FHIR Implementation Guide for HCX
0.9.0 - CI Build
FHIR Implementation Guide for HCX
0.9.0 - CI Build
FHIR Implementation Guide for HCX - Local Development build (v0.9.0). See the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="CoverageEligibilityResponseDocument-example-01"/>
<meta>
<lastUpdated value="2021-12-22T15:32:26.605+05:30"/>
</meta>
<identifier>
<system value="https://www.tmh.in/bundle"/>
<value value="CoverageEligibilityResponseDocument-example-01"/>
</identifier>
<type value="document"/>
<timestamp value="2021-12-22T15:32:26.605+05:30"/>
<entry>
<fullUrl value="Composition/42ff4a07-3e36-402f-a99e-29f16c0c9eee"/>
<resource>
<Composition>
<id value="42ff4a07-3e36-402f-a99e-29f16c0c9eee"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"> Coverage Eligibility Response document example</div>
</text>
<identifier>
<system value="https://www.tmh.in/hcx-documents"/>
<value value="42ff4a07-3e36-402f-a99e-29f16c0c9eee"/>
</identifier>
<status value="final"/>
<type>
<coding>
<system value="https://hcx.org/document-types"/>
<code value="HCXCoverageElibilityResponse"/>
<display value="Coverage Eligibility Response"/>
</coding>
</type>
<subject>
<reference value="Patient/RVH1003"/>
</subject>
<date value="2021-12-22T15:32:26.605+05:30"/>
<author>
<reference value="Practitioner/1"/>
</author>
<title value="Coverage Eligibility Response"/>
<section>
<title value="Coverage Eligibility Response"/>
<code>
<coding>
<system
value="https://www.hl7.org/fhir/valueset-resource-types"/>
<code value="CoverageEligibilityResponse"/>
<display value="Coverage Eligibility Response"/>
</coding>
<text value="CoverageEligibilityResponse"/>
</code>
<entry>
<reference value="CoverageEligibilityResponse/res-id-1"/>
</entry>
</section>
</Composition>
</resource>
</entry>
<entry>
<fullUrl value="CoverageEligibilityResponse/res-id-1"/>
<resource>
<CoverageEligibilityResponse>
<id value="res-id-1"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: CoverageEligibilityResponse</b><a name="res-id-1"> </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 CoverageEligibilityResponse "res-id-1" </p></div><p><b>identifier</b>: id: urn:uuiad:581da6a9</p><p><b>status</b>: active</p><p><b>purpose</b>: discovery, benefits</p><p><b>patient</b>: <a href="#Patient_1">See above (Patient/1: Hina Patel)</a></p><p><b>serviced</b>: 2021-12-22 --> 2021-12-25</p><p><b>created</b>: 2021-12-22</p><blockquote><p><b>insurance</b></p><p><b>coverage</b>: <a href="Coverage/9876B1">Coverage/9876B1</a></p><p><b>inforce</b>: true</p><blockquote><p><b>item</b></p><p><b>category</b>: Health Benefit Plan Coverage <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-ex-benefitcategory.html">Benefit Category Codes</a>#30)</span></p><p><b>network</b>: In Network <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-network.html">Network Type Codes</a>#in)</span></p><p><b>unit</b>: Individual <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-unit.html">Unit Type Codes</a>#individual)</span></p><p><b>term</b>: Annual <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-term.html">Benefit Term Codes</a>#annual)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: benefit <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ([not stated]#benefit)</span></p><p><b>allowed</b>: <span title="Indian Rupee">₹500,000.00</span> (INR)</p></blockquote><blockquote><p><b>benefit</b></p><p><b>type</b>: copay-maximum <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ([not stated]#copay-maximum)</span></p><p><b>allowed</b>: <span title="Indian Rupee">₹100.00</span> (INR)</p></blockquote><blockquote><p><b>benefit</b></p><p><b>type</b>: copay-percent <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ([not stated]#copay-percent)</span></p><p><b>allowed</b>: 20</p></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>category</b>: Maternity <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-ex-benefitcategory.html">Benefit Category Codes</a>#69)</span></p><p><b>network</b>: In Network <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-network.html">Network Type Codes</a>#in)</span></p><p><b>unit</b>: Individual <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-unit.html">Unit Type Codes</a>#individual)</span></p><p><b>term</b>: Annual <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-term.html">Benefit Term Codes</a>#annual)</span></p><h3>Benefits</h3><table class="grid"><tr><td>-</td><td><b>Type</b></td><td><b>Allowed[x]</b></td></tr><tr><td>*</td><td>benefit <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ([not stated]#benefit)</span></td><td><span title="Indian Rupee">₹15,000.00</span> (INR)</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>category</b>: Dental Coverage <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-ex-benefitcategory.html">Benefit Category Codes</a>#F3)</span></p><p><b>network</b>: In Network <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-network.html">Network Type Codes</a>#in)</span></p><p><b>unit</b>: Individual <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-unit.html">Unit Type Codes</a>#individual)</span></p><p><b>term</b>: Annual <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-term.html">Benefit Term Codes</a>#annual)</span></p><h3>Benefits</h3><table class="grid"><tr><td>-</td><td><b>Type</b></td><td><b>Allowed[x]</b></td></tr><tr><td>*</td><td>benefit <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ([not stated]#benefit)</span></td><td><span title="Indian Rupee">₹2,000.00</span> (INR)</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>category</b>: Vision Coverage <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-ex-benefitcategory.html">Benefit Category Codes</a>#F6)</span></p><p><b>network</b>: In Network <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-network.html">Network Type Codes</a>#in)</span></p><p><b>unit</b>: Individual <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-unit.html">Unit Type Codes</a>#individual)</span></p><p><b>term</b>: Annual <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-term.html">Benefit Term Codes</a>#annual)</span></p><h3>Benefits</h3><table class="grid"><tr><td>-</td><td><b>Type</b></td><td><b>Allowed[x]</b></td></tr><tr><td>*</td><td>benefit <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ([not stated]#benefit)</span></td><td><span title="Indian Rupee">₹400.00</span> (INR)</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>category</b>: Hospital Room and Board <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-ex-benefitcategory.html">Benefit Category Codes</a>#49)</span></p><p><b>network</b>: In Network <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-network.html">Network Type Codes</a>#in)</span></p><p><b>unit</b>: Individual <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-unit.html">Unit Type Codes</a>#individual)</span></p><p><b>term</b>: Day <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-benefit-term.html">Benefit Term Codes</a>#day)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: room <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ([not stated]#room)</span></p><p><b>allowed</b>: shared</p></blockquote><blockquote><p><b>benefit</b></p><p><b>type</b>: benefit <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ([not stated]#benefit)</span></p><p><b>allowed</b>: <span title="Indian Rupee">₹600.00</span> (INR)</p></blockquote></blockquote></blockquote></div>
</text>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuiad:581da6a9"/>
</identifier>
<status value="active"/>
<purpose value="discovery"/>
<purpose value="benefits"/>
<patient>
<reference value="Patient/1"/>
<display value="Hina Patel"/>
</patient>
<servicedPeriod>
<start value="2021-12-22"/>
<end value="2021-12-25"/>
</servicedPeriod>
<created value="2021-12-22"/>
<insurance>
<coverage>
<reference value="Coverage/9876B1"/>
</coverage>
<inforce value="true"/>
<item>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
<code value="30"/>
<display value="Health Benefit Plan Coverage"/>
</coding>
</category>
<network>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
<code value="in"/>
</coding>
</network>
<unit>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
<code value="individual"/>
</coding>
</unit>
<term>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
<code value="annual"/>
</coding>
</term>
<benefit>
<type>
<coding>
<code value="benefit"/>
</coding>
</type>
<allowedMoney>
<value value="500000"/>
<currency value="INR"/>
</allowedMoney>
</benefit>
<benefit>
<type>
<coding>
<code value="copay-maximum"/>
</coding>
</type>
<allowedMoney>
<value value="100"/>
<currency value="INR"/>
</allowedMoney>
</benefit>
<benefit>
<type>
<coding>
<code value="copay-percent"/>
</coding>
</type>
<allowedUnsignedInt value="20"/>
</benefit>
</item>
<item>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
<code value="69"/>
<display value="Maternity"/>
</coding>
</category>
<network>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
<code value="in"/>
</coding>
</network>
<unit>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
<code value="individual"/>
</coding>
</unit>
<term>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
<code value="annual"/>
</coding>
</term>
<benefit>
<type>
<coding>
<code value="benefit"/>
</coding>
</type>
<allowedMoney>
<value value="15000"/>
<currency value="INR"/>
</allowedMoney>
</benefit>
</item>
<item>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
<code value="F3"/>
