Belgian MyCareNet eAttestation Profiles
1.0.0 - STU Belgium flag

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

Resource Profile: MyCareNet eAttestation Claim BE profile

Official URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-eattestation-claim Version: 1.0.0
Draft as of 2024-03-14 Computable Name: BeEattestationClaim

Claim profile for use in the different eAttestation flow from MyCareNet.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Claim

NameFlagsCard.TypeDescription & Constraintsdoco
.. Claim C0..*ClaimClaim, Pre-determination or Pre-authorization
be-inv-eattestation-prescription-standard: Every service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard
be-inv-bodySite: BodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation
be-inv-eattestation-create-cancel: Creation requires empty identifier
be-inv-gmf-holder: GMF holder CAN only occur in a GP's attestation
be-inv-location: The location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization
be-inv-medical-advisor-decision-nr: Medical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations
be-inv-oral-hygienist: Oral Hygienist CAN only occur a dentist's attestation
be-inv-toothNumber: BodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation
be-inv-trainee: Trainee CAN only occur in a GP's attestation
be-inv-transplantation: Transplantation CAN only occur in a specialised medicine attestation
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... supplement S0..1MoneyOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-supplement
... Slices for identifier S0..*IdentifierBusiness Identifier for claim
Slice: Unordered, Open by value:system
.... identifier:eattestid S0..1IdentifierBusiness Identifier for claim
..... system 1..1uriThe namespace for the identifier value
Fixed Value: https://www.mycarenet.be/eattest
..... value 1..1stringThe value that is unique
... type
.... coding 1..1CodingCode defined by a terminology system
..... system 1..1uriIdentity of the terminology system
..... code 1..1codeSymbol in syntax defined by the system
... subType S1..1CodeableConceptMore granular claim type
Binding: Attestation types (extensible)
... use S1..1codeclaim | preauthorization | predetermination
Required Pattern: claim
... patient S1..1Reference(BePatient)The recipient of the products and services
... enterer S1..1Reference(BePractitionerRole)Author of the claim
... provider S1..1Reference(BePractitionerRole | BeOrganization)Party responsible for the claim
... priority
.... coding 0..*CodingCode defined by a terminology system
Required Pattern: At least the following
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/processpriority
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: stat
... payee
.... type
..... coding 0..*CodingCode defined by a terminology system
Required Pattern: At least the following
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/payeetype
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: subscriber
.... party 0..1Reference(BePatient)Recipient reference
... careTeam S0..*BackboneElementMembers of the care team
.... provider
..... identifier
...... system 0..1uriThe namespace for the identifier value
Required Pattern: https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi
.... role S1..1CodeableConceptFunction within the team
.... qualification S1..1CodeableConceptPractitioner credential or specialization
Binding: List of health care parties in Belgium (required)
... supportingInfo S0..*BackboneElementSupporting information
.... code S0..1CodeableConceptType of information
.... Slices for value[x] 0..1boolean, string, Quantity, Attachment, Reference(Resource)Data to be provided
Slice: Unordered, Open by type:$this
..... value[x]:valueReference S0..1Reference(Resource)Data to be provided
... insurance
.... sequence 1..1positiveIntInsurance instance identifier
Required Pattern: 1
.... focal 1..1booleanCoverage to be used for adjudication
Required Pattern: true
.... coverage
..... display 0..1stringText alternative for the resource
Required Pattern: use of mandatory insurance coverage, no further details provided here.
... item S0..*BackboneElementProduct or service provided
.... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... eid S0..1(Complex)BeExtPatientIdentityDocument
URL: https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/StructureDefinition/be-ext-patientidentitydocument
.... preAuthRef S0..1stringOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref
.... supplement S0..1MoneyOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-supplement
.... careTeamSequence S1..*positiveIntApplicable careTeam members
.... informationSequence S0..*positiveIntApplicable exception and supporting information
.... productOrService S1..1CodeableConceptBilling, service, product, or drug code
..... coding S1..1CodingCode defined by a terminology system
...... system S1..1uriIdentity of the terminology system
Required Pattern: https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature
...... code S1..1codeSymbol in syntax defined by the system
.... Slices for serviced[x] 1..1dateDate or dates of service or product delivery
Slice: Unordered, Open by type:$this
..... serviced[x]:servicedDate S1..1dateDate or dates of service or product delivery
.... Slices for location[x] 0..1CodeableConcept, Address, Reference(Location)Place of service or where product was supplied
Slice: Unordered, Open by type:$this
..... location[x]:locationReference S0..1Reference(Location)Place of service or where product was supplied
.... quantity S1..1SimpleQuantityCount of products or services
.... unitPrice S1..1MoneyFee, charge or cost per item
.... net S1..1MoneyTotal item cost
.... bodySite S0..1CodeableConceptAnatomical location
..... bodyLaterality S0..1CodingBeExtLaterality
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality
Binding: Laterality (required)
...... value[x] 0..1CodingValue of extension
Binding: Basic Laterality (required)
..... coding 0..*CodingCode defined by a terminology system
Binding: Body Site (required)
... total S0..1MoneyTotal claim cost

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Claim.subTypeextensibleBeVSEattestationTypes (a valid code from Attestation types)
https://www.ehealth.fgov.be/standards/fhir/eattestation/ValueSet/be-vs-eattestationtypes
from this IG
Claim.careTeam.qualificationrequiredBeVSCdHcParty
https://www.ehealth.fgov.be/standards/fhir/core/ValueSet/be-vs-cd-hcparty
Claim.item.bodySite.extension:bodyLaterality.value[x]requiredBeVSBasicLaterality
https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-basic-laterality
Claim.item.bodySite.codingrequiredBeVSBodySite
https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-bodysite

Constraints

IdGradePath(s)DetailsRequirements
be-inv-bodySiteerrorClaimBodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine' or code = 'dentistry').empty() implies Claim.item.bodySite.empty()
be-inv-eattestation-create-cancelerrorClaimCreation requires empty identifier
: Claim.identifier.where(system = 'https://www.mycarenet.be/eattest').empty().not() implies Claim.item.empty() and Claim.total.empty() and Claim.careTeam.empty()
be-inv-eattestation-prescription-standarderrorClaimEvery service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard
: supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).extension('https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-prescription-requester-standard').count() = supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).count()
be-inv-gmf-holdererrorClaimGMF holder CAN only occur in a GP's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'other').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty()
be-inv-locationerrorClaimThe location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization
: Claim.item.(location as Reference).empty().not() implies ( Claim.item.(location as Reference).resolve().type.memberOf('https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd') or Claim.item.(location as Reference).resolve().managingOrganization.resolve().identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') or Claim.item.(location as Reference).resolve().managingOrganization.identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') )
be-inv-medical-advisor-decision-nrerrorClaimMedical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').exists() implies Claim.item.count() <= Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').count() and Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').empty() implies Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').empty()
be-inv-oral-hygienisterrorClaimOral Hygienist CAN only occur a dentist's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').empty() implies Claim.careTeam.qualification.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty').where(code = 'persoraldentalhygienist').empty()
be-inv-toothNumbererrorClaimBodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').exists() implies (Claim.item.bodySite.coding.empty() or Claim.item.bodySite.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-toothnumber-bodysite') )
be-inv-traineeerrorClaimTrainee CAN only occur in a GP's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'assist').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty()
be-inv-transplantationerrorClaimTransplantation CAN only occur in a specialised medicine attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine').empty() implies Claim.supportingInfo.code.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-transplantation-code').empty()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Claim C0..*ClaimClaim, Pre-determination or Pre-authorization
be-inv-eattestation-prescription-standard: Every service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard
be-inv-bodySite: BodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation
be-inv-eattestation-create-cancel: Creation requires empty identifier
be-inv-gmf-holder: GMF holder CAN only occur in a GP's attestation
be-inv-location: The location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization
be-inv-medical-advisor-decision-nr: Medical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations
be-inv-oral-hygienist: Oral Hygienist CAN only occur a dentist's attestation
be-inv-toothNumber: BodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation
be-inv-trainee: Trainee CAN only occur in a GP's attestation
be-inv-transplantation: Transplantation CAN only occur in a specialised medicine attestation
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... supplement S0..1MoneyOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-supplement
... Slices for identifier S0..*IdentifierBusiness Identifier for claim
Slice: Unordered, Open by value:system
.... identifier:eattestid S0..1IdentifierBusiness Identifier for claim
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... system Σ1..1uriThe namespace for the identifier value
Fixed Value: https://www.mycarenet.be/eattest
..... value Σ1..1stringThe value that is unique
Example General: 123456
... status ?!Σ1..1codeactive | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.


Required Pattern: active
... type Σ1..1CodeableConceptCategory or discipline
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.

