Belgian MyCareNet eTariff Profiles
1.0.0 - STU
Belgian MyCareNet eTariff Profiles
1.0.0 - STU
Belgian MyCareNet eTariff 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/etariff/ and changes regularly. See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "ex08",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/etariff/StructureDefinition/be-etariff-response"
]
},
"type" : "message",
"timestamp" : "2015-07-14T11:15:37+02:00",
"entry" : [
{
"fullUrl" : "urn:uuid:667b18ce-3d37-4581-9baa-6fada338038c",
"resource" : {
"resourceType" : "MessageHeader",
"id" : "667b18ce-3d37-4581-9baa-6fada338038c",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-messageheader"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_667b18ce-3d37-4581-9baa-6fada338038c\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader 667b18ce-3d37-4581-9baa-6fada338038c</b></p><a name=\"667b18ce-3d37-4581-9baa-6fada338038c\"> </a><a name=\"hc667b18ce-3d37-4581-9baa-6fada338038c\"> </a><a name=\"667b18ce-3d37-4581-9baa-6fada338038c-en-US\"> </a><p><b>event</b>: <a href=\"https://build.fhir.org/ig/hl7-be/mycarenet/CodeSystem-message-events.html#message-events-etariffresponse-consult\">CodeSystem message events</a> etariffresponse-consult: etariffresponse-consult</p><h3>Destinations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Endpoint</b></td><td><b>Receiver</b></td></tr><tr><td style=\"display: none\">*</td><td>urn:be:fgov:person:ssin:ehealth:1.0:dentist:nihii11:30202929001</td><td><a href=\"Bundle-ex02.html#urn-uuid-1dc5d974-5447-4afe-a4ab-57081ca518c3\">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></td></tr></table><p><b>sender</b>: <a href=\"Bundle-ex02.html#urn-uuid-cfabb40d-a53f-4c56-bc19-725ea669b358\">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p><h3>Sources</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td>urn:be:fgov:kbo-bce:organization:cbe-number:0411724220</td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Identifier</b></td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td>267b18ce-3d37-4581-9baa-6fada338038b</td><td>OK</td></tr></table><p><b>focus</b>: <a href=\"Bundle-ex02.html#urn-uuid-0a0d60df-0340-45a6-a493-a5d67f74d693\">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p></div>"
},
"eventCoding" : {
"system" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events",
"code" : "etariffresponse-consult"
},
"destination" : [
{
"endpoint" : "urn:be:fgov:person:ssin:ehealth:1.0:dentist:nihii11:30202929001",
"receiver" : {
"reference" : "urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"
}
}
],
"sender" : {
"reference" : "urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"
},
"source" : {
"endpoint" : "urn:be:fgov:kbo-bce:organization:cbe-number:0411724220"
},
"response" : {
"identifier" : "267b18ce-3d37-4581-9baa-6fada338038b",
"code" : "ok"
},
"focus" : [
{
"reference" : "urn:uuid:0a0d60df-0340-45a6-a493-a5d67f74d693"
}
]
}
},
{
"fullUrl" : "urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3",
"resource" : {
"resourceType" : "PractitionerRole",
"id" : "1dc5d974-5447-4afe-a4ab-57081ca518c3",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PractitionerRole_1dc5d974-5447-4afe-a4ab-57081ca518c3\"> </a><p class=\"res-header-id\"><b>Generated Narrative: PractitionerRole 1dc5d974-5447-4afe-a4ab-57081ca518c3</b></p><a name=\"1dc5d974-5447-4afe-a4ab-57081ca518c3\"> </a><a name=\"hc1dc5d974-5447-4afe-a4ab-57081ca518c3\"> </a><a name=\"1dc5d974-5447-4afe-a4ab-57081ca518c3-en-US\"> </a><p><b>practitioner</b>: <a href=\"Bundle-ex01.html#urn-uuid-03972cc4-d781-4285-8d79-0f05810e1931\">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><p><b>code</b>: <span title=\"Codes:{https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty persdentist}\">dentist</span></p></div>"
},
"practitioner" : {
"reference" : "urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931"
},
"code" : [
{
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty",
"code" : "persdentist"
}
]
}
]
}
},
{
"fullUrl" : "urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931",
"resource" : {
"resourceType" : "Practitioner",
