Belgian MyCareNet eAttestation Profiles
1.0.0 - STU
Belgian MyCareNet eAttestation Profiles
1.0.0 - STU
Belgian MyCareNet eAttestation Profiles, published by eHealth Platform. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/eattestation/ and changes regularly. See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "ex01",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-eattestation-request"
]
},
"type" : "message",
"timestamp" : "2015-07-14T11:15:33+02:00",
"entry" : [
{
"fullUrl" : "urn:uuid:267b18ce-3d37-4581-9baa-6fada338038b",
"resource" : {
"resourceType" : "MessageHeader",
"id" : "267b18ce-3d37-4581-9baa-6fada338038b",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-messageheader"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_267b18ce-3d37-4581-9baa-6fada338038b\"> </a><p><b>Generated Narrative: MessageHeader</b><a name=\"267b18ce-3d37-4581-9baa-6fada338038b\"> </a><a name=\"hc267b18ce-3d37-4581-9baa-6fada338038b\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MessageHeader "267b18ce-3d37-4581-9baa-6fada338038b" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/hl7-be/mycarenet//StructureDefinition-be-messageheader.html\">MyCareNet MessageHeader BE profile</a></p></div><p><b>event</b>: eattest-create (Details: https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events code eattest-create = 'eattest-create', stated as 'null')</p><h3>Destinations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td>MyCareNet</td><td><code>urn:be:fgov:kbo-bce:organization:cbe-number:0820563481</code></td></tr></table><p><b>sender</b>: <a href=\"#PractitionerRole_62c7bfad-0cb3-4a39-9abb-3a62e06de834\">See above (urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834)</a></p><h3>Sources</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td><code>urn:be:fgov:person:ssin:ehealth:1.0:physiotherapist:nihii11:54263481527</code></td></tr></table><p><b>focus</b>: <a href=\"#Claim_e85173bc-6f0d-480b-a2cd-2b70d9ffff7a\">See above (urn:uuid:e85173bc-6f0d-480b-a2cd-2b70d9ffff7a)</a></p></div>"
},
"eventCoding" : {
"system" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events",
"code" : "eattest-create"
},
"destination" : [
{
"name" : "MyCareNet",
"endpoint" : "urn:be:fgov:kbo-bce:organization:cbe-number:0820563481"
}
],
"sender" : {
"reference" : "urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834"
},
"source" : // serviceProvider
{
"endpoint" : "urn:be:fgov:person:ssin:ehealth:1.0:physiotherapist:nihii11:54263481527"
},
"focus" : [
{
"reference" : "urn:uuid:e85173bc-6f0d-480b-a2cd-2b70d9ffff7a"
}
]
}
},
{
"fullUrl" : "urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834",
"resource" : {
"resourceType" : "PractitionerRole",
"id" : "62c7bfad-0cb3-4a39-9abb-3a62e06de834",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PractitionerRole_62c7bfad-0cb3-4a39-9abb-3a62e06de834\"> </a><p><b>Generated Narrative: PractitionerRole</b><a name=\"62c7bfad-0cb3-4a39-9abb-3a62e06de834\"> </a><a name=\"hc62c7bfad-0cb3-4a39-9abb-3a62e06de834\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource PractitionerRole "62c7bfad-0cb3-4a39-9abb-3a62e06de834" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-practitionerrole.html\">BePractitionerRole</a></p></div><p><b>practitioner</b>: <a href=\"#Practitioner_03972cc4-d781-4285-8d79-0f05810e1931\">See above (urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931)</a></p><p><b>organization</b>: <span><a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-cbe.html\" title=\"BCE/KBO\">BeCBENamingSystem</a>/0425.222.333</span></p><p><b>code</b>: physiotherapist <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/core//CodeSystem-cd-hcparty.html\">BeCdHcParty</a>#persphysiotherapist)</span></p></div>"
},
"practitioner" : {
"reference" : "urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931"
},
"organization" : {
"identifier" : // collector (paymentreceivingparty) for attest
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/cbe",
"value" : "0425.222.333"
}
},
"code" : [
{
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty",
"code" : "persphysiotherapist"
}
]
}
]
}
},
{
"fullUrl" : "urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931",
"resource" : {
"resourceType" : "Practitioner",
