fhir.us.carin-bb_2.0.0,162,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Pharmacy.html,"ExplanationOfBenefit.item.productOrService:
299
234
 
300
- When the Compound Code = 2, productOrService = ""compound"" and map the ingredient to ExplanationOfBenefit.item.detail.productOrService",SHALL,Health Plan,,true,NA,NA
301
- hl7.fhir.us.carin-bb_2.0.0,163,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Pharmacy.html,ExplanationOfBenefit.item.productOrService and item.detail.productOrService: Payers shall provide an 11-digit NDC.,SHALL,Health Plan,,false,NA,NA
235
+ When the Compound Code = 2, productOrService = ""compound"" and map the ingredient to ExplanationOfBenefit.item.detail.productOrService",SHALL,Health Plan,,true,NA,NA,,
236
+ hl7.fhir.us.carin-bb_2.0.0,163,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Pharmacy.html,ExplanationOfBenefit.item.productOrService and item.detail.productOrService: Payers shall provide an 11-digit NDC.,SHALL,Health Plan,,false,NA,NA,,
302
237
  hl7.fhir.us.carin-bb_2.0.0,164,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Pharmacy.html,"ExplanationOfBenefit.item.quantity:
303
238
 
304
- populate for all Compound Code values.",SHALL,Health Plan,,false,NA,NA
239
+ populate for all Compound Code values.",SHALL,Health Plan,,false,NA,NA,,
305
240
  hl7.fhir.us.carin-bb_2.0.0,165,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Pharmacy.html,"ExplanationOfBenefit.item.quantity:
306
241
 
307
- When the Compound Code = 2, if available, map the ingredient to ExplanationOfBenefit.item.detail.quantity",SHALL,Health Plan,,true,NA,NA
308
- hl7.fhir.us.carin-bb_2.0.0,166,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,.diagnosis.sequence rule: diagnosis.sequence values do not necessarily indicate any order in which the diagnosis was reported or identified. Client app implementations should not assign any significance to the sequence values. ,SHOULD NOT,Consumer,,false,Not Tested,Not Tested
309
- hl7.fhir.us.carin-bb_2.0.0,167,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,".diagnosis.sequence rule: diagnosis.sequence values do not necessarily indicate any order in which the diagnosis was reported or identified. ...Client app implementations should use the values of diagnosis.type to identify primary, secondary, etc. ",SHOULD,Consumer,,false,Not Tested,Not Tested
310
- hl7.fhir.us.carin-bb_2.0.0,168,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,.diagnosis.sequence: sequentially numbers all diagnoses at the header-level. Item-level are referenced from an item using this sequence number,SHALL,Health Plan,,false,NA,NA
311
- hl7.fhir.us.carin-bb_2.0.0,169,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,".supportingInfo[servicefacility]: Service Facility Location information conveys the name, full address and identifier of the facility where services were rendered when that is different from the Billing/Rendering Provider.",SHOULD,Health Plan,,true,NA,NA
312
- hl7.fhir.us.carin-bb_2.0.0,170,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,.item. diagnosisSequence: References the sequence number of the associated diagnosis entered above,SHALL,Health Plan,,false,NA,NA
242
+ When the Compound Code = 2, if available, map the ingredient to ExplanationOfBenefit.item.detail.quantity",SHALL,Health Plan,,true,NA,NA,,
243
+ hl7.fhir.us.carin-bb_2.0.0,166,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,.diagnosis.sequence rule: diagnosis.sequence values do not necessarily indicate any order in which the diagnosis was reported or identified. Client app implementations should not assign any significance to the sequence values.,SHOULD NOT,Consumer,,false,Not Tested,Not Tested,NA,NA
244
+ hl7.fhir.us.carin-bb_2.0.0,167,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,".diagnosis.sequence rule: diagnosis.sequence values do not necessarily indicate any order in which the diagnosis was reported or identified. ...Client app implementations should use the values of diagnosis.type to identify primary, secondary, etc.",SHOULD,Consumer,,false,Not Tested,Not Tested,NA,NA
245
+ hl7.fhir.us.carin-bb_2.0.0,168,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,.diagnosis.sequence: sequentially numbers all diagnoses at the header-level. Item-level are referenced from an item using this sequence number,SHALL,Health Plan,,false,NA,NA,,
246
+ hl7.fhir.us.carin-bb_2.0.0,169,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,".supportingInfo[servicefacility]: Service Facility Location information conveys the name, full address and identifier of the facility where services were rendered when that is different from the Billing/Rendering Provider.",SHOULD,Health Plan,,true,NA,NA,Not Tested,Not Tested
247
+ hl7.fhir.us.carin-bb_2.0.0,170,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,.item.diagnosisSequence: References the sequence number of the associated diagnosis entered above,SHALL,Health Plan,,false,NA,NA,,
313
248
  hl7.fhir.us.carin-bb_2.0.0,171,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,".item.productOrService: CPT / HCPCS procedure codes are defined as CodeableConcepts: A revenue code will not be available on a professional / non-clinician claim .