.... coding Σ1..1CodingCode defined by a terminology system
..... system Σ1..1uriIdentity of the terminology system
..... code Σ1..1codeSymbol in syntax defined by the system
... subType S1..1CodeableConceptMore granular claim type
Binding: Attestation types (extensible)
... use SΣ1..1codeclaim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.


Required Pattern: claim
... patient SΣ1..1Reference(BePatient)The recipient of the products and services
... created Σ1..1dateTimeResource creation date
... enterer S1..1Reference(BePractitionerRole)Author of the claim
... provider SΣ1..1Reference(BePractitionerRole | BeOrganization)Party responsible for the claim
... priority Σ1..1CodeableConceptDesired processing ugency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.

.... coding Σ0..*CodingCode defined by a terminology system

Required Pattern: At least the following
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/processpriority
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: stat
... careTeam S0..*BackboneElementMembers of the care team
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntOrder of care team
.... provider 1..1Reference(Practitioner | PractitionerRole | Organization)Practitioner or organization
.... role S1..1CodeableConceptFunction within the team
Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.

.... qualification S1..1CodeableConceptPractitioner credential or specialization
Binding: List of health care parties in Belgium (required)
... supportingInfo S0..*BackboneElementSupporting information
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntInformation instance identifier
.... category 1..1CodeableConceptClassification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.

.... code S0..1CodeableConceptType of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

.... Slices for value[x] 0..1Data to be provided
Slice: Unordered, Open by type:$this
..... valueBooleanboolean
..... valueStringstring
..... valueQuantityQuantity
..... valueAttachmentAttachment
..... valueReferenceReference(Resource)
..... value[x]:valueReference S0..1Reference(Resource)Data to be provided
... insurance Σ1..*BackboneElementPatient insurance information
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ1..1positiveIntInsurance instance identifier
Required Pattern: 1
.... focal Σ1..1booleanCoverage to be used for adjudication
Required Pattern: true
.... coverage Σ1..1Reference(Coverage)Insurance information
..... display Σ0..1stringText alternative for the resource
Required Pattern: use of mandatory insurance coverage, no further details provided here.
... item S0..*BackboneElementProduct or service provided
.... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... eid S0..1(Complex)BeExtPatientIdentityDocument
URL: https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/StructureDefinition/be-ext-patientidentitydocument
.... preAuthRef S0..1stringOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref
.... supplement S0..1MoneyOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-supplement
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntItem instance identifier
.... careTeamSequence S1..*positiveIntApplicable careTeam members
.... informationSequence S0..*positiveIntApplicable exception and supporting information
.... productOrService S1..1CodeableConceptBilling, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.

..... coding SΣ1..1CodingCode defined by a terminology system
...... system SΣ1..1uriIdentity of the terminology system
Required Pattern: https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature
...... code SΣ1..1codeSymbol in syntax defined by the system
.... Slices for serviced[x] 1..1dateDate or dates of service or product delivery
Slice: Unordered, Closed by type:$this
..... serviced[x]:servicedDate S1..1dateDate or dates of service or product delivery
.... Slices for location[x] 0..1Place of service or where product was supplied
Slice: Unordered, Open by type:$this
Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.

..... locationCodeableConceptCodeableConcept
..... locationAddressAddress
..... locationReferenceReference(Location)
..... location[x]:locationReference S0..1Reference(Location)Place of service or where product was supplied
.... quantity S1..1SimpleQuantityCount of products or services
.... unitPrice S1..1MoneyFee, charge or cost per item
.... net S1..1MoneyTotal item cost
.... bodySite S0..1CodeableConceptAnatomical location
Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.

..... bodyLaterality S0..1CodingBeExtLaterality
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality
Binding: Laterality (required)
...... extension 0..0
...... url 1..1uri"https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality"
...... value[x] 0..1CodingValue of extension
Binding: Basic Laterality (required)
..... coding Σ0..*CodingCode defined by a terminology system
Binding: Body Site (required)
... total S0..1MoneyTotal claim cost

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Claim.identifier:eattestid.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Claim.statusrequiredPattern: active
http://hl7.org/fhir/ValueSet/fm-status|4.0.1
from the FHIR Standard
Claim.typeextensibleClaimTypeCodes
http://hl7.org/fhir/ValueSet/claim-type
from the FHIR Standard
Claim.subTypeextensibleBeVSEattestationTypes (a valid code from Attestation types)
https://www.ehealth.fgov.be/standards/fhir/eattestation/ValueSet/be-vs-eattestationtypes
from this IG
Claim.userequiredPattern: claim
http://hl7.org/fhir/ValueSet/claim-use|4.0.1
from the FHIR Standard
Claim.priorityexampleProcessPriorityCodes
http://hl7.org/fhir/ValueSet/process-priority
from the FHIR Standard
Claim.careTeam.roleexampleClaimCareTeamRoleCodes
http://hl7.org/fhir/ValueSet/claim-careteamrole
from the FHIR Standard
Claim.careTeam.qualificationrequiredBeVSCdHcParty
https://www.ehealth.fgov.be/standards/fhir/core/ValueSet/be-vs-cd-hcparty
Claim.supportingInfo.categoryexampleClaimInformationCategoryCodes
http://hl7.org/fhir/ValueSet/claim-informationcategory
from the FHIR Standard
Claim.supportingInfo.codeexampleExceptionCodes
http://hl7.org/fhir/ValueSet/claim-exception
from the FHIR Standard
Claim.item.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard
Claim.item.location[x]exampleExampleServicePlaceCodes
http://hl7.org/fhir/ValueSet/service-place
from the FHIR Standard
Claim.item.bodySiteexampleOralSiteCodes
http://hl7.org/fhir/ValueSet/tooth
from the FHIR Standard
Claim.item.bodySite.extension:bodyLaterality.value[x]requiredBeVSBasicLaterality
https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-basic-laterality
Claim.item.bodySite.codingrequiredBeVSBodySite
https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-bodysite

Constraints

IdGradePath(s)DetailsRequirements
be-inv-bodySiteerrorClaimBodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine' or code = 'dentistry').empty() implies Claim.item.bodySite.empty()
be-inv-eattestation-create-cancelerrorClaimCreation requires empty identifier
: Claim.identifier.where(system = 'https://www.mycarenet.be/eattest').empty().not() implies Claim.item.empty() and Claim.total.empty() and Claim.careTeam.empty()
be-inv-eattestation-prescription-standarderrorClaimEvery service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard
: supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).extension('https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-prescription-requester-standard').count() = supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).count()
be-inv-gmf-holdererrorClaimGMF holder CAN only occur in a GP's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'other').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty()
be-inv-locationerrorClaimThe location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization
: Claim.item.(location as Reference).empty().not() implies ( Claim.item.(location as Reference).resolve().type.memberOf('https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd') or Claim.item.(location as Reference).resolve().managingOrganization.resolve().identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') or Claim.item.(location as Reference).resolve().managingOrganization.identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') )
be-inv-medical-advisor-decision-nrerrorClaimMedical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').exists() implies Claim.item.count() <= Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').count() and Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').empty() implies Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').empty()
be-inv-oral-hygienisterrorClaimOral Hygienist CAN only occur a dentist's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').empty() implies Claim.careTeam.qualification.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty').where(code = 'persoraldentalhygienist').empty()
be-inv-toothNumbererrorClaimBodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').exists() implies (Claim.item.bodySite.coding.empty() or Claim.item.bodySite.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-toothnumber-bodysite') )
be-inv-traineeerrorClaimTrainee CAN only occur in a GP's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'assist').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty()
be-inv-transplantationerrorClaimTransplantation CAN only occur in a specialised medicine attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine').empty() implies Claim.supportingInfo.code.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-transplantation-code').empty()
dom-2errorClaimIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorClaimIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorClaimIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorClaimIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceClaimA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Claim C0..*ClaimClaim, Pre-determination or Pre-authorization
be-inv-eattestation-prescription-standard: Every service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard
be-inv-bodySite: BodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation
be-inv-eattestation-create-cancel: Creation requires empty identifier
be-inv-gmf-holder: GMF holder CAN only occur in a GP's attestation
be-inv-location: The location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization
be-inv-medical-advisor-decision-nr: Medical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations
be-inv-oral-hygienist: Oral Hygienist CAN only occur a dentist's attestation
be-inv-toothNumber: BodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation
be-inv-trainee: Trainee CAN only occur in a GP's attestation
be-inv-transplantation: Transplantation CAN only occur in a specialised medicine attestation
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... supplement S0..1MoneyOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-supplement
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier S0..*IdentifierBusiness Identifier for claim
Slice: Unordered, Open by value:system
.... identifier:eattestid S0..1IdentifierBusiness Identifier for claim
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ1..1uriThe namespace for the identifier value
Fixed Value: https://www.mycarenet.be/eattest
..... value Σ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
... status ?!Σ1..1codeactive | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.


