0 Table of Contents |
1 Finance and Insurance (FAIS) Service Home |
2 1:XX Finance and Insurance Service (FAIS) |
3 2:3.YY2 Query Insurance Plan [ITI-YY2] |
4 2:3.YY1 Enroll Beneficiary [ITI-YY1] |
5 2:3.YY3 Check Enrollment Status [ITI-YY3] |
6 2:3.YY4 Check Coverage Eligibility [ITI-YY4] |
7 2:3.YY7 Check Coverage Eligibility Status [ITI-YY7] |
8 2:3.YY5 Submit Claim [ITI-YY5] |
9 2:3.YY8 Cancel Claim [ITI-YY8] |
10 2:3.YY9 Re-process Claim [ITI-YY9] |
11 2:3.YY6 Track Claim [ITI-YY6] |
12 Test Plan |
13 Changes to Other IHE Specifications |
14 Download and Analysis |
15 Significant Changes and Issues |
16 Artifacts Summary |
16.1 Beneficiary Manager Actor |
16.2 Beneficiary Requestor Actor |
16.3 Claims Manager Actor |
16.4 Claims Requestor Actor |
16.5 Coverage Requestor Actor |
16.6 FAIS Claim $cancel |
16.7 FAIS Claim $reprocess |
16.8 FAIS Claim $submit |
16.9 FAIS Coverage Eligibility Request $submit |
16.10 FAIS Enrollment Request $submit |
16.11 Audit Event for Cancel Claim Transaction by the Claims Requestor and Claims Manager for Update |
16.12 Audit Event for Check Coverage Eligibility Status Transaction by the Coverage Requestor and Claims Manager for Query |
16.13 Audit Event for Check Coverage Eligibility Status Transaction by the Coverage Requestor and Claims Manager for Read |
16.14 Audit Event for Check Coverage Eligibility Transaction by the Coverage Requestor and Claims Manager for Create |
16.15 Audit Event for Check Enrollment Status Transaction by the Beneficiary Requestor and Beneficiary Manager for Query |
16.16 Audit Event for Check Enrollment Status Transaction by the Beneficiary Requestor and Beneficiary Manager for Read |
16.17 Audit Event for Enroll Beneficiary Transaction by the Beneficiary Requestor and Beneficiary Manager for Create |
16.18 Audit Event for Query Insurance Plan Transaction by the Beneficiary Requestor and Beneficiary Manager for Query |
16.19 Audit Event for Query Insurance Plan Transaction by the Beneficiary Requestor and Beneficiary Manager for Read |
16.20 Audit Event for Re-process Claim Transaction by the Claims Requestor and Claims Manager for Update |
16.21 Audit Event for Submit Claim Transaction by the Claims Requestor and Claims Manager for Create |
16.22 Audit Event for Track Claim Transaction by the Claims Requestor and Claims Manager for Read |
16.23 Audit Event for Track Claim Transaction by the Coverage Requestor and Claims Manager for Query |
16.24 FAIS Claim Bundle Profile |
16.25 FAIS Claim Profile |
16.26 FAIS ClaimResponse Bundle Profile |
16.27 FAIS ClaimResponse Profile |
16.28 FAIS CoverageEligibilityRequest Bundle Profile |
16.29 FAIS CoverageEligibilityRequest Profile |
16.30 FAIS CoverageEligibilityResponse Bundle Profile |
16.31 FAIS CoverageEligibilityResponse Profile |
16.32 FAIS EnrollmentRequest Bundle Profile |
16.33 FAIS EnrollmentRequest Profile |
16.34 FAIS EnrollmentResponse Bundle Profile |
16.35 FAIS EnrollmentResponse Profile |
16.36 FAIS InsurancePlan Profile |
16.37 Audit example for ITI-YY1 for Beneficiary Requestor for submit. |
16.38 Audit example for ITI-YY2 for Beneficiary Manager for query. |
16.39 Audit example for ITI-YY2 for Beneficiary Requestor for read. |
16.40 Audit example for ITI-YY3 for Beneficiary Manager for query. |
16.41 Audit example for ITI-YY3 for Beneficiary Requestor for read. |
16.42 Audit example for ITI-YY4 for Coverage Requestor for submit. |
16.43 Audit example for ITI-YY5 for Claims Requestor for submit. |
16.44 Audit example for ITI-YY6 for Claims Manager for query. |
16.45 Audit example for ITI-YY6 for Claims Requestor for read. |
16.46 Audit example for ITI-YY7 for Beneficiary Manager for query. |
16.47 Audit example for ITI-YY7 for Claims Manager for read. |
16.48 Audit example for ITI-YY8 for Claims Requestor for cancel. |
16.49 Audit example for ITI-YY9 for Claims Requestor for re-process. |
16.50 Device Example - FAIS Beneficiary Manager |
16.51 Device Example - FAIS Beneficiary Requestor |
16.52 Device Example - FAIS Claims Manager |
16.53 Device Example - FAIS Claims Requestor |
16.54 Device Example - FAIS Coverage Requestor |
16.55 Example Coverage |
16.56 Example Coverage Eligibility Request |
16.57 Example Coverage Eligibility Request Bundle |
16.58 Example Coverage Eligibility Response |
16.59 Example Enrollment Request |
16.60 Example Enrollment Request Bundle |
16.61 Example Enrollment Response |
16.62 Example Insurer |
16.63 Example Patient Beneficiary |
16.64 Use Case 1 - Example Coverage |
16.65 Use Case 1 - Example Enrollment Request |
16.66 Use Case 1 - Example Enrollment Request Bundle |
16.67 Use Case 1 - Example Enrollment Response |
16.68 Use Case 1 - Example Enrollment Response Bundle |
16.69 Use Case 1 - Example Insurance Plan |
16.70 Use Case 1 - Example Insurer: National Health Insurance Scheme |
16.71 Use Case 1 - Example Network: National Health Hospital System |
16.72 Use Case 1 - Example Patient Beneficiary |
16.73 Use Case 2 - Example Coverage Eligibility Request |
16.74 Use Case 2 - Example Coverage Eligibility Request Bundle |
16.75 Use Case 2 - Example Coverage Eligibility Response |
16.76 Use Case 2 - Example Coverage Eligibility Response Bundle |
16.77 Use Case 2 - Example Doctor |
16.78 Use Case 2 - Local Hospital |
16.79 Use Case 3 - Example accepted claim response |
16.80 Use Case 3 - Example accepted claim response bundle |
16.81 Use Case 3 - Example cancelled claim |
16.82 Use Case 3 - Example claim |
16.83 Use Case 3 - Example claim bundle |
16.84 Use Case 3 - Example denied claim response |
16.85 Use Case 3 - Example queued claim response |
16.86 Use Case 4 - Example accepted pre-determination response |
16.87 Use Case 4 - Example pre-determination claim |
16.88 Use Case 5 - Example accepted pre-determination response |
16.89 Use Case 5 - Example pre-authorization claim |
16.90 Testing Feature File for ITI YY1 |
16.91 Testing Feature File for ITI YY2 |
16.92 Testing Feature File for ITI YY3 |
16.93 Testing Feature File for ITI YY4 |
16.94 Testing Feature File for ITI YY5 |
16.95 Testing Feature File for ITI YY6 |
16.96 Testing Feature File for ITI YY7 |
16.97 Testing Feature File for ITI YY8 |
16.98 Testing Feature File for ITI YY9 |