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" : "ex05",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementdemandreply"
]
},
"type" : "message",
"timestamp" : "2015-07-14T11:15:37+02:00",
"entry" : [
{
"fullUrl" : "urn:uuid:ce2e2084-3f5c-4f52-8551-8088bb6d3491",
"resource" : {
"resourceType" : "MessageHeader",
"id" : "667b18ce-3d37-4581-9baa-6fada338038c",
"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=\"667b18ce-3d37-4581-9baa-6fada338038c\"> </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 "667b18ce-3d37-4581-9baa-6fada338038c" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-be-messageheader.html\">MyCareNet MessageHeader BE profile</a></p></div><p><b>event</b>: claimresponse-decide (Details: https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events code claimresponse-decide = 'claimresponse-decide', stated as 'null')</p><h3>Destinations</h3><table class=\"grid\"><tr><td>-</td><td><b>Endpoint</b></td><td><b>Receiver</b></td></tr><tr><td>*</td><td><code>PractitionerRole1</code></td><td><a href=\"#PractitionerRole_PractitionerRole1\">See above (PractitionerRole/PractitionerRole1)</a></td></tr></table><p><b>sender</b>: <a href=\"#Organization_OrganizationIO1\">See above (Organization/OrganizationIO1)</a></p><h3>Sources</h3><table class=\"grid\"><tr><td>-</td><td><b>Endpoint</b></td></tr><tr><td>*</td><td><code>urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358</code></td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td>-</td><td><b>Identifier</b></td><td><b>Code</b></td></tr><tr><td>*</td><td>267b18ce-3d37-4581-9baa-6fada338038b</td><td>ok</td></tr></table><p><b>focus</b>: <a href=\"#ClaimResponse_ClaimResponse1\">See above (ClaimResponse/ClaimResponse1)</a></p></div>"
},
"eventCoding" : {
"system" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events",
"code" : "claimresponse-decide"
},
"destination" : [
{
"endpoint" : "PractitionerRole1",
"receiver" : {
"reference" : "PractitionerRole/PractitionerRole1"
}
}
],
"sender" : {
"reference" : "Organization/OrganizationIO1"
},
"source" : {
"endpoint" : "urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"
},
"response" : {
"identifier" : "267b18ce-3d37-4581-9baa-6fada338038b",
"code" : "ok"
},
"focus" : [
{
"reference" : "ClaimResponse/ClaimResponse1"
}
]
}
},
{
"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:cfabb40d-a53f-4c56-bc19-725ea669b358",
"resource" : {
"resourceType" : "Organization",
"id" : "OrganizationIO1",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"OrganizationIO1\"> </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 "OrganizationIO1" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://www.ehealth.fgov.be/standards/fhir/core/2.0.0/StructureDefinition-be-organization.html\">Organisation core BE profile</a></p></div><p><b>identifier</b>: id:\u00a0300</p><p><b>name</b>: Union Nationale des Mutualités Socialistes - Nationaal Verbond van de Socialistische Mutualiteiten</p></div>"
},
"identifier" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancenumber",
"value" : "300"
}
],
"name" : "Union Nationale des Mutualités Socialistes - Nationaal Verbond van de Socialistische Mutualiteiten"
}
},
{
"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:0a0d60df-0340-45a6-a493-a5d67f74d693",
"resource" : {
"resourceType" : "ClaimResponse",
"id" : "ClaimResponse1",
"meta" : {
"profile" : [
"https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementclaimresponse"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ClaimResponse</b><a name=\"ClaimResponse1\"> </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 ClaimResponse "ClaimResponse1" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-be-eagreementclaimresponse.html\">MyCareNet eAgreement Claim Response 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>created</b>: 2015-07-14 11:15:30+0200</p><p><b>insurer</b>: <a href=\"#Organization_OrganizationIO1\">See above (Organization/OrganizationIO1)</a></p><p><b>requestor</b>: <a href=\"#PractitionerRole_PractitionerRole1\">See above (PractitionerRole/PractitionerRole1)</a></p><p><b>outcome</b>: partial</p><p><b>preAuthRef</b>: identifiant business de la décision (accord/refus/en traitement)</p><blockquote><p><b>addItem</b></p><p><b>itemSequence</b>: 1</p><p><b>productOrService</b>: 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></p><h3>Adjudications</h3><table class=\"grid\"><tr><td>-</td><td><b>Category</b></td></tr><tr><td>*</td><td>intreatment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-decision-values.html\">CodeSystem decision values</a>#intreatment)</span></td></tr></table></blockquote></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"
},
"created" : "2015-07-14T11:15:30+02:00",
"insurer" : {
"reference" : "Organization/OrganizationIO1"
},
"requestor" : {
"reference" : "PractitionerRole/PractitionerRole1"
},
"outcome" : "partial",
"preAuthRef" : "identifiant business de la décision (accord/refus/en traitement)",
"addItem" : [
{
"itemSequence" : [
1
],
"productOrService" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/nihdi-physiotherapy-pathologysituationcode",
"code" : "fb-51"
}
]
},
"adjudication" : [
{
"category" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/decision-values",
"code" : "intreatment"
}
]
}
}
]
}
]
}
}
]
}
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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