This is the set of resources that conform to either of the profiles 自主審查報備-ClaimResponse Self Assessment TWPAS (https://nhicore.nhi.gov.tw/pas/StructureDefinition/ClaimResponse-self-assessment-twpas) and 自主審查報備-ClaimResponse Self Assessment TWPAS (https://nhicore.nhi.gov.tw/pas/StructureDefinition/ClaimResponse-self-assessment-twpas). E.g. what you have to deal with if you get resources conforming to one of them
Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
---|---|---|---|---|
![]() ![]() | 0..* | Response to a claim predetermination or preauthorization | ||
![]() ![]() ![]() | Σ | 0..1 | Meta | Metadata about the resource |
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
![]() ![]() ![]() ![]() | Σ | 0..1 | id | Version specific identifier |
![]() ![]() ![]() ![]() | Σ | 0..1 | instant | When the resource version last changed |
![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identifies where the resource comes from |
![]() ![]() ![]() ![]() | Σ | 1..1 | canonical(StructureDefinition) | Profiles this resource claims to conform to Required Pattern: https://nhicore.nhi.gov.tw/pas/StructureDefinition/ClaimResponse-self-assessment-twpas |
![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. |
![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". |
![]() ![]() ![]() | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
![]() ![]() ![]() | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language. | |
![]() ![]() ![]() | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |
![]() ![]() ![]() | 0..* | Resource | Contained, inline Resources | |
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() | ?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() ![]() | 0..* | Identifier | Business Identifier for a claim response | |
![]() ![]() ![]() | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. |
![]() ![]() ![]() | Σ | 1..1 | CodeableConcept | More granular claim type Binding: ?? (extensible): The type or discipline-style of the claim. |
![]() ![]() ![]() | 0..1 | CodeableConcept | More granular claim type Binding: ?? (example): A more granular claim typecode. | |
![]() ![]() ![]() | Σ | 1..1 | code | claim | preauthorization | predetermination Binding: ?? (required): Claim, preauthorization, predetermination. |
![]() ![]() ![]() | Σ | 1..1 | Reference(病人資訊-Patient TWPAS | #sd-Patient-twpas-Patient-twpas) | The recipient of the products and services |
![]() ![]() ![]() | SΣ | 1..1 | dateTime | 核定日期。若申請案件類別為3時須填寫。YYYY-MM-DD,西元年月日。 |
![]() ![]() ![]() | Σ | 1..1 | Reference(TW Core Organization Government) | Party responsible for reimbursement |
![]() ![]() ![]() | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Party responsible for the claim | |
![]() ![]() ![]() | Σ | 0..1 | Reference(Claim) | Id of resource triggering adjudication |
![]() ![]() ![]() | Σ | 1..1 | code | queued | complete | error | partial Binding: ?? (required): The result of the claim processing. |
![]() ![]() ![]() | 0..1 | string | Disposition Message | |
![]() ![]() ![]() | 0..1 | string | Preauthorization reference | |
![]() ![]() ![]() | 0..1 | Period | Preauthorization reference effective period | |
![]() ![]() ![]() | 0..1 | CodeableConcept | Party to be paid any benefits payable Binding: ?? (example): A code for the party to be reimbursed. | |
![]() ![]() ![]() | 0..* | BackboneElement | Adjudication for claim line items | |
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() | 1..1 | positiveInt | Claim item instance identifier | |
![]() ![]() ![]() ![]() | 0..* | positiveInt | Applicable note numbers | |
![]() ![]() ![]() ![]() | 1..* | BackboneElement | Adjudication details | |
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | 【因FHIR設計而需必填】 Binding: ?? (example): The adjudication codes. | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept |
![]() ![]() ![]() ![]() ![]() | S | 1..1 | CodeableConcept | 受理審查案件核定註記。若申請案件類別為3時須填寫。1:同意 | 2:不予同意 | 3:部份同意 | 4:補件 | 5:退件 Binding: ?? (required) |
![]() ![]() ![]() ![]() ![]() | 0..1 | Money | Monetary amount | |
![]() ![]() ![]() ![]() ![]() | S | 1..1 | decimal | 核定數量,若申請案件類別為3時須填寫。 |
![]() ![]() ![]() ![]() | 0..* | BackboneElement | Adjudication for claim details | |
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() ![]() | 1..1 | positiveInt | 請填寫對應的Claim.item.sequence | |
![]() ![]() ![]() ![]() ![]() | 0..* | positiveInt | Applicable note numbers | |
![]() ![]() ![]() ![]() ![]() | 1..* | BackboneElement | Detail level adjudication details | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | 【因FHIR設計而需必填】 Binding: ?? (example): The adjudication codes. | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept |
![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | 個別醫令核定註記。0:審核中 | 1:同意 | 2:不予同意 | 3:部份同意 | 4:補件 | 5:退件 | 6:不予同意:對應手術亦不支付 | 7:改核:如審查核定意見 Binding: ?? (required) | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | Money | Monetary amount | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | decimal | Non-monetary value | |
