Example ClaimResponse/R3501 (Turtle)
Raw Turtle (+ also see Turtle/RDF Format Specification)
A ClaimResponse for a Claim that contains processing errors
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
[a fhir:ClaimResponse;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "R3501"];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ClaimResponse that demonstrates returning errors</div>"
];
fhir:ClaimResponse.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://www.BenefitsInc.com/fhir/remittance" ];
fhir:Identifier.value [ fhir:value "R3501" ]
];
fhir:ClaimResponse.status [ fhir:value "active"];
fhir:ClaimResponse.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ];
fhir:Coding.code [ fhir:value "oral" ]
]
];
fhir:ClaimResponse.use [ fhir:value "claim"];
fhir:ClaimResponse.patient [
fhir:Reference.reference [ fhir:value "Patient/1" ]
];
fhir:ClaimResponse.created [ fhir:value "2014-08-16"^^xsd:date];
fhir:ClaimResponse.insurer [
fhir:Reference.identifier [
fhir:Identifier.system [ fhir:value "http://www.jurisdiction.org/insurers" ];
fhir:Identifier.value [ fhir:value "555123" ]
]
];
fhir:ClaimResponse.requestor [
fhir:Reference.reference [ fhir:value "Practitioner/1" ]
];
fhir:ClaimResponse.request [
fhir:Reference.reference [ fhir:value "Claim/100156" ]
];
fhir:ClaimResponse.outcome [ fhir:value "error"];
fhir:ClaimResponse.disposition [ fhir:value "Claim could not be processed"];
fhir:ClaimResponse.formCode [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/forms-codes" ];
fhir:Coding.code [ fhir:value "2" ]
]
];
fhir:ClaimResponse.processNote [
fhir:index 0;
fhir:ClaimResponse.processNote.number [ fhir:value "1"^^xsd:positiveInteger ];
fhir:ClaimResponse.processNote.type [ fhir:value "display" ];
fhir:ClaimResponse.processNote.text [ fhir:value "Invalid claim" ];
fhir:ClaimResponse.processNote.language [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "urn:ietf:bcp:47" ];
fhir:Coding.code [ fhir:value "en-CA" ]
]
]
];
fhir:ClaimResponse.communicationRequest [
fhir:index 0;
fhir:Reference.reference [ fhir:value "CommunicationRequest/fm-solicit" ]
];
fhir:ClaimResponse.error [
fhir:index 0;
fhir:ClaimResponse.error.itemSequence [ fhir:value "3"^^xsd:positiveInteger ];
fhir:ClaimResponse.error.detailSequence [ fhir:value "2"^^xsd:positiveInteger ];
fhir:ClaimResponse.error.code [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication-error" ];
fhir:Coding.code [ fhir:value "a002" ]
]
]
]] .
# - ontology header ------------------------------------------------------------
[a owl:Ontology;
owl:imports fhir:fhir.ttl] .
# -------------------------------------------------------------------------------------
Usage note: every effort has been made to ensure that the
examples are correct and useful, but they are not a normative part
of the specification.