ELTSS 0.1.0 - STU1 Ballot 1

This page is part of the electronic Long-Term Services and Supports Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

eLTSS Claim Example

Format(s):

Narrative view

Bundle claim-claim1 of type collection

Entry 1 - Full URL = http://example.org/eLTSS/claim

Resource Claim:

Entry 2 - Full URL = http://example.org/eLTSS/funding

Resource Organization:

Service Funding Source: Georgia Department of Community Health

Entry 3 - Full URL = http://example.org/eLTSS/coverage1

Resource Coverage:

Entry 4 - Full URL = http://example.org/eLTSS/patient1

Resource Patient:

Person Name: Sally Person

Person Identifier | Type: 123456ABC | MRN

Person Phone: (404) 555 1212

Person Date of Birth: 1935-05-01

Person Address: 2222 Peachtree Street, Atlanta GA, 30318

Emergency Contact Name: Jane Daughter

Emergency Contact Relationship: daughter

Emergency Contact Phone Number: (770) 224 1544