This page is part of the HL7 Belgium FHIR Implementation Guide - MyCareNet profiles (v2.0.0: Trial Use) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "ex03",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementdemand"
]
},
"type" : "message",
"timestamp" : "2015-07-14T11:15:33+02:00",
"entry" : [
{
"fullUrl" : "urn:uuid:ce2e2084-3f5c-4f52-8551-8088bb6d3491",
"resource" : {
"resourceType" : "MessageHeader",
"id" : "267b18ce-3d37-4581-9baa-6fada338038b",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-messageheader"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MessageHeader</b><a name=\"267b18ce-3d37-4581-9baa-6fada338038b\"> </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 MessageHeader "267b18ce-3d37-4581-9baa-6fada338038b" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-be-messageheader.html\">MyCareNet MessageHeader BE profile</a></p></div><p><b>event</b>: claim-ask (Details: https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events code claim-ask = 'claim-ask', stated as 'null')</p><h3>Destinations</h3><table class=\"grid\"><tr><td>-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>MyCareNet</td><td><code>MyCareNet</code></td></tr></table><p><b>sender</b>: <a href=\"#PractitionerRole_PractitionerRole1\">See above (PractitionerRole/PractitionerRole1)</a></p><h3>Sources</h3><table class=\"grid\"><tr><td>-</td><td><b>Endpoint</b></td></tr><tr><td>*</td><td><code>urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3</code></td></tr></table><p><b>focus</b>: <a href=\"#Claim_Claim1\">See above (Claim/Claim1)</a></p></div>"
},
"eventCoding" : {
"system" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events",
"code" : "claim-ask"
},
"destination" : [
{
"name" : "MyCareNet",
"endpoint" : "MyCareNet"
}
],
"sender" : {
"reference" : "PractitionerRole/PractitionerRole1"
},
"source" : {
"endpoint" : "urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"
},
"focus" : [
{
"reference" : "Claim/Claim1"
}
]
}
},
{
"fullUrl" : "urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3",
"resource" : {
"resourceType" : "PractitionerRole",
"id" : "PractitionerRole1",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: PractitionerRole</b><a name=\"PractitionerRole1\"> </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 PractitionerRole "PractitionerRole1" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://www.ehealth.fgov.be/standards/fhir/core/2.0.0/StructureDefinition-be-practitionerrole.html\">Practitioner role core BE profile</a></p></div><p><b>practitioner</b>: <a href=\"#Practitioner_Practitioner1\">See above (Practitioner/Practitioner1)</a></p><p><b>code</b>: physiotherapist <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://www.ehealth.fgov.be/standards/fhir/core/2.0.0/CodeSystem-cd-hcparty.html\">HCParty</a>#persphysiotherapist)</span></p></div>"
},
"practitioner" : {
"reference" : "Practitioner/Practitioner1"
},
"code" : [
{
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty",
"code" : "persphysiotherapist"
}
]
}
]
}
},
{
"fullUrl" : "urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931",
"resource" : {
"resourceType" : "Practitioner",
"id" : "Practitioner1",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b><a name=\"Practitioner1\"> </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 "Practitioner1" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://www.ehealth.fgov.be/standards/fhir/core/2.0.0/StructureDefinition-be-practitioner.html\">Practitioner core BE profile</a></p></div><p><b>identifier</b>: id:\u00a054263481527</p><p><b>name</b>: John Smith </p></div>"
},
"identifier" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
"value" : "54263481527"
}
],
"name" : [
{
"family" : "Smith",
"given" : [
"John"
]
}
]
}
},
{
"fullUrl" : "urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686",
"resource" : {
"resourceType" : "Patient",
"id" : "Patient1",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-patient"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"Patient1\"> </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 "Patient1" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://www.ehealth.fgov.be/standards/fhir/core/2.0.0/StructureDefinition-be-patient.html\">Patient core BE profile</a></p></div><p><b>identifier</b>: id:\u00a0n° inscription mutualiste</p><p><b>name</b>: Jean Dupont </p><p><b>gender</b>: male</p></div>"
