EDI 837 to FHIR Data Mapping

The following table demonstrates what transaction segment is used to create a corresponding FHIR resource.

FHIR Resource 837P Details
Patient

Loop 2010BA for Subscriber

Loop 2010CA for Dependent

 
RelatedPerson Loop 2010CA Only when a patient is Dependent.
Coverage - Refers to a Patient and RelatedPerson when a patient is Dependent.
Claim

Loop 2300

 
Organization (type=ins) Loop 2010BB

Defines a type of Organization. XES Module for FHIR supports only two types:

  • ins – insurer
  • prov - provider

Organization (type=prov)

Practitioner

Loop 2000A

Defines a type of Organization. XES Module for FHIR supports only two types:

  • ins – insurer
  • prov - provider
Communication

ISA segment

Loop 1000A

Loop 1000B

Carries envelope information, such as SenderID and ReceiverID, and an EDI 837 as a blob.