Belgian MyCareNet eAttestation Profiles
1.0.0 - STU Belgium flag

Belgian MyCareNet eAttestation Profiles, published by eHealth Platform. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/eattestation/ and changes regularly. See the Directory of published versions

: ex06 - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="ex06"/>
  <meta>
    <profile
             value="https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-eattestation-response"/>
  </meta>
  <type value="message"/>
  <timestamp value="2015-07-14T11:15:37+02:00"/>
  <entry>
    <fullUrl value="urn:uuid:667b18ce-3d37-4581-9baa-6fada338038c"/>
    <resource>
      <MessageHeader>
        <id value="667b18ce-3d37-4581-9baa-6fada338038c"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-messageheader"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="MessageHeader_667b18ce-3d37-4581-9baa-6fada338038c"> </a><p><b>Generated Narrative: MessageHeader</b><a name="667b18ce-3d37-4581-9baa-6fada338038c"> </a><a name="hc667b18ce-3d37-4581-9baa-6fada338038c"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource MessageHeader &quot;667b18ce-3d37-4581-9baa-6fada338038c&quot; </p><p style="margin-bottom: 0px">Profile: <a href="https://build.fhir.org/ig/hl7-be/mycarenet//StructureDefinition-be-messageheader.html">MyCareNet MessageHeader BE profile</a></p></div><p><b>event</b>: eattestresponse-create (Details: https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events code eattestresponse-create = 'eattestresponse-create', stated as 'null')</p><h3>Destinations</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Endpoint</b></td><td><b>Receiver</b></td></tr><tr><td style="display: none">*</td><td><code>urn:be:fgov:person:ssin:ehealth:1.0:dentist:nihii11:30202929001</code></td><td><a href="#PractitionerRole_1dc5d974-5447-4afe-a4ab-57081ca518c3">See above (urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3)</a></td></tr></table><p><b>sender</b>: <a href="#Organization_cfabb40d-a53f-4c56-bc19-725ea669b358">See above (urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358)</a></p><h3>Sources</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Endpoint</b></td></tr><tr><td style="display: none">*</td><td><code>urn:be:fgov:kbo-bce:organization:cbe-number:0411724220</code></td></tr></table><h3>Responses</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Identifier</b></td><td><b>Code</b></td></tr><tr><td style="display: none">*</td><td>267b18ce-3d37-4581-9baa-6fada338038b</td><td>ok</td></tr></table><p><b>focus</b>: <a href="#ClaimResponse_0a0d60df-0340-45a6-a493-a5d67f74d693">See above (urn:uuid:0a0d60df-0340-45a6-a493-a5d67f74d693)</a></p></div>
        </text>
        <eventCoding>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events"/>
          <code value="eattestresponse-create"/>
        </eventCoding>
        <destination>
          <endpoint
                    value="urn:be:fgov:person:ssin:ehealth:1.0:dentist:nihii11:30202929001"/>
          <receiver>
            <reference value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
          </receiver>
        </destination>
        <sender>
          <reference value="urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"/>
        </sender>
        <source>
          <endpoint
                    value="urn:be:fgov:kbo-bce:organization:cbe-number:0411724220"/>
        </source>
        <response>
          <identifier value="267b18ce-3d37-4581-9baa-6fada338038b"/>
          <code value="ok"/>
        </response>
        <focus>
          <reference value="urn:uuid:0a0d60df-0340-45a6-a493-a5d67f74d693"/>
        </focus>
      </MessageHeader>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
    <resource>
      <PractitionerRole>
        <id value="1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="PractitionerRole_1dc5d974-5447-4afe-a4ab-57081ca518c3"> </a><p><b>Generated Narrative: PractitionerRole</b><a name="1dc5d974-5447-4afe-a4ab-57081ca518c3"> </a><a name="hc1dc5d974-5447-4afe-a4ab-57081ca518c3"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource PractitionerRole &quot;1dc5d974-5447-4afe-a4ab-57081ca518c3&quot; </p><p style="margin-bottom: 0px">Profile: <a href="https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-practitionerrole.html">BePractitionerRole</a></p></div><p><b>practitioner</b>: <a href="#Practitioner_03972cc4-d781-4285-8d79-0f05810e1931">See above (urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931)</a></p><p><b>code</b>: dentist <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://build.fhir.org/ig/hl7-be/core//CodeSystem-cd-hcparty.html">BeCdHcParty</a>#persdentist)</span></p></div>