"id" : "03972cc4-d781-4285-8d79-0f05810e1931",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_03972cc4-d781-4285-8d79-0f05810e1931\"> </a><p><b>Generated Narrative: Practitioner</b><a name=\"03972cc4-d781-4285-8d79-0f05810e1931\"> </a><a name=\"hc03972cc4-d781-4285-8d79-0f05810e1931\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Practitioner "03972cc4-d781-4285-8d79-0f05810e1931" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-practitioner.html\">BePractitioner</a></p></div><p><b>identifier</b>: <a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-nihdi.html\" title=\"RIZIV/INAMI\">BeNIHDINamingSystem</a>/54263481527</p><p><b>name</b>: John Smith </p></div>"
},
"identifier" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
"value" : "54263481527"
}
],
"name" : [
// serviceProvider for attest (and in this case also the provider for item)
{
"family" : "Smith",
"given" : [
"John"
]
}
]
}
},
{
"fullUrl" : "urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686",
"resource" : {
"resourceType" : "Patient",
"id" : "a52efcb6-1f81-4333-a115-d45bd3183686",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-patient"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_a52efcb6-1f81-4333-a115-d45bd3183686\"> </a><p><b>Generated Narrative: Patient</b><a name=\"a52efcb6-1f81-4333-a115-d45bd3183686\"> </a><a name=\"hca52efcb6-1f81-4333-a115-d45bd3183686\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Patient "a52efcb6-1f81-4333-a115-d45bd3183686" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-patient.html\">BePatient</a></p></div><p><b>identifier</b>: <a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-ssin.html\" title=\"NISS/INSZ\">BeSSINNamingSystem</a>/73031805784</p><p><b>name</b>: Jean Dupont </p><p><b>gender</b>: male</p></div>"
},
"identifier" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/ssin",
"value" : "73031805784"
}
],
"name" : [
// patient
{
"family" : "Dupont",
"given" : [
"Jean"
]
}
],
"gender" : "male"
}
},
{
"fullUrl" : "urn:uuid:035e3de4-011f-48a4-92c9-15b2bbcec321",
"resource" : {
"resourceType" : "PractitionerRole",
"id" : "035e3de4-011f-48a4-92c9-15b2bbcec321",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PractitionerRole_035e3de4-011f-48a4-92c9-15b2bbcec321\"> </a><p><b>Generated Narrative: PractitionerRole</b><a name=\"035e3de4-011f-48a4-92c9-15b2bbcec321\"> </a><a name=\"hc035e3de4-011f-48a4-92c9-15b2bbcec321\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource PractitionerRole "035e3de4-011f-48a4-92c9-15b2bbcec321" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-practitionerrole.html\">BePractitionerRole</a></p></div><p><b>practitioner</b>: <a href=\"#Practitioner_8fc72085-d349-4bd7-ba84-91a935a4e3c6\">See above (urn:uuid:8fc72085-d349-4bd7-ba84-91a935a4e3c6)</a></p><p><b>code</b>: physician <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/core//CodeSystem-cd-hcparty.html\">BeCdHcParty</a>#persphysician)</span></p></div>"
},
"practitioner" : {
"reference" : "urn:uuid:8fc72085-d349-4bd7-ba84-91a935a4e3c6"
},
"code" : [
{
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty",
"code" : "persphysician"
}
]
}
]
}
},
{
"fullUrl" : "urn:uuid:8fc72085-d349-4bd7-ba84-91a935a4e3c6",
"resource" : {
"resourceType" : "Practitioner",
"id" : "8fc72085-d349-4bd7-ba84-91a935a4e3c6",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_8fc72085-d349-4bd7-ba84-91a935a4e3c6\"> </a><p><b>Generated Narrative: Practitioner</b><a name=\"8fc72085-d349-4bd7-ba84-91a935a4e3c6\"> </a><a name=\"hc8fc72085-d349-4bd7-ba84-91a935a4e3c6\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Practitioner "8fc72085-d349-4bd7-ba84-91a935a4e3c6" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-practitioner.html\">BePractitioner</a></p></div><p><b>identifier</b>: <a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-nihdi.html\" title=\"RIZIV/INAMI\">BeNIHDINamingSystem</a>/19234011004</p><p><b>name</b>: Prénom du prescripteur Nom du prescripteur </p></div>"
},
"identifier" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
"value" : "19234011004"
}
],
"name" : [
// prescription - requestor - identifier
{
"family" : "Nom du prescripteur",
"given" : [
"Prénom du prescripteur"
]
}
]
}
},
{
"fullUrl" : "urn:uuid:b3586cda-f1e5-4c58-a389-94249957d87a",
"resource" : {
"resourceType" : "ServiceRequest",
