R6 Ballot (2nd Draft)

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Example Contract/INS-101 (Turtle)

Financial Management Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient

Raw Turtle (+ also see Turtle/RDF Format Specification)

Health Insurance Policy

@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:Contract ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "INS-101"] ; # 
  fhir:text [
     fhir:status [ fhir:v "generated" ] ;
     fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n         <p>Plan: Your Choice Split Copay (Non-Grandfathered)</p>\n         <p>Certificate Form Number: YCSCWLN (01-2017)</p>\n      </div>"
  ] ; # 
  fhir:identifier ( [
     fhir:system [ fhir:v "http://xyz-insurance.com/forms"^^xsd:anyURI ] ;
     fhir:value [ fhir:v "YCSCWLN(01-2017)" ]
  ] ) ; # 
  fhir:applies [
     fhir:start [ fhir:v "2017-01-01"^^xsd:date ]
  ] ; # 
  fhir:subject ( [
     fhir:reference [ fhir:v "Patient/1" ]
  ] ) ; # 
  fhir:type [
     fhir:coding ( [
       fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/contract-type"^^xsd:anyURI ] ;
       fhir:code [ fhir:v "healthinsurance" ] ;
       fhir:display [ fhir:v "Health Insurance" ]
     ] )
  ] ; # 
  fhir:term ( [
     fhir:offer [
       fhir:text [ fhir:v "The benefits, limitations, exclusions and other coverage provisions in this booklet are subject to the terms of our contract with the Group. This booklet is a part of that contract, which is on file in the Group's office." ]
     ] ;
     fhir:asset ( [
       fhir:type ( [
         fhir:coding ( [
           fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
           fhir:code [ fhir:v "urn:uuid:3a48c68c-318d-4c68-8471-4a3c10fcb41b" ] ;
           fhir:display [ fhir:v "RicardianContract" ]
         ] )
       ] ) ;
       fhir:subtype ( [
         fhir:text [ fhir:v "sample" ]
       ] ) ;
       fhir:period ( [
         fhir:start [ fhir:v "2017-06-01"^^xsd:date ]
       ] ) ;
       fhir:valuedItem ( [
         fhir:entity [
           a fhir:CodeableConcept ;
           fhir:text [ fhir:v "Ford Bobcat" ]
         ] ;
         fhir:identifier [
           fhir:system [ fhir:v "http://somewhere.motor-vehicle.com/vin"^^xsd:anyURI ] ;
           fhir:value [ fhir:v "XXSVT34-7665t952236" ]
         ] ;
         fhir:effectiveTime [ fhir:v "1995"^^xsd:gYear ] ;
         fhir:quantity [
           fhir:value [ fhir:v "1"^^xsd:decimal ]
         ] ;
         fhir:unitPrice [
           fhir:value [ fhir:v "200.00"^^xsd:decimal ] ;
           fhir:currency [ fhir:v "CAD" ]
         ] ;
         fhir:factor [ fhir:v "1.0"^^xsd:decimal ] ;
         fhir:points [ fhir:v "1.0"^^xsd:decimal ] ;
         fhir:net [
           fhir:value [ fhir:v "200.00"^^xsd:decimal ] ;
           fhir:currency [ fhir:v "CAD" ]
         ]
       ] )
     ] ) ;
     fhir:group ( [
       fhir:offer [
         fhir:text [ fhir:v "Eligible Providers" ]
       ]
     ] [
       fhir:offer [
         fhir:text [ fhir:v "Responsibility for Payment" ]
       ]
     ] [
       fhir:offer [
         fhir:text [ fhir:v "List of Benefits" ]
       ] ;
       fhir:group ( [
         fhir:offer [
           fhir:text [ fhir:v "Copays" ]
         ] ;
         fhir:group ( [
           fhir:offer [
             fhir:text [ fhir:v "Emergency Room Copay" ]
           ]
         ] [
           fhir:offer [
             fhir:text [ fhir:v "Professional Visit Copay" ]
           ]
         ] )
       ] [
         fhir:offer [
           fhir:text [ fhir:v "Calendar Year Deductible" ]
         ]
       ] [
         fhir:offer [
           fhir:text [ fhir:v "Out-Of-Pocket Maximum" ]
         ]
       ] [
         fhir:offer [
           fhir:text [ fhir:v "Medical Services" ]
         ] ;
         fhir:group ( [
           fhir:offer [
             fhir:text [ fhir:v "Ambulance Services" ]
           ]
         ] [
           fhir:offer [
             fhir:text [ fhir:v "Dental Services" ]
           ]
         ] [
           fhir:offer [
             fhir:text [ fhir:v "Diagnostic Services" ]
           ]
         ] [
           fhir:offer [
             fhir:text [ fhir:v "Emergency Room Services" ]
           ]
         ] [
           fhir:offer [
             fhir:text [ fhir:v "Hospital Inpatient Care" ]
           ]
         ] )
       ] )
     ] )
  ] )] . # 

# -------------------------------------------------------------------------------------


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.