314
249
 
315
- it is recommended payers provide a data absent reason for item.revenue.",SHOULD,Health Plan,,false,NA,NA
250
+ it is recommended payers provide a data absent reason for item.revenue.",SHOULD,Health Plan,,false,NA,NA,,
316
251
  hl7.fhir.us.carin-bb_2.0.0,172,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,"A CPT / HCPCS code may not be available
317
252
 
318
- it is recommended payers provide a data absent reason when a CPT / HCPCS or code is not available.",SHOULD,Health Plan,,false,NA,NA
319
- hl7.fhir.us.carin-bb_2.0.0,173,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,Every supportingInfo repetitions with a Transportation Services Category code need to be associated with at least one line item by referencing supportingInfo.sequence through .item.informationSequence.,SHALL,Health Plan,,false,NA,NA
320
- hl7.fhir.us.carin-bb_2.0.0,174,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,item.adjudication[benefitpaymentstatus]: in network or out of network payment status for the line,SHALL,Health Plan,,false,NA,NA
321
- hl7.fhir.us.carin-bb_2.0.0,175,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Coverage.html#notes-on-fields,The Coverage Reference Resource shall be returned with data that was effective as of the date of service of the claim,SHALL,Health Plan,,false,NA,NA
322
- hl7.fhir.us.carin-bb_2.0.0,176,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Organization.html,Payers may decide to provide either the data that was in effect as of the date of service or the current data. ,MAY,Health Plan,,false,NA,NA
323
- hl7.fhir.us.carin-bb_2.0.0,177,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Organization.html,.identifier[NPI]: Value is conditional depending on the Referring Resource. Populate Service Facility NPI with the value 'NPI has not been assigned' if an NPI has not been assigned to the Service Location Organization,SHALL,Health Plan,,true,NA,NA
324
- hl7.fhir.us.carin-bb_2.0.0,178,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Organization.html,".address: Enter address of the location where the services were rendered. If the location is a component of the Billing Provider, do not populate this data element",SHALL NOT,Health Plan,,true,NA,NA
325
- hl7.fhir.us.carin-bb_2.0.0,179,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Organization.html,".meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last.",SHALL,Health Plan,,false,NA,NA
326
- hl7.fhir.us.carin-bb_2.0.0,180,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Organization.html,.meta.lastUpdated: ... Apps will use the meta.lastUpdated value to determine if the Reference resources are as of the current date or date of service. ,SHALL,Consumer,,false,Not Tested,Not Tested
327
- hl7.fhir.us.carin-bb_2.0.0,181,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Patient.html#notes-on-fields,The Member Id is the identifier payers assign to a beneficiary for a contract; it may be different for various lines of business; ie. QHP vs MA. The Unique Member Id is a mastered identifier across all lines of business.,SHALL,Health Plan,,false,NA,NA
328
- hl7.fhir.us.carin-bb_2.0.0,182,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Patient.html#notes-on-fields,Payers may decide to provide either the data that was in effect as of the date of service or the current data.,MAY,Health Plan,,false,NA,NA
329
- hl7.fhir.us.carin-bb_2.0.0,183,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Patient.html#notes-on-fields,".meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last.",SHALL,Health Plan,,false,NA,NA
330
- hl7.fhir.us.carin-bb_2.0.0,184,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Patient.html#notes-on-fields,.meta.lastUpdated: ... Apps will use the meta.lastUpdated value to determine if the Reference resources are as of the current date or date of service. ,SHALL,Health Plan,,false,NA,NA
331
