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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<Claim xmlns="http://hl7.org/fhir">
  <id value="claim-single-example"/>
  <meta>
    <profile
             value="https://fhir.doh.gov.ph/phcore/StructureDefinition/ph-core-claim"/>
    <profile
             value="http://doh.gov.ph/fhir/ph-core/StructureDefinition/ph-core-claim"/>
  </meta>
  <language value="en"/>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
      <code value="professional"/>
      <display value="Professional"/>
    </coding>
  </type>
  <use value="claim"/>
  <patient>🔗 
    <reference value="Patient/patient-single-example"/>
  </patient>
  <created value="2024-03-15"/>
  <insurer>🔗 
    <reference value="Organization/organization-single-example"/>
  </insurer>
  <provider>🔗 
    <reference value="Practitioner/practitioner-single-example"/>
  </provider>
  <priority>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/processpriority"/>
      <code value="normal"/>
      <display value="Normal"/>
    </coding>
  </priority>
  <payee>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/payeetype"/>
        <code value="provider"/>
        <display value="Provider"/>
      </coding>
    </type>
    <party>🔗 
      <reference value="Practitioner/practitioner-single-example"/>
    </party>
  </payee>
  <careTeam>
    <sequence value="1"/>
    <provider>🔗 
      <reference value="Practitioner/practitioner-single-example"/>
    </provider>
    <responsible value="true"/>
    <role>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/claimcareteamrole"/>
        <code value="primary"/>
        <display value="Primary Provider"/>
      </coding>
    </role>
  </careTeam>
  <diagnosis>
    <sequence value="1"/>
    <diagnosisReference>🔗 
      <reference value="Condition/condition-single-example"/>
    </diagnosisReference>
    <type>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/ex-diagnosistype"/>
        <code value="principal"/>
        <display value="Principal Diagnosis"/>
      </coding>
    </type>
  </diagnosis>
  <insurance>
    <sequence value="1"/>
    <focal value="true"/>
    <identifier>
      <system value="http://philhealth.gov.ph/fhir/Identifier/philhealth-id"/>
      <value value="63-584789845-5"/>
    </identifier>
    <coverage>🔗 
      <reference value="Coverage/philhealth-coverage-example"/>
    </coverage>
  </insurance>
  <item>
    <sequence value="1"/>
    <careTeamSequence value="1"/>
    <diagnosisSequence value="1"/>
    <productOrService>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="11429006"/>
        <display value="Consultation"/>
      </coding>
      <text value="Outpatient Consultation"/>
    </productOrService>
    <servicedDate value="2024-03-15"/>
    <quantity>
      <value value="1"/>
    </quantity>
    <unitPrice>
      <value value="500"/>
      <currency value="PHP"/>
    </unitPrice>
    <net>
      <value value="500"/>
      <currency value="PHP"/>
    </net>
  </item>
</Claim>