Communicationrequest-example-fm-solicit-attachment.xml

An example of a request for additional information (id = "fm-solicit")

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

<CommunicationRequest xmlns="http://hl7.org/fhir">
  <id value="fm-solicit"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">Request for Accident Report</div> 
  </text> 
  
  <!--   insert contents here   -->
  
    <contained> 
    <Organization> 
      <id value="provider"/> 
      <identifier> 
        <system value="http://www.jurisdiction.com/provideroffices"/> 
        <value value="3456"/> 
      </identifier> 
    </Organization> 
  </contained> 

  <contained> 
    <Organization> 
      <id value="payor"/> 
      <identifier> 
        <system value="http://www.jurisdiction.com/insurer"/> 
        <value value="123456"/> 
      </identifier> 
    </Organization> 
  </contained> 

  <contained> 
    <Practitioner> 
      <id value="requester"/> 
      <identifier> 
         <value value="6789"/> 
      </identifier> 
    </Practitioner> 
  </contained> 
  <!--   body of the resource   -->

  <identifier> 
    <system value="http://www.jurisdiction.com/insurer/123456"/> 
    <value value="ABC123"/>  <!--   this is the value to which the response will refer   -->
  </identifier> 
   <basedOn> 
    <display value="EligibilityRequest"/> 
  </basedOn> 
   <replaces> 
    <display value="prior CommunicationRequest"/> 
  </replaces> 
  <groupIdentifier> 
       <value value="12345"/> 
  </groupIdentifier> 
  <status value="active"/> 
  
  <category> 
     <coding> 
       <system value="http://acme.org/messagetypes"/> 
       <code value="SolicitedAttachmentRequest"/> 
     </coding> 
  </category> 
  <priority value="routine"/> 
  <medium> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/v3-ParticipationMode"/> 
      <code value="WRITTEN"/> 
      <display value="written"/> 
    </coding> 
    <text value="written"/> 
  </medium> 
  
  <encounter> 
    <reference value="Encounter/example"/> 
  </encounter> 
  <payload> 
    <contentCodeableConcept> 
    <text value="Please provide the accident report and any associated pictures to support your Claim#
       DEF5647."/> 
  </contentCodeableConcept> 
  </payload> 
  <occurrenceDateTime value="2016-06-10T11:01:10-08:00"/> 
  <authoredOn value="2016-06-10T11:01:10-08:00"/> 
  <requester> 
    <reference value="#requester"/> 
   </requester> 
   <recipient> 
      <reference value="#provider"/> 
  </recipient> 
   <informationProvider> 
     <reference value="#payor"/> 
   </informationProvider> 
   

</CommunicationRequest>