Payment date not in medical claims

[Mike Kale]

We've done some research here and there seems to be a disconnect between the HL7 document and what's on the BlueButton website:

https://build.fhir.org/ig/HL7/carin-bb/StructureDefinition-C4BB-ExplanationOfBenefit-Pharmacy-definitions.html

https://bluebutton.cms.gov/assets/ig/StructureDefinition-bluebutton-carrier-claim.html#profile

According to the bluebutton website we are receiving everything we should be - but it's missing the payment date (ExplanationOfBenefit.payment.date), which is displayed on the FHIR website. This appears to be why we're receiving all NULL payment dates for medical claims.

I'm wondering if this is a mistake, or expected. Appreciate any help.

Thanks!,

-Mike

[Idan Ben-Arieh]

Hi - Are there any updates on this one? 

[Data at the Point of Care (DPC) Community]

This user received a private message for their question. 

Users with a similar question: 

Payment.date is a FHIR resource element that is found only in prescription drug (Part D) claims. The C4BB profile that shows payment.date is for the pharmacy (Part D claims) resource profile. This may have caused some confusion about the availability of payment.date in other claim types. 

Because payment.date is not provided in the other claim types, users may need to utilize other data fields available in DPC for their business use case. The data dictionary provides a list of "date" fields that may be of interest. (Please note this document is a shared resource across DPC and another CMS API product, BCDA, which provides similar data). 

For example, Claim Through Date, Claim From Date, and Claim Effective Date are provided and may be of interest. 

If there are other Medicare FFS data fields from the Chronic Conditions Warehouse (the data warehouse that precedes our data source) that may be useful, please let us know as we collect this feedback for consideration. 

Best,
The DPC Team