Patient Cost Transparency Implementation Guide
2.0.2 - STU 2 United States of America flag

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

: PCT-GFE-Summary-1

Page standards status: Informative

Raw ttl | Download


@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 -------------------------------------------------------------------

<http://hl7.org/fhir/Claim/PCT-GFE-Summary-1> a fhir:Claim ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "PCT-GFE-Summary-1"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-summary" ;
       fhir:index -1 ;
       fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-summary>
     ]
  ] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim PCT-GFE-Summary-1</b></p><a name=\"PCT-GFE-Summary-1\"> </a><a name=\"hcPCT-GFE-Summary-1\"> </a><div style=\"display: inline-block; background-color: #fbffeb; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-davinci-pct-gfe-summary.html\">PCT Good Faith Estimate  Summary</a></p></div><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTEstimateTypeSummaryCSTemporaryTrialUse estimate-summary}\">Estimate Summary</span></p><p><b>use</b>: Predetermination</p><p><b>patient</b>: <a href=\"Patient-patient1001.html\">Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)</a></p><p><b>billablePeriod</b>: 2021-10-31 --&gt; 2021-10-31</p><p><b>created</b>: 2021-10-05</p><p><b>insurer</b>: <a href=\"Organization-org1001.html\">Umbrella Insurance Company (Payer) (Electronic Transmitter Identification Number: ETIN-3200002)</a></p><p><b>provider</b>: ?rref?</p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>Type</b></td><td><b>PackageCode</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://hl7.org/fhir/sid/icd-10-cm S06.30}\">Unspecified focal traumatic brain injury</span></td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/diagnosistype principal}\">Principal Diagnosis</span></td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-diagnosisrelatedgroup 400}\">Head trauma - concussion</span></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Coverage-coverage1001.html\">Coverage: extension = insurance; status = active; subscriberId = PFP123450000; relationship = Self; period = 2021-01-01 --&gt; 2022-01-01</a></td></tr></table><h3>Totals</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>200</td><td>United States dollar</td></tr></table></div>"
  ] ;
  fhir:Claim.status [ fhir:value "active"] ;
  fhir:Claim.type [
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTEstimateTypeSummaryCSTemporaryTrialUse" ] ;
       fhir:Coding.code [ fhir:value "estimate-summary" ] ;
       fhir:Coding.display [ fhir:value "Estimate Summary" ]
     ]
  ] ;
  fhir:Claim.use [ fhir:value "predetermination"] ;
  fhir:Claim.patient [
     fhir:link <http://hl7.org/fhir/Patient/patient1001> ;
     fhir:Reference.reference [ fhir:value "Patient/patient1001" ]
  ] ;
  fhir:Claim.billablePeriod [
     fhir:Period.start [ fhir:value "2021-10-31"^^xsd:date ] ;
     fhir:Period.end [ fhir:value "2021-10-31"^^xsd:date ]
  ] ;
  fhir:Claim.created [ fhir:value "2021-10-05"^^xsd:date] ;
  fhir:Claim.insurer [
     fhir:link <http://hl7.org/fhir/Organization/org1001> ;
     fhir:Reference.reference [ fhir:value "Organization/org1001" ]
  ] ;
  fhir:Claim.provider [
     fhir:Element.extension [
       fhir:index -1 ;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/data-absent-reason" ] ;
       fhir:Extension.valueCode [ fhir:value "not-applicable" ]
     ]
  ] ;
  fhir:Claim.priority [
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/processpriority" ] ;
       fhir:Coding.code [ fhir:value "normal" ]
     ]
  ] ;
  fhir:Claim.diagnosis [
     fhir:index -1 ;
     fhir:Claim.diagnosis.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.diagnosis.diagnosisCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/sid/icd-10-cm" ] ;
         fhir:Coding.code [ fhir:value "S06.30" ] ;
         fhir:Coding.display [ fhir:value "Unspecified focal traumatic brain injury" ]
       ]
     ] ;
     fhir:Claim.diagnosis.type [
       fhir:index -1 ;
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/diagnosistype" ] ;
         fhir:Coding.code [ fhir:value "principal" ]
       ]
     ] ;
     fhir:Claim.diagnosis.packageCode [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-diagnosisrelatedgroup" ] ;
         fhir:Coding.code [ fhir:value "400" ] ;
         fhir:Coding.display [ fhir:value "Head trauma - concussion" ]
       ]
     ]
  ] ;
  fhir:Claim.insurance [
     fhir:index -1 ;
     fhir:Claim.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.insurance.focal [ fhir:value "true"^^xsd:boolean ] ;
     fhir:Claim.insurance.coverage [
       fhir:link <http://hl7.org/fhir/Coverage/coverage1001> ;
       fhir:Reference.reference [ fhir:value "Coverage/coverage1001" ]
     ]
  ] ;
  fhir:Claim.total [
     fhir:Money.value [ fhir:value "200"^^xsd:decimal ] ;
     fhir:Money.currency [ fhir:value "USD" ]
  ] .

<http://hl7.org/fhir/Patient/patient1001> a fhir:Patient .

<http://hl7.org/fhir/Organization/org1001> a fhir:Organization .

<http://hl7.org/fhir/Coverage/coverage1001> a fhir:Coverage .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/Claim/PCT-GFE-Summary-1.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/Claim/PCT-GFE-Summary-1.ttl> .