Processresponse-example-error.json

Sample ProcessResponse with error

{
  "resourceType": "ProcessResponse",
  "id": "SR2349",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ProcessResponse</div>"
  },
  "identifier": [
    {
      "system": "http://www.BenefitsInc.com/fhir/processresponse",
      "value": "ER987634"
    }
  ],
  "status": "active",
  "created": "2014-07-14",
  "organization": {
    "reference": "Organization/2"
  },
  "request": {
    "reference": "http://happyvalley.com/fhir/claim/12204"
  },
  "outcome": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/processoutcomecodes",
        "code": "error"
      }
    ]
  },
  "disposition": "Referred to claim not found on system.",
  "requestProvider": {
    "identifier": {
      "system": "http://npid.org/providerid",
      "value": "AZ43258"
    }
  },
  "requestOrganization": {
    "reference": "Organization/1"
  },
  "form": {
    "coding": [
      {
        "system": "http://ncforms.org/formid",
        "code": "PRRESP/2016/01"
      }
    ]
  },
  "processNote": [
    {
      "type": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/note-type",
            "code": "print"
          }
        ]
      },
      "text": "Please check the submitted payor identification and local claim number."
    }
  ],
  "error": [
    {
      "coding": [
        {
          "system": "http://hl7.org/fhir/adjudication-error",
          "code": "a001"
        }
      ]
    }
  ]
}