FHIR Implementation Guide for HCX
0.7.0 - CI Build

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: HCX Claim example - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Claim;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "example-01"];
  fhir:Resource.meta [
     fhir:Meta.versionId [ fhir:value "1" ];
     fhir:Meta.lastUpdated [ fhir:value "2020-10-07T03:26:09.060+00:00"^^xsd:dateTime ];
     fhir:Meta.source [ fhir:value "#BHZcRrcF4oS0JQ42" ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Claim</b><a name=\"example-01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Claim \"example-01\" Version \"1\" Updated \"2020-10-07 03:26:09+0000\" </p><p style=\"margin-bottom: 0px\">Information Source: #BHZcRrcF4oS0JQ42!</p></div><p><b>identifier</b>: id: dc82673b-8c71-29js-8a17-16dj3i20352n</p><p><b>status</b>: active</p><p><b>type</b>: Institutional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#institutional)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <span></span></p><p><b>billablePeriod</b>: 1979-02-27 04:01:08-0500 --&gt; 1979-02-28 04:01:08-0500</p><p><b>created</b>: 1979-02-28 04:01:08-0500</p><p><b>insurer</b>: <span></span></p><p><b>provider</b>: <span></span></p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><h3>Payees</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Party</b></td></tr><tr><td>*</td><td>Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-payeetype.html\">ClaimPayeeTypeCodes</a>#provider)</span></td><td><span></span></td></tr></table><h3>CareTeams</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td>*</td><td>1</td><td><span></span></td></tr></table><blockquote><p><b>procedure</b></p><p><b>sequence</b>: 1</p><p><b>procedure</b>: PROC-1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-icd-10-procedures.html\">ICD-10 Procedure Codes</a>#123001)</span></p></blockquote><blockquote><p><b>procedure</b></p><p><b>sequence</b>: 2</p><p><b>procedure</b>: PROC-2 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-icd-10-procedures.html\">ICD-10 Procedure Codes</a>#123002)</span></p></blockquote><blockquote><p><b>procedure</b></p><p><b>sequence</b>: 3</p><p><b>procedure</b>: PROC-3 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-icd-10-procedures.html\">ICD-10 Procedure Codes</a>#123003)</span></p></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td><span>: Cigna Health</span></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: Encounter for problem <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#185347001)</span></p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>procedureSequence</b>: 1</p><p><b>productOrService</b>: Hearing examination (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#398171003)</span></p><h3>Nets</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td>*</td><td>516.65</td><td>USD</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 3</p><p><b>procedureSequence</b>: 2</p><p><b>productOrService</b>: Combined chemotherapy and radiation therapy (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#703423002)</span></p><h3>Nets</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td>*</td><td>16924.49</td><td>USD</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 4</p><p><b>procedureSequence</b>: 3</p><p><b>productOrService</b>: High resolution computed tomography of chest without contrast (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#16335031000119103)</span></p><h3>Nets</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td>*</td><td>516.65</td><td>USD</td></tr></table></blockquote><h3>Totals</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td>*</td><td>129.16</td><td>USD</td></tr></table></div>"
  ];
  fhir:Claim.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "https://www.tmh.in/claim-request" ];
     fhir:Identifier.value [ fhir:value "dc82673b-8c71-29js-8a17-16dj3i20352n" ]
  ];
  fhir:Claim.status [ fhir:value "active"];
  fhir:Claim.type [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ];
       fhir:Coding.code [ fhir:value "institutional" ]     ]
  ];
  fhir:Claim.use [ fhir:value "claim"];
  fhir:Claim.patient [
     fhir:Element.id [ fhir:value "RVH1003" ];
     fhir:Reference.identifier [
       fhir:Identifier.type [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ];
           fhir:Coding.code [ fhir:value "SN" ];
           fhir:Coding.display [ fhir:value "Subscriber Number" ]         ]       ];
       fhir:Identifier.system [ fhir:value "http://gicofIndia.com/beneficiaries" ];
       fhir:Identifier.value [ fhir:value "BEN-101" ]     ]
  ];
  fhir:Claim.billablePeriod [
     fhir:Period.start [ fhir:value "1979-02-27T16:01:08-05:00"^^xsd:dateTime ];
     fhir:Period.end [ fhir:value "1979-02-28T16:01:08-05:00"^^xsd:dateTime ]
  ];
  fhir:Claim.created [ fhir:value "1979-02-28T16:01:08-05:00"^^xsd:dateTime];
  fhir:Claim.insurer [
     fhir:Element.id [ fhir:value "GICOFINDIA" ];
     fhir:Reference.identifier [
       fhir:Identifier.system [ fhir:value "http://irdai.gov.in/insurers" ];
       fhir:Identifier.value [ fhir:value "112" ]     ]
  ];
  fhir:Claim.provider [
     fhir:Element.id [ fhir:value "Tmh01" ];
     fhir:Reference.identifier [
