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

: JoeDoeEnquiringResponse - XML Representation

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<CoverageEligibilityResponse xmlns="http://hl7.org/fhir">
  <id value="JoeDoeEnquiringResponse"/>
  <meta>
    <profile
             value="https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/openimis-coverage-eligibility-response"/>
  </meta>
  <text>
    <status value="generated"/>
    <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 --&gt; 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>
  </text>
  <identifier>
    <type>
      <coding>
        <system
                value="https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/openimis-identifiers"/>
        <code value="UUID"/>
      </coding>
    </type>
    <value value="D30F70DF-D10B-43D4-9578-5137C118AD84"/>
  </identifier>
  <status value="active"/>
  <purpose value="benefits"/>
  <patient>
    <reference value="joe-doe"/>
  </patient>
  <created value="2021-09-17"/>
  <request>
    <reference value="CoverageEligibilityRequest/JoeDoeEnquiring"/>
  </request>
  <outcome value="complete"/>
  <insurer>
    <reference value="Organization/openIMIS-Implementation"/>
  </insurer>
  <insurance>
    <coverage>
      <reference value="Coverage/JoeDoeCoverage"/>
    </coverage>
    <benefitPeriod>
      <start value="2021-07-01"/>
      <end value="2022-06-30"/>
    </benefitPeriod>
    <item>
      <category>
        <coding>
          <system
                  value="https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-category"/>
          <code value="benefit"/>
          <display value="Benefit Package"/>
        </coding>
      </category>
      <name value="RX01"/>
      <description value="Regional fixed enrolment"/>
      <benefit>
        <type>
          <coding>
            <system
                    value="https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type"/>
            <code value="admissions_left"/>
            <display value="total_admissions"/>
          </coding>
        </type>
        <allowedUnsignedInt value="2"/>
      </benefit>
      <benefit>
        <type>
          <coding>
            <system
                    value="https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type"/>
            <code value="consultations_left"/>
            <display value="total_consultations"/>
          </coding>
        </type>
        <allowedUnsignedInt value="4"/>
      </benefit>
      <benefit>
        <type>
          <coding>
            <system
                    value="https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type"/>
            <code value="surgeries_left"/>
            <display value="total_surgeries"/>
          </coding>
        </type>
        <allowedUnsignedInt value="1"/>
      </benefit>
      <benefit>
        <type>
          <coding>
            <system
                    value="https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type"/>
            <code value="deliveries_left"/>
            <display value="total_deliveries"/>
          </coding>
        </type>
        <allowedUnsignedInt value="1"/>
      </benefit>
      <benefit>
        <type>
          <coding>
            <system
                    value="https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type"/>
            <code value="hospitalization_amount"/>
            <display value="hospitalization_amount"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="25000"/>
        </allowedMoney>
      </benefit>
      <benefit>
        <type>
          <coding>
            <system
                    value="https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type"/>
            <code value="consultation_amount"/>
            <display value="consultation_amount"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="15000"/>
        </allowedMoney>
      </benefit>
      <benefit>
        <type>
          <coding>
            <system
                    value="https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type"/>
            <code value="surgery_amount"/>
            <display value="surgery_amount"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="70000"/>
        </allowedMoney>
      </benefit>
      <benefit>
        <type>
          <coding>
            <system
                    value="https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-benefit-type"/>
            <code value="delivery_amount"/>
            <display value="delivery_amount"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="15000"/>
        </allowedMoney>
      </benefit>
    </item>
    <item>
      <category>
        <coding>
          <system
                  value="https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/coverage-item-category"/>
          <code value="service"/>
          <display value="Service"/>
        </coding>
      </category>
      <productOrService>
        <text value="A1"/>
      </productOrService>
      <excluded value="false"/>
    </item>
  </insurance>
</CoverageEligibilityResponse>