Handling claim amendments when referenced resource...
# support
m
Hi folks, We're working through a claim amendment workflow and hitting an issue with FHIR versioned resources. Curious how others handle this. The scenario: Submit a claim that references versioned resources (e.g., Patient with DOB 12/1/2000) Time passes, client info changes (moves out of state) Clearinghouse rejects the claim, requires amendments Need to resubmit with updated data The problem: FHIR versioning doesn't support branching. When we cancel and recreate the claim with amended data, we need somewhere to put the new data alongside the versioned snapshots, but FHIR doesn't give us a way to "branch" a versioned resource. Our current thinking: Create a separate claims table in our own DB that holds flat claim data (not just references), which syncs 1:1 with Medplum claims via CDC. This gives us a place to stage edits before syncing back to Medplum and submitting to clearinghouse. Question: How do folks generally handle claim amendments when referenced resources have changed? Is maintaining parallel claim storage a common pattern, or is there a better FHIR-native way to handle this that we're missing? Thanks!
j
@reshma - Do you have thoughts here? Basically if data from a claim's relationships change (such as patient name or address) after the claim is submitted, then the claim isn't really an accurate representation of what was submitted. Do you have experience with how people are using Claim in relation to the actual claim submitted to a clearinghouse?
r
HEy @Jim Fiorato ! Sorry for the delay - so here's generally what we see in practice: Resubmissions are a new Claim resource with a new snapshot and reference the other one. Does that help?
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