FHIR Implementation Guide for ABDM
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FHIR Implementation Guide for ABDM - Local Development build (v3.1.0). See the Directory of published versions

: CoverageEligibilityResponseBundle-validation-example-01 - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Bundle ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "CoverageEligibilityResponseBundle-validation-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 <https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponseBundle>     ] )
  ] ; # 
  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 "2022-07-09T15:32:26.605+05:30"^^xsd:dateTime] ; # 
  fhir:entry ( [
fhir:fullUrl [ fhir:v "CoverageEligibilityResponse/validation-example-01"^^xsd:anyURI ] ;
    ( fhir:resource <CoverageEligibilityResponse/validation-example-01> )
  ] [
fhir:fullUrl [ fhir:v "Patient/example-01"^^xsd:anyURI ] ;
    ( fhir:resource <Patient/example-01> )
  ] [
fhir:fullUrl [ fhir:v "Organization/example-01"^^xsd:anyURI ] ;
    ( fhir:resource <Organization/example-01> )
  ] [
fhir:fullUrl [ fhir:v "CoverageEligibilityRequest/validation-example-01"^^xsd:anyURI ] ;
    ( fhir:resource <CoverageEligibilityRequest/validation-example-01> )
  ] [
fhir:fullUrl [ fhir:v "Organization/example-02"^^xsd:anyURI ] ;
    ( fhir:resource <Organization/example-02> )
  ] [
fhir:fullUrl [ fhir:v "Coverage/example-01"^^xsd:anyURI ] ;
    ( fhir:resource <Coverage/example-01> )
  ] ) . # 

<CoverageEligibilityResponse/validation-example-01> a fhir:CoverageEligibilityResponse ;
  fhir:id [ fhir:v "validation-example-01"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse"^^xsd:anyURI ;
fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse>     ] )
  ] ; # 
  fhir:language [ fhir:v "en"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p><b>Generated Narrative: CoverageEligibilityResponse</b><a name=\"validation-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 &quot;validation-example-01&quot;  (Language &quot;en&quot;) </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>: validation</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_validation-example-01\">See above (CoverageEligibilityRequest/validation-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><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Coverage</b></td><td><b>Inforce</b></td><td><b>BenefitPeriod</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"#Coverage_example-01\">See above (Coverage/example-01)</a></td><td>true</td><td>2022-05-07 --&gt; 2025-08-07</td></tr></table></div>"
  ] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:purpose ( [ fhir:v "validation"] ) ; # 
  fhir:patient [
fhir:reference [ fhir:v "Patient/example-01" ]
  ] ; # 
  fhir:created [ fhir:v "2022-08-07"^^xsd:date] ; # 
  fhir:requestor [
fhir:reference [ fhir:v "Organization/example-01" ]
  ] ; # 
  fhir:request [
fhir:reference [ fhir:v "CoverageEligibilityRequest/validation-example-01" ]
  ] ; # 
  fhir:outcome [ fhir:v "complete"] ; # 
  fhir:disposition [ fhir:v "Policy is currently in-force."] ; # 
  fhir:insurer [
fhir:reference [ fhir:v "Organization/example-02" ]
  ] ; # 
  fhir:insurance ( [
fhir:coverage [
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 ]     ]
  ] ) . # 

<Patient/example-01> 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 <https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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 &quot;example-01&quot; Version &quot;1&quot; Updated &quot;2020-07-09 14:58:58+0530&quot; </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>"
  ] ; # 
  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] . # 

<Organization/example-01> 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 <https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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 &quot;example-01&quot; </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>"
  ] ; # 
  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" ]
  ] ) . # 

<CoverageEligibilityRequest/validation-example-01> a fhir:CoverageEligibilityRequest ;
  fhir:id [ fhir:v "validation-example-01"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest"^^xsd:anyURI ;
fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest>     ] )
  ] ; # 
  fhir:language [ fhir:v "en"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p><b>Generated Narrative: CoverageEligibilityRequest</b><a name=\"validation-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 &quot;validation-example-01&quot;  (Language &quot;en&quot;) </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-CoverageEligibilityRequest.html\">CoverageEligibilityRequest</a></p></div><p><b>identifier</b>: id: 7612345</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>: validation</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> &quot;&quot;</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> &quot;South Wing, second floor&quot;</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></div>"
  ] ; # 
  fhir:identifier ( [
fhir:system [ fhir:v "http://happypharma.com/claim"^^xsd:anyURI ] ;
fhir:value [ fhir:v "7612345" ]
  ] ) ; # 
  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 "validation"] ) ; # 
  fhir:patient [
fhir:reference [ fhir:v "Patient/example-01" ]
  ] ; # 
  fhir:created [ fhir:v "2022-12-20T11:01:00+05:00"^^xsd:dateTime] ; # 
  fhir:enterer [
fhir:reference [ fhir:v "Practitioner/example-01" ]
  ] ; # 
  fhir:provider [
fhir:reference [ fhir:v "Organization/example-01" ]
  ] ; # 
  fhir:insurer [
fhir:reference [ fhir:v "Organization/example-01" ]
  ] ; # 
  fhir:facility [
fhir:reference [ fhir:v "Location/example-01" ]
  ] ; # 
  fhir:supportingInfo ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:information [
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:reference [ fhir:v "Coverage/example-01" ]     ]
  ] ) . # 

<Organization/example-02> 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 <https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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 &quot;example-01&quot; </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>"
  ] ; # 
  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" ]
  ] ) . # 

<Coverage/example-01> a fhir:Coverage ;
  fhir:id [ fhir:v "example-01"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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 &quot;example-01&quot; </p></div><p><b>identifier</b>: id: SP12345678</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>: 2022-05-07 --&gt; 2025-08-07</p><p><b>payor</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p></div>"
  ] ; # 
  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:reference [ fhir:v "Patient/example-01" ]
  ] ; # 
  fhir:beneficiary [
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:start [ fhir:v "2022-05-07"^^xsd:date ] ;
fhir:end [ fhir:v "2025-08-07"^^xsd:date ]
  ] ; # 
  fhir:payor ( [
fhir:reference [ fhir:v "Patient/example-01" ]
  ] ) . #