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

: no-authorization-single-code - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="no-authorization-single-code"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2023-10-30T12:16:52.092+00:00"/>
    <source value="#OWv6TVW3y30WsF2S"/>
  </meta>
  <type value="collection"/>
  <entry>
    <fullUrl value="urn:uuid:7528e4d8-d2de-4e38-9792-eb0013e0570b"/>
    <resource>
      <CoverageEligibilityResponse>
        <id value="90f540a4-f1a8-4a8e-a031-0ed887ce980e"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="CoverageEligibilityResponse_90f540a4-f1a8-4a8e-a031-0ed887ce980e"> </a><p class="res-header-id"><b>Generated Narrative: CoverageEligibilityResponse 90f540a4-f1a8-4a8e-a031-0ed887ce980e</b></p><a name="90f540a4-f1a8-4a8e-a031-0ed887ce980e"> </a><a name="hc90f540a4-f1a8-4a8e-a031-0ed887ce980e"> </a><a name="90f540a4-f1a8-4a8e-a031-0ed887ce980e-en-US"> </a><p><b>identifier</b>: <a href="http://terminology.hl7.org/5.0.0/NamingSystem-uri.html" title="As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt 

This oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid: 

Note that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.

This OID may also be used in CD.codeSystem.">URI</a>/urn:uuid:90f540a4-f1a8-4a8e-a031-0ed887ce980e</p><p><b>status</b>: Active</p><p><b>purpose</b>: Coverage Validation</p><p><b>patient</b>: Identifier: <code>http://fhir.leumit.co.il/identifier/magnetic-card</code>/1-123456-123456-789</p><p><b>created</b>: 2023-07-02 13:44:58+0000</p><p><b>requestor</b>: בי&quot;ח איכילוב (Identifier: Israeli Legal Entity/500106919)</p><p><b>request</b>: Identifier: <code>http://fhir.tlvmc.gov.il/identifier/preauth-req-no</code>/3772</p><p><b>outcome</b>: Processing Complete</p><p><b>disposition</b>: הבקשה להתחייבות לא אושרה</p><p><b>insurer</b>: לאומית (Identifier: Israeli Legal Entity/580039899)</p><blockquote><p><b>insurance</b></p><p><b>coverage</b>: אין מספר התחייבות</p><h3>Items</h3><table class="grid"><tr><td style="display: none">-</td><td><b>ProductOrService</b></td><td><b>Modifier</b></td><td><b>Excluded</b></td><td><b>Name</b></td><td><b>Description</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://fhir.health.gov.il/cs/medical-service-moh L9258}">בדיקת רופא ילדים במרפאה</span></td><td><span title="Codes:{http://fhir.health.gov.il/cs/moh-form17-issue-code charge-not-authorized}">ללקוח אין הרשאת חיוב</span></td><td>true</td><td>בדיקת רופא - התמחות בכליות</td><td>בדיקת רופא ילדים עם התמחות לכליות</td></tr></table></blockquote></div>
        </text>
        <identifier>
          <system value="urn:ietf:rfc:3986"/>
          <value value="urn:uuid:90f540a4-f1a8-4a8e-a031-0ed887ce980e"/>
        </identifier>
        <status value="active"/>
        <purpose value="validation"/>
        <patient>
          <identifier>
            <system
                    value="http://fhir.leumit.co.il/identifier/magnetic-card"/>
            <value value="1-123456-123456-789"/>
          </identifier>
        </patient>
        <created value="2023-07-02T13:44:58.429Z"/>
        <requestor>
          <type value="Organization"/>
          <identifier>
            <system
                    value="http://fhir.health.gov.il/identifier/legal-entity"/>
            <value value="500106919"/>
          </identifier>
          <display value="בי&quot;ח איכילוב"/>
        </requestor>
        <request>
          <identifier>
            <system
                    value="http://fhir.tlvmc.gov.il/identifier/preauth-req-no"/>
            <value value="3772"/>
          </identifier>
        </request>
        <outcome value="complete"/>
        <disposition value="הבקשה להתחייבות לא אושרה"/>
        <insurer>
          <identifier>
            <system
                    value="http://fhir.health.gov.il/identifier/legal-entity"/>
            <value value="580039899"/>
          </identifier>
          <display value="לאומית"/>
        </insurer>
        <insurance>
          <coverage>
            <display value="אין מספר התחייבות"/>
          </coverage>
          <item>
            <productOrService>
              <coding>
                <system
                        value="http://fhir.health.gov.il/cs/medical-service-moh"/>
                <code value="L9258"/>
                <display value="בדיקת רופא ילדים במרפאה"/>
              </coding>
            </productOrService>
            <modifier>
              <coding>
                <system
                        value="http://fhir.health.gov.il/cs/moh-form17-issue-code"/>
                <code value="charge-not-authorized"/>
                <display value="ללקוח אין הרשאת חיוב"/>
              </coding>
            </modifier>
            <excluded value="true"/>
            <name value="בדיקת רופא - התמחות בכליות"/>
            <description value="בדיקת רופא ילדים עם התמחות לכליות"/>
          </item>
        </insurance>
      </CoverageEligibilityResponse>
    </resource>
  </entry>
</Bundle>