臺灣長期照顧實作指引(TW LTC IG)
1.1.0 - STU 1.1.0

臺灣長期照顧實作指引(TW LTC IG), published by 經濟部產業發展署. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Lorex/TWLongTermCare_IG_Build/ and changes regularly. See the Directory of published versions

Logical Model: LTCFeeAuditDetailModel - Mappings

Draft as of 2026-10-30

Mappings for the LTCFeeAuditDetailModel logical model.

Mappings to Structures in this Implementation Guide

Name長照支付審查-分案審核明細邏輯模型對應doco
LTCFeeAuditDetailModel
ClaimResponse
分案審核明細整體對應至 ClaimResponse
LTCFeeAuditDetailModel / queryInfo
LTCFeeAuditDetailModel / queryInfo / @id
LTCFeeAuditDetailModel / queryInfo / extension
LTCFeeAuditDetailModel / queryInfo / modifierExtension
LTCFeeAuditDetailModel / queryInfo / writeoffYyyymm
//ltc-ig.fhir.tw/identifier/feeaudit/yyyymm').value
支審年月(yyyyMM)
LTCFeeAuditDetailModel / queryInfo / transNo
ClaimResponse
本次查詢之交易序號,屬傳輸層查詢參數,不落於回覆之 ClaimResponse
LTCFeeAuditDetailModel / queryInfo / queryType
ClaimResponse
查詢類別固定值 B,屬傳輸層查詢參數,不落於回覆之 ClaimResponse
LTCFeeAuditDetailModel / queryInfo / cityCd
ClaimResponse.insurer
縣市代碼,以 Reference(LTCOrganization) 指向受理本分案之縣市主管機關,代碼記錄於 Organization.identifier.value
LTCFeeAuditDetailModel / queryInfo / caseNo
//ltc-ig.fhir.tw/identifier/feeaudit/case-no').value
核銷案號
LTCFeeAuditDetailModel / auditResult
LTCFeeAuditDetailModel / auditResult / @id
LTCFeeAuditDetailModel / auditResult / extension
LTCFeeAuditDetailModel / auditResult / modifierExtension
LTCFeeAuditDetailModel / auditResult / caseNo
//ltc-ig.fhir.tw/identifier/feeaudit/case-no').value
核銷案號,以 identifier[caseNo] 切片表達
LTCFeeAuditDetailModel / auditResult / records
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-AuditSummary').extension('records').valueInteger
服務記錄筆數;亦等於 ClaimResponse.item 與 ClaimResponse.error 之筆數合計
LTCFeeAuditDetailModel / auditResult / cases
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-AuditSummary').extension('cases').valueInteger
個案數
LTCFeeAuditDetailModel / auditResult / amount
ClaimResponse.total.where(category.coding.code='submitted').amount
申請核銷金額,落於分案層級之 total,category 為 submitted
LTCFeeAuditDetailModel / auditResult / auditMan
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-AuditSummary').extension('auditMan').valueString
承辦人員;不可使用 ClaimResponse.requestor,該元素於 FHIR R4 之語意為提出申報之服務提供方,與審查機關之承辦人語意方向相反
LTCFeeAuditDetailModel / auditResult / auditReason
ClaimResponse.disposition
承辦審核意見
LTCFeeAuditDetailModel / auditResult / docVer
//ltc-ig.fhir.tw/identifier/feeaudit/doc-ver').value
總表版次,以 identifier[docVer] 切片表達
LTCFeeAuditDetailModel / auditResult / verDt
ClaimResponse.created
版次時間(yyyyMMddhhmmss),以 dateTime 表達
LTCFeeAuditDetailModel / auditResult / approveCaseNum
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-AuditSummary').extension('approveCaseNum').valueInteger
核定個案數
LTCFeeAuditDetailModel / auditResult / approveRecordCount
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-AuditSummary').extension('approveRecordCount').valueInteger
核定服務記錄數;亦等於 ClaimResponse.item 之筆數
LTCFeeAuditDetailModel / auditResult / approveFee
ClaimResponse.total.where(category.coding.code='approveFee').amount
核定金額,屬分案層級金額,落於 total
LTCFeeAuditDetailModel / auditResult / aSvcFee
ClaimResponse.total.where(category.coding.code='aSvcFee').amount
政策鼓勵金額,屬分案層級金額,落於 total
LTCFeeAuditDetailModel / auditResult / tempPaymentStatus
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-AuditSummary').extension('tempPaymentStatus').valueString
暫付申請狀態,有申請暫付才顯示
LTCFeeAuditDetailModel / auditResult / tempPaymentFee
ClaimResponse.total.where(category.coding.code='tempPaymentFee').amount
分案暫付金額,屬分案層級金額,落於 total
LTCFeeAuditDetailModel / auditResult / tempPaymentDocUrl
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl').where(extension('docType').valueCodeableConcept.coding.code='tempPaymentDoc').extension('url').valueUrl
暫付總表下載路徑
LTCFeeAuditDetailModel / auditResult / caseSummaryNoticeUrl
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl').where(extension('docType').valueCodeableConcept.coding.code='caseSummaryNotice').extension('url').valueUrl
總表下載路徑
LTCFeeAuditDetailModel / auditResult / caseSvcListUrl
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl').where(extension('docType').valueCodeableConcept.coding.code='caseSvcList').extension('url').valueUrl
清冊路徑
LTCFeeAuditDetailModel / auditResult / caseSvcListExcelUrl
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl').where(extension('docType').valueCodeableConcept.coding.code='caseSvcListExcel').extension('url').valueUrl
清冊 EXCEL 下載路徑
LTCFeeAuditDetailModel / auditResult / caseASvcListUrl
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl').where(extension('docType').valueCodeableConcept.coding.code='caseASvcList').extension('url').valueUrl
A 碼清冊路徑
LTCFeeAuditDetailModel / auditResult / caseASvcListExcelUrl