Required Pattern: active
... type Σ1..1CodeableConceptCategory or discipline
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.

.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ1..1CodingCode defined by a terminology system
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subType S1..1CodeableConceptMore granular claim type
Binding: Attestation types (extensible)
... use SΣ1..1codeclaim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.


Required Pattern: claim
... patient SΣ1..1Reference(BePatient)The recipient of the products and services
... billablePeriod Σ0..1PeriodRelevant time frame for the claim
... created Σ1..1dateTimeResource creation date
... enterer S1..1Reference(BePractitionerRole)Author of the claim
... insurer Σ0..1Reference(Organization)Target
... provider SΣ1..1Reference(BePractitionerRole | BeOrganization)Party responsible for the claim
... priority Σ1..1CodeableConceptDesired processing ugency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.

.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ0..*CodingCode defined by a terminology system

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/processpriority
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: stat
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... fundsReserve 0..1CodeableConceptFor whom to reserve funds
Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).

... related 0..*BackboneElementPrior or corollary claims
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... claim 0..1Reference(Claim)Reference to the related claim
.... relationship 0..1CodeableConceptHow the reference claim is related
Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.

.... reference 0..1IdentifierFile or case reference
... prescription 0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Prescription authorizing services and products
... originalPrescription 0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Original prescription if superseded by fulfiller
... payee 0..1BackboneElementRecipient of benefits payable
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type 1..1CodeableConceptCategory of recipient
Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ0..*CodingCode defined by a terminology system

Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/payeetype
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: subscriber
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... party 0..1Reference(BePatient)Recipient reference
... referral 0..1Reference(ServiceRequest)Treatment referral
... facility 0..1Reference(Location)Servicing facility
... careTeam S0..*BackboneElementMembers of the care team
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntOrder of care team
.... provider 1..1Reference(Practitioner | PractitionerRole | Organization)Practitioner or organization
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... reference ΣC0..1stringLiteral reference, Relative, internal or absolute URL
..... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

..... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

...... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

...... system Σ0..1uriThe namespace for the identifier value
Required Pattern: https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi
...... value Σ0..1stringThe value that is unique
Example General: 123456
...... period Σ0..1PeriodTime period when id is/was valid for use
...... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
..... display Σ0..1stringText alternative for the resource
.... responsible 0..1booleanIndicator of the lead practitioner
.... role S1..1CodeableConceptFunction within the team
Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.

.... qualification S1..1CodeableConceptPractitioner credential or specialization
Binding: List of health care parties in Belgium (required)
... supportingInfo S0..*BackboneElementSupporting information
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntInformation instance identifier
.... category 1..1CodeableConceptClassification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.

.... code S0..1CodeableConceptType of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

.... timing[x] 0..1When it occurred
..... timingDatedate
..... timingPeriodPeriod
.... Slices for value[x] 0..1Data to be provided
Slice: Unordered, Open by type:$this
..... valueBooleanboolean
..... valueStringstring
..... valueQuantityQuantity
..... valueAttachmentAttachment
..... valueReferenceReference(Resource)
..... value[x]:valueReference S0..1Reference(Resource)Data to be provided
.... reason 0..1CodeableConceptExplanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

... diagnosis 0..*BackboneElementPertinent diagnosis information
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntDiagnosis instance identifier
.... diagnosis[x] 1..1Nature of illness or problem
Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.

..... diagnosisCodeableConceptCodeableConcept
..... diagnosisReferenceReference(Condition)
.... type 0..*CodeableConceptTiming or nature of the diagnosis
Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.


.... onAdmission 0..1CodeableConceptPresent on admission
Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.

.... packageCode 0..1CodeableConceptPackage billing code
Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.

... procedure 0..*BackboneElementClinical procedures performed
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntProcedure instance identifier
.... type 0..*CodeableConceptCategory of Procedure
Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.


.... date 0..1dateTimeWhen the procedure was performed
.... procedure[x] 1..1Specific clinical procedure
Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.

..... procedureCodeableConceptCodeableConcept
..... procedureReferenceReference(Procedure)
.... udi 0..*Reference(Device)Unique device identifier
... insurance Σ1..*BackboneElementPatient insurance information
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ1..1positiveIntInsurance instance identifier
Required Pattern: 1
.... focal Σ1..1booleanCoverage to be used for adjudication
Required Pattern: true
.... identifier 0..1IdentifierPre-assigned Claim number
.... coverage Σ1..1Reference(Coverage)Insurance information
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... reference ΣC0..1stringLiteral reference, Relative, internal or absolute URL
..... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

..... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
..... display Σ0..1stringText alternative for the resource
Required Pattern: use of mandatory insurance coverage, no further details provided here.
.... businessArrangement 0..1stringAdditional provider contract number
.... preAuthRef 0..*stringPrior authorization reference number
.... claimResponse 0..1Reference(ClaimResponse)Adjudication results
... accident 0..1BackboneElementDetails of the event
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... date 1..1dateWhen the incident occurred
.... type 0..1CodeableConceptThe nature of the accident
Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc.

.... location[x] 0..1Where the event occurred
..... locationAddressAddress
..... locationReferenceReference(Location)
... item S0..*BackboneElementProduct or service provided
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... eid S0..1(Complex)BeExtPatientIdentityDocument
URL: https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/StructureDefinition/be-ext-patientidentitydocument
.... preAuthRef S0..1stringOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref
.... supplement S0..1MoneyOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-supplement
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntItem instance identifier
.... careTeamSequence S1..*positiveIntApplicable careTeam members
.... diagnosisSequence 0..*positiveIntApplicable diagnoses
.... procedureSequence 0..*positiveIntApplicable procedures
.... informationSequence S0..*positiveIntApplicable exception and supporting information
.... revenue 0..1CodeableConceptRevenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

.... category 0..1CodeableConceptBenefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

.... productOrService S1..1CodeableConceptBilling, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ1..1uriIdentity of the terminology system
Required Pattern: https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... modifier 0..*CodeableConceptProduct or service billing modifiers
Binding: ModifierTypeCodes (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.


.... programCode 0..*CodeableConceptProgram the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


.... Slices for serviced[x] 1..1dateDate or dates of service or product delivery
Slice: Unordered, Closed by type:$this
..... serviced[x]:servicedDate S1..1dateDate or dates of service or product delivery
.... Slices for location[x] 0..1Place of service or where product was supplied
Slice: Unordered, Open by type:$this
Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.

..... locationCodeableConceptCodeableConcept
..... locationAddressAddress
..... locationReferenceReference(Location)
..... location[x]:locationReference S0..1Reference(Location)Place of service or where product was supplied
.... quantity S1..1SimpleQuantityCount of products or services
.... unitPrice S1..1MoneyFee, charge or cost per item
.... factor 0..1decimalPrice scaling factor
.... net S1..1MoneyTotal item cost
.... udi 0..*Reference(Device)Unique device identifier
.... bodySite S0..1CodeableConceptAnatomical location
Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.

..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... bodyLaterality S0..1CodingBeExtLaterality
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality
Binding: Laterality (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..0
...... url 1..1uri"https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality"
...... value[x] 0..1CodingValue of extension
Binding: Basic Laterality (required)
..... coding Σ0..*CodingCode defined by a terminology system
Binding: Body Site (required)
..... text Σ0..1stringPlain text representation of the concept
.... subSite 0..*CodeableConceptAnatomical sub-location
Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.


.... encounter 0..*Reference(Encounter)Encounters related to this billed item
.... detail 0..*BackboneElementProduct or service provided
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence 1..1positiveIntItem instance identifier
..... revenue 0..1CodeableConceptRevenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

..... category 0..1CodeableConceptBenefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

..... productOrService 1..1CodeableConceptBilling, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.

..... modifier 0..*CodeableConceptService/Product billing modifiers
Binding: ModifierTypeCodes (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.


..... programCode 0..*CodeableConceptProgram the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


..... quantity 0..1SimpleQuantityCount of products or services
..... unitPrice 0..1MoneyFee, charge or cost per item
..... factor 0..1decimalPrice scaling factor
..... net 0..1MoneyTotal item cost
..... udi 0..*Reference(Device)Unique device identifier
..... subDetail 0..*BackboneElementProduct or service provided
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... sequence 1..1positiveIntItem instance identifier
...... revenue 0..1CodeableConceptRevenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

...... category 0..1CodeableConceptBenefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

...... productOrService 1..1CodeableConceptBilling, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.

...... modifier 0..*CodeableConceptService/Product billing modifiers
Binding: ModifierTypeCodes (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.