"id" : "b3586cda-f1e5-4c58-a389-94249957d87a",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-eattestationservicerequest"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_b3586cda-f1e5-4c58-a389-94249957d87a\"> </a><p><b>Generated Narrative: ServiceRequest</b><a name=\"b3586cda-f1e5-4c58-a389-94249957d87a\"> </a><a name=\"hcb3586cda-f1e5-4c58-a389-94249957d87a\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource ServiceRequest "b3586cda-f1e5-4c58-a389-94249957d87a" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-be-eattestationservicerequest.html\">MyCareNet eAttestation ServiceRequest BE profile</a></p></div><p><b>BeExtPrescriptionRequesterStandard</b>: 1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-requester-norm.html\">Prescriber Standard</a>#1)</span></p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>category</b>: Physical therapy procedure <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#91251008)</span></p><p><b>code</b>: Physical therapy procedure <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#91251008)</span></p><p><b>subject</b>: <a href=\"#Patient_a52efcb6-1f81-4333-a115-d45bd3183686\">See above (urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686)</a></p><p><b>authoredOn</b>: 2015-07-14</p><p><b>requester</b>: <a href=\"#PractitionerRole_035e3de4-011f-48a4-92c9-15b2bbcec321\">See above (urn:uuid:035e3de4-011f-48a4-92c9-15b2bbcec321)</a></p></div>"
},
"extension" : [
{
"url" : "https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-prescription-requester-standard",
"valueCodeableConcept" : // prescription requester standard for item
{
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-requester-norm",
"code" : "1"
}
]
}
}
],
"status" : "active",
"intent" : "order",
"category" : [
{
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "91251008",
"display" : "Physical therapy procedure"
}
]
}
],
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "91251008",
"display" : "Physical therapy procedure"
}
]
},
"subject" : {
"reference" : "urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"
},
"authoredOn" : "2015-07-14",
"requester" : // prescription - authoredOn
{
"reference" : "urn:uuid:035e3de4-011f-48a4-92c9-15b2bbcec321"
}
}
},
{
"fullUrl" : "urn:uuid:8fc72085-d349-4bd7-ba84-91a935a4e3c7",
"resource" : {
"resourceType" : "Location",
"id" : "8fc72085-d349-4bd7-ba84-91a935a4e3c7",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_8fc72085-d349-4bd7-ba84-91a935a4e3c7\"> </a><p><b>Generated Narrative: Location</b><a name=\"8fc72085-d349-4bd7-ba84-91a935a4e3c7\"> </a><a name=\"hc8fc72085-d349-4bd7-ba84-91a935a4e3c7\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Location "8fc72085-d349-4bd7-ba84-91a935a4e3c7" </p></div><p><b>managingOrganization</b>: <span><a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-nihdi.html\" title=\"RIZIV/INAMI\">BeNIHDINamingSystem</a>/19234011004</span></p></div>"
},
"managingOrganization" : {
"identifier" : {
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
"value" : "19234011004"
}
}
}
},
// location - identifier
{
"fullUrl" : "urn:uuid:8fc72085-d349-4bd7-ba84-91a935a4e3c8",
"resource" : {
"resourceType" : "Location",
"id" : "8fc72085-d349-4bd7-ba84-91a935a4e3c8",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_8fc72085-d349-4bd7-ba84-91a935a4e3c8\"> </a><p><b>Generated Narrative: Location</b><a name=\"8fc72085-d349-4bd7-ba84-91a935a4e3c8\"> </a><a name=\"hc8fc72085-d349-4bd7-ba84-91a935a4e3c8\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Location "8fc72085-d349-4bd7-ba84-91a935a4e3c8" </p></div><p><b>type</b>: 130 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-hospital-service-cd.html\">Hospital Service Code</a>#130)</span></p><p><b>partOf</b>: <a href=\"#Location_8fc72085-d349-4bd7-ba84-91a935a4e3c7\">See above (urn:uuid:8fc72085-d349-4bd7-ba84-91a935a4e3c7)</a></p></div>"
},
"type" : [
{
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-hospital-service-cd",
"code" : "130"
}
]
}
],
"partOf" : // location department
{
"reference" : "urn:uuid:8fc72085-d349-4bd7-ba84-91a935a4e3c7"
}
}
},
{
"fullUrl" : "urn:uuid:e85173bc-6f0d-480b-a2cd-2b70d9ffff7a",
"resource" : {
"resourceType" : "Claim",
"id" : "e85173bc-6f0d-480b-a2cd-2b70d9ffff7a",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-eattestation-claim"
]
},
"text" : // new profile to create for the request
{
