This
page
is
part
of
the
FHIR
Specification
(v5.0.0:
R5
-
STU
v6.0.0-ballot2:
Release
6
Ballot
(2nd
Draft)
(see
Ballot
Notes
).
This
is
the
The
current
published
version
in
it's
permanent
home
(it
will
always
be
available
at
this
URL).
is
5.0.0
.
For
a
full
list
of
available
versions,
see
the
Directory
of
published
versions
.
Page
versions:
R5
R4B
R4
Example
Contract/INS-101
(Turtle)
Raw
Turtle
(+
also
see
Turtle/RDF
Format
Specification
)
Health
Insurance
Policy
@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:Contract ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "INS-101"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>Plan: Your Choice Split Copay (Non-Grandfathered)</p>\n <p>Certificate Form Number: YCSCWLN (01-2017)</p>\n </div>"
] ; #
fhir:identifier ( [
fhir:system [ fhir:v "http://xyz-insurance.com/forms"^^xsd:anyURI ] ;
fhir:value [ fhir:v "YCSCWLN(01-2017)" ]
] ) ; #
fhir:applies [
fhir:start [ fhir:v "2017-01-01"^^xsd:date ]
] ; #
fhir:subject ( [
fhir:reference [ fhir:v "Patient/1" ]
] ) ; #
fhir:type [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/contract-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "healthinsurance" ] ;
fhir:display [ fhir:v "Health Insurance" ]
] )
] ; #
fhir:term ( [
fhir:offer [
fhir:text [ fhir:v "The benefits, limitations, exclusions and other coverage provisions in this booklet are subject to the terms of our contract with the Group. This booklet is a part of that contract, which is on file in the Group's office." ]
] ;
fhir:asset ( [
fhir:type ( [
fhir:coding ( [
fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
fhir:code [ fhir:v "urn:uuid:3a48c68c-318d-4c68-8471-4a3c10fcb41b" ] ;
fhir:display [ fhir:v "RicardianContract" ]
] )
] ) ;
fhir:subtype ( [
fhir:text [ fhir:v "sample" ]
] ) ;
fhir:period ( [
fhir:start [ fhir:v "2017-06-01"^^xsd:date ]
] ) ;
fhir:valuedItem ( [
fhir:entity [
a fhir:CodeableConcept ;
fhir:text [ fhir:v "Ford Bobcat" ]
] ;
fhir:identifier [
fhir:system [ fhir:v "http://somewhere.motor-vehicle.com/vin"^^xsd:anyURI ] ;
fhir:value [ fhir:v "XXSVT34-7665t952236" ]
] ;
fhir:effectiveTime [ fhir:v "1995"^^xsd:gYear ] ;
fhir:quantity [
fhir:value [ fhir:v "1"^^xsd:decimal ]
] ;
fhir:unitPrice [
fhir:value [ fhir:v "200.00"^^xsd:decimal ] ;
fhir:currency [ fhir:v "CAD" ]
] ;
fhir:factor [ fhir:v "1.0"^^xsd:decimal ] ;
fhir:points [ fhir:v "1.0"^^xsd:decimal ] ;
fhir:net [
fhir:value [ fhir:v "200.00"^^xsd:decimal ] ;
fhir:currency [ fhir:v "CAD" ]
]
] )
] ) ;
fhir:group ( [
fhir:offer [
fhir:text [ fhir:v "Eligible Providers" ]
]
] [
fhir:offer [
fhir:text [ fhir:v "Responsibility for Payment" ]
]
] [
fhir:offer [
fhir:text [ fhir:v "List of Benefits" ]
] ;
fhir:group ( [
fhir:offer [
fhir:text [ fhir:v "Copays" ]
] ;
fhir:group ( [
fhir:offer [
fhir:text [ fhir:v "Emergency Room Copay" ]
]
] [
fhir:offer [
fhir:text [ fhir:v "Professional Visit Copay" ]
]
] )
] [
fhir:offer [
fhir:text [ fhir:v "Calendar Year Deductible" ]
]
] [
fhir:offer [
fhir:text [ fhir:v "Out-Of-Pocket Maximum" ]
]
] [
fhir:offer [
fhir:text [ fhir:v "Medical Services" ]
] ;
fhir:group ( [
fhir:offer [
fhir:text [ fhir:v "Ambulance Services" ]
]
] [
fhir:offer [
fhir:text [ fhir:v "Dental Services" ]
]
] [
fhir:offer [
fhir:text [ fhir:v "Diagnostic Services" ]
]
] [
fhir:offer [
fhir:text [ fhir:v "Emergency Room Services" ]
]
] [
fhir:offer [
fhir:text [ fhir:v "Hospital Inpatient Care" ]
]
] )
] )
] )
] )] . #
# -------------------------------------------------------------------------------------
Usage
note:
every
effort
has
been
made
to
ensure
that
the
examples
are
correct
and
useful,
but
they
are
not
a
normative
part
of
the
specification.