FHIR_To_Oscar_Mapping: # This mapping governs the write-back path: # Jarvis (or any FHIR client) POSTs a NexusEmrCoreInvoice → Oscar creates # billing_on_cheader1 + billing_on_item rows. # Also covers read-back round-trip fidelity via the existing # InvoiceConverter.toOscarObject(Invoice) direction. NexusEmrCoreInvoice: id: "billing_on_cheader1.id (server-assigned on POST)" identifier: "billing_on_cheader1.header_id (when present)" identifier[rawCode]: "billing_on_cheader1.header_id or provider_ohip_no or hin (per identifier system)" status: "See status table below (+ oscarBillingStatus extension takes precedence if present)" extension[oscarBillingStatus]: "**Primary** source for billing_on_cheader1.status when set (carries raw 10-code Oscar enum)" extension[shadowBill]: "Informational — derived from billing_on_cheader1.status='H'; Jarvis should not set this on write (write sets status='H' and shadowBill is derived on read)" type.coding[payProgram].code: "billing_on_cheader1.pay_program (moved from extension[payProgram] in 1.9.9)" extension[admissionDate]: "billing_on_cheader1.admission_date" extension[appointmentNo]: "billing_on_cheader1.appointment_no" extension[facilityNum]: "billing_on_cheader1.facilty_num (sic)" extension[serviceLocation].valueReference: "Reference(NexusEmrCoreLocation) resolving billing_on_cheader1.location — SLI code carried on Location.identifier[sliCode] (refactored from string extension in 1.9.9)" extension[manualReview]: "billing_on_cheader1.man_review" extension[paid]: "billing_on_cheader1.paid" extension[province]: "billing_on_cheader1.province (always 'ON' in Phase 1)" extension[visitType]: "billing_on_cheader1.visittype" subject.reference: "billing_on_cheader1.demographic_no (strip 'Patient/' prefix)" issuer.reference: "billing_on_cheader1.clinic" date: "billing_on_cheader1.billing_date + billing_time" participant[role=billing].actor: "billing_on_cheader1.provider_no" participant[role=appointment].actor: "billing_on_cheader1.apptProvider_no" participant[role=assistant].actor: "billing_on_cheader1.asstProvider_no" participant[role=referring].actor: "billing_on_cheader1.ref_num" totalGross.value: "billing_on_cheader1.total" note[0].text: "billing_on_cheader1.comment1" # ------------------------------------------------------------------------- # Invoice.status (canonical FHIR) → billing_on_cheader1.status # When oscarBillingStatus extension is present, it wins. # Otherwise default mapping from the canonical FHIR code. # ------------------------------------------------------------------------- Invoice_status_reverse: issued: "If payProgram=PAT → 'P'; payProgram=WCB → 'W'; else 'O' (Bill OHIP default)" balanced: "If shadowBill=true → 'H' (Capitated); else 'S' (Settled)" cancelled: "If oscarBillingStatus=X → 'X' (Bad Debt); else 'D' (Deleted)" "entered-in-error": "'N' (Do Not Bill)" draft: "**Not currently used** — reserved for a future provider-review intermediate state, not yet scoped" # ------------------------------------------------------------------------- # Invoice.lineItem[] → billing_on_item rows # ------------------------------------------------------------------------- Invoice_lineItem: id: "billing_on_item.id (server-assigned on POST)" sequence: "**Not stored** — used only for ordering on FHIR side" chargeItemCodeableConcept.coding[ohip].code: "billing_on_item.service_code" priceComponent[type=base].amount.value: "billing_on_item.fee (serialize as String)" priceComponent[type=base].factor: "billing_on_item.ser_num (serialize as String)" extension[DIAGNOSTIC_1].valueCodeableConcept: "billing_on_item.dx (primary)" extension[DIAGNOSTIC_2].valueCodeableConcept: "billing_on_item.dx1 (secondary)" extension[DIAGNOSTIC_3].valueCodeableConcept: "billing_on_item.dx2 (tertiary) — note typo in extension URL (diagnositc3)" extension[SERVICE_DATE].valueDate: "billing_on_item.service_date" extension[STATUS].valueString: "billing_on_item.status ('D' = soft-delete; filtered