Finance and Insurance Service (FAIS)
1.0.0 - trial-use International flag

This page is part of the IHE ITI Finance and Insurance Services (v1.0.0: Publication) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Example Bundle: Use Case 3 - Example accepted claim response bundle

Generated Narrative: Bundle ex-claim-response-acc-bundle-3

Bundle ex-claim-response-acc-bundle-3 of type collection

Entry 1 - fullUrl = https://profiles.ihe.net/ITI/FAIS/ClaimResponse/ex-claim-response-acc-3

Resource ClaimResponse:

Generated Narrative: ClaimResponse ex-claim-response-acc-3

status: Active

type: Institutional

use: Claim

patient: Purity Atieno Female, DoB: 2000-05-04

created: 2024-07-16 03:00:00+0000

insurer: Organization National Health Insurance Scheme

request: Claim: status = active; type = Institutional; use = claim; created = 2024-07-15 03:00:00+0000; priority = Normal

outcome: complete

disposition: Accepted

Insurances

-SequenceFocalCoverage
*1trueCoverage: status = active; type = public healthcare; subscriberId = 05710b56-4448-11ef-b676-774a043da147; relationship = Self; period = 2024-01-01 --> 2024-12-31

Entry 2 - fullUrl = https://profiles.ihe.net/ITI/FAIS/Patient/ex-beneficiary-1

Resource Patient:

Generated Narrative: Patient ex-beneficiary-1

Purity Atieno Female, DoB: 2000-05-04

Entry 3 - fullUrl = https://profiles.ihe.net/ITI/FAIS/Claim/ex-claim-3

Resource Claim:

Generated Narrative: Claim ex-claim-3

status: Active

type: Institutional

use: Claim

patient: Purity Atieno Female, DoB: 2000-05-04

created: 2024-07-15 03:00:00+0000

enterer: Practitioner Kalu Kalu

insurer: Organization National Health Insurance Scheme

provider: Practitioner Kalu Kalu

priority: Normal

Payees

-TypeParty
*ProviderOrganization National Health Hospital System

facility: Location Local Hospital

Diagnoses

-SequenceDiagnosis[x]
*1Hybrid oncocytic chromophobe tumour

Procedures

-SequenceProcedure[x]
*1Chemotherapy treatment Cancer

Insurances

-SequenceFocalCoverage
*1trueCoverage: status = active; type = public healthcare; subscriberId = 05710b56-4448-11ef-b676-774a043da147; relationship = Self; period = 2024-01-01 --> 2024-12-31

Entry 4 - fullUrl = https://profiles.ihe.net/ITI/FAIS/Organization/ex-insurer-1

Resource Organization:

Generated Narrative: Organization ex-insurer-1

name: National Health Insurance Scheme

Entry 5 - fullUrl = https://profiles.ihe.net/ITI/FAIS/Coverage/ex-coverage-1

Resource Coverage:

Generated Narrative: Coverage ex-coverage-1

status: Active

type: public healthcare

policyHolder: Purity Atieno Female, DoB: 2000-05-04

subscriber: Purity Atieno Female, DoB: 2000-05-04

subscriberId: 05710b56-4448-11ef-b676-774a043da147

beneficiary: Purity Atieno Female, DoB: 2000-05-04

relationship: Self

period: 2024-01-01 --> 2024-12-31