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_e85173bc-6f0d-480b-a2cd-2b70d9ffff7a\"> </a><p><b>Generated Narrative: Claim</b><a name=\"e85173bc-6f0d-480b-a2cd-2b70d9ffff7a\"> </a><a name=\"hce85173bc-6f0d-480b-a2cd-2b70d9ffff7a\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Claim "e85173bc-6f0d-480b-a2cd-2b70d9ffff7a" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-be-eattestation-claim.html\">MyCareNet eAttestation Claim BE profile</a></p></div><p><b>BeExtEAttestationSupplement</b>: <span title=\"Euro\">€60.00</span> (EUR)</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>subType</b>: physiotherapy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-be-cs-eattestation-types.html\">Attestation types</a>#physiotherapy)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <a href=\"#Patient_a52efcb6-1f81-4333-a115-d45bd3183686\">See above (urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686)</a></p><p><b>created</b>: 2015-07-14 11:15:30+0200</p><p><b>enterer</b>: <a href=\"#PractitionerRole_62c7bfad-0cb3-4a39-9abb-3a62e06de834\">See above (urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834)</a></p><p><b>provider</b>: <a href=\"#PractitionerRole_62c7bfad-0cb3-4a39-9abb-3a62e06de834\">See above (urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834)</a></p><p><b>priority</b>: Immediate <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#stat)</span></p><h3>Payees</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Party</b></td></tr><tr><td style=\"display: none\">*</td><td>Subscriber <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-payeetype.html\">Payee Type Codes</a>#subscriber)</span></td><td><a href=\"#Patient_a52efcb6-1f81-4333-a115-d45bd3183686\">See above (urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686)</a></td></tr></table><blockquote><p><b>careTeam</b></p><p><b>sequence</b>: 1</p><p><b>provider</b>: <span><a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-nihdi.html\" title=\"RIZIV/INAMI\">BeNIHDINamingSystem</a>/numéro inami du prestataire</span></p><p><b>role</b>: Other <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claimcareteamrole.html\">Claim Care Team Role Codes</a>#other)</span></p><p><b>qualification</b>: physician <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/core//CodeSystem-cd-hcparty.html\">BeCdHcParty</a>#persphysician)</span></p></blockquote><blockquote><p><b>careTeam</b></p><p><b>sequence</b>: 2</p><p><b>provider</b>: <span><a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-nihdi.html\" title=\"RIZIV/INAMI\">BeNIHDINamingSystem</a>/numéro inami du prestataire</span></p><p><b>role</b>: Assisting Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claimcareteamrole.html\">Claim Care Team Role Codes</a>#assist)</span></p><p><b>qualification</b>: physician <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/core//CodeSystem-cd-hcparty.html\">BeCdHcParty</a>#persphysician)</span></p></blockquote><blockquote><p><b>careTeam</b></p><p><b>sequence</b>: 3</p><p><b>provider</b>: <span><a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-nihdi.html\" title=\"RIZIV/INAMI\">BeNIHDINamingSystem</a>/numéro inami du prestataire</span></p><p><b>role</b>: Assisting Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claimcareteamrole.html\">Claim Care Team Role Codes</a>#assist)</span></p><p><b>qualification</b>: oral dental hygienist <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/core//CodeSystem-cd-hcparty.html\">BeCdHcParty</a>#persoraldentalhygienist)</span></p></blockquote><blockquote><p><b>careTeam</b></p><p><b>sequence</b>: 4</p><p><b>provider</b>: <span><a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-nihdi.html\" title=\"RIZIV/INAMI\">BeNIHDINamingSystem</a>/numéro inami du prestataire</span></p><p><b>role</b>: Primary provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claimcareteamrole.html\">Claim Care Team Role Codes</a>#primary)</span></p><p><b>qualification</b>: physiotherapist <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/core//CodeSystem-cd-hcparty.html\">BeCdHcParty</a>#persphysiotherapist)</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: 0050 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-treatment-reason.html\">Treatment Reason</a>#0050)</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: 1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-claim-norm-code.html\">Claim Norm Code</a>#1)</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 3</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: 000000 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (be-ns-claim-related-claim#000000)</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 4</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: 1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-claim-transplantation-code.html\">Claim Transplantation Code</a>#1)</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 5</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: 01 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-claim-exemption-code.html\">Claim Exemption Code</a>#01)</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 6</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>value</b>: <a href=\"#ServiceRequest_b3586cda-f1e5-4c58-a389-94249957d87a\">See above (urn:uuid:b3586cda-f1e5-4c58-a389-94249957d87a)</a></p></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><span>: use of mandatory insurance coverage, no further details provided here.