מדריך למטמיע - טופס 17
1.0.0 - ci-build

This page is part of the T17 IG (v1.0.0: draft-1 Draft) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Example Bundle: authorization-and-falure-multiple-codes

Generated Narrative: Bundle authorization-and-falure-multiple-codes

version: 2; Last updated: 2023-10-30 10:48:52+0000;

Information Source: #WGwwSydRIDyGKjKs

Bundle authorization-and-falure-multiple-codes of type collection

Entry 1 - fullUrl = urn:uuid:7528e4d8-d2de-4e38-9792-eb0013e0570b

Resource CoverageEligibilityResponse:

Generated Narrative: CoverageEligibilityResponse 106917e1-a8e6-4ead-b419-83e7a43c9c4d

identifier: URI/urn:uuid:106917e1-a8e6-4ead-b419-83e7a43c9c4d

status: Active

purpose: Coverage Validation

patient: Identifier: http://fhir.leumit.co.il/identifier/magnetic-card/1-123456-123456-789

created: 2023-07-02 13:44:58+0000

requestor: בי"ח איכילוב (Identifier: Israeli Legal Entity/500106919)

request: Identifier: http://fhir.tlvmc.gov.il/identifier/preauth-req-no/3772

outcome: Error

disposition: לא ניתן לסיים את עיבוד הבקשה

insurer: לאומית (Identifier: Israeli Legal Entity/580039899)

insurance

coverage: Bundle: type = collection

benefitPeriod: 2023-09-01 --> 2023-10-01

item

productOrService: בדיקת רופא נפרולוג במרפאה

excluded: false

name: בדיקת רופא - התמחות בכליות

description: בדיקת רופא ילדים עם התמחות לכליות

Benefits

-TypeAllowed[x]Used[x]
*benefit31

Errors

-ExtensionCode
*קוד לא מזוהה

Entry 2 - fullUrl = urn:uuid:1f8407ea-c10d-481e-9cef-829bc2560b6f

Resource DocumentReference:

Generated Narrative: DocumentReference Inline-Instance-for-4142-2

identifier: URI/urn:uuid:cb512709-9276-4afd-9271-4990e5ef2889

status: Current

type: מסמך התחייבות מאושרת

subject: Identifier: http://fhir.leumit.co.il/identifier/magnetic-card/1-123456-123456-789

date: 2023-07-04 05:02:03+0000

authenticator: לאומית (Identifier: Israeli Legal Entity/580039899)

description: מסמך אישור התחייבות לקבלת שירות בבית החולים

content

Attachments

-ContentTypeUrl
*application/pdfhttp://example.org/xds/mhd/Binary/07a6483f-732b-461e-86b6-edb665c45510

Contexts

-Related
*Bundle: type = collection

Entry 3 - fullUrl = http://hapi-fhir.outburn.co.il/fhir/Coverage/3819

Resource Coverage:

Generated Narrative: Coverage 3819

identifier: http://fhir.leumit.co.il/identifier/obligation-num/1-1222223

status: Active

type: התחייבות

beneficiary: Identifier: http://fhir.leumit.co.il/identifier/magnetic-card/1-123456-123456-789

period: 2023-09-01 --> 2023-10-01

payor: לאומית (Identifier: Israeli Legal Entity/580039899)

Classes

-TypeValue
*OBL-BASKETהתחייבות במסגרת הסל

CostToBeneficiaries

-TypeValue[x]
*גובה השתתפות עצמית₪200.00 (ILS)