Generated Narrative: Bundle HomecareAuthorizationDifferentialBundleExample

Bundle HomecareAuthorizationDifferentialBundleExample of type collection

Entry 1 - fullUrl = http://example.org/fhir/Claim/HomecareAuthorizationDifferentialExample

Resource Claim:

Generated Narrative: Claim HomecareAuthorizationDifferentialExample

identifier: http://example.org/PATIENT_EVENT_TRACE_NUMBER/111099-UPDATE-DIFF

status: Active

type: Professional

use: Preauthorization

patient: JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)

created: 2019-07-20 11:01:00+0500

insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY

provider: Organization DR. JOE SMITH CORPORATION

priority: Normal

Relateds

-	Claim	Relationship
*	Claim: extension = ; identifier = http://example.org/PATIENT_EVENT_TRACE_NUMBER#111099; status = active; type = Professional; use = preauthorization; created = 2019-07-20 11:01:00+0500; priority = Normal	Prior Claim

Insurances

-	Sequence	Focal	Coverage
*	1	true	Coverage: status = active; subscriberId = 1122334455; relationship = Self

item

ServiceItemRequestType: Health Services Review

CertificationType: Initial

InfoCancelledFlag: true

sequence: 2

category: Home Health Care

productOrService: B4184

location: 11

item

ServiceItemRequestType: Health Services Review

CertificationType: Initial

InfoChanged: added

sequence: 3

category: Home Health Care

productOrService: B4185

location: 11

Entry 2 - fullUrl = http://example.org/fhir/Organization/UMOExample

Resource Organization:

Generated Narrative: Organization UMOExample

identifier: United States National Provider Identifier/8189991234

active: true

type: X3

name: DR. JOE SMITH CORPORATION

Contacts

-	Address
*	111 1ST STREET SAN DIEGO CA 92101 US

Entry 3 - fullUrl = http://example.org/fhir/Organization/InsurerExample

Resource Organization:

Generated Narrative: Organization InsurerExample

identifier: United States National Provider Identifier/1234567893

active: true

type: PR

name: MARYLAND CAPITAL INSURANCE COMPANY

Entry 4 - fullUrl = http://example.org/fhir/Coverage/InsuranceExample

Resource Coverage:

Generated Narrative: Coverage InsuranceExample

status: Active

subscriberId: 1122334455

beneficiary: JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)

relationship: Self

Entry 5 - fullUrl = http://example.org/fhir/Patient/SubscriberExample

Resource Patient:

Generated Narrative: Patient SubscriberExample

JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)

---

RU

Entry 6 - fullUrl = http://example.org/fhir/Claim/HomecareAuthorizationExample

Resource Claim:

Generated Narrative: Claim HomecareAuthorizationExample

HomeHealthCareInformation

• prognosis: 1
• date: 2005-05-02

identifier: http://example.org/PATIENT_EVENT_TRACE_NUMBER/111099

status: Active

type: Professional

use: Preauthorization

patient: JOE SMITH Male, DoB Unknown ( http://example.org/MIN#12345678901)

created: 2019-07-20 11:01:00+0500

insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY

provider: Organization DR. JOE SMITH CORPORATION

priority: Normal

Insurances

-	Sequence	Focal	Coverage
*	1	true	Coverage: status = active; subscriberId = 1122334455; relationship = Self

item

ServiceItemRequestType: Health Services Review

CertificationType: Initial

sequence: 1

category: Home Health Care

productOrService: G0154

location: 11

item

ServiceItemRequestType: Health Services Review

CertificationType: Initial

sequence: 2

category: Home Health Care

productOrService: B4184

location: 11