Release 4 5

This page is part of the FHIR Specification (v4.0.1: R4 (v5.0.0: R5 - Mixed Normative and STU ) ). This is the current published version in it's permanent home (it will always be available at this URL). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

Claimresponse-example-2.ttl

Example ClaimResponse/R3501 (Turtle)

Financial Management Work Group Maturity Level : N/A Standards Status : Informative Compartments : Patient , Practitioner

Raw Turtle (+ also see Turtle/RDF Format Specification )

A ClaimResponse for a Claim that contains processing errors 

@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 -------------------------------------------------------------------

<http://hl7.org/fhir/ClaimResponse/R3501> a fhir:ClaimResponse;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "R3501"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ClaimResponse that demonstrates returning errors</div>"
  ];
  fhir:ClaimResponse.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "http://www.BenefitsInc.com/fhir/remittance" ];
     fhir:Identifier.value [ fhir:value "R3501" ]
  ];
  fhir:ClaimResponse.status [ fhir:value "active"];
  fhir:ClaimResponse.type [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ];
       fhir:Coding.code [ fhir:value "oral" ]
     ]
  ];
  fhir:ClaimResponse.use [ fhir:value "claim"];
  fhir:ClaimResponse.patient [
     fhir:link <http://hl7.org/fhir/Patient/1>;
     fhir:Reference.reference [ fhir:value "Patient/1" ]
  ];
  fhir:ClaimResponse.created [ fhir:value "2014-08-16"^^xsd:date];
  fhir:ClaimResponse.insurer [
     fhir:Reference.identifier [
       fhir:Identifier.system [ fhir:value "http://www.jurisdiction.org/insurers" ];
       fhir:Identifier.value [ fhir:value "555123" ]
     ]
  ];
  fhir:ClaimResponse.requestor [
     fhir:link <http://hl7.org/fhir/Practitioner/1>;
     fhir:Reference.reference [ fhir:value "Practitioner/1" ]
  ];
  fhir:ClaimResponse.request [
     fhir:link <http://hl7.org/fhir/Claim/100156>;
     fhir:Reference.reference [ fhir:value "Claim/100156" ]
  ];
  fhir:ClaimResponse.outcome [ fhir:value "error"];
  fhir:ClaimResponse.disposition [ fhir:value "Claim could not be processed"];
  fhir:ClaimResponse.formCode [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/forms-codes" ];
       fhir:Coding.code [ fhir:value "2" ]

[a fhir:ClaimResponse ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "R3501"] ; # 
  fhir:text [
     fhir:status [ fhir:v "generated" ] ;
     fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ClaimResponse that demonstrates returning errors</div>"
  ] ; # 
  fhir:identifier ( [
     fhir:system [ fhir:v "http://www.BenefitsInc.com/fhir/remittance"^^xsd:anyURI ] ;
     fhir:value [ fhir:v "R3501" ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
     fhir:coding ( [
       fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ] ;
       fhir:code [ fhir:v "oral" ]
     ] )
  ] ; # 
  fhir:use [ fhir:v "claim"] ; # 
  fhir:patient [
     fhir:reference [ fhir:v "Patient/1" ]
  ] ; # 
  fhir:created [ fhir:v "2014-08-16"^^xsd:date] ; # 
  fhir:insurer [
     fhir:identifier [
       fhir:system [ fhir:v "http://www.jurisdiction.org/insurers"^^xsd:anyURI ] ;
       fhir:value [ fhir:v "555123" ]

     ]
  ];
  fhir:ClaimResponse.processNote [
     fhir:index 0;
     fhir:ClaimResponse.processNote.number [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:ClaimResponse.processNote.type [ fhir:value "display" ];
     fhir:ClaimResponse.processNote.text [ fhir:value "Invalid claim" ];
     fhir:ClaimResponse.processNote.language [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "urn:ietf:bcp:47" ];
         fhir:Coding.code [ fhir:value "en-CA" ]
       ]

  ] ; # 
  fhir:requestor [
     fhir:reference [ fhir:v "Practitioner/1" ]
  ] ; # 
  fhir:request [
     fhir:reference [ fhir:v "Claim/100156" ]
  ] ; # 
  fhir:outcome [ fhir:v "error"] ; # 
  fhir:disposition [ fhir:v "Claim could not be processed"] ; # 
  fhir:formCode [
     fhir:coding ( [
       fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/forms-codes"^^xsd:anyURI ] ;
       fhir:code [ fhir:v "2" ]
     ] )
  ] ; # 
  fhir:processNote ( [
     fhir:number [ fhir:v "1"^^xsd:positiveInteger ] ;
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://hl7.org/fhir/note-type"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "display" ]
       ] )
     ] ;
     fhir:text [ fhir:v "Invalid claim" ] ;
     fhir:language [
       fhir:coding ( [
         fhir:system [ fhir:v "urn:ietf:bcp:47"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "en-CA" ]
       ] )

     ]
  ];
  fhir:ClaimResponse.communicationRequest [
     fhir:index 0;
     fhir:link <http://hl7.org/fhir/CommunicationRequest/fm-solicit>;
     fhir:Reference.reference [ fhir:value "CommunicationRequest/fm-solicit" ]
  ];
  fhir:ClaimResponse.error [
     fhir:index 0;
     fhir:ClaimResponse.error.itemSequence [ fhir:value "3"^^xsd:positiveInteger ];
     fhir:ClaimResponse.error.detailSequence [ fhir:value "2"^^xsd:positiveInteger ];
     fhir:ClaimResponse.error.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication-error" ];
         fhir:Coding.code [ fhir:value "a002" ]
       ]

  ] ) ; # 
  fhir:communicationRequest ( [
     fhir:reference [ fhir:v "CommunicationRequest/fm-solicit" ]
  ] ) ; # 
  fhir:error ( [
     fhir:itemSequence [ fhir:v "3"^^xsd:positiveInteger ] ;
     fhir:detailSequence [ fhir:v "2"^^xsd:positiveInteger ] ;
     fhir:code [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication-error"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "a002" ]
       ] )

     ]
  ] .

<http://hl7.org/fhir/Patient/1> a fhir:Patient .

<http://hl7.org/fhir/Practitioner/1> a fhir:Practitioner .

<http://hl7.org/fhir/Claim/100156> a fhir:Claim .

<http://hl7.org/fhir/CommunicationRequest/fm-solicit> a fhir:CommunicationRequest .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/ClaimResponse/R3501.ttl> a owl:Ontology;
  owl:imports fhir:fhir.ttl;
  owl:versionIRI <http://build.fhir.org/ClaimResponse/R3501.ttl> .

  ] )] . #   Detailed error description  


# -------------------------------------------------------------------------------------

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.