@prefix fhir: . @prefix owl: . @prefix rdfs: . @prefix sct: . @prefix xsd: . # - resource ------------------------------------------------------------------- a fhir:Bundle ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "CoverageEligibilityResponseBundle-benefit-example-01"] ; # fhir:meta [ fhir:versionId [ fhir:v "2" ] ; fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponseBundle"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:identifier [ fhir:system [ fhir:v "http://hip.in"^^xsd:anyURI ] ; fhir:value [ fhir:v "bc3c6c57-2053-4d0e-ac40-139ccccff645" ] ] ; # fhir:type [ fhir:v "collection"] ; # fhir:timestamp [ fhir:v "2020-07-09T15:32:26.605+05:30"^^xsd:dateTime] ; # fhir:entry ( [ fhir:fullUrl [ fhir:v "CoverageEligibilityResponse/benefit-example-01"^^xsd:anyURI ] ; fhir:resource ( ) ] [ fhir:fullUrl [ fhir:v "Patient/example-01"^^xsd:anyURI ] ; fhir:resource ( ) ] [ fhir:fullUrl [ fhir:v "Organization/example-01"^^xsd:anyURI ] ; fhir:resource ( ) ] [ fhir:fullUrl [ fhir:v "CoverageEligibilityRequest/benefit-example-01"^^xsd:anyURI ] ; fhir:resource ( ) ] [ fhir:fullUrl [ fhir:v "Organization/example-02"^^xsd:anyURI ] ; fhir:resource ( ) ] [ fhir:fullUrl [ fhir:v "Coverage/example-01"^^xsd:anyURI ] ; fhir:resource ( ) ] ) . # a fhir:CoverageEligibilityResponse ; fhir:id [ fhir:v "benefit-example-01"] ; # fhir:meta [ fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:language [ fhir:v "en"] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "

Generated Narrative: CoverageEligibilityResponse

Resource CoverageEligibilityResponse "benefit-example-01" (Language "en")

Profile: CoverageEligibilityResponse

status: active

purpose: benefits

patient: See above (Patient/example-01)

created: 2022-08-07

requestor: See above (Organization/example-01)

request: See above (CoverageEligibilityRequest/benefit-example-01)

outcome: complete

disposition: Policy is currently in-force.

insurer: See above (Organization/example-02)

insurance

coverage: See above (Coverage/example-01)

inforce: true

benefitPeriod: 2022-05-07 --> 2025-08-07

item

productOrService: Removal of foreign body (SNOMED CT#10849003)

Benefits

-TypeAllowed[x]Used[x]
*Benefit (Benefit Type Codes#benefit)₹40,000.00 (INR)₹0.00 (INR)
" ] ; # fhir:status [ fhir:v "active"] ; # fhir:purpose ( [ fhir:v "benefits"] ) ; # fhir:patient [ fhir:link ; fhir:reference [ fhir:v "Patient/example-01" ] ] ; # fhir:created [ fhir:v "2022-08-07"^^xsd:date] ; # fhir:requestor [ fhir:link ; fhir:reference [ fhir:v "Organization/example-01" ] ] ; # fhir:request [ fhir:link ; fhir:reference [ fhir:v "CoverageEligibilityRequest/benefit-example-01" ] ] ; # fhir:outcome [ fhir:v "complete"] ; # fhir:disposition [ fhir:v "Policy is currently in-force."] ; # fhir:insurer [ fhir:link ; fhir:reference [ fhir:v "Organization/example-02" ] ] ; # fhir:insurance ( [ fhir:coverage [ fhir:link ; fhir:reference [ fhir:v "Coverage/example-01" ] ] ; fhir:inforce [ fhir:v "true"^^xsd:boolean ] ; fhir:benefitPeriod [ fhir:start [ fhir:v "2022-05-07"^^xsd:date ] ; fhir:end [ fhir:v "2025-08-07"^^xsd:date ] ] ; fhir:item ( [ fhir:productOrService [ fhir:coding ( [ a sct:10849003 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "10849003" ] ; fhir:display [ fhir:v "Removal of foreign body" ] ] ) ] ; fhir:benefit ( [ fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-type"^^xsd:anyURI ] ; fhir:code [ fhir:v "benefit" ] ; fhir:display [ fhir:v "Benefit" ] ] ) ] ; fhir:allowed [ a fhir:Money ; fhir:value [ fhir:v "40000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ; fhir:used [ a fhir:Money ; fhir:value [ fhir:v "0"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ] ) ] ) ] ) . # a fhir:Patient ; fhir:id [ fhir:v "example-01"] ; # fhir:meta [ fhir:versionId [ fhir:v "1" ] ; fhir:lastUpdated [ fhir:v "2020-07-09T14:58:58.181+05:30"^^xsd:dateTime ] ; fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "

