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. For a full list of available versions, see the Directory of published versions
Generated Narrative: Bundle authroization-with-commitment-num-single-code
version: 1; Last updated: 2023-10-30 12:14:35+0000;
Information Source: #DlWFKilqJGbOoSdZ
Bundle authroization-with-commitment-num-single-code 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/1-123456-123456-789created: 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/3772outcome: Processing Complete
disposition: הבקשה להתחייבות אושרה
insurer: לאומית (Identifier: Israeli Legal Entity/580039899)
insurance
coverage: Bundle: type = collection
benefitPeriod: 2023-09-01 --> 2023-10-01
item
productOrService: בדיקת רופא ילדים במרפאה
excluded: false
name: בדיקת רופא - התמחות בכליות
description: בדיקת רופא ילדים עם התמחות לכליות
Benefits
Type Allowed[x] Used[x] benefit 3 1
Entry 2 - fullUrl = urn:uuid:1f8407ea-c10d-481e-9cef-829bc2560b6f
Resource DocumentReference:
Generated Narrative: DocumentReference Inline-Instance-for-4153-2
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/1-123456-123456-789date: 2023-07-04 05:02:03+0000
authenticator: לאומית (Identifier: Israeli Legal Entity/580039899)
description: מסמך אישור התחייבות לקבלת שירות בבית החולים
content
Attachments
ContentType Url application/pdf http://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/1-1222223status: Active
type: התחייבות
beneficiary: Identifier:
http://fhir.leumit.co.il/identifier/magnetic-card/1-123456-123456-789period: 2023-09-01 --> 2023-10-01
payor: לאומית (Identifier: Israeli Legal Entity/580039899)
Classes
Type Value OBL-BASKET התחייבות במסגרת הסל CostToBeneficiaries
Type Value[x] גובה השתתפות עצמית ₪200.00 (ILS)