...... programCode 0..*CodeableConceptProgram the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


...... quantity 0..1SimpleQuantityCount of products or services
...... unitPrice 0..1MoneyFee, charge or cost per item
...... factor 0..1decimalPrice scaling factor
...... net 0..1MoneyTotal item cost
...... udi 0..*Reference(Device)Unique device identifier
... total S0..1MoneyTotal claim cost

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Claim.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Claim.identifier:eattestid.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Claim.identifier:eattestid.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Claim.statusrequiredPattern: active
http://hl7.org/fhir/ValueSet/fm-status|4.0.1
from the FHIR Standard
Claim.typeextensibleClaimTypeCodes
http://hl7.org/fhir/ValueSet/claim-type
from the FHIR Standard
Claim.subTypeextensibleBeVSEattestationTypes (a valid code from Attestation types)
https://www.ehealth.fgov.be/standards/fhir/eattestation/ValueSet/be-vs-eattestationtypes
from this IG
Claim.userequiredPattern: claim
http://hl7.org/fhir/ValueSet/claim-use|4.0.1
from the FHIR Standard
Claim.priorityexampleProcessPriorityCodes
http://hl7.org/fhir/ValueSet/process-priority
from the FHIR Standard
Claim.fundsReserveexampleFunds Reservation Codes
http://hl7.org/fhir/ValueSet/fundsreserve
from the FHIR Standard
Claim.related.relationshipexampleExampleRelatedClaimRelationshipCodes
http://hl7.org/fhir/ValueSet/related-claim-relationship
from the FHIR Standard
Claim.payee.typeexampleClaim Payee Type Codes
http://hl7.org/fhir/ValueSet/payeetype
from the FHIR Standard
Claim.careTeam.provider.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Claim.careTeam.provider.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Claim.careTeam.provider.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Claim.careTeam.roleexampleClaimCareTeamRoleCodes
http://hl7.org/fhir/ValueSet/claim-careteamrole
from the FHIR Standard
Claim.careTeam.qualificationrequiredBeVSCdHcParty
https://www.ehealth.fgov.be/standards/fhir/core/ValueSet/be-vs-cd-hcparty
Claim.supportingInfo.categoryexampleClaimInformationCategoryCodes
http://hl7.org/fhir/ValueSet/claim-informationcategory
from the FHIR Standard
Claim.supportingInfo.codeexampleExceptionCodes
http://hl7.org/fhir/ValueSet/claim-exception
from the FHIR Standard
Claim.supportingInfo.reasonexampleMissingToothReasonCodes
http://hl7.org/fhir/ValueSet/missing-tooth-reason
from the FHIR Standard
Claim.diagnosis.diagnosis[x]exampleICD-10Codes
http://hl7.org/fhir/ValueSet/icd-10
from the FHIR Standard
Claim.diagnosis.typeexampleExampleDiagnosisTypeCodes
http://hl7.org/fhir/ValueSet/ex-diagnosistype
from the FHIR Standard
Claim.diagnosis.onAdmissionexampleExampleDiagnosisOnAdmissionCodes
http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission
from the FHIR Standard
Claim.diagnosis.packageCodeexampleExampleDiagnosisRelatedGroupCodes
http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup
from the FHIR Standard
Claim.procedure.typeexampleExampleProcedureTypeCodes
http://hl7.org/fhir/ValueSet/ex-procedure-type
from the FHIR Standard
Claim.procedure.procedure[x]exampleICD-10ProcedureCodes
http://hl7.org/fhir/ValueSet/icd-10-procedures
from the FHIR Standard
Claim.insurance.coverage.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Claim.accident.typeextensibleActIncidentCode
http://terminology.hl7.org/ValueSet/v3-ActIncidentCode
Claim.item.revenueexampleExampleRevenueCenterCodes
http://hl7.org/fhir/ValueSet/ex-revenue-center
from the FHIR Standard
Claim.item.categoryexampleBenefitCategoryCodes
http://hl7.org/fhir/ValueSet/ex-benefitcategory
from the FHIR Standard
Claim.item.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard
Claim.item.modifierexampleModifierTypeCodes
http://hl7.org/fhir/ValueSet/claim-modifiers
from the FHIR Standard
Claim.item.programCodeexampleExampleProgramReasonCodes
http://hl7.org/fhir/ValueSet/ex-program-code
from the FHIR Standard
Claim.item.location[x]exampleExampleServicePlaceCodes
http://hl7.org/fhir/ValueSet/service-place
from the FHIR Standard
Claim.item.bodySiteexampleOralSiteCodes
http://hl7.org/fhir/ValueSet/tooth
from the FHIR Standard
Claim.item.bodySite.extension:bodyLaterality.value[x]requiredBeVSBasicLaterality
https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-basic-laterality
Claim.item.bodySite.codingrequiredBeVSBodySite
https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-bodysite
Claim.item.subSiteexampleSurfaceCodes
http://hl7.org/fhir/ValueSet/surface
from the FHIR Standard
Claim.item.detail.revenueexampleExampleRevenueCenterCodes
http://hl7.org/fhir/ValueSet/ex-revenue-center
from the FHIR Standard
Claim.item.detail.categoryexampleBenefitCategoryCodes
http://hl7.org/fhir/ValueSet/ex-benefitcategory
from the FHIR Standard
Claim.item.detail.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard
Claim.item.detail.modifierexampleModifierTypeCodes
http://hl7.org/fhir/ValueSet/claim-modifiers
from the FHIR Standard
Claim.item.detail.programCodeexampleExampleProgramReasonCodes
http://hl7.org/fhir/ValueSet/ex-program-code
from the FHIR Standard
Claim.item.detail.subDetail.revenueexampleExampleRevenueCenterCodes
http://hl7.org/fhir/ValueSet/ex-revenue-center
from the FHIR Standard
Claim.item.detail.subDetail.categoryexampleBenefitCategoryCodes
http://hl7.org/fhir/ValueSet/ex-benefitcategory
from the FHIR Standard
Claim.item.detail.subDetail.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard
Claim.item.detail.subDetail.modifierexampleModifierTypeCodes
http://hl7.org/fhir/ValueSet/claim-modifiers
from the FHIR Standard
Claim.item.detail.subDetail.programCodeexampleExampleProgramReasonCodes
http://hl7.org/fhir/ValueSet/ex-program-code
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
be-inv-bodySiteerrorClaimBodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine' or code = 'dentistry').empty() implies Claim.item.bodySite.empty()
be-inv-eattestation-create-cancelerrorClaimCreation requires empty identifier
: Claim.identifier.where(system = 'https://www.mycarenet.be/eattest').empty().not() implies Claim.item.empty() and Claim.total.empty() and Claim.careTeam.empty()
be-inv-eattestation-prescription-standarderrorClaimEvery service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard
: supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).extension('https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-prescription-requester-standard').count() = supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).count()
be-inv-gmf-holdererrorClaimGMF holder CAN only occur in a GP's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'other').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty()
be-inv-locationerrorClaimThe location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization
: Claim.item.(location as Reference).empty().not() implies ( Claim.item.(location as Reference).resolve().type.memberOf('https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd') or Claim.item.(location as Reference).resolve().managingOrganization.resolve().identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') or Claim.item.(location as Reference).resolve().managingOrganization.identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') )
be-inv-medical-advisor-decision-nrerrorClaimMedical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').exists() implies Claim.item.count() <= Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').count() and Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').empty() implies Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').empty()
be-inv-oral-hygienisterrorClaimOral Hygienist CAN only occur a dentist's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').empty() implies Claim.careTeam.qualification.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty').where(code = 'persoraldentalhygienist').empty()
be-inv-toothNumbererrorClaimBodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').exists() implies (Claim.item.bodySite.coding.empty() or Claim.item.bodySite.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-toothnumber-bodysite') )
be-inv-traineeerrorClaimTrainee CAN only occur in a GP's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'assist').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty()
be-inv-transplantationerrorClaimTransplantation CAN only occur in a specialised medicine attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine').empty() implies Claim.supportingInfo.code.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-transplantation-code').empty()
dom-2errorClaimIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorClaimIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorClaimIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorClaimIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceClaimA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from Claim

Summary

Mandatory: 5 elements (13 nested mandatory elements)
Must-Support: 32 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Claim.identifier is sliced based on the value of value:system
  • The element Claim.supportingInfo.value[x] is sliced based on the value of type:$this
  • The element Claim.item.serviced[x] is sliced based on the value of type:$this
  • The element Claim.item.location[x] is sliced based on the value of type:$this

