This page is part of the electronic Long-Term Services and Supports Implementation Guide (v1.0.0: STU 1) based on FHIR R4. 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
{ "resourceType" : "Bundle", "id" : "contract-contract1", "type" : "collection", "entry" : [ { "fullUrl" : "http://example.org/eLTSS/planner", "resource" : { "resourceType" : "Practitioner", "id" : "planner1", "meta" : { "profile" : [ "http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss" ] }, "text" : { "status" : "generated", "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>Support Planner / Phone:</b> Mark Planner / (678) 555 1221</p>\n </div>" }, "identifier" : [ { "system" : "http://www.acme.org/practitioners", "value" : "23" } ], "name" : [ { "text" : "Mark Planner", "family" : "Planner", "given" : [ "Mark" ] } ], "telecom" : [ { "system" : "phone", "value" : "(678) 555 1221" } ] } }, { "fullUrl" : "http://example.org/eLTSS/caremgr", "resource" : { "resourceType" : "Practitioner", "id" : "caremgr1", "meta" : { "profile" : [ "http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss" ] }, "text" : { "status" : "generated", "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>Plan Monitor / Phone:</b> Sam Monitor / (770) 224 1599</p>\n </div>" }, "identifier" : [ { "system" : "http://www.acme.org/practitioners", "value" : "24" } ], "name" : [ { "text" : "Sam Monitor", "family" : "Monitor", "given" : [ "Sam" ] } ], "telecom" : [ { "system" : "phone", "value" : "(770) 224 1599" } ] } }, { "fullUrl" : "http://example.org/eLTSS/provider1", "resource" : { "resourceType" : "Practitioner", "id" : "provider1", "meta" : { "profile" : [ "http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss" ] }, "text" : { "status" : "generated", "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>Provider:</b> Lisa Performer </p>\n </div>" }, "identifier" : [ { "system" : "http://www.acme.org/practitioners", "value" : "987654" } ], "name" : [ { "text" : "Lisa Performer", "family" : "Performer", "given" : [ "Lisa" ] } ], "telecom" : [ { "system" : "phone", "value" : "(404) 555 1213" } ] } }, { "fullUrl" : "http://example.org/eLTSS/provider2", "resource" : { "resourceType" : "Organization", "id" : "provider2", "text" : { "status" : "generated", "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>Organization:</b> The Transporter</p>\n </div>" }, "identifier" : [ { "value" : "24680" } ], "name" : "The Transporter, Inc.", "telecom" : [ { "system" : "phone", "value" : "(404) 555 1313" } ], "address" : [ { "text" : "111 Business Street, Atlanta GA, 30318" } ] } }, { "fullUrl" : "http://example.org/eLTSS/provider3", "resource" : { "resourceType" : "Practitioner", "id" : "provider3", "meta" : { "profile" : [ "http://hl7.org/fhir/us/eltss/StructureDefinition/Practitioner-eltss" ] }, "text" : { "status" : "generated", "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p><b>Practitioner:</b> Bill Driver</p>\n </div>" }, "identifier" : [ { "system" : "http://www.acme.org/practitioners", "value" : "11223344" } ], "name" : [ { "text" : "Bill Driver", "family" : "Driver", "given" : [ "Bill" ] } ], "telecom" : [ { "system" : "phone", "value" : "(678) 111 2222" } ] } }, { "fullUrl" : "http://example.org/eLTSS/contract", "resource" : { "resourceType" : "Contract", "id" : "contract1", "meta" : { "profile" : [ "http://hl7.org/fhir/us/eltss/StructureDefinition/Contract-eltss" ] }, "text" : { "status" : "additional", "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>eLTSS Signature in Contract form [eLTSS Support Planner Signature], [eLTSS Support Planner Printed Name], [eLTSS Support Planner Signature Date] </p>\n </div>" }, "signer" : [ { "type" : { "system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes", "code" : "AUT" }, "party" : { "reference" : "Practitioner/planner1" }, "signature" : [ { "type" : [ { "code" : "1.2.840.10065.1.12.1.1" } ], "when" : "2018-04-02T03:00:00Z", "who" : { "reference" : "Practitioner/planner1" }, "sigFormat" : "image/jpeg", "data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw==" } ] }, { "type" : { "system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes", "code" : "HPROV" }, "party" : { "reference" : "Practitioner/provider1" }, "signature" : [ { "type" : [ { "code" : "1.2.840.10065.1.12.1.7" } ], "when" : "2018-04-02T03:00:00Z", "who" : { "reference" : "Practitioner/provider1" }, "sigFormat" : "image/jpeg", "data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw==" } ] }, { "type" : { "system" : "http://terminology.hl7.org/CodeSystem/contractsignertypecodes", "code" : "HPROV" }, "party" : { "reference" : "Organization/provider2" }, "signature" : [ { "type" : [ { "code" : "1.2.840.10065.1.12.1.7" } ], "when" : "2018-04-02T03:00:00Z", "who" : { "reference" : "Practitioner/provider3" }, "sigFormat" : "image/jpeg", "data" : "R0lGODlhIAAgALMAADNmmWNjnGOcnJycnJzOnM7OnP///////////////////////////////////////yH5BAEAAAUALAAAAAAgACAAAARosMhJq704680l6OD0fSFHFmd5pai6vi7FerGYzWAK7HKs8zYVazcUVojH0gyZzFmYvQ4OGtXgUMDn5kqtwlZZLeaKJXOtYbG31lrXdKb0lyySi+l1PE1v5CtpbE0eRISFhod+gYoXEQAAOw==" } ] } ] } } ] }