<display value="Dental Coverage"/>
</coding>
</category>
<network>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
<code value="in"/>
</coding>
</network>
<unit>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
<code value="individual"/>
</coding>
</unit>
<term>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
<code value="annual"/>
</coding>
</term>
<benefit>
<type>
<coding>
<code value="benefit"/>
</coding>
</type>
<allowedMoney>
<value value="2000"/>
<currency value="INR"/>
</allowedMoney>
</benefit>
</item>
<item>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
<code value="F6"/>
<display value="Vision Coverage"/>
</coding>
</category>
<network>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
<code value="in"/>
</coding>
</network>
<unit>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
<code value="individual"/>
</coding>
</unit>
<term>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
<code value="annual"/>
</coding>
</term>
<benefit>
<type>
<coding>
<code value="benefit"/>
</coding>
</type>
<allowedMoney>
<value value="400"/>
<currency value="INR"/>
</allowedMoney>
</benefit>
</item>
<item>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
<code value="49"/>
<display value="Hospital Room and Board"/>
</coding>
</category>
<network>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
<code value="in"/>
</coding>
</network>
<unit>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
<code value="individual"/>
</coding>
</unit>
<term>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
<code value="day"/>
</coding>
</term>
<benefit>
<type>
<coding>
<code value="room"/>
</coding>
</type>
<allowedString value="shared"/>
</benefit>
<benefit>
<type>
<coding>
<code value="benefit"/>
</coding>
</type>
<allowedMoney>
<value value="600"/>
<currency value="INR"/>
</allowedMoney>
</benefit>
</item>
</insurance>
</CoverageEligibilityResponse>
</resource>
</entry>
<entry>
<fullUrl value="Patient/1"/>
<resource>
<Patient>
<id value="1"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Patient</b><a name="1"> </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 Patient "1" </p></div><p><b>identifier</b>: PHRADDR: 654321, PMJAYID: QWRT12345</p><p><b>name</b>: Hina Patel (OFFICIAL)</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1974-12-25</p></div>
</text>
<identifier>
<type>
<coding>
<system value="http://ndhm.gov.in/ValueSet/identifier-type"/>
<code value="PHRADDR"/>
</coding>
</type>
<system value="http://ndhm.gov.in/healthId"/>
<value value="654321"/>
</identifier>
<identifier>
<type>
<coding>
<system value="http://ndhm.gov.in/ValueSet/identifier-type"/>
<code value="PMJAYID"/>
</coding>
</type>
<system value="http://ndhm.gov.in/pmjay"/>
<value value="QWRT12345"/>
</identifier>
<name>
<use value="official"/>
<family value="Patel"/>
<given value="Hina"/>
</name>
<gender value="female"/>
<birthDate value="1974-12-25"/>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="Organization/MaxSaket01"/>
<resource>
<Organization>
<id value="MaxSaket01"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Organization</b><a name="MaxSaket01"> </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 Organization "MaxSaket01" </p></div><p><b>identifier</b>: id: HFR-10000005</p><p><b>name</b>: Max Super Speciality Hospital, Saket</p></div>
</text>
<identifier>
<system value="https://ndhm.gov.in/hfr"/>
<value value="HFR-10000005"/>
</identifier>
<name value="Max Super Speciality Hospital, Saket"/>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="Organization/2"/>
<resource>
<Organization>
<id value="2"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Organization</b><a name="2"> </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 Organization "2" </p></div><p><b>identifier</b>: id: PMJAY</p><p><b>name</b>: PMJAY, MoHFW, Govt Of India</p></div>
</text>
<identifier>
<system value="https://hcx.org/orgs"/>
<value value="PMJAY"/>
</identifier>
<name value="PMJAY, MoHFW, Govt Of India"/>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="Practitioner/1"/>
<resource>
<Practitioner>
<id value="1"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Practitioner</b><a name="1"> </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 Practitioner "1" </p></div><p><b>identifier</b>: id: NPR-6897</p><p><b>name</b>: Sudhir Naik (PMJAY Gujrat)</p></div>
</text>
<identifier>
<system value="https://ndhm.gov.in/npr"/>
<value value="NPR-6897"/>
</identifier>
<name>
<text value="Sudhir Naik (PMJAY Gujrat)"/>
<prefix value="Dr"/>
<suffix value="MD"/>
</name>
</Practitioner>
</resource>
</entry>
</Bundle>
IG © 2021+ HCX Open Community. Package hcxprotocol.io#0.9.0 based on FHIR 4.0.1. Generated 2023-12-14
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