R6 Ballot (1st Draft)
FinancialThis page is part of the FHIR Specification v6.0.0-ballot1: Release 6 Ballot (1st Draft) (see Ballot Notes). The current version is 5.0.0. For a full list of available versions, see the Directory of published versions 
| Financial Management Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Patient, Practitioner |
Raw Turtle (+ also see Turtle/RDF Format Specification)
General Person Primary Coverage with Benefit Details
@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:CoverageEligibilityResponse ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "E2501"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the CoverageEligibilityResponse.</div>"
] ; #
fhir:identifier ( [
fhir:system [ fhir:v "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse"^^xsd:anyURI ] ;
fhir:value [ fhir:v "881234" ]
] ) ; #
fhir:status [ fhir:v "active"] ; #
fhir:purpose ( [ fhir:v "validation"] [ fhir:v "benefits"] ) ; #
fhir:patient [
fhir:reference [ fhir:v "Patient/pat1" ]
] ; #
fhir:serviced [ fhir:v "2014-09-17"^^xsd:date] ; #
fhir:created [ fhir:v "2014-08-16"^^xsd:date] ; # Anticipated service date
fhir:request [
fhir:link <http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332402> ;
fhir:reference [ fhir:v "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332402" ]
] ; #
fhir:outcome [ fhir:v "complete"] ; #
fhir:disposition [ fhir:v "Policy is currently in-force."] ; #
fhir:insurer [
fhir:reference [ fhir:v "Organization/2" ]
] ; #
fhir:insurance ( [
fhir:coverage [
fhir:reference [ fhir:v "Coverage/9876B1" ]
] ;
fhir:inforce [ fhir:v "true"^^xsd:boolean ] ;
fhir:item ( [
fhir:category [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "30" ] ;
fhir:display [ fhir:v "Health Benefit Plan Coverage" ]
] )
] ;
fhir:network [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;
fhir:code [ fhir:v "in" ]
] )
] ;
fhir:unit [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;
fhir:code [ fhir:v "individual" ]
] )
] ;
fhir:term [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;
fhir:code [ fhir:v "annual" ]
] )
] ;
fhir:benefit ( [
fhir:type [
fhir:coding ( [
fhir:code [ fhir:v "benefit" ]
] )
] ;
fhir:allowed [
a fhir:Money ;
fhir:value [ fhir:v "500000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]
]
] [
fhir:type [
fhir:coding ( [
fhir:code [ fhir:v "copay-maximum" ]
] )
] ;
fhir:allowed [
a fhir:Money ;
fhir:value [ fhir:v "100"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]
]
] [
fhir:type [
fhir:coding ( [
fhir:code [ fhir:v "copay-percent" ]
] )
] ;
fhir:allowed [ fhir:v "20"^^xsd:nonNegativeInteger ]
] )
] [
fhir:category [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "69" ] ;
fhir:display [ fhir:v "Maternity" ]
] )
] ;
fhir:network [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;
fhir:code [ fhir:v "in" ]
] )
] ;
fhir:unit [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;
fhir:code [ fhir:v "individual" ]
] )
] ;
fhir:term [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;
fhir:code [ fhir:v "annual" ]
] )
] ;
fhir:benefit ( [
fhir:type [
fhir:coding ( [
fhir:code [ fhir:v "benefit" ]
] )
] ;
fhir:allowed [
a fhir:Money ;
fhir:value [ fhir:v "15000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]
]
] )
] [
fhir:category [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "F3" ] ;
fhir:display [ fhir:v "Dental Coverage" ]
] )
] ;
fhir:network [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;
fhir:code [ fhir:v "in" ]
] )
] ;
fhir:unit [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;
fhir:code [ fhir:v "individual" ]
] )
] ;
fhir:term [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;
fhir:code [ fhir:v "annual" ]
] )
] ;
fhir:benefit ( [
fhir:type [
fhir:coding ( [
fhir:code [ fhir:v "benefit" ]
] )
] ;
fhir:allowed [
a fhir:Money ;
fhir:value [ fhir:v "2000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]
]
] )
] [
fhir:category [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "F6" ] ;
fhir:display [ fhir:v "Vision Coverage" ]
] )
] ;
fhir:network [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;
fhir:code [ fhir:v "in" ]
] )
] ;
fhir:unit [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;
fhir:code [ fhir:v "individual" ]
] )
] ;
fhir:term [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;
fhir:code [ fhir:v "annual" ]
] )
] ;
fhir:benefit ( [
fhir:type [
fhir:coding ( [
fhir:code [ fhir:v "benefit" ]
] )
] ;
fhir:allowed [
a fhir:Money ;
fhir:value [ fhir:v "400"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]
]
] )
] [
fhir:category [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "49" ] ;
fhir:display [ fhir:v "Hospital Room and Board" ]
] )
] ;
fhir:network [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;
fhir:code [ fhir:v "in" ]
] )
] ;
fhir:unit [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;
fhir:code [ fhir:v "individual" ]
] )
] ;
fhir:term [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;
fhir:code [ fhir:v "day" ]
] )
] ;
fhir:benefit ( [
fhir:type [
fhir:coding ( [
fhir:code [ fhir:v "room" ]
] )
] ;
fhir:allowed [ fhir:v "shared" ]
] [
fhir:type [
fhir:coding ( [
fhir:code [ fhir:v "benefit" ]
] )
] ;
fhir:allowed [
a fhir:Money ;
fhir:value [ fhir:v "600"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]
]
] )
] )
] )] . #
# -------------------------------------------------------------------------------------
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.
FHIR ®© HL7.org 2011+. FHIR R6 hl7.fhir.core#6.0.0-ballot1 generated on Mon, Dec 18, 2023 15:17+1100.
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