Generated Narrative: Patient

Resource Patient "example-01" Version "1" Updated "2020-07-09 14:58:58+0530"

Profile: Patient

identifier: Adhaar number: 7225-4829-5255

name: Ayush Sharma

telecom: +919818512600

gender: male

birthDate: 1981-01-12

" ] ; # fhir:identifier ( [ fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code"^^xsd:anyURI ] ; fhir:code [ fhir:v "ADN" ] ; fhir:display [ fhir:v "Adhaar number" ] ] ) ] ; fhir:system [ fhir:v "https://uidai.gov.in/"^^xsd:anyURI ] ; fhir:value [ fhir:v "7225-4829-5255" ] ] ) ; # fhir:name ( [ fhir:text [ fhir:v "Ayush Sharma" ] ] ) ; # fhir:telecom ( [ fhir:system [ fhir:v "phone" ] ; fhir:value [ fhir:v "+919818512600" ] ; fhir:use [ fhir:v "home" ] ] ) ; # fhir:gender [ fhir:v "male"] ; # fhir:birthDate [ fhir:v "1981-01-12"^^xsd:date] . # a fhir:Organization ; fhir:id [ fhir:v "example-01"] ; # fhir:meta [ fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "

Generated Narrative: Organization

Resource Organization "example-01"

Profile: Organization

identifier: Provider number: 4567878

name: Apollo Hospital Pvt.Ltd.

telecom: +91 243 2634 1234, contact@xyz.org

" ] ; # fhir:identifier ( [ fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ; fhir:code [ fhir:v "PRN" ] ; fhir:display [ fhir:v "Provider number" ] ] ) ] ; fhir:system [ fhir:v "https://facility.ndhm.gov.in"^^xsd:anyURI ] ; fhir:value [ fhir:v "4567878" ] ] ) ; # fhir:name [ fhir:v "Apollo Hospital Pvt.Ltd."] ; # fhir:telecom ( [ fhir:system [ fhir:v "phone" ] ; fhir:value [ fhir:v "+91 243 2634 1234" ] ; fhir:use [ fhir:v "work" ] ] [ fhir:system [ fhir:v "email" ] ; fhir:value [ fhir:v "contact@xyz.org" ] ; fhir:use [ fhir:v "work" ] ] ) . # a fhir:CoverageEligibilityRequest ; fhir:id [ fhir:v "benefit-example-01"] ; # fhir:meta [ fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:language [ fhir:v "en"] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "

Generated Narrative: CoverageEligibilityRequest

Resource CoverageEligibilityRequest "benefit-example-01" (Language "en")

Profile: CoverageEligibilityRequest

identifier: id: dc82673b-8c71-48c2-8a17-16dcb3b035f6

status: active

priority: Normal (Process Priority Codes#normal)

purpose: benefits

patient: See above (Patient/example-01)

created: 2022-12-20 11:01:00+0500

enterer: Practitioner/example-01 ""

provider: See above (Organization/example-01)

insurer: See above (Organization/example-01)

facility: Location/example-01 "South Wing, second floor"

SupportingInfos

-SequenceInformationAppliesToAll
*1DocumentReference/example-01true

Insurances

-FocalCoverage
*trueSee above (Coverage/example-01)

item

supportingInfoSequence: 1

productOrService: Removal of foreign body (SNOMED CT#10849003)