"id" : "03972cc4-d781-4285-8d79-0f05810e1931",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_03972cc4-d781-4285-8d79-0f05810e1931\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner 03972cc4-d781-4285-8d79-0f05810e1931</b></p><a name=\"03972cc4-d781-4285-8d79-0f05810e1931\"> </a><a name=\"hc03972cc4-d781-4285-8d79-0f05810e1931\"> </a><a name=\"03972cc4-d781-4285-8d79-0f05810e1931-en-US\"> </a><p><b>identifier</b>: <a href=\"https://build.fhir.org/ig/hl7-be/core/NamingSystem-be-nihdi.html\" title=\"RIZIV/INAMI\">BeNIHDINamingSystem</a>/30202929001</p><p><b>name</b>: Pierre Durand </p></div>"
},
"identifier" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
"value" : "30202929001"
}
],
"name" : [
{
"family" : "Durand",
"given" : [
"Pierre"
]
}
]
}
},
{
"fullUrl" : "urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358",
"resource" : {
"resourceType" : "Organization",
"id" : "cfabb40d-a53f-4c56-bc19-725ea669b358",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_cfabb40d-a53f-4c56-bc19-725ea669b358\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization cfabb40d-a53f-4c56-bc19-725ea669b358</b></p><a name=\"cfabb40d-a53f-4c56-bc19-725ea669b358\"> </a><a name=\"hccfabb40d-a53f-4c56-bc19-725ea669b358\"> </a><a name=\"cfabb40d-a53f-4c56-bc19-725ea669b358-en-US\"> </a><p><b>identifier</b>: <a href=\"https://build.fhir.org/ig/hl7-be/core/NamingSystem-be-insurancenumber.html\" title=\"the identification number of a mutual insurance association (mutualité) as “a not-for-profit association, which, with foresight, assistance and solidarity aims to promote the physical, mental and social well-being of its members” (The Belgian law of 6 August 1990)\">BeInsuranceNumberNamingSystem</a>/300</p><p><b>name</b>: Union Nationale des Mutualités Socialistes - Nationaal Verbond van de Socialistische Mutualiteiten</p></div>"
},
"identifier" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancenumber",
"value" : "300"
}
],
"name" : "Union Nationale des Mutualités Socialistes - Nationaal Verbond van de Socialistische Mutualiteiten"
}
},
{
"fullUrl" : "urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686",
"resource" : {
"resourceType" : "Patient",
"id" : "a52efcb6-1f81-4333-a115-d45bd3183686",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-patient"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_a52efcb6-1f81-4333-a115-d45bd3183686\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient a52efcb6-1f81-4333-a115-d45bd3183686</b></p><a name=\"a52efcb6-1f81-4333-a115-d45bd3183686\"> </a><a name=\"hca52efcb6-1f81-4333-a115-d45bd3183686\"> </a><a name=\"a52efcb6-1f81-4333-a115-d45bd3183686-en-US\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Jean Dupont Male, DoB Unknown ( https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/ssin#BeSSINNamingSystem#70319666960)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Other Id (see the one above)\">Other Id:</td><td colspan=\"3\"><a href=\"https://build.fhir.org/ig/hl7-be/core/NamingSystem-be-insurancymembership.html\" title=\"Membership number of a patient with an insurance organization\">BeInsurancymembershipNamingSystem</a>/1234567890123</td></tr></table></div>"
},
"identifier" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/ssin",
"value" : "70319666960"
},
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancymembership",
"value" : "1234567890123",
"assigner" : {
"identifier" : {
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancenumber",
"value" : "301"
}
}
}
],
"name" : [
{
"family" : "Dupont",
"given" : [
"Jean"
]
}
],
"gender" : "male"
}
},
{
"fullUrl" : "urn:uuid:5330da7f-db68-4380-a265-d364aeed8653",
"resource" : {
"resourceType" : "Coverage",
"id" : "5330da7f-db68-4380-a265-d364aeed8653",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-mycarenet-coverage"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_5330da7f-db68-4380-a265-d364aeed8653\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage 5330da7f-db68-4380-a265-d364aeed8653</b></p><a name=\"5330da7f-db68-4380-a265-d364aeed8653\"> </a><a name=\"hc5330da7f-db68-4380-a265-d364aeed8653\"> </a><a name=\"5330da7f-db68-4380-a265-d364aeed8653-en-US\"> </a><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode PUBLICPOL}\">public healthcare</span></p><p><b>beneficiary</b>: <a href=\"Bundle-ex01.html#urn-uuid-a52efcb6-1f81-4333-a115-d45bd3183686\">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><p><b>payor</b>: <a href=\"Bundle-ex02.html#urn-uuid-cfabb40d-a53f-4c56-bc19-725ea669b358\">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}\">Plan</span></p><p><b>value</b>: Mandatory Health Insurance</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class subplan}\">SubPlan</span></p><p><b>value</b>: 110</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class subplan}\">SubPlan</span></p><p><b>value</b>: 150</p></blockquote></div>"