},
"identifier" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancymembership",
"value" : "n° inscription mutualiste",
"assigner" : {
"identifier" : {
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancenumber",
"value" : "n° mutualité"
}
}
}
],
"name" : [
{
"family" : "Dupont",
"given" : [
"Jean"
]
}
],
"gender" : "male"
}
},
{
"fullUrl" : "urn:uuid:035e3de4-011f-48a4-92c9-15b2bbcec321",
"resource" : {
"resourceType" : "PractitionerRole",
"id" : "PractitionerRole2",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: PractitionerRole</b><a name=\"PractitionerRole2\"> </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 PractitionerRole "PractitionerRole2" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://www.ehealth.fgov.be/standards/fhir/core/2.0.0/StructureDefinition-be-practitionerrole.html\">Practitioner role core BE profile</a></p></div><p><b>practitioner</b>: <a href=\"#Practitioner_Practitioner2\">See above (Practitioner/Practitioner2)</a></p><p><b>code</b>: physician <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://www.ehealth.fgov.be/standards/fhir/core/2.0.0/CodeSystem-cd-hcparty.html\">HCParty</a>#persphysician)</span></p></div>"
},
"practitioner" : {
"reference" : "Practitioner/Practitioner2"
},
"code" : [
{
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty",
"code" : "persphysician"
}
]
}
]
}
},
{
"fullUrl" : "urn:uuid:8fc72085-d349-4bd7-ba84-91a935a4e3c6",
"resource" : {
"resourceType" : "Practitioner",
"id" : "Practitioner2",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b><a name=\"Practitioner2\"> </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 "Practitioner2" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://www.ehealth.fgov.be/standards/fhir/core/2.0.0/StructureDefinition-be-practitioner.html\">Practitioner core BE profile</a></p></div><p><b>identifier</b>: id:\u00a019234011004</p><p><b>name</b>: Prénom du prescripteur Nom du prescripteur </p></div>"
},
"identifier" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
"value" : "19234011004"
}
],
"name" : [
{
"family" : "Nom du prescripteur",
"given" : [
"Prénom du prescripteur"
]
}
]
}
},
{
"fullUrl" : "urn:uuid:b3586cda-f1e5-4c58-a389-94249957d87a",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "ServiceRequest1",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementservicerequest"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ServiceRequest</b><a name=\"ServiceRequest1\"> </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 ServiceRequest "ServiceRequest1" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-be-eagreementservicerequest.html\">MyCareNet eAgreement ServiceRequest BE profile</a></p></div><p><b>identifier</b>: id:\u00a0n° de la prescription</p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>subject</b>: <a href=\"#Patient_Patient1\">See above (Patient/Patient1)</a></p><p><b>requester</b>: <a href=\"#PractitionerRole_PractitionerRole2\">See above (PractitionerRole/PractitionerRole2)</a></p></div>"
},
"identifier" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/uhmep",
"value" : "n° de la prescription"
}
],
"status" : "active",
"intent" : "order",
"subject" : {
"reference" : "Patient/Patient1"
},
"requester" : {
"reference" : "PractitionerRole/PractitionerRole2"
}
}
},
{
"fullUrl" : "urn:uuid:3b8e1245-b480-4af6-90c0-f67037ef276b",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "ServiceRequest2",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementservicerequest"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ServiceRequest</b><a name=\"ServiceRequest2\"> </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 ServiceRequest "ServiceRequest2" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-be-eagreementservicerequest.html\">MyCareNet eAgreement ServiceRequest BE profile</a></p></div><p><b>identifier</b>: id:\u00a0n° de la prescription</p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>subject</b>: <a href=\"#Patient_Patient1\">See above (Patient/Patient1)</a></p><p><b>requester</b>: <a href=\"#PractitionerRole_PractitionerRole2\">See above (PractitionerRole/PractitionerRole2)</a></p></div>"
},
"identifier" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/uhmep",
"value" : "n° de la prescription"
}
],
"status" : "active",
"intent" : "order",
"subject" : {
"reference" : "Patient/Patient1"
},
"requester" : {
