FHIR Implementation Guide for ABDM
3.1.0 - active
FHIR Implementation Guide for ABDM
3.1.0 - active
FHIR Implementation Guide for ABDM - Local Development build (v3.1.0). See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "CoverageEligibilityResponseBundle-auth-requirements-example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponseBundle"
]
},
"identifier" : {
"system" : "http://hip.in",
"value" : "bc3c6c57-2053-4d0e-ac40-139ccccff645"
},
"type" : "collection",
"timestamp" : "2020-07-09T15:32:26.605+05:30",
"entry" : [
{
"fullUrl" : "CoverageEligibilityResponse/auth-requirements-example-01",
"resource" : {
"resourceType" : "CoverageEligibilityResponse",
"id" : "auth-requirements-example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse"
]
},
"language" : "en",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p><b>Generated Narrative: CoverageEligibilityResponse</b><a name=\"auth-requirements-example-01\"> </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 "auth-requirements-example-01" (Language "en") </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-CoverageEligibilityResponse.html\">CoverageEligibilityResponse</a></p></div><p><b>status</b>: active</p><p><b>purpose</b>: auth-requirements</p><p><b>patient</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p><p><b>created</b>: 2022-08-07</p><p><b>requestor</b>: <a href=\"#Organization_example-01\">See above (Organization/example-01)</a></p><p><b>request</b>: <a href=\"#CoverageEligibilityRequest_auth-requirement-example-01\">See above (CoverageEligibilityRequest/auth-requirement-example-01)</a></p><p><b>outcome</b>: complete</p><p><b>disposition</b>: Policy is currently in-force.</p><p><b>insurer</b>: <a href=\"#Organization_example-01\">See above (Organization/example-02)</a></p><blockquote><p><b>insurance</b></p><p><b>coverage</b>: <a href=\"#Coverage_example-01\">See above (Coverage/example-01)</a></p><p><b>inforce</b>: true</p><p><b>benefitPeriod</b>: 2022-05-07 --> 2025-08-07</p><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ProductOrService</b></td></tr><tr><td style=\"display: none\">*</td><td>Removal of foreign body <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#10849003)</span></td></tr></table></blockquote></div>"
},
"status" : "active",
"purpose" : [
"auth-requirements"
],
"patient" : {
"reference" : "Patient/example-01"
},
"created" : "2022-08-07",
"requestor" : {
"reference" : "Organization/example-01"
},
"request" : {
"reference" : "CoverageEligibilityRequest/auth-requirement-example-01"
},
"outcome" : "complete",
"disposition" : "Policy is currently in-force.",
"insurer" : {
"reference" : "Organization/example-02"
},
"insurance" : [
{
"coverage" : {
"reference" : "Coverage/example-01"
},
"inforce" : true,
"benefitPeriod" : {
"start" : "2022-05-07",
"end" : "2025-08-07"
},
"item" : [
{
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "10849003",
"display" : "Removal of foreign body"
}
]
}
}
]
}
]
}
},
{
"fullUrl" : "Patient/example-01",
"resource" : {
"resourceType" : "Patient",
"id" : "example-01",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-07-09T14:58:58.181+05:30",
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"example-01\"> </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 "example-01" Version "1" Updated "2020-07-09 14:58:58+0530" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Patient.html\">Patient</a></p></div><p><b>identifier</b>: Adhaar number: 7225-4829-5255</p><p><b>name</b>: Ayush Sharma</p><p><b>telecom</b>: <a href=\"tel:+919818512600\">+919818512600</a></p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1981-01-12</p></div>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code",
"code" : "ADN",
"display" : "Adhaar number"
}
]
},
"system" : "https://uidai.gov.in/",
"value" : "7225-4829-5255"
}
],
"name" : [
{
"text" : "Ayush Sharma"
}
],
"telecom" : [
{
"system" : "phone",
"value" : "+919818512600",
"use" : "home"
}
],
"gender" : "male",
"birthDate" : "1981-01-12"
}
},
{
"fullUrl" : "Organization/example-01",
"resource" : {
"resourceType" : "Organization",
"id" : "example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"example-01\"> </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 "example-01" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Organization.html\">Organization</a></p></div><p><b>identifier</b>: Provider number: 4567878</p><p><b>name</b>: Apollo Hospital Pvt.Ltd.</p><p><b>telecom</b>: <a href=\"tel:+9124326341234\">+91 243 2634 1234</a>, <a href=\"mailto:contact@xyz.org\">contact@xyz.org</a></p></div>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "PRN",
"display" : "Provider number"
}
]
},
"system" : "https://facility.ndhm.gov.in",
"value" : "4567878"
}
],
"name" : "Apollo Hospital Pvt.Ltd.",
"telecom" : [
{
"system" : "phone",
"value" : "+91 243 2634 1234",
"use" : "work"
},
{
"system" : "email",
"value" : "contact@xyz.org",
"use" : "work"
}
]
}
},
{
"fullUrl" : "CoverageEligibilityRequest/auth-requirement-example-01",
"resource" : {
"resourceType" : "CoverageEligibilityRequest",
"id" : "auth-requirement-example-01",
