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 ClaimResponse: Use Case 4 - Example accepted pre-determination response

Generated Narrative: ClaimResponse ex-predetermination-response-4

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 = predetermination; created = 2024-07-15 03:00:00+0000; priority = Normal

outcome: Processing 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