UnitPrices

-ValueCurrency
*40000INR

Diagnoses

-Diagnosis[x]
*Condition/example-01
" ] ; # fhir:identifier ( [ fhir:system [ fhir:v "https://www.tmh.in/coverage-eligibility-request"^^xsd:anyURI ] ; fhir:value [ fhir:v "dc82673b-8c71-48c2-8a17-16dcb3b035f6" ] ] ) ; # fhir:status [ fhir:v "active"] ; # fhir:priority [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ] ; fhir:code [ fhir:v "normal" ] ; fhir:display [ fhir:v "Normal" ] ] ) ] ; # fhir:purpose ( [ fhir:v "benefits"] ) ; # fhir:patient [ fhir:link ; fhir:reference [ fhir:v "Patient/example-01" ] ] ; # fhir:created [ fhir:v "2022-12-20T11:01:00+05:00"^^xsd:dateTime] ; # fhir:enterer [ fhir:link ; fhir:reference [ fhir:v "Practitioner/example-01" ] ] ; # fhir:provider [ fhir:link ; fhir:reference [ fhir:v "Organization/example-01" ] ] ; # fhir:insurer [ fhir:link ; fhir:reference [ fhir:v "Organization/example-01" ] ] ; # fhir:facility [ fhir:link ; fhir:reference [ fhir:v "Location/example-01" ] ] ; # fhir:supportingInfo ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:information [ fhir:link ; fhir:reference [ fhir:v "DocumentReference/example-01" ] ] ; fhir:appliesToAll [ fhir:v "true"^^xsd:boolean ] ] ) ; # fhir:insurance ( [ fhir:focal [ fhir:v "true"^^xsd:boolean ] ; fhir:coverage [ fhir:link ; fhir:reference [ fhir:v "Coverage/example-01" ] ] ] ) ; # fhir:item ( [ fhir:supportingInfoSequence ( [ fhir:v "1"^^xsd:positiveInteger ] ) ; fhir:productOrService [ fhir:coding ( [ a sct:10849003 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "10849003" ] ; fhir:display [ fhir:v "Removal of foreign body" ] ] ) ] ; fhir:unitPrice [ fhir:value [ fhir:v "40000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ; fhir:diagnosis ( [ fhir:diagnosis [ a fhir:Reference ; fhir:link ; fhir:reference [ fhir:v "Condition/example-01" ] ] ] ) ] ) . # a fhir:Organization ; fhir:id [ fhir:v "example-02"] ; # fhir:meta [ fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "

Generated Narrative: Organization

Resource Organization "example-02"

Profile: Organization

identifier: Provider number: 4567878

name: Star Health Insurance Pvt.Ltd.

telecom: +91 243 2634 1234, contact@xyz.org

" ] ; # fhir:identifier ( [ fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ; fhir:code [ fhir:v "PRN" ] ; fhir:display [ fhir:v "Provider number" ] ] ) ] ; fhir:system [ fhir:v "https://facility.ndhm.gov.in"^^xsd:anyURI ] ; fhir:value [ fhir:v "4567878" ] ] ) ; # fhir:name [ fhir:v "Star Health Insurance Pvt.Ltd."] ; # fhir:telecom ( [ fhir:system [ fhir:v "phone" ] ; fhir:value [ fhir:v "+91 243 2634 1234" ] ; fhir:use [ fhir:v "work" ] ] [ fhir:system [ fhir:v "email" ] ; fhir:value [ fhir:v "contact@xyz.org" ] ; fhir:use [ fhir:v "work" ] ] ) . # a fhir:Coverage ; fhir:id [ fhir:v "example-01"] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "

Generated Narrative: Coverage

Resource Coverage "example-01"

identifier: id: SP12345678

status: active

type: PAY (Coverage SelfPay Codes#pay)

subscriber: See above (Patient/example-01)

beneficiary: See above (Patient/example-01)

relationship: Self (SubscriberPolicyholder Relationship Codes#self)

period: ?? --> 2012-03-17

payor: See above (Patient/example-01)

" ] ; # fhir:identifier ( [ fhir:system [ fhir:v "http://hospitalx.com/selfpayagreement"^^xsd:anyURI ] ; fhir:value [ fhir:v "SP12345678" ] ] ) ; # fhir:status [ fhir:v "active"] ; # fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-selfpay"^^xsd:anyURI ] ; fhir:code [ fhir:v "pay" ] ; fhir:display [ fhir:v "PAY" ] ] ) ] ; # fhir:subscriber [ fhir:link ; fhir:reference [ fhir:v "Patient/example-01" ] ] ; # fhir:beneficiary [ fhir:link ; fhir:reference [ fhir:v "Patient/example-01" ] ] ; # fhir:relationship [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ] ; fhir:code [ fhir:v "self" ] ] ) ] ; # fhir:period [ fhir:end [ fhir:v "2012-03-17"^^xsd:date ] ] ; # fhir:payor ( [ fhir:link ; fhir:reference [ fhir:v "Patient/example-01" ] ] ) . # # -------------------------------------------------------------------------------------