openIMIS FHIR R4 Implementation Guide
1.0.0 - ci-build
openIMIS FHIR R4 Implementation Guide
1.0.0 - ci-build
openIMIS FHIR R4 Implementation Guide - Local Development build (v1.0.0). See the Directory of published versions
{
"resourceType" : "CoverageEligibilityResponse",
"id" : "JoeDoeEnquiringResponse",
"meta" : {
"profile" : [
"https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/openimis-coverage-eligibility-response"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></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 \"JoeDoeEnquiringResponse\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-openimis-coverage-eligibility-response.html\">openIMIS CoverageEligibilityResponse</a></p></div><p><b>identifier</b>: UUID unique identifier: D30F70DF-D10B-43D4-9578-5137C118AD84</p><p><b>status</b>: active</p><p><b>purpose</b>: benefits</p><p><b>patient</b>: <a href=\"joe-doe\">joe-doe</a></p><p><b>created</b>: 2021-09-17</p><p><b>request</b>: <a href=\"CoverageEligibilityRequest-JoeDoeEnquiring.html\">CoverageEligibilityRequest/JoeDoeEnquiring</a></p><p><b>outcome</b>: complete</p><p><b>insurer</b>: <a href=\"Organization-openIMIS-Implementation.html\">Organization/openIMIS-Implementation</a> \"openIMIS Implementation\"</p><blockquote><p><b>insurance</b></p><p><b>coverage</b>: <a href=\"Coverage-JoeDoeCoverage.html\">Coverage/JoeDoeCoverage</a></p><p><b>benefitPeriod</b>: 2021-07-01 --> 2022-06-30</p><blockquote><p><b>item</b></p><p><b>category</b>: Benefit Package <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-coverage-item-category.html\">Category of the item (Coverage)</a>#benefit)</span></p><p><b>name</b>: RX01</p><p><b>description</b>: Regional fixed enrolment</p><blockquote><p><b>benefit</b></p><p><b>type</b>: total_admissions <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-coverage-item-benefit-type.html\">Type of benefit (Coverage)</a>#admissions_left)</span></p><p><b>allowed</b>: 2</p></blockquote><blockquote><p><b>benefit</b></p><p><b>type</b>: total_consultations <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-coverage-item-benefit-type.html\">Type of benefit (Coverage)</a>#consultations_left)</span></p><p><b>allowed</b>: 4</p></blockquote><blockquote><p><b>benefit</b></p><p><b>type</b>: total_surgeries <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-coverage-item-benefit-type.html\">Type of benefit (Coverage)</a>#surgeries_left)</span></p><p><b>allowed</b>: 1</p></blockquote><blockquote><p><b>benefit</b></p><p><b>type</b>: total_deliveries <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-coverage-item-benefit-type.html\">Type of benefit (Coverage)</a>#deliveries_left)</span></p><p><b>allowed</b>: 1</p></blockquote><blockquote><p><b>benefit</b></p><p><b>type</b>: hospitalization_amount <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-coverage-item-benefit-type.html\">Type of benefit (Coverage)</a>#hospitalization_amount)</span></p><p><b>allowed</b>: </p></blockquote></blockquote></blockquote><p><b style=\"color: maroon\">Exception generating Narrative: null</b></p></div>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/openimis-identifiers",
"code" : "UUID"
}
]
},
"value" : "D30F70DF-D10B-43D4-9578-5137C118AD84"
}
],
"status" : "active",
"purpose" : [
"benefits"
],
"patient" : {
"reference" : "joe-doe"
},
"created" : "2021-09-17",
"request" : {
"reference" : "CoverageEligibilityRequest/JoeDoeEnquiring"
},
"outcome" : "complete",
"insurer" : {
"reference" : "Organization/openIMIS-Implementation"
},
"insurance" : [
{
"coverage" : {
"reference" : "Coverage/JoeDoeCoverage"
},
"benefitPeriod" : {
"start" : "2021-07-01",
"end" : "2022-06-30"
},
"item" : [
{
"category" : {
"coding" : [
{
"system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-category",
"code" : "benefit",
"display" : "Benefit Package"
}
]
},
"name" : "RX01",
"description" : "Regional fixed enrolment",
"benefit" : [
{
"type" : {
"coding" : [
{
"system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type",
"code" : "admissions_left",
"display" : "total_admissions"
}
]
},
"allowedUnsignedInt" : 2
},
{
"type" : {
"coding" : [
{
"system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type",
"code" : "consultations_left",
"display" : "total_consultations"
}
]
},
"allowedUnsignedInt" : 4
},
{
"type" : {
"coding" : [
{
"system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type",
"code" : "surgeries_left",
"display" : "total_surgeries"
}
]
},
"allowedUnsignedInt" : 1
},
{
"type" : {
"coding" : [
{
"system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type",
"code" : "deliveries_left",
"display" : "total_deliveries"
}
]
},
"allowedUnsignedInt" : 1
},
{
"type" : {
"coding" : [
{
"system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type",
"code" : "hospitalization_amount",
"display" : "hospitalization_amount"
}
]
},
"allowedMoney" : {
"value" : 25000
}
},
{
"type" : {
"coding" : [
{
"system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type",
"code" : "consultation_amount",
"display" : "consultation_amount"
}
]
},
"allowedMoney" : {
"value" : 15000
}
},
{
"type" : {
"coding" : [
{
"system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type",
"code" : "surgery_amount",
"display" : "surgery_amount"
}
]
},
"allowedMoney" : {
"value" : 70000
}
},
{
"type" : {
"coding" : [
{
"system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type",
"code" : "delivery_amount",
"display" : "delivery_amount"
}
]
},
"allowedMoney" : {
"value" : 15000
}
}
]
},
{
"category" : {
"coding" : [
{
"system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-category",
"code" : "service",
"display" : "Service"
}
]
},
"productOrService" : {
"text" : "A1"
},
"excluded" : false
}
]
}
]
}