Explanationofbenefit.questionnaire.xml

Generated Questionnaire for ExplanationOfBenefit

<?xml version="1.0" encoding="UTF-8"?>

<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="qs1"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
  </identifier>
  <status value="draft"/>
  <date value="2015-02-23T09:07:27+11:00"/>
  <publisher value="HL7 FHIR Project (Financial Management)"/>
  <group>
    <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
      <valueString value="This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided."/>
    </extension>
    <linkId value="ExplanationOfBenefit"/>
    <title value="Remittance resource"/>
    <required value="true"/>
    <repeats value="false"/>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="The logical id of the resource, as used in the url for the resoure. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Bundles always have an id, though it is usually a generated UUID."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="string"/>
      </extension>
      <linkId value="ExplanationOfBenefit.id"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <linkId value="ExplanationOfBenefit.id.value"/>
        <text value="Logical id of this artefact"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
      </extension>
      <linkId value="ExplanationOfBenefit.meta"/>
      <text value="Metadata about the resource"/>
      <required value="false"/>
      <repeats value="true"/>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="uri"/>
      </extension>
      <linkId value="ExplanationOfBenefit.implicitRules"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <linkId value="ExplanationOfBenefit.implicitRules.value"/>
        <text value="A set of rules under which this content was created"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource

Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="code"/>
      </extension>
      <linkId value="ExplanationOfBenefit.language"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <linkId value="ExplanationOfBenefit.language.value"/>
        <text value="language"/>
        <type value="choice"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative."/>
      </extension>
      <linkId value="ExplanationOfBenefit.text"/>
      <text value="Text summary of the resource, for human interpretation"/>
      <required value="false"/>
      <repeats value="true"/>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/>
      </extension>
      <linkId value="ExplanationOfBenefit.contained"/>
      <text value="Contained, inline Resources"/>
      <required value="false"/>
      <repeats value="true"/>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="The Response Business Identifier."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="Identifier"/>
      </extension>
      <linkId value="ExplanationOfBenefit.identifier"/>
      <text value="Business Identifier"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <linkId value="ExplanationOfBenefit.identifier.label"/>
        <text value="label:"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
      <question>
        <linkId value="ExplanationOfBenefit.identifier.system"/>
        <text value="system:"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
      <question>
        <linkId value="ExplanationOfBenefit.identifier.value"/>
        <text value="value:"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="Original request resource reference."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="Reference"/>
      </extension>
      <linkId value="ExplanationOfBenefit.request"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#reference">
          <valueString value="/OralHealthClaim?subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
        </extension>
        <linkId value="ExplanationOfBenefit.request.value"/>
        <text value="Claim reference"/>
        <type value="reference"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="Transaction status: error, complete."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="code"/>
      </extension>
      <linkId value="ExplanationOfBenefit.outcome"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <linkId value="ExplanationOfBenefit.outcome.value"/>
        <text value="outcome"/>
        <type value="choice"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="A description of the status of the adjudication."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="string"/>
      </extension>
      <linkId value="ExplanationOfBenefit.disposition"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <linkId value="ExplanationOfBenefit.disposition.value"/>
        <text value="Disposition Message"/>
        <type value="string"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="Coding"/>
      </extension>
      <linkId value="ExplanationOfBenefit.ruleset"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <linkId value="ExplanationOfBenefit.ruleset.value"/>
        <text value="Resource version"/>
        <type value="open-choice"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="The style (standard) and version of the original material which was converted into this resource."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="Coding"/>
      </extension>
      <linkId value="ExplanationOfBenefit.originalRuleset"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <linkId value="ExplanationOfBenefit.originalRuleset.value"/>
        <text value="Original version"/>
        <type value="open-choice"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="The date when the enclosed suite of services were performed or completed."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="datetime"/>
      </extension>
      <linkId value="ExplanationOfBenefit.created"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <linkId value="ExplanationOfBenefit.created.value"/>
        <text value="Creation date"/>
        <type value="dateTime"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="The Insurer who produced this adjudicated response."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="Reference"/>
      </extension>
      <linkId value="ExplanationOfBenefit.organization"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#reference">
          <valueString value="/Organization?subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
        </extension>
        <linkId value="ExplanationOfBenefit.organization.value"/>
        <text value="Insurer"/>
        <type value="reference"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="The practitioner who is responsible for the services rendered to the patient."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="Reference"/>
      </extension>
      <linkId value="ExplanationOfBenefit.requestProvider"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#reference">
          <valueString value="/Practitioner?subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
        </extension>
        <linkId value="ExplanationOfBenefit.requestProvider.value"/>
        <text value="Responsible practitioner"/>
        <type value="reference"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
    <group>
      <extension url="http://hl7.org/fhir/Profile/questionnaire-extensions#flyover">
        <valueString value="The organization which is responsible for the services rendered to the patient."/>
      </extension>
      <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#type">
        <valueString value="Reference"/>
      </extension>
      <linkId value="ExplanationOfBenefit.requestOrganization"/>
      <required value="false"/>
      <repeats value="true"/>
      <question>
        <extension url="http://www.healthintersections.com.au/fhir/Profile/metadata#reference">
          <valueString value="/Organization?subject=$subj&amp;patient=$subj&amp;encounter=$encounter"/>
        </extension>
        <linkId value="ExplanationOfBenefit.requestOrganization.value"/>
        <text value="Responsible organization"/>
        <type value="reference"/>
        <required value="false"/>
        <repeats value="false"/>
      </question>
    </group>
  </group>
</Questionnaire>