Differential View

This structure is derived from Claim

NameFlagsCard.TypeDescription & Constraintsdoco
.. Claim C0..*ClaimClaim, Pre-determination or Pre-authorization
be-inv-eattestation-prescription-standard: Every service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard
be-inv-bodySite: BodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation
be-inv-eattestation-create-cancel: Creation requires empty identifier
be-inv-gmf-holder: GMF holder CAN only occur in a GP's attestation
be-inv-location: The location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization
be-inv-medical-advisor-decision-nr: Medical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations
be-inv-oral-hygienist: Oral Hygienist CAN only occur a dentist's attestation
be-inv-toothNumber: BodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation
be-inv-trainee: Trainee CAN only occur in a GP's attestation
be-inv-transplantation: Transplantation CAN only occur in a specialised medicine attestation
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... supplement S0..1MoneyOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-supplement
... Slices for identifier S0..*IdentifierBusiness Identifier for claim
Slice: Unordered, Open by value:system
.... identifier:eattestid S0..1IdentifierBusiness Identifier for claim
..... system 1..1uriThe namespace for the identifier value
Fixed Value: https://www.mycarenet.be/eattest
..... value 1..1stringThe value that is unique
... type
.... coding 1..1CodingCode defined by a terminology system
..... system 1..1uriIdentity of the terminology system
..... code 1..1codeSymbol in syntax defined by the system
... subType S1..1CodeableConceptMore granular claim type
Binding: Attestation types (extensible)
... use S1..1codeclaim | preauthorization | predetermination
Required Pattern: claim
... patient S1..1Reference(BePatient)The recipient of the products and services
... enterer S1..1Reference(BePractitionerRole)Author of the claim
... provider S1..1Reference(BePractitionerRole | BeOrganization)Party responsible for the claim
... priority
.... coding 0..*CodingCode defined by a terminology system
Required Pattern: At least the following
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/processpriority
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: stat
... payee
.... type
..... coding 0..*CodingCode defined by a terminology system
Required Pattern: At least the following
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/payeetype
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: subscriber
.... party 0..1Reference(BePatient)Recipient reference
... careTeam S0..*BackboneElementMembers of the care team
.... provider
..... identifier
...... system 0..1uriThe namespace for the identifier value
Required Pattern: https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi
.... role S1..1CodeableConceptFunction within the team
.... qualification S1..1CodeableConceptPractitioner credential or specialization
Binding: List of health care parties in Belgium (required)
... supportingInfo S0..*BackboneElementSupporting information
.... code S0..1CodeableConceptType of information
.... Slices for value[x] 0..1boolean, string, Quantity, Attachment, Reference(Resource)Data to be provided
Slice: Unordered, Open by type:$this
..... value[x]:valueReference S0..1Reference(Resource)Data to be provided
... insurance
.... sequence 1..1positiveIntInsurance instance identifier
Required Pattern: 1
.... focal 1..1booleanCoverage to be used for adjudication
Required Pattern: true
.... coverage
..... display 0..1stringText alternative for the resource
Required Pattern: use of mandatory insurance coverage, no further details provided here.
... item S0..*BackboneElementProduct or service provided
.... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... eid S0..1(Complex)BeExtPatientIdentityDocument
URL: https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/StructureDefinition/be-ext-patientidentitydocument
.... preAuthRef S0..1stringOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref
.... supplement S0..1MoneyOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-supplement
.... careTeamSequence S1..*positiveIntApplicable careTeam members
.... informationSequence S0..*positiveIntApplicable exception and supporting information
.... productOrService S1..1CodeableConceptBilling, service, product, or drug code
..... coding S1..1CodingCode defined by a terminology system
...... system S1..1uriIdentity of the terminology system
Required Pattern: https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature
...... code S1..1codeSymbol in syntax defined by the system
.... Slices for serviced[x] 1..1dateDate or dates of service or product delivery
Slice: Unordered, Open by type:$this
..... serviced[x]:servicedDate S1..1dateDate or dates of service or product delivery
.... Slices for location[x] 0..1CodeableConcept, Address, Reference(Location)Place of service or where product was supplied
Slice: Unordered, Open by type:$this
..... location[x]:locationReference S0..1Reference(Location)Place of service or where product was supplied
.... quantity S1..1SimpleQuantityCount of products or services
.... unitPrice S1..1MoneyFee, charge or cost per item
.... net S1..1MoneyTotal item cost
.... bodySite S0..1CodeableConceptAnatomical location
..... bodyLaterality S0..1CodingBeExtLaterality
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality
Binding: Laterality (required)
...... value[x] 0..1CodingValue of extension
Binding: Basic Laterality (required)
..... coding 0..*CodingCode defined by a terminology system
Binding: Body Site (required)
... total S0..1MoneyTotal claim cost

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Claim.subTypeextensibleBeVSEattestationTypes (a valid code from Attestation types)
https://www.ehealth.fgov.be/standards/fhir/eattestation/ValueSet/be-vs-eattestationtypes
from this IG
Claim.careTeam.qualificationrequiredBeVSCdHcParty
https://www.ehealth.fgov.be/standards/fhir/core/ValueSet/be-vs-cd-hcparty
Claim.item.bodySite.extension:bodyLaterality.value[x]requiredBeVSBasicLaterality
https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-basic-laterality
Claim.item.bodySite.codingrequiredBeVSBodySite
https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-bodysite

Constraints

IdGradePath(s)DetailsRequirements
be-inv-bodySiteerrorClaimBodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine' or code = 'dentistry').empty() implies Claim.item.bodySite.empty()
be-inv-eattestation-create-cancelerrorClaimCreation requires empty identifier
: Claim.identifier.where(system = 'https://www.mycarenet.be/eattest').empty().not() implies Claim.item.empty() and Claim.total.empty() and Claim.careTeam.empty()
be-inv-eattestation-prescription-standarderrorClaimEvery service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard
: supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).extension('https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-prescription-requester-standard').count() = supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).count()
be-inv-gmf-holdererrorClaimGMF holder CAN only occur in a GP's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'other').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty()
be-inv-locationerrorClaimThe location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization
: Claim.item.(location as Reference).empty().not() implies ( Claim.item.(location as Reference).resolve().type.memberOf('https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd') or Claim.item.(location as Reference).resolve().managingOrganization.resolve().identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') or Claim.item.(location as Reference).resolve().managingOrganization.identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') )
be-inv-medical-advisor-decision-nrerrorClaimMedical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').exists() implies Claim.item.count() <= Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').count() and Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').empty() implies Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').empty()
be-inv-oral-hygienisterrorClaimOral Hygienist CAN only occur a dentist's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').empty() implies Claim.careTeam.qualification.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty').where(code = 'persoraldentalhygienist').empty()
be-inv-toothNumbererrorClaimBodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').exists() implies (Claim.item.bodySite.coding.empty() or Claim.item.bodySite.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-toothnumber-bodysite') )
be-inv-traineeerrorClaimTrainee CAN only occur in a GP's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'assist').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty()
be-inv-transplantationerrorClaimTransplantation CAN only occur in a specialised medicine attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine').empty() implies Claim.supportingInfo.code.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-transplantation-code').empty()

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Claim C0..*ClaimClaim, Pre-determination or Pre-authorization
be-inv-eattestation-prescription-standard: Every service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard
be-inv-bodySite: BodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation
be-inv-eattestation-create-cancel: Creation requires empty identifier
be-inv-gmf-holder: GMF holder CAN only occur in a GP's attestation
be-inv-location: The location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization
be-inv-medical-advisor-decision-nr: Medical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations
be-inv-oral-hygienist: Oral Hygienist CAN only occur a dentist's attestation
be-inv-toothNumber: BodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation
be-inv-trainee: Trainee CAN only occur in a GP's attestation
be-inv-transplantation: Transplantation CAN only occur in a specialised medicine attestation
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... supplement S0..1MoneyOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-supplement
... Slices for identifier S0..*IdentifierBusiness Identifier for claim
Slice: Unordered, Open by value:system
.... identifier:eattestid S0..1IdentifierBusiness Identifier for claim
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... system Σ1..1uriThe namespace for the identifier value
Fixed Value: https://www.mycarenet.be/eattest
..... value Σ1..1stringThe value that is unique
Example General: 123456
... status ?!Σ1..1codeactive | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.


Required Pattern: active
... type Σ1..1CodeableConceptCategory or discipline
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.

.... coding Σ1..1CodingCode defined by a terminology system
..... system Σ1..1uriIdentity of the terminology system
..... code Σ1..1codeSymbol in syntax defined by the system
... subType S1..1CodeableConceptMore granular claim type
Binding: Attestation types (extensible)
... use SΣ1..1codeclaim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.


Required Pattern: claim
... patient SΣ1..1Reference(BePatient)The recipient of the products and services
... created Σ1..1dateTimeResource creation date
... enterer S1..1Reference(BePractitionerRole)Author of the claim
... provider SΣ1..1Reference(BePractitionerRole | BeOrganization)Party responsible for the claim
... priority Σ1..1CodeableConceptDesired processing ugency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.

.... coding Σ0..*CodingCode defined by a terminology system

Required Pattern: At least the following
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/processpriority
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: stat
... careTeam S0..*BackboneElementMembers of the care team
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntOrder of care team
.... provider 1..1Reference(Practitioner | PractitionerRole | Organization)Practitioner or organization
.... role S1..1CodeableConceptFunction within the team
Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.