        </text>
        <practitioner>
          <reference value="urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931"/>
        </practitioner>
        <code>
          <coding>
            <system
                    value="https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty"/>
            <code value="persdentist"/>
          </coding>
        </code>
      </PractitionerRole>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931"/>
    <resource>
      <Practitioner>
        <id value="03972cc4-d781-4285-8d79-0f05810e1931"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Practitioner_03972cc4-d781-4285-8d79-0f05810e1931"> </a><p><b>Generated Narrative: Practitioner</b><a name="03972cc4-d781-4285-8d79-0f05810e1931"> </a><a name="hc03972cc4-d781-4285-8d79-0f05810e1931"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Practitioner &quot;03972cc4-d781-4285-8d79-0f05810e1931&quot; </p><p style="margin-bottom: 0px">Profile: <a href="https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-practitioner.html">BePractitioner</a></p></div><p><b>identifier</b>: <a href="https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-nihdi.html" title="RIZIV/INAMI">BeNIHDINamingSystem</a>/30202929001</p><p><b>name</b>: John Smith </p></div>
        </text>
        <identifier>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi"/>
          <value value="30202929001"/>
        </identifier>
        <name>
          <family value="Smith"/>
          <given value="John"/>
        </name>
      </Practitioner>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"/>
    <resource>
      <Organization>
        <id value="cfabb40d-a53f-4c56-bc19-725ea669b358"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-organization"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_cfabb40d-a53f-4c56-bc19-725ea669b358"> </a><p><b>Generated Narrative: Organization</b><a name="cfabb40d-a53f-4c56-bc19-725ea669b358"> </a><a name="hccfabb40d-a53f-4c56-bc19-725ea669b358"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Organization &quot;cfabb40d-a53f-4c56-bc19-725ea669b358&quot; </p><p style="margin-bottom: 0px">Profile: <a href="https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-organization.html">BeOrganization</a></p></div><p><b>identifier</b>: <a href="https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-insurancenumber.html" title="insurance number">BeInsuranceNumberNamingSystem</a>/300</p><p><b>name</b>: Union Nationale des Mutualités Socialistes - Nationaal Verbond van de Socialistische Mutualiteiten</p></div>
        </text>
        <identifier>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancenumber"/>
          <value value="300"/>
        </identifier>
        <name
              value="Union Nationale des Mutualités Socialistes - Nationaal Verbond van de Socialistische Mutualiteiten"/>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"/>
    <resource>
      <Patient>
        <id value="a52efcb6-1f81-4333-a115-d45bd3183686"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-patient"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_a52efcb6-1f81-4333-a115-d45bd3183686"> </a><p><b>Generated Narrative: Patient</b><a name="a52efcb6-1f81-4333-a115-d45bd3183686"> </a><a name="hca52efcb6-1f81-4333-a115-d45bd3183686"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Patient &quot;a52efcb6-1f81-4333-a115-d45bd3183686&quot; </p><p style="margin-bottom: 0px">Profile: <a href="https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-patient.html">BePatient</a></p></div><p><b>identifier</b>: <a href="https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-ssin.html" title="NISS/INSZ">BeSSINNamingSystem</a>/61032004773</p><p><b>name</b>: Jean Dupont </p><p><b>gender</b>: male</p></div>
        </text>
        <identifier>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/ssin"/>
          <value value="61032004773"/>
        </identifier>
        <name>
          <family value="Dupont"/>
          <given value="Jean"/>
        </name>
        <gender value="male"/>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:0a0d60df-0340-45a6-a493-a5d67f74d693"/>
    <resource>
      <ClaimResponse>
