Belgian MyCareNet Profiles
2.0.0 - STU Belgium flag

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

: ex05 - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="ex05"/>
  <meta>
    <profile
             value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementdemandreply"/>
  </meta>
  <type value="message"/>
  <timestamp value="2015-07-14T11:15:37+02:00"/>
  <entry>
    <fullUrl value="urn:uuid:ce2e2084-3f5c-4f52-8551-8088bb6d3491"/>
    <resource>
      <MessageHeader>
        <id value="667b18ce-3d37-4581-9baa-6fada338038c"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-messageheader"/>
        </meta>
        <text>
          <status value="generated"/>
          <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 &quot;667b18ce-3d37-4581-9baa-6fada338038c&quot; </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>
        </text>
        <eventCoding>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events"/>
          <code value="claimresponse-decide"/>
        </eventCoding>
        <destination>
          <endpoint value="PractitionerRole1"/>
          <receiver>
            <reference value="PractitionerRole/PractitionerRole1"/>
          </receiver>
        </destination>
        <sender>
          <reference value="Organization/OrganizationIO1"/>
        </sender>
        <source>
          <endpoint value="urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"/>
        </source>
        <response>
          <identifier value="267b18ce-3d37-4581-9baa-6fada338038b"/>
          <code value="ok"/>
        </response>
        <focus>
          <reference value="ClaimResponse/ClaimResponse1"/>
        </focus>
      </MessageHeader>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
    <resource>
      <PractitionerRole>
        <id value="PractitionerRole1"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole"/>
        </meta>
        <text>
          <status value="generated"/>
          <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 &quot;PractitionerRole1&quot; </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>
        </text>
        <practitioner>
          <reference value="Practitioner/Practitioner1"/>
        </practitioner>
        <code>
          <coding>
            <system
                    value="https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty"/>
            <code value="persphysiotherapist"/>
          </coding>
        </code>
      </PractitionerRole>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931"/>
    <resource>
      <Practitioner>
        <id value="Practitioner1"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner"/>
        </meta>
        <text>
          <status value="generated"/>
          <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 &quot;Practitioner1&quot; </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: 54263481527</p><p><b>name</b>: John Smith </p></div>
        </text>
        <identifier>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi"/>
          <value value="54263481527"/>
        </identifier>
        <name>
          <family value="Smith"/>
          <given value="John"/>
        </name>
      </Practitioner>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"/>
    <resource>
      <Organization>
        <id value="OrganizationIO1"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-organization"/>
        </meta>
        <text>
          <status value="generated"/>
          <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 &quot;OrganizationIO1&quot; </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: 300</p><p><b>name</b>: Union Nationale des Mutualités Socialistes - Nationaal Verbond van de Socialistische Mutualiteiten</p></div>
        </text>
        <identifier>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancenumber"/>
          <value value="300"/>
        </identifier>
        <name
              value="Union Nationale des Mutualités Socialistes - Nationaal Verbond van de Socialistische Mutualiteiten"/>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"/>
    <resource>
      <Patient>
        <id value="Patient1"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-patient"/>
        </meta>
        <text>
          <status value="generated"/>
          <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 &quot;Patient1&quot; </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: n° inscription mutualiste</p><p><b>name</b>: Jean Dupont </p><p><b>gender</b>: male</p></div>
        </text>
        <identifier>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancymembership"/>
          <value value="n° inscription mutualiste"/>
          <assigner>
            <identifier>
              <system
                      value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancenumber"/>
              <value value="n° mutualité"/>
            </identifier>
          </assigner>
        </identifier>
        <name>
          <family value="Dupont"/>
          <given value="Jean"/>
        </name>
        <gender value="male"/>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:0a0d60df-0340-45a6-a493-a5d67f74d693"/>
    <resource>
      <ClaimResponse>
        <id value="ClaimResponse1"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementclaimresponse"/>
        </meta>
        <text>
          <status value="generated"/>
          <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 &quot;ClaimResponse1&quot; </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>
        </text>
        <status value="active"/>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
            <code value="professional"/>
          </coding>
        </type>
        <subType>
          <coding>
            <system
                    value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/agreement-types"/>
            <code value="physiotherapy-fb"/>
          </coding>
        </subType>
        <use value="preauthorization"/>
        <patient>
          <reference value="Patient/Patient1"/>
        </patient>
        <created value="2015-07-14T11:15:30+02:00"/>
        <insurer>
          <reference value="Organization/OrganizationIO1"/>
        </insurer>
        <requestor>
          <reference value="PractitionerRole/PractitionerRole1"/>
        </requestor>
        <outcome value="partial"/>
        <preAuthRef
                    value="identifiant business de la décision (accord/refus/en traitement)"/>
        <addItem>
          <itemSequence value="1"/>
          <productOrService>
            <coding>
              <system
                      value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/nihdi-physiotherapy-pathologysituationcode"/>
              <code value="fb-51"/>
            </coding>
          </productOrService>
          <adjudication>
            <category>
              <coding>
                <system
                        value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/decision-values"/>
                <code value="intreatment"/>
              </coding>
            </category>
          </adjudication>
        </addItem>
      </ClaimResponse>
    </resource>
  </entry>
</Bundle>