FHIR Implementation Guide for ABDM
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FHIR Implementation Guide for ABDM - Local Development build (v5.0.0). See the Directory of published versions

: CoverageEligibilityRequestBundle-validation-example-01 - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="CoverageEligibilityRequestBundle-validation-example-01"/>
  <meta>
    <versionId value="1"/>
    <profile
             value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequestBundle"/>
  </meta>
  <identifier>
    <system value="http://hip.in"/>
    <value value="bc3c6c57-2053-4d0e-ac40-139ccccff645"/>
  </identifier>
  <type value="collection"/>
  <timestamp value="2023-09-07T15:32:26.605+05:30"/>
  <entry>
    <fullUrl
             value="CoverageEligibilityRequest/CoverageEligibilityRequest-validation-example-01"/>
    <resource>
      <CoverageEligibilityRequest>
        <id value="CoverageEligibilityRequest-validation-example-01"/>
        <meta>
          <profile
                   value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><p><b>Generated Narrative: CoverageEligibilityRequest</b><a name="CoverageEligibilityRequest-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;CoverageEligibilityRequest-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/5.3.0/CodeSystem-processpriority.html">Process Priority Codes</a>#normal)</span></p><p><b>purpose</b>: validation</p><p><b>patient</b>: <a href="#Patient_Patient-example-01">See above (Patient/Patient-example-01)</a></p><p><b>created</b>: 2023-09-07 11:01:00+0500</p><p><b>enterer</b>: <a href="#Practitioner_Practitioner-example-01">See above (Practitioner/Practitioner-example-01)</a></p><p><b>provider</b>: <a href="#Practitioner_Practitioner-example-01">See above (Practitioner/Practitioner-example-01)</a></p><p><b>insurer</b>: <a href="#Organization_Organization-example-01">See above (Organization/Organization-example-01)</a></p><p><b>facility</b>: <a href="#Location_Location-example-01">See above (Location/Location-example-01)</a></p><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.html">Coverage/example-01</a></td></tr></table></div>
        </text>
        <identifier>
          <system value="https://irdai.gov.in"/>
          <value value="7612345"/>
        </identifier>
        <status value="active"/>
        <priority>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/processpriority"/>
            <code value="normal"/>
            <display value="Normal"/>
          </coding>
        </priority>
        <purpose value="validation"/>
        <patient>
          <reference value="Patient/Patient-example-01"/>
        </patient>
        <created value="2023-09-07T11:01:00+05:00"/>
        <enterer>
          <reference value="Practitioner/Practitioner-example-01"/>
        </enterer>
        <provider>
          <reference value="Practitioner/Practitioner-example-01"/>
        </provider>
        <insurer>
          <reference value="Organization/Organization-example-01"/>
        </insurer>
        <facility>
          <reference value="Location/Location-example-01"/>
        </facility>
        <insurance>
          <focal value="true"/>
          <coverage>
            <reference value="Coverage/example-01"/>
          </coverage>
        </insurance>
      </CoverageEligibilityRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl value="Patient/Patient-example-01"/>
    <resource>
      <Patient>
        <id value="Patient-example-01"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2023-09-07T14:58:58.181+05:30"/>
          <profile
                   value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Patient</b><a name="Patient-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;Patient-example-01&quot; Version &quot;1&quot; Updated &quot;2023-09-07 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>: Adarsh Agrawal</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>
        </text>
        <identifier>
          <type>
            <coding>
              <system
                      value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code"/>
              <code value="ADN"/>
              <display value="Adhaar number"/>
            </coding>
          </type>
          <system value="https://uidai.gov.in/"/>
          <value value="7225-4829-5255"/>
        </identifier>
        <name>
          <text value="Adarsh Agrawal"/>
        </name>
        <telecom>
          <system value="phone"/>
          <value value="+919818512600"/>
          <use value="home"/>
        </telecom>
        <gender value="male"/>
        <birthDate value="1981-01-12"/>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl value="Practitioner/Practitioner-example-01"/>
    <resource>
      <Practitioner>
        <id value="Practitioner-example-01"/>
        <meta>
          <versionId value="1"/>
          <lastUpdated value="2023-09-07T14:58:58.181+05:30"/>
          <profile
                   value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Practitioner</b><a name="Practitioner-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 Practitioner &quot;Practitioner-example-01&quot; Version &quot;1&quot; Updated &quot;2023-09-07 14:58:58+0530&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-Practitioner.html">Practitioner</a></p></div><p><b>identifier</b>: Medical License number: 21-1521-3828-3227</p><p><b>name</b>: Dr. Aayush Agrawal</p></div>
        </text>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="MD"/>
              <display value="Medical License number"/>
            </coding>
          </type>
          <system value="https://doctor.ndhm.gov.in"/>
          <value value="21-1521-3828-3227"/>
        </identifier>
        <name>
          <text value="Dr. Aayush Agrawal"/>
        </name>
      </Practitioner>
    </resource>
  </entry>
  <entry>
    <fullUrl value="Organization/Organization-example-01"/>
    <resource>
      <Organization>
        <id value="Organization-example-01"/>
        <meta>
          <profile
