Finance and Insurance Service (FAIS)
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Finance and Insurance Service (FAIS), published by IHE IT Infrastructure Technical Committee. This guide is not an authorized publication; it is the continuous build for version 1.0.1-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/ITI.Finance/ and changes regularly. See the Directory of published versions

: Use Case 2 - Example Coverage Eligibility Request Bundle - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "ex-check-coverage-bundle-2",
  "meta" : {
    "profile" : [
      🔗 "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.CoverageEligibilityRequest.Bundle"
    ]
  },
  "type" : "collection",
  "entry" : [
    {
      "fullUrl" : "https://profiles.ihe.net/ITI/FAIS/CoverageEligibilityRequest/ex-check-coverage-2",
      "resource" : {
        "resourceType" : "CoverageEligibilityRequest",
        "id" : "ex-check-coverage-2",
        "meta" : {
          "profile" : [
            🔗 "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.CoverageEligibilityRequest"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"CoverageEligibilityRequest_ex-check-coverage-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: CoverageEligibilityRequest ex-check-coverage-2</b></p><a name=\"ex-check-coverage-2\"> </a><a name=\"hcex-check-coverage-2\"> </a><a name=\"ex-check-coverage-2-en-US\"> </a><p><b>status</b>: Active</p><p><b>purpose</b>: Coverage benefits</p><p><b>patient</b>: <a href=\"Patient-ex-beneficiary-1.html\">Purity Atieno  Female, DoB: 2000-05-04</a></p><p><b>serviced</b>: 2024-07-01 --&gt; 2024-12-31</p><p><b>created</b>: 2024-06-01 15:00:00+0000</p><p><b>enterer</b>: <a href=\"Practitioner-ex-doctor-2.html\">Practitioner Kalu Kalu </a></p><p><b>provider</b>: <a href=\"Practitioner-ex-doctor-2.html\">Practitioner Kalu Kalu </a></p><p><b>insurer</b>: <a href=\"Organization-ex-insurer-1.html\">Organization National Health Insurance Scheme</a></p><p><b>facility</b>: <a href=\"Location-ex-hospital-2.html\">Location Local Hospital</a></p><blockquote><p><b>item</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-benefitcategory 1}\">Medical Care</span></p><p><b>productOrService</b>: <span title=\"Codes:{http://loinc.org 21946-9}\">Chemotherapy treatment Cancer</span></p><p><b>provider</b>: <a href=\"Practitioner-ex-doctor-2.html\">Practitioner Kalu Kalu </a></p><p><b>facility</b>: <a href=\"Location-ex-hospital-2.html\">Location Local Hospital</a></p><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://id.who.int/icd/release/11/mms XH1VB1}\">Hybrid oncocytic chromophobe tumour</span></td></tr></table></blockquote></div>"
        },
        "status" : "active",
        "purpose" : [
          "benefits"
        ],
        "patient" : {
          🔗 "reference" : "Patient/ex-beneficiary-1"
        },
        "servicedPeriod" : {
          "start" : "2024-07-01",
          "end" : "2024-12-31"
        },
        "created" : "2024-06-01T15:00:00Z",
        "enterer" : {
          🔗 "reference" : "Practitioner/ex-doctor-2"
        },
        "provider" : {
          🔗 "reference" : "Practitioner/ex-doctor-2"
        },
        "insurer" : {
          🔗 "reference" : "Organization/ex-insurer-1"
        },
        "facility" : {
          🔗 "reference" : "Location/ex-hospital-2"
        },
        "item" : [
          {
            "category" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/ex-benefitcategory",
                  "code" : "1"
                }
              ]
            },
            "productOrService" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "21946-9",
                  "display" : "Chemotherapy treatment Cancer"
                }
              ]
            },
            "provider" : {
              🔗 "reference" : "Practitioner/ex-doctor-2"
            },
            "facility" : {
              🔗 "reference" : "Location/ex-hospital-2"
            },
            "diagnosis" : [
              {
                "diagnosisCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://id.who.int/icd/release/11/mms",
                      "code" : "XH1VB1",
                      "display" : "Hybrid oncocytic chromophobe tumour"
                    }
                  ]
                }
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "https://profiles.ihe.net/ITI/FAIS/Practitioner/ex-doctor-2",
      "resource" : {
        "resourceType" : "Practitioner",
        "id" : "ex-doctor-2",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_ex-doctor-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner ex-doctor-2</b></p><a name=\"ex-doctor-2\"> </a><a name=\"hcex-doctor-2\"> </a><a name=\"ex-doctor-2-en-US\"> </a><p><b>name</b>: Kalu Kalu </p></div>"
        },
        "name" : [
          {
            "family" : "Kalu",
            "given" : [
              "Kalu"
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "https://profiles.ihe.net/ITI/FAIS/Organization/ex-insurer-1",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "ex-insurer-1",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_ex-insurer-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization ex-insurer-1</b></p><a name=\"ex-insurer-1\"> </a><a name=\"hcex-insurer-1\"> </a><a name=\"ex-insurer-1-en-US\"> </a><p><b>name</b>: National Health Insurance Scheme</p></div>"
        },
        "name" : "National Health Insurance Scheme"
      }
    },
    {
      "fullUrl" : "https://profiles.ihe.net/ITI/FAIS/Patient/ex-beneficiary-1",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "ex-beneficiary-1",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_ex-beneficiary-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient ex-beneficiary-1</b></p><a name=\"ex-beneficiary-1\"> </a><a name=\"hcex-beneficiary-1\"> </a><a name=\"ex-beneficiary-1-en-US\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Purity Atieno  Female, DoB: 2000-05-04</p><hr/></div>"
        },
        "name" : [
          {
            "family" : "Atieno",
            "given" : [
              "Purity"
            ]
          }
        ],
        "gender" : "female",
        "birthDate" : "2000-05-04"
      }
    },
    {
      "fullUrl" : "https://profiles.ihe.net/ITI/FAIS/Location/ex-hospital-2",
      "resource" : {
        "resourceType" : "Location",
        "id" : "ex-hospital-2",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_ex-hospital-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Location ex-hospital-2</b></p><a name=\"ex-hospital-2\"> </a><a name=\"hcex-hospital-2\"> </a><a name=\"ex-hospital-2-en-US\"> </a><p><b>name</b>: Local Hospital</p></div>"
        },
        "name" : "Local Hospital"
      }
    }
  ]
}