"language" : "en",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p><b>Generated Narrative: CoverageEligibilityRequest</b><a name=\"auth-requirement-example-01\"> </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 CoverageEligibilityRequest "auth-requirement-example-01" (Language "en") </p></div><p><b>identifier</b>: id:\u00a07612345</p><p><b>status</b>: active</p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><p><b>purpose</b>: auth-requirements</p><p><b>patient</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p><p><b>created</b>: 2022-12-20 11:01:00+0500</p><p><b>enterer</b>: <a href=\"Practitioner-example-01.html\">Practitioner/example-01</a> ""</p><p><b>provider</b>: <a href=\"#Organization_example-01\">See above (Organization/example-01)</a></p><p><b>insurer</b>: <a href=\"#Organization_example-01\">See above (Organization/example-01)</a></p><p><b>facility</b>: <a href=\"Location-example-01.html\">Location/example-01</a> "South Wing, second floor"</p><h3>SupportingInfos</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Information</b></td><td><b>AppliesToAll</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><a href=\"DocumentReference-example-01.html\">DocumentReference/example-01</a></td><td>true</td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>true</td><td><a href=\"#Coverage_example-01\">See above (Coverage/example-01)</a></td></tr></table><blockquote><p><b>item</b></p><p><b>supportingInfoSequence</b>: 1</p><p><b>productOrService</b>: Cardiac tamponade <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#35304003)</span></p><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Condition-example-01.html\">Condition/example-01</a></td></tr></table></blockquote></div>"
},
"identifier" : [
{
"system" : "http://happypharma.com/claim",
"value" : "7612345"
}
],
"status" : "active",
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "normal",
"display" : "Normal"
}
]
},
"purpose" : [
"auth-requirements"
],
"patient" : {
"reference" : "Patient/example-01"
},
"created" : "2022-12-20T11:01:00+05:00",
"enterer" : {
"reference" : "Practitioner/example-01"
},
"provider" : {
"reference" : "Organization/example-01"
},
"insurer" : {
"reference" : "Organization/example-01"
},
"facility" : {
"reference" : "Location/example-01"
},
"supportingInfo" : [
{
"sequence" : 1,
"information" : {
"reference" : "DocumentReference/example-01"
},
"appliesToAll" : true
}
],
"insurance" : [
{
"focal" : true,
"coverage" : {
"reference" : "Coverage/example-01"
}
}
],
"item" : [
{
"supportingInfoSequence" : [
1
],
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "35304003",
"display" : "Cardiac tamponade"
}
]
},
"diagnosis" : [
{
"diagnosisReference" : {
"reference" : "Condition/example-01"
}
}
]
}
]
}
},
{
"fullUrl" : "Organization/example-02",
"resource" : {
"resourceType" : "Organization",
"id" : "example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"example-01\"> </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 "example-01" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Organization.html\">Organization</a></p></div><p><b>identifier</b>: Provider number: 4567878</p><p><b>name</b>: Star Health Insurance Pvt.Ltd.</p><p><b>telecom</b>: <a href=\"tel:+9124326341234\">+91 243 2634 1234</a>, <a href=\"mailto:contact@xyz.org\">contact@xyz.org</a></p></div>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "PRN",
"display" : "Provider number"
}
]
},
"system" : "https://facility.ndhm.gov.in",
"value" : "4567878"
}
],
"name" : "Star Health Insurance Pvt.Ltd.",
"telecom" : [
{
"system" : "phone",
"value" : "+91 243 2634 1234",
"use" : "work"
},
{
"system" : "email",
"value" : "contact@xyz.org",
"use" : "work"
}
]
}
},
{
"fullUrl" : "Coverage/example-01",
"resource" : {
"resourceType" : "Coverage",
"id" : "example-01",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b><a name=\"example-01\"> </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 Coverage "example-01" </p></div><p><b>identifier</b>: id:\u00a0SP12345678</p><p><b>status</b>: active</p><p><b>type</b>: PAY <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-coverage-selfpay.html\">Coverage SelfPay Codes</a>#pay)</span></p><p><b>subscriber</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p><p><b>beneficiary</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p><p><b>relationship</b>: Self <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>period</b>: 2012-03-17 --> 2025-03-17</p><p><b>payor</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p></div>"
},
"identifier" : [
{
"system" : "http://hospitalx.com/selfpayagreement",
"value" : "SP12345678"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-selfpay",
"code" : "pay",
"display" : "PAY"
}
]
},
"subscriber" : {
"reference" : "Patient/example-01"
},
"beneficiary" : {
"reference" : "Patient/example-01"
},
"relationship" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"code" : "self"
}
]
},
"period" : {
"start" : "2012-03-17",
"end" : "2025-03-17"
},
"payor" : [
{
"reference" : "Patient/example-01"
}
]
}
}
]
}
IG © 2020+ National Resource Center for EHR Standards. Package ndhm.in#3.1.0 based on FHIR 4.0.1. Generated 2023-08-10
Links: Table of Contents |
QA Report
| Version History |