- hl7.fhir.us.carin-bb_2.0.0,185,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Practitioner.html#notes-on-fields,Payers may decide to provide either the data that was in effect as of the date of service or the current data.,MAY,Health Plan,,false,NA,NA
332
- hl7.fhir.us.carin-bb_2.0.0,186,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Practitioner.html#notes-on-fields,".identifier[NPI], .identifier[tax]: One of these identifiers must be provided",SHALL,Health Plan,,false,NA,NA
333
- hl7.fhir.us.carin-bb_2.0.0,187,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Practitioner.html#notes-on-fields,".meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last.",SHALL,Health Plan,,false,NA,NA
334
- hl7.fhir.us.carin-bb_2.0.0,188,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Practitioner.html#notes-on-fields,.meta.lastUpdated: … Apps will use the meta.lastUpdated value to determine if the Reference resources are as of the current date or date of service. ,SHALL,Consumer,,false,Not Tested,Not Tested
335
- hl7.fhir.us.carin-bb_2.0.0,189,https://hl7.org/fhir/us/carin-bb/STU2/,COMPUTABLE REQUIREMENTS TBD,,Health Plan,,,NA,NA
253
+ it is recommended payers provide a data absent reason when a CPT / HCPCS or code is not available.",SHOULD,Health Plan,,false,NA,NA,,
254
+ hl7.fhir.us.carin-bb_2.0.0,173,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,Every supportingInfo repetitions with a Transportation Services Category code need to be associated with at least one line item by referencing supportingInfo.sequence through .item.informationSequence.,SHALL,Health Plan,,false,NA,NA,,
255
+ hl7.fhir.us.carin-bb_2.0.0,174,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,item.adjudication[benefitpaymentstatus]: in network or out of network payment status for the line,SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
256
+ hl7.fhir.us.carin-bb_2.0.0,175,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Coverage.html#notes-on-fields,The Coverage Reference Resource shall be returned with data that was effective as of the date of service of the claim,SHALL,Health Plan,,false,NA,NA,,
257
+ hl7.fhir.us.carin-bb_2.0.0,176,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Organization.html,Payers may decide to provide either the data that was in effect as of the date of service or the current data.,MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
258
+ hl7.fhir.us.carin-bb_2.0.0,177,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Organization.html,.identifier[NPI]: Value is conditional depending on the Referring Resource. Populate Service Facility NPI with the value 'NPI has not been assigned' if an NPI has not been assigned to the Service Location Organization,SHALL,Health Plan,,true,NA,NA,,
259
+ hl7.fhir.us.carin-bb_2.0.0,178,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Organization.html,".address: Enter address of the location where the services were rendered. If the location is a component of the Billing Provider, do not populate this data element",SHALL NOT,Health Plan,,true,NA,NA,,
260
+ hl7.fhir.us.carin-bb_2.0.0,179,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Organization.html,".meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last.",SHALL,Health Plan,,false,NA,NA,,
261
+ hl7.fhir.us.carin-bb_2.0.0,180,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Organization.html,.meta.lastUpdated: ... Apps will use the meta.lastUpdated value to determine if the Reference resources are as of the current date or date of service.,SHALL,Consumer,,false,Not Tested,Not Tested,NA,NA
262
+ hl7.fhir.us.carin-bb_2.0.0,181,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Patient.html#notes-on-fields,The Member Id is the identifier payers assign to a beneficiary for a contract; it may be different for various lines of business; ie. QHP vs MA. The Unique Member Id is a mastered identifier across all lines of business.,SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
263