        <id value="0a0d60df-0340-45a6-a493-a5d67f74d693"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-eattestation-claimresponse"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="ClaimResponse_0a0d60df-0340-45a6-a493-a5d67f74d693"> </a><p><b>Generated Narrative: ClaimResponse</b><a name="0a0d60df-0340-45a6-a493-a5d67f74d693"> </a><a name="hc0a0d60df-0340-45a6-a493-a5d67f74d693"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource ClaimResponse &quot;0a0d60df-0340-45a6-a493-a5d67f74d693&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-be-eattestation-claimresponse.html">MyCareNet eAttestation Claim Response BE profile</a></p></div><p><b>identifier</b>: <code>https://www.mycarenet.be/eattest</code>/300-1-170127-0000005-32</p><p><b>status</b>: active</p><p><b>type</b>: Oral <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-claim-type.html">Claim Type Codes</a>#oral)</span></p><p><b>subType</b>: dentistry <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-be-cs-eattestation-types.html">Attestation types</a>#dentistry)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <a href="#Patient_a52efcb6-1f81-4333-a115-d45bd3183686">See above (urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686)</a></p><p><b>created</b>: 2015-07-14 11:15:30+0200</p><p><b>insurer</b>: <a href="#Organization_cfabb40d-a53f-4c56-bc19-725ea669b358">See above (urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358)</a></p><p><b>requestor</b>: <a href="#PractitionerRole_1dc5d974-5447-4afe-a4ab-57081ca518c3">See above (urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3)</a></p><p><b>outcome</b>: partial</p><blockquote><p><b>addItem</b></p><p><b>itemSequence</b>: 1</p><p><b>provider</b>: <a href="#PractitionerRole_1dc5d974-5447-4afe-a4ab-57081ca518c3">See above (urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3)</a></p><p><b>productOrService</b>: 373590 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (be-ns-nihdi-nomenclature#373590)</span></p><p><b>serviced</b>: 2020-01-14</p><p><b>quantity</b>: 1</p><h3>UnitPrices</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>25.00</td><td>EUR</td></tr></table><h3>Nets</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>25.00</td><td>EUR</td></tr></table><h3>Adjudications</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Category</b></td></tr><tr><td style="display: none">*</td><td>intreatment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://build.fhir.org/ig/hl7-be/mycarenet//CodeSystem-decision-values.html">CodeSystem decision values</a>#intreatment)</span></td></tr></table></blockquote></div>
        </text>
        <identifier>
          <!--  attestationID  -->
          <system value="https://www.mycarenet.be/eattest"/>
          <value value="300-1-170127-0000005-32"/>
        </identifier>
        <status value="active"/>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
            <code value="oral"/>
          </coding>
        </type>
        <subType>
          <!--  attestationType  -->
          <coding>
            <system
                    value="https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types"/>
            <code value="dentistry"/>
          </coding>
        </subType>
        <use value="claim"/>
        <patient>
          <reference value="urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"/>
        </patient>
        <created value="2015-07-14T11:15:30+02:00"/>
        <insurer>
          <reference value="urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"/>
        </insurer>
        <requestor>
          <!--  serviceProvider  -->
          <reference value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
        </requestor>
        <outcome value="partial"/>
        <addItem>
          <itemSequence value="1"/>
          <provider>
            <!--  healthcare provider  -->
            <reference value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
          </provider>
          <productOrService>
            <!--  service identifier for item  -->
            <coding>
              <system
                      value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature"/>
              <code value="373590"/>
            </coding>
          </productOrService>
          <!--  date for item  -->
          <servicedDate value="2020-01-14"/>
          <!--  count for item  -->
          <quantity>
            <value value="1"/>
          </quantity>
          <unitPrice>
            <value value="25.00"/>
            <currency value="EUR"/>
          </unitPrice>
          <net>
            <!--  fee for item  -->
            <value value="25.00"/>
            <currency value="EUR"/>
          </net>
          <adjudication>
            <category>
              <coding>
                <system
                        value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/decision-values"/>
                <code value="intreatment"/>
              </coding>
            </category>
          </adjudication>
        </addItem>
      </ClaimResponse>
    </resource>
  </entry>
</Bundle>