{ "resourceType" : "Bundle", "id" : "ltc-bundle-feeaudit-response-example", "meta" : { "profile" : ["http://ltc-ig.fhir.tw/StructureDefinition/LTCBundleFeeAuditResponse"] }, "type" : "searchset", "total" : 2, "link" : [{ "relation" : "self", "url" : "http://ltc-ig.fhir.tw/fhir/ClaimResponse?identifier=http://ltc-ig.fhir.tw/identifier/feeaudit/case-no|201907C010163" }], "entry" : [{ "fullUrl" : "http://ltc-ig.fhir.tw/ClaimResponse/ltc-claimresponse-feeaudit-example", "resource" : { "resourceType" : "ClaimResponse", "id" : "ltc-claimresponse-feeaudit-example", "meta" : { "profile" : ["http://ltc-ig.fhir.tw/StructureDefinition/LTCClaimResponseFeeAudit"] }, "text" : { "status" : "extensions", "div" : "

Generated Narrative: ClaimResponse ltc-claimresponse-feeaudit-example

Profile: 長照支付審查－分案審核明細

長照支付審查－分案審核統計與承辦資訊

長照支付審查－清冊文件下載路徑

長照支付審查－清冊文件下載路徑

長照支付審查－清冊文件下載路徑

長照支付審查－清冊文件下載路徑

長照支付審查－清冊文件下載路徑

長照支付審查－清冊文件下載路徑

長照支付審查－清冊文件下載路徑

長照支付審查－清冊文件下載路徑

identifier: http://ltc-ig.fhir.tw/identifier/feeaudit/case-no/201907C010163, http://ltc-ig.fhir.tw/identifier/feeaudit/doc-ver/006, http://ltc-ig.fhir.tw/identifier/feeaudit/yyyymm/201907

status: Active

type: Professional

use: Claim

patient: 陳明慧 Female, DoB: 1945-03-15 ( National Person Identifier (TWN):\u00a0A123456789\u00a0(use:\u00a0official,\u00a0))

