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 Coverage Eligibility Request Bundle - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Bundle ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "ex-covreq-bundle"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.CoverageEligibilityRequest.Bundle"^^xsd:anyURI ;
fhir:link <https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.CoverageEligibilityRequest.Bundle>     ] )
  ] ; # 
  fhir:type [ fhir:v "collection"] ; # 
  fhir:entry ( [
fhir:fullUrl [ fhir:v "https://profiles.ihe.net/ITI/FAIS/CoverageEligibilityRequest/ex-check-coverage"^^xsd:anyURI ] ;
    ( fhir:resource <https://profiles.ihe.net/ITI/FAIS/CoverageEligibilityRequest/ex-check-coverage> )
  ] [
fhir:fullUrl [ fhir:v "https://profiles.ihe.net/ITI/FAIS/Patient/ex-beneficiary"^^xsd:anyURI ] ;
    ( fhir:resource <https://profiles.ihe.net/ITI/FAIS/Patient/ex-beneficiary> )
  ] [
fhir:fullUrl [ fhir:v "https://profiles.ihe.net/ITI/FAIS/Organization/ex-insurer"^^xsd:anyURI ] ;
    ( fhir:resource <https://profiles.ihe.net/ITI/FAIS/Organization/ex-insurer> )
  ] [
fhir:fullUrl [ fhir:v "https://profiles.ihe.net/ITI/FAIS/Coverage/ex-coverage"^^xsd:anyURI ] ;
    ( fhir:resource <https://profiles.ihe.net/ITI/FAIS/Coverage/ex-coverage> )
  ] ) . # 

<https://profiles.ihe.net/ITI/FAIS/CoverageEligibilityRequest/ex-check-coverage> a fhir:CoverageEligibilityRequest ;
  fhir:id [ fhir:v "ex-check-coverage"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.CoverageEligibilityRequest"^^xsd:anyURI ;
fhir:link <https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.CoverageEligibilityRequest>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"CoverageEligibilityRequest_ex-check-coverage\"> </a><p class=\"res-header-id\"><b>Generated Narrative: CoverageEligibilityRequest ex-check-coverage</b></p><a name=\"ex-check-coverage\"> </a><a name=\"hcex-check-coverage\"> </a><a name=\"ex-check-coverage-en-US\"> </a><p><b>status</b>: Active</p><p><b>purpose</b>: Coverage Validation</p><p><b>patient</b>: <a href=\"Patient-ex-beneficiary.html\">Jane Doe  Female, DoB: 2000-05-04</a></p><p><b>created</b>: 2024-05-04</p><p><b>insurer</b>: <a href=\"Organization-ex-insurer.html\">Organization Example Public Insurance</a></p><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>true</td><td><a href=\"Coverage-ex-coverage.html\">Coverage: status = active; type = public healthcare; subscriberId = a8978d4a-0c9f-11ef-9633-cb733e9641ef; relationship = Self; period = 2024-01-01 --&gt; 2024-12-31</a></td></tr></table></div>"
  ] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:purpose ( [ fhir:v "validation"] ) ; # 
  fhir:patient [
fhir:reference [ fhir:v "Patient/ex-beneficiary" ]
  ] ; # 
  fhir:created [ fhir:v "2024-05-04"^^xsd:date] ; # 
  fhir:insurer [
fhir:reference [ fhir:v "Organization/ex-insurer" ]
  ] ; # 
  fhir:insurance ( [
fhir:focal [ fhir:v "true"^^xsd:boolean ] ;
fhir:coverage [
fhir:reference [ fhir:v "Coverage/ex-coverage" ]     ]
  ] ) . # 

<https://profiles.ihe.net/ITI/FAIS/Patient/ex-beneficiary> a fhir:Patient ;
  fhir:id [ fhir:v "ex-beneficiary"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_ex-beneficiary\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient ex-beneficiary</b></p><a name=\"ex-beneficiary\"> </a><a name=\"hcex-beneficiary\"> </a><a name=\"ex-beneficiary-en-US\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Jane Doe  Female, DoB: 2000-05-04</p><hr/></div>"
  ] ; # 
  fhir:name ( [
fhir:family [ fhir:v "Doe" ] ;
    ( fhir:given [ fhir:v "Jane" ] )
  ] ) ; # 
  fhir:gender [ fhir:v "female"] ; # 
  fhir:birthDate [ fhir:v "2000-05-04"^^xsd:date] . # 

<https://profiles.ihe.net/ITI/FAIS/Organization/ex-insurer> a fhir:Organization ;
  fhir:id [ fhir:v "ex-insurer"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_ex-insurer\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization ex-insurer</b></p><a name=\"ex-insurer\"> </a><a name=\"hcex-insurer\"> </a><a name=\"ex-insurer-en-US\"> </a><p><b>name</b>: Example Public Insurance</p></div>"
  ] ; # 
  fhir:name [ fhir:v "Example Public Insurance"] . # 

<https://profiles.ihe.net/ITI/FAIS/Coverage/ex-coverage> a fhir:Coverage ;
  fhir:id [ fhir:v "ex-coverage"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_ex-coverage\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage ex-coverage</b></p><a name=\"ex-coverage\"> </a><a name=\"hcex-coverage\"> </a><a name=\"ex-coverage-en-US\"> </a><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode PUBLICPOL}\">public healthcare</span></p><p><b>policyHolder</b>: <a href=\"Patient-ex-beneficiary.html\">Jane Doe  Female, DoB: 2000-05-04</a></p><p><b>subscriber</b>: <a href=\"Patient-ex-beneficiary.html\">Jane Doe  Female, DoB: 2000-05-04</a></p><p><b>subscriberId</b>: a8978d4a-0c9f-11ef-9633-cb733e9641ef</p><p><b>beneficiary</b>: <a href=\"Patient-ex-beneficiary.html\">Jane Doe  Female, DoB: 2000-05-04</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: 2024-01-01 --&gt; 2024-12-31</p><p><b>payor</b>: <a href=\"Organization-ex-insurer.html\">Organization Example Public Insurance</a></p></div>"
  ] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "PUBLICPOL" ] ;
fhir:display [ fhir:v "public healthcare" ]     ] )
  ] ; # 
  fhir:policyHolder [
fhir:reference [ fhir:v "Patient/ex-beneficiary" ]
  ] ; # 
  fhir:subscriber [
fhir:reference [ fhir:v "Patient/ex-beneficiary" ]
  ] ; # 
  fhir:subscriberId [ fhir:v "a8978d4a-0c9f-11ef-9633-cb733e9641ef"] ; # 
  fhir:beneficiary [
fhir:reference [ fhir:v "Patient/ex-beneficiary" ]
  ] ; # 
  fhir:relationship [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ] ;
fhir:code [ fhir:v "self" ] ;
fhir:display [ fhir:v "Self" ]     ] )
  ] ; # 
  fhir:period [
fhir:start [ fhir:v "2024-01-01"^^xsd:date ] ;
fhir:end [ fhir:v "2024-12-31"^^xsd:date ]
  ] ; # 
  fhir:payor ( [
fhir:reference [ fhir:v "Organization/ex-insurer" ]
  ] ) . #