.... qualification S1..1CodeableConceptPractitioner credential or specialization
Binding: List of health care parties in Belgium (required)
... supportingInfo S0..*BackboneElementSupporting information
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntInformation instance identifier
.... category 1..1CodeableConceptClassification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.

.... code S0..1CodeableConceptType of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

.... Slices for value[x] 0..1Data to be provided
Slice: Unordered, Open by type:$this
..... valueBooleanboolean
..... valueStringstring
..... valueQuantityQuantity
..... valueAttachmentAttachment
..... valueReferenceReference(Resource)
..... value[x]:valueReference S0..1Reference(Resource)Data to be provided
... insurance Σ1..*BackboneElementPatient insurance information
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ1..1positiveIntInsurance instance identifier
Required Pattern: 1
.... focal Σ1..1booleanCoverage to be used for adjudication
Required Pattern: true
.... coverage Σ1..1Reference(Coverage)Insurance information
..... display Σ0..1stringText alternative for the resource
Required Pattern: use of mandatory insurance coverage, no further details provided here.
... item S0..*BackboneElementProduct or service provided
.... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... eid S0..1(Complex)BeExtPatientIdentityDocument
URL: https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/StructureDefinition/be-ext-patientidentitydocument
.... preAuthRef S0..1stringOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref
.... supplement S0..1MoneyOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-supplement
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntItem instance identifier
.... careTeamSequence S1..*positiveIntApplicable careTeam members
.... informationSequence S0..*positiveIntApplicable exception and supporting information
.... productOrService S1..1CodeableConceptBilling, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.

..... coding SΣ1..1CodingCode defined by a terminology system
...... system SΣ1..1uriIdentity of the terminology system
Required Pattern: https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature
...... code SΣ1..1codeSymbol in syntax defined by the system
.... Slices for serviced[x] 1..1dateDate or dates of service or product delivery
Slice: Unordered, Closed by type:$this
..... serviced[x]:servicedDate S1..1dateDate or dates of service or product delivery
.... Slices for location[x] 0..1Place of service or where product was supplied
Slice: Unordered, Open by type:$this
Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.

..... locationCodeableConceptCodeableConcept
..... locationAddressAddress
..... locationReferenceReference(Location)
..... location[x]:locationReference S0..1Reference(Location)Place of service or where product was supplied
.... quantity S1..1SimpleQuantityCount of products or services
.... unitPrice S1..1MoneyFee, charge or cost per item
.... net S1..1MoneyTotal item cost
.... bodySite S0..1CodeableConceptAnatomical location
Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.

..... bodyLaterality S0..1CodingBeExtLaterality
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality
Binding: Laterality (required)
...... extension 0..0
...... url 1..1uri"https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality"
...... value[x] 0..1CodingValue of extension
Binding: Basic Laterality (required)
..... coding Σ0..*CodingCode defined by a terminology system
Binding: Body Site (required)
... total S0..1MoneyTotal claim cost

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Claim.identifier:eattestid.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Claim.statusrequiredPattern: active
http://hl7.org/fhir/ValueSet/fm-status|4.0.1
from the FHIR Standard
Claim.typeextensibleClaimTypeCodes
http://hl7.org/fhir/ValueSet/claim-type
from the FHIR Standard
Claim.subTypeextensibleBeVSEattestationTypes (a valid code from Attestation types)
https://www.ehealth.fgov.be/standards/fhir/eattestation/ValueSet/be-vs-eattestationtypes
from this IG
Claim.userequiredPattern: claim
http://hl7.org/fhir/ValueSet/claim-use|4.0.1
from the FHIR Standard
Claim.priorityexampleProcessPriorityCodes
http://hl7.org/fhir/ValueSet/process-priority
from the FHIR Standard
Claim.careTeam.roleexampleClaimCareTeamRoleCodes
http://hl7.org/fhir/ValueSet/claim-careteamrole
from the FHIR Standard
Claim.careTeam.qualificationrequiredBeVSCdHcParty
https://www.ehealth.fgov.be/standards/fhir/core/ValueSet/be-vs-cd-hcparty
Claim.supportingInfo.categoryexampleClaimInformationCategoryCodes
http://hl7.org/fhir/ValueSet/claim-informationcategory
from the FHIR Standard
Claim.supportingInfo.codeexampleExceptionCodes
http://hl7.org/fhir/ValueSet/claim-exception
from the FHIR Standard
Claim.item.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard
Claim.item.location[x]exampleExampleServicePlaceCodes
http://hl7.org/fhir/ValueSet/service-place
from the FHIR Standard
Claim.item.bodySiteexampleOralSiteCodes
http://hl7.org/fhir/ValueSet/tooth
from the FHIR Standard
Claim.item.bodySite.extension:bodyLaterality.value[x]requiredBeVSBasicLaterality
https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-basic-laterality
Claim.item.bodySite.codingrequiredBeVSBodySite
https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-bodysite

Constraints

IdGradePath(s)DetailsRequirements
be-inv-bodySiteerrorClaimBodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine' or code = 'dentistry').empty() implies Claim.item.bodySite.empty()
be-inv-eattestation-create-cancelerrorClaimCreation requires empty identifier
: Claim.identifier.where(system = 'https://www.mycarenet.be/eattest').empty().not() implies Claim.item.empty() and Claim.total.empty() and Claim.careTeam.empty()
be-inv-eattestation-prescription-standarderrorClaimEvery service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard
: supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).extension('https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-prescription-requester-standard').count() = supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).count()
be-inv-gmf-holdererrorClaimGMF holder CAN only occur in a GP's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'other').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty()
be-inv-locationerrorClaimThe location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization
: Claim.item.(location as Reference).empty().not() implies ( Claim.item.(location as Reference).resolve().type.memberOf('https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd') or Claim.item.(location as Reference).resolve().managingOrganization.resolve().identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') or Claim.item.(location as Reference).resolve().managingOrganization.identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') )
be-inv-medical-advisor-decision-nrerrorClaimMedical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').exists() implies Claim.item.count() <= Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').count() and Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').empty() implies Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').empty()
be-inv-oral-hygienisterrorClaimOral Hygienist CAN only occur a dentist's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').empty() implies Claim.careTeam.qualification.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty').where(code = 'persoraldentalhygienist').empty()
be-inv-toothNumbererrorClaimBodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').exists() implies (Claim.item.bodySite.coding.empty() or Claim.item.bodySite.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-toothnumber-bodysite') )
be-inv-traineeerrorClaimTrainee CAN only occur in a GP's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'assist').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty()
be-inv-transplantationerrorClaimTransplantation CAN only occur in a specialised medicine attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine').empty() implies Claim.supportingInfo.code.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-transplantation-code').empty()
dom-2errorClaimIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorClaimIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorClaimIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorClaimIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceClaimA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Claim C0..*ClaimClaim, Pre-determination or Pre-authorization
be-inv-eattestation-prescription-standard: Every service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard
be-inv-bodySite: BodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation
be-inv-eattestation-create-cancel: Creation requires empty identifier
be-inv-gmf-holder: GMF holder CAN only occur in a GP's attestation
be-inv-location: The location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization
be-inv-medical-advisor-decision-nr: Medical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations
be-inv-oral-hygienist: Oral Hygienist CAN only occur a dentist's attestation
be-inv-toothNumber: BodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation
be-inv-trainee: Trainee CAN only occur in a GP's attestation
be-inv-transplantation: Transplantation CAN only occur in a specialised medicine attestation
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... supplement S0..1MoneyOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-supplement
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier S0..*IdentifierBusiness Identifier for claim
Slice: Unordered, Open by value:system
.... identifier:eattestid S0..1IdentifierBusiness Identifier for claim
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ1..1uriThe namespace for the identifier value
Fixed Value: https://www.mycarenet.be/eattest
..... value Σ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
... status ?!Σ1..1codeactive | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.


Required Pattern: active
... type Σ1..1CodeableConceptCategory or discipline
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.

.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ1..1CodingCode defined by a terminology system
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ1..1uriIdentity of the terminology system
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subType S1..1CodeableConceptMore granular claim type
Binding: Attestation types (extensible)
... use SΣ1..1codeclaim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.


Required Pattern: claim
... patient SΣ1..1Reference(BePatient)The recipient of the products and services
... billablePeriod Σ0..1PeriodRelevant time frame for the claim
... created Σ1..1dateTimeResource creation date
... enterer S1..1Reference(BePractitionerRole)Author of the claim
... insurer Σ0..1Reference(Organization)Target
... provider SΣ1..1Reference(BePractitionerRole | BeOrganization)Party responsible for the claim
... priority Σ1..1CodeableConceptDesired processing ugency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.

.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ0..*CodingCode defined by a terminology system

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/processpriority
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: stat
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... fundsReserve 0..1CodeableConceptFor whom to reserve funds
Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).

