Finance and Insurance Service (FAIS)
1.0.1-current - ci-build International flag

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

Example Bundle: Use Case 2 - Example Coverage Eligibility Response Bundle

Generated Narrative: Bundle ex-check-coverage-resp-bundle-2

Bundle ex-check-coverage-resp-bundle-2 of type collection

Entry 1 - fullUrl = https://profiles.ihe.net/ITI/FAIS/CoverageEligibilityResponse/ex-check-coverage-resp-2

Resource CoverageEligibilityResponse:

Generated Narrative: CoverageEligibilityResponse ex-check-coverage-resp-2

status: Active

purpose: Coverage benefits

patient: Purity Atieno Female, DoB: 2000-05-04

created: 2024-06-01 15:01:00+0000

request: CoverageEligibilityRequest: status = active; purpose = benefits; serviced[x] = 2024-07-01 --> 2024-12-31; created = 2024-06-01 15:00:00+0000

outcome: Processing Complete

disposition: Allowed

insurer: Organization National Health Insurance Scheme

Insurances

-CoverageInforce
*Coverage: status = active; type = public healthcare; subscriberId = 05710b56-4448-11ef-b676-774a043da147; relationship = Self; period = 2024-01-01 --> 2024-12-31true

Entry 2 - fullUrl = https://profiles.ihe.net/ITI/FAIS/Organization/ex-insurer-1

Resource Organization:

Generated Narrative: Organization ex-insurer-1

name: National Health Insurance Scheme

Entry 3 - fullUrl = https://profiles.ihe.net/ITI/FAIS/Patient/ex-beneficiary-1

Resource Patient:

Generated Narrative: Patient ex-beneficiary-1

Purity Atieno Female, DoB: 2000-05-04

Entry 4 - fullUrl = https://profiles.ihe.net/ITI/FAIS/Coverage/ex-coverage-1

Resource Coverage:

Generated Narrative: Coverage ex-coverage-1

status: Active

type: public healthcare

policyHolder: Purity Atieno Female, DoB: 2000-05-04

subscriber: Purity Atieno Female, DoB: 2000-05-04

subscriberId: 05710b56-4448-11ef-b676-774a043da147

beneficiary: Purity Atieno Female, DoB: 2000-05-04

relationship: Self

period: 2024-01-01 --> 2024-12-31

payor: Organization National Health Insurance Scheme