![]() ![]() ![]() ![]() ![]() | 0..* | BackboneElement | Adjudication for claim sub-details | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | positiveInt | Claim sub-detail instance identifier | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | positiveInt | Applicable note numbers | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Subdetail level adjudication details | ||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | 【因FHIR設計而需必填】 Binding: ?? (example): The adjudication codes. | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | S | 1..1 | CodeableConcept | 受理審查案件核定註記。若申請案件類別為3時須填寫。1:同意 | 2:不予同意 | 3:部份同意 | 4:補件 | 5:退件 Binding: ?? (required) |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | Money | Monetary amount | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | S | 1..1 | decimal | 核定數量,若申請案件類別為3時須填寫。 |
![]() ![]() ![]() | 0..* | BackboneElement | Insurer added line items | |
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() | 0..* | positiveInt | Item sequence number | |
![]() ![]() ![]() ![]() | 0..* | positiveInt | Detail sequence number | |
![]() ![]() ![]() ![]() | 0..* | positiveInt | Subdetail sequence number | |
![]() ![]() ![]() ![]() | 0..* | Reference(Practitioner | PractitionerRole | Organization) | Authorized providers | |
![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. | |
![]() ![]() ![]() ![]() | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |
![]() ![]() ![]() ![]() | 0..* | CodeableConcept | Program the product or service is provided under Binding: ?? (example): Program specific reason codes. | |
![]() ![]() ![]() ![]() | 0..1 | Date or dates of service or product delivery | ||
![]() ![]() ![]() ![]() ![]() | date | |||
![]() ![]() ![]() ![]() ![]() | Period | |||
![]() ![]() ![]() ![]() | 0..1 | Place of service or where product was supplied Binding: ?? (example): Place of service: pharmacy, school, prison, etc. | ||
![]() ![]() ![]() ![]() ![]() | CodeableConcept | |||
![]() ![]() ![]() ![]() ![]() | Address | |||
![]() ![]() ![]() ![]() ![]() | Reference(Location) | |||
![]() ![]() ![]() ![]() | 0..1 | ?? | Count of products or services | |
![]() ![]() ![]() ![]() | 0..1 | Money | Fee, charge or cost per item | |
![]() ![]() ![]() ![]() | 0..1 | decimal | Price scaling factor | |
![]() ![]() ![]() ![]() | 0..1 | Money | Total item cost | |
![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Anatomical location Binding: ?? (example): The code for the teeth, quadrant, sextant and arch. | |
![]() ![]() ![]() ![]() | 0..* | CodeableConcept | Anatomical sub-location Binding: ?? (example): The code for the tooth surface and surface combinations. | |
![]() ![]() ![]() ![]() | 0..* | positiveInt | Applicable note numbers | |
![]() ![]() ![]() ![]() | 1..* | Added items adjudication | ||
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | 【因FHIR設計而需必填】 Binding: ?? (example): The adjudication codes. | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept |
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept |
![]() ![]() ![]() ![]() ![]() | S | 1..1 | CodeableConcept | 受理審查案件核定註記。若申請案件類別為3時須填寫。1:同意 | 2:不予同意 | 3:部份同意 | 4:補件 | 5:退件 Binding: ?? (required) |
![]() ![]() ![]() ![]() ![]() | 0..1 | Money | Monetary amount | |
![]() ![]() ![]() ![]() ![]() | S | 1..1 | decimal | 核定數量,若申請案件類別為3時須填寫。 |
![]() ![]() ![]() ![]() | 0..* | BackboneElement | Insurer added line details | |
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. | |
![]() ![]() ![]() ![]() ![]() | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |
![]() ![]() ![]() ![]() ![]() | 0..1 | ?? | Count of products or services | |
![]() ![]() ![]() ![]() ![]() | 0..1 | Money | Fee, charge or cost per item | |
![]() ![]() ![]() ![]() ![]() | 0..1 | decimal | Price scaling factor | |
![]() ![]() ![]() ![]() ![]() | 0..1 | Money | Total item cost | |
![]() ![]() ![]() ![]() ![]() | 0..* | positiveInt | Applicable note numbers | |
![]() ![]() ![]() ![]() ![]() | 1..* | Added items detail adjudication | ||
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | 【因FHIR設計而需必填】 Binding: ?? (example): The adjudication codes. | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept |
![]() ![]() ![]() ![]() ![]() ![]() | S | 1..1 | CodeableConcept | 受理審查案件核定註記。若申請案件類別為3時須填寫。1:同意 | 2:不予同意 | 3:部份同意 | 4:補件 | 5:退件 Binding: ?? (required) |
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | Money | Monetary amount | |
![]() ![]() ![]() ![]() ![]() ![]() | S | 1..1 | decimal | 核定數量,若申請案件類別為3時須填寫。 |
![]() ![]() ![]() ![]() ![]() | 0..* | BackboneElement | Insurer added line items | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | CodeableConcept | Service/Product billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | ?? | Count of products or services | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | Money | Fee, charge or cost per item | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | decimal | Price scaling factor | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | Money | Total item cost | |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | positiveInt | Applicable note numbers | |
