Draft PH Core Implementation Guide
0.2.0 - ci-build PH

Draft PH Core Implementation Guide, published by UP Manila National TeleHealth Center. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/UP-Manila-SILab/ph-core/ and changes regularly. See the Directory of published versions

: claim-single-example

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{
  "resourceType" : "Claim",
  "id" : "claim-single-example",
  "meta" : {
    "profile" : [
      🔗 "https://fhir.doh.gov.ph/phcore/StructureDefinition/ph-core-claim",
      "http://doh.gov.ph/fhir/ph-core/StructureDefinition/ph-core-claim"
    ]
  },
  "language" : "en",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Claim:</b> PhilHealth Outpatient Consultation</p><p><b>Status:</b> Active</p><p><b>Patient:</b> Juan Dela Cruz (PhilHealth ID: 63-584789845-5)</p><p><b>Created:</b> March 15, 2024</p><p><b>Insurer:</b> Philippine Health Insurance Corporation (PhilHealth)</p><p><b>Provider:</b> Dr. Maria Clara Santos</p><p><b>Diagnosis:</b> Type 2 Diabetes Mellitus (Principal)</p><p><b>Service:</b> Outpatient Consultation on March 15, 2024 - PHP 500.00</p></div>"
  },
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "code" : "professional",
        "display" : "Professional"
      }
    ]
  },
  "use" : "claim",
  "patient" : {
    🔗 "reference" : "Patient/patient-single-example"
  },
  "created" : "2024-03-15",
  "insurer" : {
    🔗 "reference" : "Organization/organization-single-example"
  },
  "provider" : {
    🔗 "reference" : "Practitioner/practitioner-single-example"
  },
  "priority" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
        "code" : "normal",
        "display" : "Normal"
      }
    ]
  },
  "payee" : {
    "type" : {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/payeetype",
          "code" : "provider",
          "display" : "Provider"
        }
      ]
    },
    "party" : {
      🔗 "reference" : "Practitioner/practitioner-single-example"
    }
  },
  "careTeam" : [
    {
      "sequence" : 1,
      "provider" : {
        🔗 "reference" : "Practitioner/practitioner-single-example"
      },
      "responsible" : true,
      "role" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
            "code" : "primary",
            "display" : "Primary Provider"
          }
        ]
      }
    }
  ],
  "diagnosis" : [
    {
      "sequence" : 1,
      "diagnosisReference" : {
        🔗 "reference" : "Condition/condition-single-example"
      },
      "type" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
              "code" : "principal",
              "display" : "Principal Diagnosis"
            }
          ]
        }
      ]
    }
  ],
  "insurance" : [
    {
      "sequence" : 1,
      "focal" : true,
      "identifier" : {
        "system" : "http://philhealth.gov.ph/fhir/Identifier/philhealth-id",
        "value" : "63-584789845-5"
      },
      "coverage" : {
        🔗 "reference" : "Coverage/philhealth-coverage-example"
      }
    }
  ],
  "item" : [
    {
      "sequence" : 1,
      "careTeamSequence" : [
        1
      ],
      "diagnosisSequence" : [
        1
      ],
      "productOrService" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "11429006",
            "display" : "Consultation"
          }
        ],
        "text" : "Outpatient Consultation"
      },
      "servicedDate" : "2024-03-15",
      "quantity" : {
        "value" : 1
      },
      "unitPrice" : {
        "value" : 500,
        "currency" : "PHP"
      },
      "net" : {
        "value" : 500,
        "currency" : "PHP"
      }
    }
  ]
}