ANSI Claim to FHIR Java Object


#1

Newbie to FHIR and a developer at a claims insurance company. We are in the early stages of redesigning our claims loading/import process. Two questions:

  1. Are there Java classes (beans) out there that represent the FHIR defined claims object?
  2. Will everything in a ANSI 837 (5010) claim map to the FHIR claim object (and vice versa)?

Thanks in Advance


#2

HAPI has POJOs. They are not beans in as much as they are not serializable, and there’s no way to make them serializable using a format that is conformant with FHIR.

I don’t know about the claim map question


#3

Yes, there are several insurers and third parties, analytics firms etc., who have moved to using the FHIR claim or ExplanationOfBenefit, depending on whether they want to report on just the claim or the claim and the remittance advice, for reporting of all of their claims: 837, UB04, NCPDP, CMS1500 etc. Also, Blue Button 2.0 is based on the FHIR ExplanationOfBenefit.

If you find content which you cannot map or are unsure of the mapping please reach out to the HL7 Financial Management Work Group.