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl').where(extension('docType').valueCodeableConcept.coding.code='caseASvcListExcel').extension('url').valueUrl
A 碼清冊 EXCEL 下載路徑
LTCFeeAuditDetailModel / auditResult / caseErrListUrl
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl').where(extension('docType').valueCodeableConcept.coding.code='caseErrList').extension('url').valueUrl
申請記錄不通過清冊路徑
LTCFeeAuditDetailModel / auditResult / caseErrListExcelUrl
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl').where(extension('docType').valueCodeableConcept.coding.code='caseErrListExcel').extension('url').valueUrl
申請記錄不通過 EXCEL 清冊路徑
LTCFeeAuditDetailModel / auditResult / transNos
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-AuditSummary').extension('transNo').valueString
分案已處理之申請單單號,為多筆字串,逐筆各為一個子擴充實例;不可使用 ClaimResponse.request,該元素於 FHIR R4 為 0..1 Reference
LTCFeeAuditDetailModel / auditResult / incInAcc
ClaimResponse.total.where(category.coding.code='incInAcc').amount
核增金額,屬分案層級金額,落於 total
LTCFeeAuditDetailModel / auditResult / incInReason
ClaimResponse.processNote.text
核增原因,以審核附註之自由文字表達
LTCFeeAuditDetailModel / auditResult / decInAcc
ClaimResponse.total.where(category.coding.code='decInAcc').amount
核減金額,屬分案層級金額,落於 total
LTCFeeAuditDetailModel / auditResult / decInReason
ClaimResponse.processNote.text
核減原因,以審核附註之自由文字表達
LTCFeeAuditDetailModel / auditResult / approveRecords
ClaimResponse.item
審核通過服務記錄,逐筆對應 ClaimResponse.item;item.itemSequence 僅為本資源內之流水序號
LTCFeeAuditDetailModel / auditResult / approveRecords / @id
LTCFeeAuditDetailModel / auditResult / approveRecords / extension
LTCFeeAuditDetailModel / auditResult / approveRecords / modifierExtension
LTCFeeAuditDetailModel / auditResult / approveRecords / sourceSystem
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-RecordRef').extension('sourceSystem').valueString
來源系統別
LTCFeeAuditDetailModel / auditResult / approveRecords / objid
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-RecordRef').extension('objid').valueString
服務記錄識別碼;不可使用 item.itemSequence,該元素於 FHIR R4 為 positiveInt
LTCFeeAuditDetailModel / auditResult / approveRecords / transNo
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-RecordRef').extension('transNo').valueString
交易序號
LTCFeeAuditDetailModel / auditResult / approveRecords / price
ClaimResponse.item.adjudication.where(category.coding.code='price').amount
單價,屬逐筆服務記錄之金額,落於 item.adjudication
LTCFeeAuditDetailModel / auditResult / approveRecords / copayment
ClaimResponse.item.adjudication.where(category.coding.code='copayment').amount
自付額,屬逐筆服務記錄之金額,落於 item.adjudication
LTCFeeAuditDetailModel / auditResult / errRecords
ClaimResponse.error
錯誤服務記錄,逐筆對應 ClaimResponse.error;若該筆之 err_code/err_message 為空而無法填入 error.code(1..1 且綁定錯誤代碼值集),得改以隨附之 LTCOperationOutcomeFeeAudit 表達
LTCFeeAuditDetailModel / auditResult / errRecords / @id
LTCFeeAuditDetailModel / auditResult / errRecords / extension
LTCFeeAuditDetailModel / auditResult / errRecords / modifierExtension
LTCFeeAuditDetailModel / auditResult / errRecords / sourceSystem
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-RecordRef').extension('sourceSystem').valueString
來源系統別
LTCFeeAuditDetailModel / auditResult / errRecords / objid
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-RecordRef').extension('objid').valueString
服務記錄識別碼;不可使用 error.itemSequence,該元素於 FHIR R4 為 positiveInt
LTCFeeAuditDetailModel / auditResult / errRecords / transNo
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-RecordRef').extension('transNo').valueString
交易序號
LTCFeeAuditDetailModel / auditResult / errRecords / errCode
ClaimResponse.error.code.coding.code
錯誤碼
LTCFeeAuditDetailModel / auditResult / errRecords / errMessage
ClaimResponse.error.code.text
錯誤原因
LTCFeeAuditDetailModel / auditResult / aSvcRecords
ClaimResponse.addItem
A 碼加成資料,逐筆對應 ClaimResponse.addItem
LTCFeeAuditDetailModel / auditResult / aSvcRecords / @id
LTCFeeAuditDetailModel / auditResult / aSvcRecords / extension
LTCFeeAuditDetailModel / auditResult / aSvcRecords / modifierExtension
LTCFeeAuditDetailModel / auditResult / aSvcRecords / refSourceSystem
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-RecordRef').extension('sourceSystem').valueString
所加成之審核通過服務記錄來源系統別
LTCFeeAuditDetailModel / auditResult / aSvcRecords / refObjid
//ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-RecordRef').extension('objid').valueString
所加成之審核通過服務記錄識別碼;不可使用 addItem.itemSequence,該元素於 FHIR R4 為 positiveInt 且語意上指向原申請單之項目序號
LTCFeeAuditDetailModel / auditResult / aSvcRecords / aGovItemCd
ClaimResponse.addItem.productOrService
A 碼加成之給付項目代碼
LTCFeeAuditDetailModel / auditResult / aSvcRecords / price

doco Documentation for this format

Mappings to other Structures

No Mappings Found

Other Mappings

No Mappings Found