This page is part of the FHIR Specification (v5.0.0-draft-final: Final QA Preview for R5 - see ballot notes). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4
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:id [ fhir:v "R3501"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ClaimResponse that demonstrates returning errors</div>"
] ; #
fhir:identifier ( [
fhir:system [ fhir:v "http://www.BenefitsInc.com/fhir/remittance"^^xsd:anyURI ] ;
fhir:value [ fhir:v "R3501" ]
] ) ; #
fhir:status [ fhir:v "active"] ; #
fhir:type [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "oral" ]
] )
] ; #
fhir:use [ fhir:v "claim"] ; #
fhir:patient [
fhir:reference [ fhir:v "Patient/1" ]
] ; #
fhir:created [ fhir:v "2014-08-16"^^xsd:date] ; #
fhir:insurer [
fhir:identifier [
fhir:system [ fhir:v "http://www.jurisdiction.org/insurers"^^xsd:anyURI ] ;
fhir:value [ fhir:v "555123" ]
]
] ; #
fhir:requestor [
fhir:reference [ fhir:v "Practitioner/1" ]
] ; #
fhir:request [
fhir:reference [ fhir:v "Claim/100156" ]
] ; #
fhir:outcome [ fhir:v "error"] ; #
fhir:disposition [ fhir:v "Claim could not be processed"] ; #
fhir:formCode [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/forms-codes"^^xsd:anyURI ] ;
fhir:code [ fhir:v "2" ]
] )
] ; #
fhir:processNote ( [
fhir:number [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:type [
fhir:coding ( [
fhir:system [ fhir:v "http://hl7.org/fhir/note-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "display" ]
] )
] ;
fhir:text [ fhir:v "Invalid claim" ] ;
fhir:language [
fhir:coding ( [
fhir:system [ fhir:v "urn:ietf:bcp:47"^^xsd:anyURI ] ;
fhir:code [ fhir:v "en-CA" ]
] )
]
] ) ; #
fhir:communicationRequest ( [
fhir:reference [ fhir:v "CommunicationRequest/fm-solicit" ]
] ) ; #
fhir:error ( [
fhir:itemSequence [ fhir:v "3"^^xsd:positiveInteger ] ;
fhir:detailSequence [ fhir:v "2"^^xsd:positiveInteger ] ;
fhir:code [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication-error"^^xsd:anyURI ] ;
fhir:code [ fhir:v "a002" ]
] )
]
] )] . # Detailed error description
# -------------------------------------------------------------------------------------
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.