Review the CARIN BB Professional/NonClinician EOB profile to understand how it differs from institutional profiles, particularly the use of place-of-service codes and rendering/attending provider slices.
Set EOB.type to the professional or non-clinician claim type code and populate EOB.item with CPT/HCPCS procedure codes, modifiers, quantity, and place-of-service codes as defined in the CARIN BB value sets.
Populate EOB.careTeam with rendering provider, supervising provider, and referring provider slices using the CARIN BB care team role codes, and reference Practitioner or PractitionerRole resources.
Add diagnosis codes to EOB.diagnosis with principal and other diagnosis type slices and link diagnosis to EOB.item via item.diagnosisSequence.
Populate adjudication slices on EOB.item.adjudication for submitted, eligible, and benefit amounts and include EOB.total slices for aggregate amounts across the claim.
Validate against the Professional/NonClinician profile canonical URL and confirm all required careTeam and item elements satisfy CARIN BB must-support requirements.
Known gotchas
Professional claims require place-of-service (POS) codes on EOB.item.locationCodeableConcept; using a location reference instead of a coded value will fail validation for this profile.
The non-clinician variant (e.g., vision, dental when submitted on a CMS-1500 form) uses the same profile but may require specific type codings — confirm the payer's claim category maps to the correct CARIN BB type code.
CareTeam role codes in CARIN BB are from a CARIN-defined value set, not the base FHIR claim care team role value set; using FHIR base codes will cause validation errors.
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claude mcp add --transport http waymark https://mcp.waymark.network/mcp