FHIR Implementation Guide for ABDM
5.0.0 - active
India
FHIR Implementation Guide for ABDM
5.0.0 - active
India
FHIR Implementation Guide for ABDM - Local Development build (v5.0.0). See the Directory of published versions
Generated Narrative: ClaimResponse
Resource ClaimResponse "ClaimResponse-enhancement-example-01"
Profile: ClaimResponse
status: active
type: Inpatient care management (procedure) (SNOMED CT#737481003)
subType: Emergency Claim (Example Claim SubType Codes#emergency)
use: preauthorization
patient: Patient/example-01 ""
created: 2023-12-12 15:32:26+0530
insurer: Organization/example-02 "XYZ Insurance Co. Ltd."
requestor: Organization/example-03 "Maharashtra State Government"
request: Claim/Claim-enhancement-example-01
outcome: complete
disposition: The enclosed services are authorized for your provision within 30 days of this notice.
preAuthRef: 123456
payeeType: Provider (Payee Type Codes#provider)
addItem
itemSequence: 1
productOrService: Angiography (SNOMED CT#77343006)
Nets
Value Currency 10000.00 INR adjudication
category: Eligible Amount (Adjudication Value Codes#eligible)
reason: Covered (SNOMED CT#255334000)
amount
₹10,000.00 (INR)
addItem
itemSequence: 2
productOrService: Angioplasty of blood vessel (SNOMED CT#418285008)
Nets
Value Currency 10000 INR adjudication
category: Eligible Amount (Adjudication Value Codes#eligible)
reason: Covered (SNOMED CT#255334000)
amount
₹10,000.00 (INR)
total
category: Submitted Amount (Adjudication Value Codes#submitted)
Amounts
Value Currency 20000 INR
| Sequence | Focal | Coverage |
| 1 | true | Coverage/example-02 |