+ hl7.fhir.us.carin-bb_2.0.0,182,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Patient.html#notes-on-fields,Payers may decide to provide either the data that was in effect as of the date of service or the current data.,MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
264
+ hl7.fhir.us.carin-bb_2.0.0,183,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Patient.html#notes-on-fields,".meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last.",SHALL,Health Plan,,false,NA,NA,,
265
+ hl7.fhir.us.carin-bb_2.0.0,184,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Patient.html#notes-on-fields,.meta.lastUpdated: ... Apps will use the meta.lastUpdated value to determine if the Reference resources are as of the current date or date of service.,SHALL,Consumer,,false,Not Tested,Not Tested,NA,NA
266
+ hl7.fhir.us.carin-bb_2.0.0,185,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Practitioner.html#notes-on-fields,Payers may decide to provide either the data that was in effect as of the date of service or the current data.,MAY,Health Plan,,false,NA,NA,Not Tested,Not Tested
267
+ hl7.fhir.us.carin-bb_2.0.0,186,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Practitioner.html#notes-on-fields,".identifier[NPI], .identifier[tax]: One of these identifiers must be provided",SHALL,Health Plan,,false,NA,NA,,
268
+ hl7.fhir.us.carin-bb_2.0.0,187,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Practitioner.html#notes-on-fields,".meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last.",SHALL,Health Plan,,false,NA,NA,,
269
+ hl7.fhir.us.carin-bb_2.0.0,188,https://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-Practitioner.html#notes-on-fields,.meta.lastUpdated: … Apps will use the meta.lastUpdated value to determine if the Reference resources are as of the current date or date of service.,SHALL,Consumer,,false,Not Tested,Not Tested,NA,NA
270
+ hl7.fhir.us.carin-bb_2.0.0,189,https://hl7.org/fhir/us/carin-bb/STU2/,COMPUTABLE REQUIREMENTS TBD,,Health Plan,,,NA,NA,,
271
+ hl7.fhir.us.carin-bb_2.0.0,190,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,.adjudication.amount...: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
272
+ hl7.fhir.us.carin-bb_2.0.0,191,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html#notes-on-fields,.item.adjudication.amount: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
273
+ hl7.fhir.us.carin-bb_2.0.0,192,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.html#notes-on-fields,.total.amount: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
274
+ hl7.fhir.us.carin-bb_2.0.0,193,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.html#notes-on-fields,.adjudication.amount...: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
275
+ hl7.fhir.us.carin-bb_2.0.0,194,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.html#notes-on-fields,.item.adjudication.amount: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
276
+ hl7.fhir.us.carin-bb_2.0.0,195,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,.adjudication.amount...: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
277
+ hl7.fhir.us.carin-bb_2.0.0,196,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html#notes-on-fields,.item.adjudication.amount: Eligible amount = submitted amount - the noncovered amount - discount. The subscriber pays the member liability = deductible + coinsurance + copay + noncovered. (part of the member liability may have already been paid to the provider as paidbypatient). The eligible amount - the member liability is the payment amount to the provider (paidtoprovider) or the subscriber (paidtopatient),SHALL,Health Plan,,false,NA,NA,Not Tested,Not Tested
278
+ hl7.fhir.us.carin-bb_2.0.0,197,http://hl7.org/fhir/us/carin-bb/STU2/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.html#notes-on-fields,.adjudication.amount (populate only if item.adjudication is not available):,SHALL NOT,Health Plan,,true,NA,NA,,