                   value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Organization</b><a name="Organization-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;Organization-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>type</b>: Insurance Company <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-organization-type.html">Organization type</a>#ins)</span></p><p><b>name</b>: XYZ Insurance Co. 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>
        </text>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="PRN"/>
              <display value="Provider number"/>
            </coding>
          </type>
          <system value="https://facility.ndhm.gov.in"/>
          <value value="4567878"/>
        </identifier>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/organization-type"/>
            <code value="ins"/>
            <display value="Insurance Company"/>
          </coding>
        </type>
        <name value="XYZ Insurance Co. Ltd."/>
        <telecom>
          <system value="phone"/>
          <value value="+91 243 2634 1234"/>
          <use value="work"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="contact@xyz.org"/>
          <use value="work"/>
        </telecom>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="Location/Location-example-01"/>
    <resource>
      <Location>
        <id value="Location-example-01"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Location</b><a name="Location-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 Location &quot;Location-example-01&quot; </p></div><p><b>identifier</b>: id: B1-S.F2</p><p><b>status</b>: active</p><p><b>name</b>: South Wing, second floor</p><p><b>alias</b>: IndiaFirst Life Insurance Co. Ltd., South Wing, second floor</p><p><b>description</b>: Second floor of the Old South Wing, formerly in use by Psychiatry</p><p><b>mode</b>: instance</p><p><b>telecom</b>: ph: 2328(WORK), fax: 2329(WORK), <a href="http://sampleorg.com/southwing">http://sampleorg.com/southwing</a></p><p><b>address</b>: 91, Building A Pune 451855 IND (WORK)</p><p><b>physicalType</b>: Wing <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-location-physical-type.html">Location type</a>#wi)</span></p><h3>Positions</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Longitude</b></td><td><b>Latitude</b></td><td><b>Altitude</b></td></tr><tr><td style="display: none">*</td><td>-83.6945691</td><td>42.25475478</td><td>0</td></tr></table><p><b>managingOrganization</b>: <a href="Organization-example-01.html">Organization/example-01</a> &quot;XYZ Lab Pvt.Ltd.&quot;</p></div>
        </text>
        <identifier>
          <value value="B1-S.F2"/>
        </identifier>
        <status value="active"/>
        <name value="South Wing, second floor"/>
        <alias
               value="IndiaFirst Life Insurance Co. Ltd., South Wing, second floor"/>
        <description
                     value="Second floor of the Old South Wing, formerly in use by Psychiatry"/>
        <mode value="instance"/>
        <telecom>
          <system value="phone"/>
          <value value="2328"/>
          <use value="work"/>
        </telecom>
        <telecom>
          <system value="fax"/>
          <value value="2329"/>
          <use value="work"/>
        </telecom>
        <telecom>
          <system value="url"/>
          <value value="http://sampleorg.com/southwing"/>
          <use value="work"/>
        </telecom>
        <address>
          <use value="work"/>
          <line value="91, Building A"/>
          <city value="Pune"/>
          <postalCode value="451855"/>
          <country value="IND"/>
        </address>
        <physicalType>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/location-physical-type"/>
            <code value="wi"/>
            <display value="Wing"/>
          </coding>
        </physicalType>
        <position>
          <longitude value="-83.6945691"/>
          <latitude value="42.25475478"/>
          <altitude value="0"/>
        </position>
        <managingOrganization>
          <reference value="Organization/example-01"/>
        </managingOrganization>
      </Location>
    </resource>
  </entry>
  <entry>
    <fullUrl value="Coverage/Coverage-example-01"/>
    <resource>
      <Coverage>
        <id value="Coverage-example-01"/>
        <meta>
          <profile
                   value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Coverage"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Coverage</b><a name="Coverage-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;Coverage-example-01&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-Coverage.html">Coverage</a></p></div><p><b>identifier</b>: id: 235037120</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/5.3.0/CodeSystem-coverage-selfpay.html">Coverage SelfPay Codes</a>#pay)</span></p><p><b>subscriber</b>: <a href="#Patient_Patient-example-01">See above (Patient/Patient-example-01)</a></p><p><b>subscriberId</b>: ABC123456BI007</p><p><b>beneficiary</b>: <a href="#Patient_Patient-example-01">See above (Patient/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/5.3.0/CodeSystem-subscriber-relationship.html">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>period</b>: ?? --&gt; 2026-03-17</p><p><b>payor</b>: <a href="#Organization_Organization-example-01">See above (Organization/Organization-example-01)</a></p></div>
        </text>
        <identifier>
          <system value="https://xyzinsurance.in/policynumber/"/>
          <value value="235037120"/>
        </identifier>
        <status value="active"/>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/coverage-selfpay"/>
            <code value="pay"/>
            <display value="PAY"/>
          </coding>
        </type>
        <subscriber>
          <reference value="Patient/Patient-example-01"/>
        </subscriber>
        <subscriberId value="ABC123456BI007"/>
        <beneficiary>
          <reference value="Patient/Patient-example-01"/>
        </beneficiary>
        <relationship>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
            <code value="self"/>
          </coding>
        </relationship>
        <period>
          <end value="2026-03-17"/>
        </period>
        <payor>
          <reference value="Organization/Organization-example-01"/>
        </payor>
      </Coverage>
    </resource>
  </entry>
</Bundle>