... related 0..*BackboneElementPrior or corollary claims
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... claim 0..1Reference(Claim)Reference to the related claim
.... relationship 0..1CodeableConceptHow the reference claim is related
Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.

.... reference 0..1IdentifierFile or case reference
... prescription 0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Prescription authorizing services and products
... originalPrescription 0..1Reference(DeviceRequest | MedicationRequest | VisionPrescription)Original prescription if superseded by fulfiller
... payee 0..1BackboneElementRecipient of benefits payable
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type 1..1CodeableConceptCategory of recipient
Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ0..*CodingCode defined by a terminology system

Required Pattern: At least the following
...... id0..1stringUnique id for inter-element referencing
...... extension0..*ExtensionAdditional content defined by implementations
...... system1..1uriIdentity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/payeetype
...... version0..1stringVersion of the system - if relevant
...... code1..1codeSymbol in syntax defined by the system
Fixed Value: subscriber
...... display0..1stringRepresentation defined by the system
...... userSelected0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... party 0..1Reference(BePatient)Recipient reference
... referral 0..1Reference(ServiceRequest)Treatment referral
... facility 0..1Reference(Location)Servicing facility
... careTeam S0..*BackboneElementMembers of the care team
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntOrder of care team
.... provider 1..1Reference(Practitioner | PractitionerRole | Organization)Practitioner or organization
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... reference ΣC0..1stringLiteral reference, Relative, internal or absolute URL
..... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

..... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

...... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

...... system Σ0..1uriThe namespace for the identifier value
Required Pattern: https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi
...... value Σ0..1stringThe value that is unique
Example General: 123456
...... period Σ0..1PeriodTime period when id is/was valid for use
...... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
..... display Σ0..1stringText alternative for the resource
.... responsible 0..1booleanIndicator of the lead practitioner
.... role S1..1CodeableConceptFunction within the team
Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.

.... qualification S1..1CodeableConceptPractitioner credential or specialization
Binding: List of health care parties in Belgium (required)
... supportingInfo S0..*BackboneElementSupporting information
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntInformation instance identifier
.... category 1..1CodeableConceptClassification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.

.... code S0..1CodeableConceptType of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

.... timing[x] 0..1When it occurred
..... timingDatedate
..... timingPeriodPeriod
.... Slices for value[x] 0..1Data to be provided
Slice: Unordered, Open by type:$this
..... valueBooleanboolean
..... valueStringstring
..... valueQuantityQuantity
..... valueAttachmentAttachment
..... valueReferenceReference(Resource)
..... value[x]:valueReference S0..1Reference(Resource)Data to be provided
.... reason 0..1CodeableConceptExplanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

... diagnosis 0..*BackboneElementPertinent diagnosis information
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntDiagnosis instance identifier
.... diagnosis[x] 1..1Nature of illness or problem
Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.

..... diagnosisCodeableConceptCodeableConcept
..... diagnosisReferenceReference(Condition)
.... type 0..*CodeableConceptTiming or nature of the diagnosis
Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.


.... onAdmission 0..1CodeableConceptPresent on admission
Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.

.... packageCode 0..1CodeableConceptPackage billing code
Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.

... procedure 0..*BackboneElementClinical procedures performed
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntProcedure instance identifier
.... type 0..*CodeableConceptCategory of Procedure
Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.


.... date 0..1dateTimeWhen the procedure was performed
.... procedure[x] 1..1Specific clinical procedure
Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.

..... procedureCodeableConceptCodeableConcept
..... procedureReferenceReference(Procedure)
.... udi 0..*Reference(Device)Unique device identifier
... insurance Σ1..*BackboneElementPatient insurance information
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence Σ1..1positiveIntInsurance instance identifier
Required Pattern: 1
.... focal Σ1..1booleanCoverage to be used for adjudication
Required Pattern: true
.... identifier 0..1IdentifierPre-assigned Claim number
.... coverage Σ1..1Reference(Coverage)Insurance information
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... reference ΣC0..1stringLiteral reference, Relative, internal or absolute URL
..... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

..... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
..... display Σ0..1stringText alternative for the resource
Required Pattern: use of mandatory insurance coverage, no further details provided here.
.... businessArrangement 0..1stringAdditional provider contract number
.... preAuthRef 0..*stringPrior authorization reference number
.... claimResponse 0..1Reference(ClaimResponse)Adjudication results
... accident 0..1BackboneElementDetails of the event
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... date 1..1dateWhen the incident occurred
.... type 0..1CodeableConceptThe nature of the accident
Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc.

.... location[x] 0..1Where the event occurred
..... locationAddressAddress
..... locationReferenceReference(Location)
... item S0..*BackboneElementProduct or service provided
.... id 0..1stringUnique id for inter-element referencing
.... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... eid S0..1(Complex)BeExtPatientIdentityDocument
URL: https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/StructureDefinition/be-ext-patientidentitydocument
.... preAuthRef S0..1stringOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref
.... supplement S0..1MoneyOptional Extensions Element
URL: https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-supplement
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... sequence 1..1positiveIntItem instance identifier
.... careTeamSequence S1..*positiveIntApplicable careTeam members
.... diagnosisSequence 0..*positiveIntApplicable diagnoses
.... procedureSequence 0..*positiveIntApplicable procedures
.... informationSequence S0..*positiveIntApplicable exception and supporting information
.... revenue 0..1CodeableConceptRevenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

.... category 0..1CodeableConceptBenefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

.... productOrService S1..1CodeableConceptBilling, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ1..1uriIdentity of the terminology system
Required Pattern: https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeSymbol in syntax defined by the system
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... modifier 0..*CodeableConceptProduct or service billing modifiers
Binding: ModifierTypeCodes (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.


.... programCode 0..*CodeableConceptProgram the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


.... Slices for serviced[x] 1..1dateDate or dates of service or product delivery
Slice: Unordered, Closed by type:$this
..... serviced[x]:servicedDate S1..1dateDate or dates of service or product delivery
.... Slices for location[x] 0..1Place of service or where product was supplied
Slice: Unordered, Open by type:$this
Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.

..... locationCodeableConceptCodeableConcept
..... locationAddressAddress
..... locationReferenceReference(Location)
..... location[x]:locationReference S0..1Reference(Location)Place of service or where product was supplied
.... quantity S1..1SimpleQuantityCount of products or services
.... unitPrice S1..1MoneyFee, charge or cost per item
.... factor 0..1decimalPrice scaling factor
.... net S1..1MoneyTotal item cost
.... udi 0..*Reference(Device)Unique device identifier
.... bodySite S0..1CodeableConceptAnatomical location
Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.

..... id 0..1stringUnique id for inter-element referencing
..... Slices for extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... bodyLaterality S0..1CodingBeExtLaterality
URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality
Binding: Laterality (required)
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..0
...... url 1..1uri"https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality"
...... value[x] 0..1CodingValue of extension
Binding: Basic Laterality (required)
..... coding Σ0..*CodingCode defined by a terminology system
Binding: Body Site (required)
..... text Σ0..1stringPlain text representation of the concept
.... subSite 0..*CodeableConceptAnatomical sub-location
Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.


.... encounter 0..*Reference(Encounter)Encounters related to this billed item
.... detail 0..*BackboneElementProduct or service provided
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... sequence 1..1positiveIntItem instance identifier
..... revenue 0..1CodeableConceptRevenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

..... category 0..1CodeableConceptBenefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

..... productOrService 1..1CodeableConceptBilling, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.

..... modifier 0..*CodeableConceptService/Product billing modifiers
Binding: ModifierTypeCodes (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.


..... programCode 0..*CodeableConceptProgram the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


..... quantity 0..1SimpleQuantityCount of products or services
..... unitPrice 0..1MoneyFee, charge or cost per item
..... factor 0..1decimalPrice scaling factor
..... net 0..1MoneyTotal item cost
..... udi 0..*Reference(Device)Unique device identifier
..... subDetail 0..*BackboneElementProduct or service provided
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... sequence 1..1positiveIntItem instance identifier
...... revenue 0..1CodeableConceptRevenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

...... category 0..1CodeableConceptBenefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

...... productOrService 1..1CodeableConceptBilling, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.

...... modifier 0..*CodeableConceptService/Product billing modifiers
Binding: ModifierTypeCodes (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.


...... programCode 0..*CodeableConceptProgram the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.