out of BillingONCHeader1.billingItems collection via @Where at BillingONCHeader1.java:190)" extension[HEADER_ID].valueInteger: "billing_on_item.ch1_id (= parent Invoice's billing_on_cheader1.id)" extension[LAST_UPDATED].valueDateTime: "billing_on_item.timestamp" # ------------------------------------------------------------------------- # NexusEmrCorePractitioner → provider # ------------------------------------------------------------------------- NexusEmrCorePractitioner: identifier.value: "provider.provider_no (PK)" identifier[ohipBillingNumber].value: "provider.ohip_no (NEW slice — required for providers billing OHIP)" identifier[rmaNumber].value: "provider.rma_no (NEW slice — optional; RMA / group billing)" identifier[rawCode]: "provider.billing_no, provider.practitionerNo (by system URI)" name.family: "provider.last_name" name.given: "provider.first_name" name.prefix: "provider.title" gender: "provider.sex" birthDate: "provider.dob" address.line: "provider.address" address.city: "provider.city" address.state: "provider.province" address.postalCode: "provider.postalCode" telecom[use=home].value: "provider.phone" telecom[use=work].value: "provider.work_phone" telecom[system=email].value: "provider.email" active: "provider.status ('1' ↔ true)" qualification: "provider.credentials" # ------------------------------------------------------------------------- # NexusEmrCorePatient → demographic (write-back scenarios rare for Jarvis) # ------------------------------------------------------------------------- NexusEmrCorePatient: identifier.value: "demographic.demographic_no" identifier[jurisdictional].value: "demographic.hin" identifier[jurisdictional].extension[hcnVersion]: "demographic.ver" name.family: "demographic.last_name" name.given: "demographic.first_name" birthDate: "demographic.year_of_birth + month_of_birth + date_of_birth (all String columns)" gender: "demographic.sex" address: "demographic.address / city / province / postal" telecom: "demographic.phone / phone2 / email" active: "demographic.patient_status ('AC' ↔ true)" extension[rosterStatus]: "demographic.roster_status" # ------------------------------------------------------------------------- # NexusEmrCoreCondition → dxresearch or casemgmt_issue (depending on category) # ------------------------------------------------------------------------- NexusEmrCoreCondition: "category=problem-list-item from dxresearch source": id: "dxresearch.dxresearch_no" subject: "dxresearch.demographic_no" code.coding.code: "dxresearch.dxresearch_code" code.coding.system: "dxresearch.coding_system (must reverse-map $ICD9CM → 'icd9' for Oscar write)" onsetDateTime: "dxresearch.start_date" recorder: "dxresearch.providerNo" # column is camelCase — DxResearch.java:50 has no @Column override clinicalStatus: "dxresearch.status (active→A, inactive→C)" "category=problem-list-item from casemgmt_issue source (Medical History)": id: "casemgmt_issue.id" subject: "casemgmt_issue.demographic_no" code: "Looked up via casemgmt_issue.issue_id → Issue catalog" type: "casemgmt_issue.type = 'MedHistory' (or confirmed value)" clinicalStatus: "casemgmt_issue.resolved (true→resolved, false→active)" # ------------------------------------------------------------------------- # Unsupported / deferred (Phase 1) # ------------------------------------------------------------------------- unsupported_phase1: Claim: "Payer submission — Oscar submits to OHIP via H-file, not FHIR Claim" ClaimResponse: "Payer adjudication — deferred to Phase 2 if rejection loop is scoped in" ExplanationOfBenefit: "Patient-facing — Jarvis is practitioner-facing" Coverage: "No multi-payer filtering in Phase 1" Account: "Patient ledger — not a Phase 1 use case" ChargeItem_standalone: "Not needed — inline Invoice.lineItem[] suffices" ChargeItemDefinition: "OHIP fee catalog exposed via REST (/api/billing/service), not FHIR" CoverageEligibilityRequest: "No pre-service eligibility check in Phase 1"