</span></td></tr></table><blockquote><p><b>item</b></p><p><b>BeExtEAttestationItemSupplement</b>: <span title=\"Euro\">€60.00</span> (EUR)</p><p><b>BeExtEAttestationItemPreAuthRef</b>: preauthref number</p><blockquote><p><b>BeExtPatientIdentityDocument</b></p><blockquote><p><b>url</b></p><code>readingDate</code></blockquote><p><b>value</b>: 2015-07-14</p><blockquote><p><b>url</b></p><code>readingTime</code></blockquote><p><b>value</b>: 11:14:30</p><blockquote><p><b>url</b></p><code>entryType</code></blockquote><p><b>value</b>: 4 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-id-doc-input-type.html\">Id Doc Input Type</a>#4)</span></p><blockquote><p><b>url</b></p><code>reasonManual</code></blockquote><p><b>value</b>: 2 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-id-doc-manual-input-justification.html\">Id Doc Manual Input Justification</a>#2)</span></p><blockquote><p><b>url</b></p><code>medium</code></blockquote><p><b>value</b>: 1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-id-doc-media-type.html\">Id Doc Media Type</a>#1)</span></p><blockquote><p><b>url</b></p><code>stickerReason</code></blockquote><p><b>value</b>: 1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-id-doc-vignette-use-justification.html\">Id Doc Vignette Use Justification</a>#1)</span></p><blockquote><p><b>url</b></p><code>serialNumber</code></blockquote><p><b>value</b>: actual cardnumber as string</p></blockquote><p><b>sequence</b>: 1</p><p><b>careTeamSequence</b>: 1, 2, 3, 4</p><p><b>informationSequence</b>: 2, 3, 4, 5, 6</p><p><b>productOrService</b>: 101032 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (be-ns-nihdi-nomenclature#101032)</span></p><p><b>serviced</b>: 2020-01-14</p><p><b>location</b>: <a href=\"#Location_8fc72085-d349-4bd7-ba84-91a935a4e3c7\">See above (urn:uuid:8fc72085-d349-4bd7-ba84-91a935a4e3c7)</a></p><p><b>quantity</b>: 10</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>50</td><td>EUR</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>500</td><td>EUR</td></tr></table><p><b>bodySite</b>: Mandibular left first premolar tooth <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#2400006)</span></p></blockquote><h3>Totals</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>500</td><td>EUR</td></tr></table></div>"
},
"extension" : [
{
"url" : "https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-supplement",
"valueMoney" : // supplement for eattest
{
"value" : 60,
"currency" : "EUR"
}
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "professional"
}
]
},
"subType" : {
"coding" : [
// attestationType
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types",
"code" : "physiotherapy"
}
]
},
"use" : "claim",
"patient" : {
"reference" : "urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"
},
"created" : "2015-07-14T11:15:30+02:00",
"enterer" : {
"reference" : "urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834"
},
"provider" : {
"reference" : "urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834"
},
"priority" : // provider for item
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "stat"
}
]
},
"payee" : {
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/payeetype",
"code" : "subscriber"
}
]
},
"party" : {
"reference" : "urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"
}
},
"careTeam" : [
{
"sequence" : 1,
"provider" : // auxiliaryProvider: gmf manager
{
"identifier" : {
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
"value" : "numéro inami du prestataire"
}
},
"role" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code" : "other"
}
]
},
"qualification" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty",
"code" : "persphysician"
}
]
}
},
{
"sequence" : 2,
"provider" : // AuxiliaryProvider: trainee
{
"identifier" : {
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
"value" : "numéro inami du prestataire"
}
},
"role" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code" : "assist"
}
]
},
"qualification" : {
"coding" : [
// hcparty ?