...... quantity 0..1SimpleQuantityCount of products or services
...... unitPrice 0..1MoneyFee, charge or cost per item
...... factor 0..1decimalPrice scaling factor
...... net 0..1MoneyTotal item cost
...... udi 0..*Reference(Device)Unique device identifier
... total S0..1MoneyTotal claim cost

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Claim.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Claim.identifier:eattestid.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Claim.identifier:eattestid.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Claim.statusrequiredPattern: active
http://hl7.org/fhir/ValueSet/fm-status|4.0.1
from the FHIR Standard
Claim.typeextensibleClaimTypeCodes
http://hl7.org/fhir/ValueSet/claim-type
from the FHIR Standard
Claim.subTypeextensibleBeVSEattestationTypes (a valid code from Attestation types)
https://www.ehealth.fgov.be/standards/fhir/eattestation/ValueSet/be-vs-eattestationtypes
from this IG
Claim.userequiredPattern: claim
http://hl7.org/fhir/ValueSet/claim-use|4.0.1
from the FHIR Standard
Claim.priorityexampleProcessPriorityCodes
http://hl7.org/fhir/ValueSet/process-priority
from the FHIR Standard
Claim.fundsReserveexampleFunds Reservation Codes
http://hl7.org/fhir/ValueSet/fundsreserve
from the FHIR Standard
Claim.related.relationshipexampleExampleRelatedClaimRelationshipCodes
http://hl7.org/fhir/ValueSet/related-claim-relationship
from the FHIR Standard
Claim.payee.typeexampleClaim Payee Type Codes
http://hl7.org/fhir/ValueSet/payeetype
from the FHIR Standard
Claim.careTeam.provider.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Claim.careTeam.provider.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Claim.careTeam.provider.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Claim.careTeam.roleexampleClaimCareTeamRoleCodes
http://hl7.org/fhir/ValueSet/claim-careteamrole
from the FHIR Standard
Claim.careTeam.qualificationrequiredBeVSCdHcParty
https://www.ehealth.fgov.be/standards/fhir/core/ValueSet/be-vs-cd-hcparty
Claim.supportingInfo.categoryexampleClaimInformationCategoryCodes
http://hl7.org/fhir/ValueSet/claim-informationcategory
from the FHIR Standard
Claim.supportingInfo.codeexampleExceptionCodes
http://hl7.org/fhir/ValueSet/claim-exception
from the FHIR Standard
Claim.supportingInfo.reasonexampleMissingToothReasonCodes
http://hl7.org/fhir/ValueSet/missing-tooth-reason
from the FHIR Standard
Claim.diagnosis.diagnosis[x]exampleICD-10Codes
http://hl7.org/fhir/ValueSet/icd-10
from the FHIR Standard
Claim.diagnosis.typeexampleExampleDiagnosisTypeCodes
http://hl7.org/fhir/ValueSet/ex-diagnosistype
from the FHIR Standard
Claim.diagnosis.onAdmissionexampleExampleDiagnosisOnAdmissionCodes
http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission
from the FHIR Standard
Claim.diagnosis.packageCodeexampleExampleDiagnosisRelatedGroupCodes
http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup
from the FHIR Standard
Claim.procedure.typeexampleExampleProcedureTypeCodes
http://hl7.org/fhir/ValueSet/ex-procedure-type
from the FHIR Standard
Claim.procedure.procedure[x]exampleICD-10ProcedureCodes
http://hl7.org/fhir/ValueSet/icd-10-procedures
from the FHIR Standard
Claim.insurance.coverage.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Claim.accident.typeextensibleActIncidentCode
http://terminology.hl7.org/ValueSet/v3-ActIncidentCode
Claim.item.revenueexampleExampleRevenueCenterCodes
http://hl7.org/fhir/ValueSet/ex-revenue-center
from the FHIR Standard
Claim.item.categoryexampleBenefitCategoryCodes
http://hl7.org/fhir/ValueSet/ex-benefitcategory
from the FHIR Standard
Claim.item.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard
Claim.item.modifierexampleModifierTypeCodes
http://hl7.org/fhir/ValueSet/claim-modifiers
from the FHIR Standard
Claim.item.programCodeexampleExampleProgramReasonCodes
http://hl7.org/fhir/ValueSet/ex-program-code
from the FHIR Standard
Claim.item.location[x]exampleExampleServicePlaceCodes
http://hl7.org/fhir/ValueSet/service-place
from the FHIR Standard
Claim.item.bodySiteexampleOralSiteCodes
http://hl7.org/fhir/ValueSet/tooth
from the FHIR Standard
Claim.item.bodySite.extension:bodyLaterality.value[x]requiredBeVSBasicLaterality
https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-basic-laterality
Claim.item.bodySite.codingrequiredBeVSBodySite
https://www.ehealth.fgov.be/standards/fhir/core-clinical/ValueSet/be-vs-bodysite
Claim.item.subSiteexampleSurfaceCodes
http://hl7.org/fhir/ValueSet/surface
from the FHIR Standard
Claim.item.detail.revenueexampleExampleRevenueCenterCodes
http://hl7.org/fhir/ValueSet/ex-revenue-center
from the FHIR Standard
Claim.item.detail.categoryexampleBenefitCategoryCodes
http://hl7.org/fhir/ValueSet/ex-benefitcategory
from the FHIR Standard
Claim.item.detail.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard
Claim.item.detail.modifierexampleModifierTypeCodes
http://hl7.org/fhir/ValueSet/claim-modifiers
from the FHIR Standard
Claim.item.detail.programCodeexampleExampleProgramReasonCodes
http://hl7.org/fhir/ValueSet/ex-program-code
from the FHIR Standard
Claim.item.detail.subDetail.revenueexampleExampleRevenueCenterCodes
http://hl7.org/fhir/ValueSet/ex-revenue-center
from the FHIR Standard
Claim.item.detail.subDetail.categoryexampleBenefitCategoryCodes
http://hl7.org/fhir/ValueSet/ex-benefitcategory
from the FHIR Standard
Claim.item.detail.subDetail.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard
Claim.item.detail.subDetail.modifierexampleModifierTypeCodes
http://hl7.org/fhir/ValueSet/claim-modifiers
from the FHIR Standard
Claim.item.detail.subDetail.programCodeexampleExampleProgramReasonCodes
http://hl7.org/fhir/ValueSet/ex-program-code
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
be-inv-bodySiteerrorClaimBodySite and laterality CAN only occur in a specialised medicine attestation or a dentistry attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine' or code = 'dentistry').empty() implies Claim.item.bodySite.empty()
be-inv-eattestation-create-cancelerrorClaimCreation requires empty identifier
: Claim.identifier.where(system = 'https://www.mycarenet.be/eattest').empty().not() implies Claim.item.empty() and Claim.total.empty() and Claim.careTeam.empty()
be-inv-eattestation-prescription-standarderrorClaimEvery service request in supporting info SHALL have an BeExtPrescriptionRequesterStandard
: supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).extension('https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-prescription-requester-standard').count() = supportingInfo.select(value as Reference).resolve().ofType(ServiceRequest).count()
be-inv-gmf-holdererrorClaimGMF holder CAN only occur in a GP's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'other').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty()
be-inv-locationerrorClaimThe location SHALL be indicated using a value from https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd if it is a department code, or a https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi for an organization
: Claim.item.(location as Reference).empty().not() implies ( Claim.item.(location as Reference).resolve().type.memberOf('https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/ValueSet/be-vs-hospital-service-cd') or Claim.item.(location as Reference).resolve().managingOrganization.resolve().identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') or Claim.item.(location as Reference).resolve().managingOrganization.identifier.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi') )
be-inv-medical-advisor-decision-nrerrorClaimMedical advisor decision number SHALL occur for physiotherapy and SHALL NOT for the other eattestations
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').exists() implies Claim.item.count() <= Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').count() and Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'physiotherapy' or code = 'speechtherapy').empty() implies Claim.item.extension.where(url = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-preauthref').empty()
be-inv-oral-hygienisterrorClaimOral Hygienist CAN only occur a dentist's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').empty() implies Claim.careTeam.qualification.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty').where(code = 'persoraldentalhygienist').empty()
be-inv-toothNumbererrorClaimBodySite SHALL contain a value from BeVSToothNumberBodySite, if available, in a dentistry attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'dentistry').exists() implies (Claim.item.bodySite.coding.empty() or Claim.item.bodySite.coding.memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-toothnumber-bodysite') )
be-inv-traineeerrorClaimTrainee CAN only occur in a GP's attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'generalpractice').empty() implies Claim.careTeam.where(role.coding.where(code = 'assist').exists()).where(qualification.coding.where(code = 'persphysician').exists()).empty()
be-inv-transplantationerrorClaimTransplantation CAN only occur in a specialised medicine attestation
: Claim.subType.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types').where(code = 'specializedmedicine').empty() implies Claim.supportingInfo.code.coding.where(system = 'https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-transplantation-code').empty()
dom-2errorClaimIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorClaimIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorClaimIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorClaimIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceClaimA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from Claim

Summary

Mandatory: 5 elements (13 nested mandatory elements)
Must-Support: 32 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Claim.identifier is sliced based on the value of value:system
  • The element Claim.supportingInfo.value[x] is sliced based on the value of type:$this
  • The element Claim.item.serviced[x] is sliced based on the value of type:$this
  • The element Claim.item.location[x] is sliced based on the value of type:$this

 

Other representations of profile: CSV, Excel, Schematron