created: 2019-07-23 15:43:51+0800

insurer: Organization 新北市政府衛生局

outcome: Partial Processing

disposition: 請長照機構於5日內將總表送至本局

item

長照支付審查－服務記錄識別資訊

  • objid: 882601915
  • sourceSystem: TranCareCenter
  • transNo: A123456789

itemSequence: 1

adjudication

category: 單價

Amounts

-ValueCurrency
*400New Taiwan dollar

adjudication

category: 自付額

Amounts

-ValueCurrency
*85New Taiwan dollar

addItem

長照支付審查－服務記錄識別資訊

  • objid: 882601915
  • sourceSystem: TranCareCenter

itemSequence: 1

productOrService: 照顧困難之服務加計

adjudication

category: 單價

Amounts

-ValueCurrency
*200New Taiwan dollar

total

category: 申請核銷金額

Amounts

-ValueCurrency
*4500New Taiwan dollar

total

category: 核定金額

Amounts

-ValueCurrency
*1596New Taiwan dollar

total

category: 政策鼓勵金額

Amounts

-ValueCurrency
*400New Taiwan dollar

total

category: 分案暫付金額

Amounts

-ValueCurrency
*17500New Taiwan dollar

total

category: 核增金額

Amounts

-ValueCurrency
*4000New Taiwan dollar

total

category: 核減金額

Amounts

-ValueCurrency
*500New Taiwan dollar

processNote

number: 1

type: Display

text: 核增原因（inc_in_reason）：因個案身分異動

processNote

number: 2

type: Display

text: 核減原因（dec_in_reason）：因個案CMS等級異動

" }, "extension" : [{ "extension" : [{ "url" : "records", "valueInteger" : 3 }, { "url" : "cases", "valueInteger" : 2 }, { "url" : "approveCaseNum", "valueInteger" : 2 }, { "url" : "approveRecordCount", "valueInteger" : 1 }, { "url" : "tempPaymentStatus", "valueString" : "1: 等待暫付總表" }, { "url" : "transNo", "valueString" : "00106" }, { "url" : "auditMan", "valueString" : "CG碼承辦人" }], "url" : "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-AuditSummary" }, { "extension" : [{ "url" : "docType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type", "code" : "tempPaymentDoc", "display" : "暫付總表" }] } }, { "url" : "url", "valueUrl" : "http://url/download/doc/dc6a" }], "url" : "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl" }, { "extension" : [{ "url" : "docType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type", "code" : "caseSummaryNotice", "display" : "總表" }] } }, { "url" : "url", "valueUrl" : "http://url/download/doc/dc6adc6a" }], "url" : "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl" }, { "extension" : [{ "url" : "docType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type", "code" : "caseSvcList", "display" : "清冊" }] } }, { "url" : "url", "valueUrl" : "http://url/download/doc/dc6afa306c" }], "url" : "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl" }, { "extension" : [{ "url" : "docType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type", "code" : "caseSvcListExcel", "display" : "清冊EXCEL" }] } }, { "url" : "url", "valueUrl" : "http://url/download/doc/dc6a6c" }], "url" : "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl" }, { "extension" : [{ "url" : "docType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type", "code" : "caseASvcList", "display" : "A碼清冊" }] } }, { "url" : "url", "valueUrl" : "http://url/download/doc/dc6afa306cc554311c" }], "url" : "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl" }, { "extension" : [{ "url" : "docType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type", "code" : "caseASvcListExcel", "display" : "A碼清冊EXCEL" }] } }, { "url" : "url", "valueUrl" : "http://url/download/doc9967-7bddc554311c" }], "url" : "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl" }, { "extension" : [{ "url" : "docType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type", "code" : "caseErrList", "display" : "申請記錄不通過清冊" }] } }, { "url" : "url", "valueUrl" : "http://url/download/doc/dc6afa306cc-5ce29d30f843" }], "url" : "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl" }, { "extension" : [{ "url" : "docType", "valueCodeableConcept" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type", "code" : "caseErrListExcel", "display" : "申請記錄不通過EXCEL清冊" }] } }, { "url" : "url", "valueUrl" : "http://url/download/doc/dc6afa306c-5ce29d30f843" }], "url" : "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl" }], "identifier" : [{ "system" : "http://ltc-ig.fhir.tw/identifier/feeaudit/case-no", "value" : "201907C010163" }, { "system" : "http://ltc-ig.fhir.tw/identifier/feeaudit/doc-ver", "value" : "006" }, { "system" : "http://ltc-ig.fhir.tw/identifier/feeaudit/yyyymm", "value" : "201907" }], "status" : "active", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/claim-type", "code" : "professional", "display" : "Professional" }] }, "use" : "claim", "patient" : { "reference" : "Patient/ltc-patient-chen-ming-hui" }, "created" : "2019-07-23T15:43:51+08:00", "insurer" : { "reference" : "Organization/ltc-organization-feeaudit-authority-example" }, "outcome" : "partial", "disposition" : "請長照機構於5日內將總表送至本局", "item" : [{ "extension" : [{ "extension" : [{ "url" : "objid", "valueString" : "882601915" }, { "url" : "sourceSystem", "valueString" : "TranCareCenter" }, { "url" : "transNo", "valueString" : "A123456789" }], "url" : "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-RecordRef" }], "itemSequence" : 1, "adjudication" : [{ "category" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication", "code" : "price", "display" : "單價" }] }, "amount" : { "value" : 400, "currency" : "TWD" } }, { "category" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication", "code" : "copayment", "display" : "自付額" }] }, "amount" : { "value" : 85, "currency" : "TWD" } }] }], "addItem" : [{ "extension" : [{ "extension" : [{ "url" : "objid", "valueString" : "882601915" }, { "url" : "sourceSystem", "valueString" : "TranCareCenter" }], "url" : "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-RecordRef" }], "itemSequence" : [1], "productOrService" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-service-item", "code" : "AA05", "display" : "照顧困難之服務加計" }] }, "adjudication" : [{ "category" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication", "code" : "price", "display" : "單價" }] }, "amount" : { "value" : 200, "currency" : "TWD" } }] }], "total" : [{ "category" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication", "code" : "submitted", "display" : "申請核銷金額" }] }, "amount" : { "value" : 4500, "currency" : "TWD" } }, { "category" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication", "code" : "approveFee", "display" : "核定金額" }] }, "amount" : { "value" : 1596, "currency" : "TWD" } }, { "category" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication", "code" : "aSvcFee", "display" : "政策鼓勵金額" }] }, "amount" : { "value" : 400, "currency" : "TWD" } }, { "category" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication", "code" : "tempPaymentFee", "display" : "分案暫付金額" }] }, "amount" : { "value" : 17500, "currency" : "TWD" } }, { "category" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication", "code" : "incInAcc", "display" : "核增金額" }] }, "amount" : { "value" : 4000, "currency" : "TWD" } }, { "category" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication", "code" : "decInAcc", "display" : "核減金額" }] }, "amount" : { "value" : 500, "currency" : "TWD" } }], "processNote" : [{ "number" : 1, "type" : "display", "text" : "核增原因（inc_in_reason）：因個案身分異動" }, { "number" : 2, "type" : "display", "text" : "核減原因（dec_in_reason）：因個案CMS等級異動" }] }, "search" : { "mode" : "match" } }, { "fullUrl" : "http://ltc-ig.fhir.tw/OperationOutcome/ltc-operationoutcome-feeaudit-example", "resource" : { "resourceType" : "OperationOutcome", "id" : "ltc-operationoutcome-feeaudit-example", "meta" : { "profile" : ["http://ltc-ig.fhir.tw/StructureDefinition/LTCOperationOutcomeFeeAudit"] }, "text" : { "status" : "extensions", "div" : "

Generated Narrative: OperationOutcome ltc-operationoutcome-feeaudit-example

Profile: 長照支付審查－申報檢核結果

長照 SDK－案件編號（CASENO）: 201907C010163

Issues

-SeverityCodeDetailsDiagnosticsExpression
*ErrorProcessing Failure單位已執行申報確認通知，不在受理新的服務紀錄申報錯誤服務記錄（err_records）：識別碼（objid）882601914；來源系統別（source_system）TranCareCenter；交易序號（trans_no）00106Claim.identifier.where(system='http://ltc-ig.fhir.tw/identifier/feeaudit/objid' and value='882601914')
" }, "extension" : [{ "url" : "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-Export-CaseNo", "valueString" : "201907C010163" }], "issue" : [{ "severity" : "error", "code" : "processing", "details" : { "coding" : [{ "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-error-code", "code" : "E4015", "display" : "單位已執行申報確認通知，不在受理新的服務紀錄申報" }], "text" : "單位已執行申報確認通知，不在受理新的服務紀錄申報" }, "diagnostics" : "錯誤服務記錄（err_records）：識別碼（objid）882601914；來源系統別（source_system）TranCareCenter；交易序號（trans_no）00106", "expression" : ["Claim.identifier.where(system='http://ltc-ig.fhir.tw/identifier/feeaudit/objid' and value='882601914')"] }] }, "search" : { "mode" : "outcome" } }] }