FHIR Implementation Guide for ABDM
4.0.0 - active
FHIR Implementation Guide for ABDM
4.0.0 - active
FHIR Implementation Guide for ABDM - Local Development build (v4.0.0). See the Directory of published versions
Generated Narrative: ClaimResponse
Resource ClaimResponse "preauth-example-01"
Profile: ClaimResponse
status: active
type: Management of health status after discharge from hospital (procedure) (SNOMED CT#710967003)
subType: Emergency Claim (Example Claim SubType Codes#emergency)
use: preauthorization
patient: Patient/example-01 ""
created: 2023-09-07 15:32:26+0530
insurer: Organization/example-02 "XYZ Insurance Co. Ltd."
requestor: Practitioner/example-01 ""
request: Claim/preauth-example-01
outcome: complete
disposition: The enclosed services are authorized for your provision within 30 days of this notice.
preAuthRef: 12S52
payeeType: Provider (Payee Type Codes#provider)
addItem
itemSequence: 1
productOrService: Consultant (SNOMED CT#768839008)
Nets
Value Currency 500.00 INR adjudication
category: Eligible Amount (Adjudication Value Codes#eligible)
reason: Covered (SNOMED CT#255334000)
amount
₹500.00 (INR)
addItem
itemSequence: 2
productOrService: Metformin hydrochloride 500 mg prolonged-release oral tablet (SNOMED CT#765507008)
Nets
Value Currency 910.28 INR adjudication
category: Eligible Amount (Adjudication Value Codes#eligible)
reason: Covered (SNOMED CT#255334000)
amount
₹910.28 (INR)
total
category: Submitted Amount (Adjudication Value Codes#submitted)
Amounts
Value Currency 1410.28 INR
| Sequence | Focal | Coverage |
| 1 | true | Coverage/example-01 |