       fhir:Identifier.system [ fhir:value "http://abdm.gov.in/facilities" ];
       fhir:Identifier.value [ fhir:value "HFR-ID-FOR-TMH" ]     ]
  ];
  fhir:Claim.priority [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/processpriority" ];
       fhir:Coding.code [ fhir:value "normal" ]     ]
  ];
  fhir:Claim.payee [
     fhir:Claim.payee.type [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/payeetype" ];
         fhir:Coding.code [ fhir:value "provider" ]       ]     ];
     fhir:Claim.payee.party [
       fhir:Element.id [ fhir:value "Tmh02" ];
       fhir:Reference.identifier [
         fhir:Identifier.system [ fhir:value "http://abdm.gov.in/facilities" ];
         fhir:Identifier.value [ fhir:value "HFR-ID-FOR-TMH" ]       ]     ]
  ];
  fhir:Claim.careTeam [
     fhir:index 0;
     fhir:Claim.careTeam.sequence [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:Claim.careTeam.provider [
       fhir:Element.id [ fhir:value "Tmh03" ];
       fhir:Reference.identifier [
         fhir:Identifier.system [ fhir:value "http://abdm.gov.in/facilities" ];
         fhir:Identifier.value [ fhir:value "HFR-ID-FOR-TMH" ]       ]     ]
  ];
  fhir:Claim.procedure [
     fhir:index 0;
     fhir:Claim.procedure.sequence [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:Claim.procedure.procedureCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/sid/ex-icd-10-procedures" ];
         fhir:Coding.code [ fhir:value "123001" ]       ]     ]
  ], [
     fhir:index 1;
     fhir:Claim.procedure.sequence [ fhir:value "2"^^xsd:positiveInteger ];
     fhir:Claim.procedure.procedureCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/sid/ex-icd-10-procedures" ];
         fhir:Coding.code [ fhir:value "123002" ]       ]     ]
  ], [
     fhir:index 2;
     fhir:Claim.procedure.sequence [ fhir:value "3"^^xsd:positiveInteger ];
     fhir:Claim.procedure.procedureCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/sid/ex-icd-10-procedures" ];
         fhir:Coding.code [ fhir:value "123003" ]       ]     ]
  ];
  fhir:Claim.insurance [
     fhir:index 0;
     fhir:Claim.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:Claim.insurance.focal [ fhir:value "true"^^xsd:boolean ];
     fhir:Claim.insurance.coverage [
       fhir:Reference.display [ fhir:value "Cigna Health" ]     ]
  ];
  fhir:Claim.item [
     fhir:index 0;
     fhir:Claim.item.sequence [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         a sct:185347001;
         fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
         fhir:Coding.code [ fhir:value "185347001" ];
         fhir:Coding.display [ fhir:value "Encounter for problem" ]       ];
       fhir:CodeableConcept.text [ fhir:value "Encounter for problem" ]     ]
  ], [
     fhir:index 1;
     fhir:Claim.item.sequence [ fhir:value "2"^^xsd:positiveInteger ];
     fhir:Claim.item.procedureSequence [
       fhir:value "1"^^xsd:positiveInteger;
       fhir:index 0     ];
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         a sct:398171003;
         fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
         fhir:Coding.code [ fhir:value "398171003" ];
         fhir:Coding.display [ fhir:value "Hearing examination (procedure)" ]       ];
       fhir:CodeableConcept.text [ fhir:value "Hearing examination (procedure)" ]     ];
     fhir:Claim.item.net [
       fhir:Money.value [ fhir:value "516.65"^^xsd:decimal ];
       fhir:Money.currency [ fhir:value "USD" ]     ]
  ], [
     fhir:index 2;
     fhir:Claim.item.sequence [ fhir:value "3"^^xsd:positiveInteger ];
     fhir:Claim.item.procedureSequence [
       fhir:value "2"^^xsd:positiveInteger;
       fhir:index 0     ];
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         a sct:703423002;
         fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
         fhir:Coding.code [ fhir:value "703423002" ];
         fhir:Coding.display [ fhir:value "Combined chemotherapy and radiation therapy (procedure)" ]       ];
       fhir:CodeableConcept.text [ fhir:value "Combined chemotherapy and radiation therapy (procedure)" ]     ];
     fhir:Claim.item.net [
       fhir:Money.value [ fhir:value "16924.49"^^xsd:decimal ];
       fhir:Money.currency [ fhir:value "USD" ]     ]
  ], [
     fhir:index 3;
     fhir:Claim.item.sequence [ fhir:value "4"^^xsd:positiveInteger ];
     fhir:Claim.item.procedureSequence [
       fhir:value "3"^^xsd:positiveInteger;
       fhir:index 0     ];
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         a sct:16335031000119103;
         fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
         fhir:Coding.code [ fhir:value "16335031000119103" ];
         fhir:Coding.display [ fhir:value "High resolution computed tomography of chest without contrast (procedure)" ]       ];
       fhir:CodeableConcept.text [ fhir:value "High resolution computed tomography of chest without contrast (procedure)" ]     ];
     fhir:Claim.item.net [
       fhir:Money.value [ fhir:value "516.65"^^xsd:decimal ];
       fhir:Money.currency [ fhir:value "USD" ]     ]
  ];
  fhir:Claim.total [
     fhir:Money.value [ fhir:value "129.16"^^xsd:decimal ];
     fhir:Money.currency [ fhir:value "USD" ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.