臺灣健保事前審查實作指引
1.1.0 - ci-build

臺灣健保事前審查實作指引, published by 衛生福利部中央健康保險署. 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/TWNHIFHIR/pas/ and changes regularly. See the Directory of published versions

## Resource Profile: ClaimResponseSelfAssessmentTWPAS - Mappings

Active as of 2025-12-17

Mappings for the ClaimResponse-self-assessment-twpas resource profile.

#### Mappings to Structures in this Implementation Guide

Name | Mapping to TWPAS ClaimResponse Self Assessment | Mapping to TWPAS ClaimResponse Self Assessment
--- | --- | ---
ClaimResponse |  |
id |  |
meta |  |
id |  |
extension |  |
versionId |  |
lastUpdated |  |
source |  |
profile |  |
security |  |
tag |  |
implicitRules |  |
language |  |
text |  |
contained |  |
Slices for extension | ApplyImmModel.apply.approver | ApplyModel.apply.approver
extension:requestor | ApplyImmModel.apply.approver | ApplyModel.apply.approver
modifierExtension |  |
identifier |  |
status |  |
type |  |
subType |  |
use |  |
patient |  |
created | ApplyImmModel.apply.approveDate | ApplyModel.apply.approveDate
insurer |  |
requestor |  |
request |  |
outcome |  |
disposition |  |
preAuthRef |  |
preAuthPeriod |  |
payeeType |  |
item |  |
id |  |
extension |  |
modifierExtension |  |
itemSequence |  |
noteNumber |  |
adjudication |  |
id |  |
extension |  |
modifierExtension |  |
category |  |
id |  |
extension |  |
coding |  |
id |  |
extension |  |
system |  |
version |  |
code |  |
display |  |
userSelected |  |
text |  |
reason | ApplyImmModel.apply.approveComment | ApplyModel.apply.approveComment
amount |  |
value | ApplyImmModel.apply.approveNum | ApplyModel.apply.approveNum
detail |  |
id |  |
extension |  |
modifierExtension |  |
detailSequence |  |
noteNumber |  |
adjudication |  |
id |  |
extension |  |
modifierExtension |  |
category |  |
id |  |
extension |  |
coding |  |
id |  |
extension |  |
system |  |
version |  |
code |  |
display |  |
userSelected |  |
text |  |
reason | ApplyImmModel.apply.acceptanceStatus | ApplyModel.apply.acceptanceStatus
amount |  |
value |  |
subDetail |  |
id |  |
extension |  |
modifierExtension |  |
subDetailSequence |  |
noteNumber |  |
adjudication |  |
addItem |  |
id |  |
extension |  |
modifierExtension |  |
itemSequence |  |
detailSequence |  |
subdetailSequence |  |
provider |  |
productOrService |  |
modifier |  |
programCode |  |
serviced[x] |  |
location[x] |  |
quantity |  |
unitPrice |  |
factor |  |
net |  |
bodySite |  |
subSite |  |
noteNumber |  |
adjudication |  |
detail |  |
id |  |
extension |  |
modifierExtension |  |
productOrService |  |
modifier |  |
quantity |  |
unitPrice |  |
factor |  |
net |  |
noteNumber |  |
adjudication |  |
subDetail |  |
id |  |
extension |  |
modifierExtension |  |
productOrService |  |
modifier |  |
quantity |  |
unitPrice |  |
factor |  |
net |  |
noteNumber |  |
adjudication |  |
adjudication |  |
total |  |
id |  |
extension |  |
modifierExtension |  |
category |  |
amount |  |
payment |  |
id |  |
extension |  |
modifierExtension |  |
type |  |
adjustment |  |
adjustmentReason |  |
date |  |
amount |  |
identifier |  |
fundsReserve |  |
formCode |  |
form |  |
processNote |  |
id |  |
extension |  |
modifierExtension |  |
number |  |
type |  |
text |  |
language |  |
communicationRequest |  |
insurance |  |
id |  |
extension |  |
modifierExtension |  |
sequence |  |
focal |  |
coverage |  |
businessArrangement |  |
claimResponse |  |
error |  |
id |  |
extension |  |
modifierExtension |  |
itemSequence |  |
detailSequence |  |
subDetailSequence |  |
code |  |
Documentation for this format