"reference" : "PractitionerRole/PractitionerRole2"
}
}
},
{
"fullUrl" : "urn:uuid:e85173bc-6f0d-480b-a2cd-2b70d9ffff7a",
"resource" : {
"resourceType" : "Claim",
"id" : "Claim1",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementclaim-kine"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Claim</b><a name=\"Claim1\"> </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 Claim "Claim1" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-be-eagreementclaim-kine.html\">MyCareNet eAgreement Claim Kine BE profile</a></p></div><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>subType</b>: physiotherapy-fb <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-agreement-types.html\">CodeSystem agreement types</a>#physiotherapy-fb)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\"#Patient_Patient1\">See above (Patient/Patient1)</a></p><p><b>billablePeriod</b>: 2020-01-15 --> (ongoing)</p><p><b>created</b>: 2015-07-14 11:15:30+0200</p><p><b>enterer</b>: <a href=\"#PractitionerRole_PractitionerRole1\">See above (PractitionerRole/PractitionerRole1)</a></p><p><b>provider</b>: <a href=\"#PractitionerRole_PractitionerRole1\">See above (PractitionerRole/PractitionerRole1)</a></p><p><b>priority</b>: Immediate <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>#stat)</span></p><p><b>referral</b>: <a href=\"#ServiceRequest_ServiceRequest1\">See above (ServiceRequest/ServiceRequest1)</a></p><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: Attachment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#attachment)</span></p><p><b>code</b>: functional-report <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-annex-types.html\">CodeSystem annex types</a>#functional-report)</span></p><p><b>value</b>: </p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>value</b>: additional Information</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 3</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>value</b>: <a href=\"#ServiceRequest_ServiceRequest2\">See above (ServiceRequest/ServiceRequest2)</a></p></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td><span>: use of mandatory insurance coverage, no further details provided here.</span></td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>ProductOrService</b></td><td><b>Serviced[x]</b></td></tr><tr><td>*</td><td>1</td><td>fb-51 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-nihdi-physiotherapy-pathologysituationcode.html\">CodeSystem NIHDIPhysiotherapyPathology</a>#fb-51)</span></td><td>2020-01-14</td></tr></table></div>"
},
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "professional"
}
]
},
"subType" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/agreement-types",
"code" : "physiotherapy-fb"
}
]
},
"use" : "preauthorization",
"patient" : {
"reference" : "Patient/Patient1"
},
"billablePeriod" : {
"start" : "2020-01-15"
},
"created" : "2015-07-14T11:15:30+02:00",
"enterer" : {
"reference" : "PractitionerRole/PractitionerRole1"
},
"provider" : {
"reference" : "PractitionerRole/PractitionerRole1"
},
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "stat"
}
]
},
"referral" : {
"reference" : "ServiceRequest/ServiceRequest1"
},
"supportingInfo" : [
{
"sequence" : 1,
"category" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code" : "attachment"
}
]
},
"code" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/annex-types",
"code" : "functional-report"
}
]
},
"valueAttachment" : {
"contentType" : "application/pdf",
"data" : "QW5uZXhlIGlubGluZSwgYmFzZTY0ZWQ=",
"title" : "nom/description de l'annexe"
}
},
{
"sequence" : 2,
"category" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code" : "info"
}
]
},
"valueString" : "additional Information"
},
{
"sequence" : 3,
"category" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code" : "info"
}
]
},
"valueReference" : {
"reference" : "ServiceRequest/ServiceRequest2"
}
}
],
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
"display" : "use of mandatory insurance coverage, no further details provided here."
}
}
],
"item" : [
{
"sequence" : 1,
"productOrService" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/nihdi-physiotherapy-pathologysituationcode",
"code" : "fb-51"
}
]
},
"servicedDate" : "2020-01-14"
}
]
}
}
]
}
IG © 2022+ eHealth Platform. Package hl7.fhir.be.mycarenet#2.0.0 based on FHIR 4.0.1. Generated 2023-04-27
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