FHIR Implementation Guide for HCX
0.8.0 - CI Build
FHIR Implementation Guide for HCX
0.8.0 - CI Build
FHIR Implementation Guide for HCX - Local Development build (v0.8.0). See the Directory of published versions
Generated Narrative: Composition
Resource Composition "1" Version "1" Updated "2021-12-22 15:32:26+0530"
| - | Div |
| * | <div/> |
identifier: id: urn:uuid:28b6b35e
status: FINAL
type: Claim Response (document-types#HCXClaimResponse)
date: 2021-12-22 15:32:26+0530
author: See above (Practitioner/1: Dr. Sudhir Naik (PMJAY Gujrat))
title: Claim Request
| - | Mode | Time | Party |
| * | Official (CompositionAttestationMode#official) | 2021-12-22 14:10:14+0000 | See above (Organization/2: PMJAY, MoHFW, Govt Of India) |
2. ClaimResponse/ress-id-1 (ClaimResponse/1355110)
Generated Narrative: ClaimResponse
Resource ClaimResponse "1355110" Version "1" Updated "2020-07-03 22:50:39+0000"
Information Source: #JrkobxCRdZUI6QNh!
Texts
- Div * <div/> status: ACTIVE
type: institutional ([not stated]#institutional)
use: PREAUTHORIZATION
patient: Patient/1353519
created: 2020-07-03 18:50:39-0400
insurer: Organization/185
request: Claim/1355109
outcome: COMPLETE
item
itemSequence: 1
adjudication
category: eligible ([not stated]#eligible)
Amounts
- Value Currency * 500000 INR adjudication
category: copay ([not stated]#copay)
Amounts
- Value Currency * 50000 INR adjudication
category: eligpercent ([not stated]#eligpercent)
adjudication
category: benefit ([not stated]#benefit)
reason: Plan Limit Reached (Adjudication Reason Codes#ar002)
Amounts
- Value Currency * 360000 INR total
category: submitted ([not stated]#submitted)
Amounts
- Value Currency * 500000 INR total
category: benefit ([not stated]#benefit)
Amounts
- Value Currency * 360000 INR payment
type: Complete (Example Payment Type Codes#complete)
date: 2014-08-31
Amounts
- Value Currency * 410000 INR identifier: id: 201408-2-1569478
3. Patient/1 (Patient/1)
Hina Patel (OFFICIAL) Female, DoB: 1974-12-25 ( PHRADDR: 654321)
4. Organization/MaxSaket01 (Organization/MaxSaket01)
Generated Narrative: Organization
Resource Organization "MaxSaket01"
Texts
- Div * <div/> identifier: id: HFR-10000005
name: Max Super Speciality Hospital, Saket
5. Organization/2 (Organization/2)
Generated Narrative: Organization
Resource Organization "2"
Texts
- Div * <div/> identifier: id: PMJAY
name: PMJAY, MoHFW, Govt Of India
6. Practitioner/1 (Practitioner/1)
Generated Narrative: Practitioner
Resource Practitioner "1"
Texts
- Div * <div/> identifier: id: NPR-6897
name: Sudhir Naik (PMJAY Gujrat)