#### Mappings to other Structures

No Mappings Found

#### Other Mappings

Name | Workflow Pattern | FiveWs Pattern Mapping | RIM Mapping
--- | --- | --- | ---
ClaimResponse | Event |  | Entity. Role or Act
id |  |  |
meta |  |  |
id |  |  | n/a
extension |  |  | n/a
versionId |  |  |
lastUpdated |  |  |
source |  |  |
profile |  |  |
security |  |  |
tag |  |  |
implicitRules |  |  |
language |  |  |
text |  |  | Act.text?
contained |  |  | N/A
Slices for extension |  |  |
extension:requestor |  |  |
modifierExtension |  |  | N/A
identifier | Event.identifier | FiveWs.identifier |
status | Event.status | FiveWs.status |
type |  | FiveWs.class |
subType |  | FiveWs.class |
use |  | FiveWs.class |
patient |  | FiveWs.subject |
created | Event.occurrence[x] | FiveWs.recorded |
insurer | Event.performer |  |
requestor |  | FiveWs.source |
request | Event.basedOn | FiveWs.why[x] |
outcome |  |  |
disposition | Event.note |  |
preAuthRef |  |  |
preAuthPeriod |  |  |
payeeType |  |  |
item |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
itemSequence |  |  |
noteNumber |  |  |
adjudication |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
category |  |  |
id |  |  | n/a
extension |  |  | n/a
coding |  |  | union(. ./translation)
id |  |  | n/a
extension |  |  | n/a
system |  |  | ./codeSystem
version |  |  | ./codeSystemVersion
code |  |  | ./code
display |  |  | CV.displayName
userSelected |  |  | CD.codingRationale
text |  |  | ./originalText[mediaType/code="text/plain"]/data
reason |  |  |
amount |  |  |
value |  |  |
detail |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
detailSequence |  |  |
noteNumber |  |  |
adjudication |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
category |  |  |
id |  |  | n/a
extension |  |  | n/a
coding |  |  | union(. ./translation)
id |  |  | n/a
extension |  |  | n/a
system |  |  | ./codeSystem
version |  |  | ./codeSystemVersion
code |  |  | ./code
display |  |  | CV.displayName
userSelected |  |  | CD.codingRationale
text |  |  | ./originalText[mediaType/code="text/plain"]/data
reason |  |  |
amount |  |  |
value |  |  |
subDetail |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
subDetailSequence |  |  |
noteNumber |  |  |
adjudication |  |  |
addItem |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
itemSequence |  |  |
detailSequence |  |  |
subdetailSequence |  |  |
provider |  | FiveWs.source |
productOrService |  |  |
modifier |  |  | 24.C 24.D mods
programCode |  |  | 24.H
serviced[x] |  | FiveWs.done[x] | 24.A
location[x] |  | FiveWs.where[x] | 24.B
quantity |  |  | 24.G
unitPrice |  |  |
factor |  |  |
net |  |  | 24.F
bodySite |  |  |
subSite |  |  |
noteNumber |  |  |
adjudication |  |  |
detail |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
productOrService |  |  |
modifier |  |  | 24.C 24.D mods
quantity |  |  | 24.G
unitPrice |  |  |
factor |  |  |
net |  |  | 24.F
noteNumber |  |  |
adjudication |  |  |
subDetail |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
productOrService |  |  |
modifier |  |  | 24.C 24.D mods
quantity |  |  | 24.G
unitPrice |  |  |
factor |  |  |
net |  |  | 24.F
noteNumber |  |  |
adjudication |  |  |
adjudication |  |  |
total |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
category |  |  |
amount |  |  |
payment |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
type |  |  |
adjustment |  |  |
adjustmentReason |  |  |
date |  |  |
amount |  |  |
identifier |  |  |
fundsReserve |  |  |
formCode |  |  |
form |  |  |
processNote |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
number |  |  |
type |  |  |
text |  |  |
language |  |  |
communicationRequest |  |  |
insurance |  |  | Coverage
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
sequence |  |  |
focal |  |  |
coverage |  |  |
businessArrangement |  |  |
claimResponse |  |  |
error |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
itemSequence |  |  |
detailSequence |  |  |
subDetailSequence |  |  |
code |  |  |
Documentation for this format