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

InsurancePlan:

Generated Narrative: InsurancePlan

Resource InsurancePlan "AB_GUJ_UniqueIdForTheObject"

identifier: id: AB_GUJ_Plan1 (use: USUAL, period: 2001-05-06 --> (ongoing))

status: active

type: Medical (Insurance plan type#medical)

name: PMJAY-Mukhyamantri Amrutam & Mukhyamantri Vatsalya

period: 2020-09-23 --> (ongoing)

ownedBy: Organization/AB_GUJ_SHA: Gujarat State Health Protection Society

administeredBy: Organization/AB_GUJ_TPA_1: MD India Healthcare Service (TPA) Pvt. Ltd.

coverageArea: Location/GUJARAT: Gujarat

coverage

type: Medical (coverage-type#Medical)

benefit

type: Inpatient (benefit-type#Inpatient)

Limits

-Value
*500000 INR

plan

type: PMJAY_GUJ_GOLD_CARD (plan-type#PMJAY_GUJ_GOLD_CARD)

specificCost

category: Inpatient-packages (cost-category#Inpatient-packages)

benefit

type: Vertebroplasty (packages#IN010)

Costs

-TypeApplicabilityValue
*hospitalization (pacakgeCostTypes#hospitalization)Gujarat SHA empaneled hospitals (applicabilityCodes#in-network)22800 INR

benefit

type: ABC Surgery (procedures#MC999A; unknown#ICD_PCS_001)

cost

type: hospitalization (pacakgeCostTypes#hospitalization)

applicability: Gujarat SHA empaneled hospitals (applicabilityCodes#in-network)

value: 11000 INR

cost

type: hospitalization (pacakgeCostTypes#hospitalization)

applicability: Gujarat SHA empaneled hospitals (applicabilityCodes#in-network)

qualifiers: STRAT002 (stratificationTypes#STRAT002), IMP0005 (implantCodes#IMP0005)

value: 12000 INR

benefit

type: Microlaryngoscopic Surgery (packages#HBP_PACKAGE_00003)

Costs

-TypeApplicabilityQualifiersValue
*hospitalization (pacakgeCostTypes#hospitalization)Gujarat SHA empaneled hospitals (applicabilityCodes#in-network)STRAT002 (stratificationTypes#STRAT002), IMP0005 (implantCodes#IMP0005)18500 INR