Bundle ex01 of type message

Entry 1 - fullUrl = urn:uuid:267b18ce-3d37-4581-9baa-6fada338038b

Resource MessageHeader:

Generated Narrative: MessageHeader

Resource MessageHeader "267b18ce-3d37-4581-9baa-6fada338038b"

Profile: MyCareNet MessageHeader BE profile

event: claim-ask (Details: https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events code claim-ask = 'claim-ask', stated as 'null')

Destinations

-	Name	Endpoint
*	MyCareNet	MyCareNet

sender: See above (Organization/Organization1)

Sources

-	Endpoint
*	urn:uuid:e2c6f73a-74d8-40f2-af0b-a61ad20c53d4

focus: See above (Claim/Claim1)

Entry 2 - fullUrl = urn:uuid:e2c6f73a-74d8-40f2-af0b-a61ad20c53d4

Resource Organization:

Generated Narrative: Organization

Resource Organization "Organization1"

Profile: Organisation core BE profile

identifier: id: 71000436000

type: hospital (HCParty#orghospital)

Entry 3 - fullUrl = urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834

Resource PractitionerRole:

Generated Narrative: PractitionerRole

Resource PractitionerRole "PractitionerRole1"

Profile: Practitioner role core BE profile

practitioner: See above (Practitioner/Practitioner1)

code: physiotherapist (HCParty#persphysiotherapist)

Entry 4 - fullUrl = urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931

Resource Practitioner:

Generated Narrative: Practitioner

Resource Practitioner "Practitioner1"

Profile: Practitioner core BE profile

identifier: id: 54263481527

name: John Smith

Entry 5 - fullUrl = urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686

Resource Patient:

Jean Dupont Male, DoB: ( id: n° inscription mutualiste)

Entry 6 - fullUrl = urn:uuid:035e3de4-011f-48a4-92c9-15b2bbcec321

Resource PractitionerRole:

Generated Narrative: PractitionerRole

Resource PractitionerRole "PractitionerRole2"

Profile: Practitioner role core BE profile

practitioner: See above (Practitioner/Practitioner2)

code: physician (HCParty#persphysician)

Entry 7 - fullUrl = urn:uuid:8fc72085-d349-4bd7-ba84-91a935a4e3c6

Resource Practitioner:

Generated Narrative: Practitioner

Resource Practitioner "Practitioner2"

Profile: Practitioner core BE profile

identifier: id: 19234011004

name: Prénom du prescripteur Nom du prescripteur

Entry 8 - fullUrl = urn:uuid:b3586cda-f1e5-4c58-a389-94249957d87a

Resource ServiceRequest:

Generated Narrative: ServiceRequest

Resource ServiceRequest "ServiceRequest1"

Profile: MyCareNet eAgreement ServiceRequest BE profile

status: ACTIVE

intent: ORDER

category: Physical therapy procedure (SNOMED CT#91251008)

code: Physical therapy procedure (SNOMED CT#91251008)

quantity: 15

subject: See above (Patient/Patient1)

authoredOn: 2015-07-10

requester: See above (PractitionerRole/PractitionerRole2)

supportingInfo: #annexSR1

---

Generated Narrative: Binary #annexSR1

contentType: application/pdf

data: QW5uZXhlIGlubGluZSwgYmFzZTY0ZWQ=

Entry 9 - fullUrl = urn:uuid:3b8e1245-b480-4af6-90c0-f67037ef276b

Resource ServiceRequest:

Generated Narrative: ServiceRequest

Resource ServiceRequest "ServiceRequest2"

Profile: MyCareNet eAgreement ServiceRequest BE profile

identifier: id: n° de la prescription

status: ACTIVE

intent: ORDER

subject: See above (Patient/Patient1)

requester: See above (PractitionerRole/PractitionerRole2)

Entry 10 - fullUrl = urn:uuid:e85173bc-6f0d-480b-a2cd-2b70d9ffff7a

Resource Claim:

Generated Narrative: Claim

Resource Claim "Claim1"

Profile: MyCareNet eAgreement Claim Kine BE profile

status: ACTIVE

type: Professional (Claim Type Codes#professional)

subType: physiotherapy-fb (CodeSystem agreement types#physiotherapy-fb)

use: PREAUTHORIZATION

patient: See above (Patient/Patient1)

billablePeriod: 2020-01-15 --> (ongoing)

created: 2015-07-14 11:15:30+0200

enterer: See above (PractitionerRole/PractitionerRole1)

provider: See above (PractitionerRole/PractitionerRole1)

priority: Immediate (Process Priority Codes#stat)

referral: See above (ServiceRequest/ServiceRequest1)

supportingInfo

sequence: 1

category: Attachment (Claim Information Category Codes#attachment)

code: functional-report (CodeSystem annex types#functional-report)

value:

supportingInfo

sequence: 2

category: Information (Claim Information Category Codes#info)

value: additional Information

supportingInfo

sequence: 3

category: Information (Claim Information Category Codes#info)

value: See above (ServiceRequest/ServiceRequest2)

Insurances

-	Sequence	Focal	Coverage
*	1	true	: use of mandatory insurance coverage, no further details provided here.

Items

-	Sequence	ProductOrService	Serviced[x]
*	1	fb-51 (CodeSystem NIHDIPhysiotherapyPathology#fb-51)	2020-01-14