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty",
"code" : "persphysician"
}
]
}
},
{
"sequence" : 3,
"provider" : // AuxiliaryProvider: oralHygienist
{
"identifier" : {
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
"value" : "numéro inami du prestataire"
}
},
"role" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code" : "assist"
}
]
},
"qualification" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty",
"code" : "persoraldentalhygienist"
}
]
}
},
{
"sequence" : 4,
"provider" : // service - Provider
{
"identifier" : {
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
"value" : "numéro inami du prestataire"
}
},
"role" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
"code" : "primary"
}
]
},
"qualification" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty",
"code" : "persphysiotherapist"
}
]
}
}
],
"supportingInfo" : [
{
"sequence" : 1,
"category" : // treatmentCauses for attest
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code" : "info"
}
]
},
"code" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-treatment-reason",
"code" : "0050"
}
]
}
},
{
"sequence" : 2,
"category" : // standard (claim norm) for item
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code" : "info"
}
]
},
"code" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-norm-code",
"code" : "1"
}
]
}
},
{
"sequence" : 3,
"category" : // related (claim) for item
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code" : "info"
}
]
},
"code" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/NamingSystem/be-ns-claim-related-claim",
"code" : "000000"
}
]
}
},
{
"sequence" : 4,
"category" : // transplantation for item
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code" : "info"
}
]
},
"code" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-transplantation-code",
"code" : "1"
}
]
}
},
{
"sequence" : 5,
"category" : // identical (exemption) for item
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code" : "info"
}
]
},
"code" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-exemption-code",
"code" : "01"
}
]
}
},
{
"sequence" : 6,
"category" : // prescription for item
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code" : "info"
}
]
},
"valueReference" : {
"reference" : "urn:uuid:b3586cda-f1e5-4c58-a389-94249957d87a"
}
}
],
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
"display" : "use of mandatory insurance coverage, no further details provided here."
}
}
],
"item" : [
// laterality for item
<bodySite>
<extension url="https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="419161000"/>
</valueCoding>
</extension>
</bodySite>
{
"extension" : [
{
"url" : "https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-supplement",
"valueMoney" : // supplement for item
{
"value" : 60,
"currency" : "EUR"
}
},
{
"url" : "https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref",
"valueString" : "preauthref number"
},
// medicalAdvisorDecisionNr for item
{
"url" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/StructureDefinition/be-ext-patientidentitydocument",
"extension" : [
// patientIdentityDocument for item
{
"url" : "readingDate",
"valueDate" : "2015-07-14"
},
{
"url" : "readingTime",
"valueTime" : "11:14:30"
},
{
"url" : "entryType",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-id-doc-input-type",
"code" : "4"
}
]
}
},
{
"url" : "reasonManual",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-id-doc-manual-input-justification",
"code" : "2"
}
]
}
},
{
"url" : "medium",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-id-doc-media-type",
"code" : "1"
}
]
}
},
{
"url" : "stickerReason",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-id-doc-vignette-use-justification",
"code" : "1"
}
]
}
},
{
"url" : "serialNumber",
"valueString" : "actual cardnumber as string"
}
]
}
],
"sequence" : 1,
"careTeamSequence" : [
1,
2,
3,
4
],
"informationSequence" : [
2,
3,
4,
5,
6
],
"productOrService" : {
"coding" : [
// identifier for item
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature",
"code" : "101032"
}
]
},
"servicedDate" : "2020-01-14",
"locationReference" : // date for item
{
"reference" : "urn:uuid:8fc72085-d349-4bd7-ba84-91a935a4e3c7"
},
"quantity" : // location for item
// count for item
{
"value" : 10
},
"unitPrice" : {
"value" : 50,
"currency" : "EUR"
},
"net" : {
"value" : 500,
"currency" : "EUR"
},
"bodySite" : // fee for item
{
"coding" : [
// toothNumber for item
// Mandibular left first premolar tooth
{
"system" : "http://snomed.info/sct",
"code" : "2400006"
}
]
}
}
],
"total" : {
"value" : 500,
"currency" : "EUR"
}
}
}
]
}
IG © 2023+ eHealth Platform. Package hl7.fhir.be.eattestation#1.0.0 based on FHIR 4.0.1. Generated 2024-03-14
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