![]() ![]() ![]() ![]() ![]() ![]() | 1..* | Added items detail adjudication | ||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | 【因FHIR設計而需必填】 Binding: ?? (example): The adjudication codes. | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | S | 1..1 | CodeableConcept | 受理審查案件核定註記。若申請案件類別為3時須填寫。1:同意 | 2:不予同意 | 3:部份同意 | 4:補件 | 5:退件 Binding: ?? (required) |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | Money | Monetary amount | |
![]() ![]() ![]() ![]() ![]() ![]() ![]() | S | 1..1 | decimal | 核定數量,若申請案件類別為3時須填寫。 |
![]() ![]() ![]() | 0..* | Header-level adjudication | ||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | 【因FHIR設計而需必填】 Binding: ?? (example): The adjudication codes. | |
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system |
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept |
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system |
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Identity of the terminology system Example General: http://terminology.hl7.org/CodeSystem/adjudication |
![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant |
![]() ![]() ![]() ![]() | Σ | 0..1 | code | Symbol in syntax defined by the system Example General: submitted |
![]() ![]() ![]() ![]() | Σ | 0..1 | string | Representation defined by the system |
![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept |
![]() ![]() ![]() ![]() | S | 1..1 | CodeableConcept | 受理審查案件核定註記。若申請案件類別為3時須填寫。1:同意 | 2:不予同意 | 3:部份同意 | 4:補件 | 5:退件 Binding: ?? (required) |
![]() ![]() ![]() ![]() | 0..1 | Money | Monetary amount | |
![]() ![]() ![]() ![]() | S | 1..1 | decimal | 核定數量,若申請案件類別為3時須填寫。 |
![]() ![]() ![]() | Σ | 0..* | BackboneElement | Adjudication totals |
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() | Σ | 1..1 | CodeableConcept | Type of adjudication information Binding: ?? (example): The adjudication codes. |
![]() ![]() ![]() ![]() | Σ | 1..1 | Money | Financial total for the category |
![]() ![]() ![]() | 0..1 | BackboneElement | Payment Details | |
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Partial or complete payment Binding: ?? (example): The type (partial, complete) of the payment. | |
![]() ![]() ![]() ![]() | 0..1 | Money | Payment adjustment for non-claim issues | |
![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Explanation for the adjustment Binding: ?? (example): Payment Adjustment reason codes. | |
![]() ![]() ![]() ![]() | 0..1 | date | Expected date of payment | |
![]() ![]() ![]() ![]() | 1..1 | Money | Payable amount after adjustment | |
![]() ![]() ![]() ![]() | 0..1 | Identifier | Business identifier for the payment | |
![]() ![]() ![]() | 0..1 | CodeableConcept | Funds reserved status Binding: ?? (example): For whom funds are to be reserved: (Patient, Provider, None). | |
![]() ![]() ![]() | 0..1 | CodeableConcept | Printed form identifier Binding: ?? (example): The forms codes. | |
![]() ![]() ![]() | 0..1 | Attachment | Printed reference or actual form | |
![]() ![]() ![]() | 0..* | BackboneElement | Note concerning adjudication | |
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() | 0..1 | positiveInt | Note instance identifier | |
![]() ![]() ![]() ![]() | 0..1 | code | display | print | printoper Binding: ?? (required): The presentation types of notes. | |
![]() ![]() ![]() ![]() | 1..1 | string | Note explanatory text | |
![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Language of the text Binding: ?? (preferred): A human language. | |
![]() ![]() ![]() | 0..* | Reference(CommunicationRequest) | Request for additional information | |
![]() ![]() ![]() | 0..* | BackboneElement | Patient insurance information | |
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() | 1..1 | positiveInt | Insurance instance identifier | |
![]() ![]() ![]() ![]() | 1..1 | boolean | Coverage to be used for adjudication | |
![]() ![]() ![]() ![]() | 1..1 | Reference(Coverage) | Insurance information | |
![]() ![]() ![]() ![]() | 0..1 | string | Additional provider contract number | |
![]() ![]() ![]() ![]() | 0..1 | Reference(ClaimResponse) | Adjudication results | |
![]() ![]() ![]() | 0..* | BackboneElement | Processing errors | |
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() | 0..1 | positiveInt | Item sequence number | |
![]() ![]() ![]() ![]() | 0..1 | positiveInt | Detail sequence number | |
![]() ![]() ![]() ![]() | 0..1 | positiveInt | Subdetail sequence number | |
![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Error code detailing processing issues Binding: ?? (example): The adjudication error codes. | |
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