Release 5

This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

Example ClaimResponse/R3501 (Turtle)

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

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.