},
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code" : "PUBLICPOL"
}
]
},
"beneficiary" : {
"reference" : "urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"
},
"payor" : [
{
"reference" : "urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"
}
],
"class" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
"code" : "plan"
}
]
},
"value" : "Mandatory Health Insurance"
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
"code" : "subplan"
}
]
},
"value" : "110",
"_value" : {
"extension" : [
{
"url" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system",
"valueUri" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1"
}
]
}
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
"code" : "subplan"
}
]
},
"value" : "150",
"_value" : {
"extension" : [
{
"url" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system",
"valueUri" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2"
}
]
}
}
]
}
},
{
"fullUrl" : "urn:uuid:0a0d60df-0340-45a6-a493-a5d67f74d693",
"resource" : {
"resourceType" : "ClaimResponse",
"id" : "0a0d60df-0340-45a6-a493-a5d67f74d693",
"meta" : {
"profile" : [
🔗 "https://www.ehealth.fgov.be/standards/fhir/etariff/StructureDefinition/be-etariff-claimresponse"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClaimResponse_0a0d60df-0340-45a6-a493-a5d67f74d693\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse 0a0d60df-0340-45a6-a493-a5d67f74d693</b></p><a name=\"0a0d60df-0340-45a6-a493-a5d67f74d693\"> </a><a name=\"hc0a0d60df-0340-45a6-a493-a5d67f74d693\"> </a><a name=\"0a0d60df-0340-45a6-a493-a5d67f74d693-en-US\"> </a><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}\">Professional</span></p><p><b>subType</b>: <span title=\"Codes:{https://www.ehealth.fgov.be/standards/fhir/etariff/CodeSystem/be-cs-etariff-types dentistry}\">dentistry</span></p><p><b>use</b>: Predetermination</p><p><b>patient</b>: <a href=\"Bundle-ex01.html#urn-uuid-a52efcb6-1f81-4333-a115-d45bd3183686\">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><p><b>created</b>: 2015-07-14 11:15:30+0200</p><p><b>insurer</b>: <a href=\"Bundle-ex02.html#urn-uuid-cfabb40d-a53f-4c56-bc19-725ea669b358\">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p><p><b>requestor</b>: <a href=\"Bundle-ex02.html#urn-uuid-1dc5d974-5447-4afe-a4ab-57081ca518c3\">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p><p><b>outcome</b>: Processing Complete</p><blockquote><p><b>addItem</b></p><p><b>BeExtItemReimbursement</b>: <span title=\"Euro\">€15.00</span> (EUR)</p><p><b>BeExtItemPatientFee</b>: <span title=\"Euro\">€10.00</span> (EUR)</p><p><b>BeExtEtariffItemCommitment</b>: 123456789012345678901234567890120000000000002000</p><p><b>itemSequence</b>: 1</p><p><b>provider</b>: <a href=\"Bundle-ex02.html#urn-uuid-1dc5d974-5447-4afe-a4ab-57081ca518c3\">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p><p><b>productOrService</b>: <span title=\"Codes:{https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature 373590}\">373590</span></p><p><b>serviced</b>: 2013-01-12</p><p><b>quantity</b>: 1</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>25</td><td>Euro</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>25</td><td>Euro</td></tr></table><h3>Adjudications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Category</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/decision-values tariff}\">tariff</span></td></tr></table></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Bundle-ex02.html#urn-uuid-5330da7f-db68-4380-a265-d364aeed8653\">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></td></tr></table></div>"
},
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "professional"
}
]
},
"subType" : {
"coding" : [
// attestationType
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/etariff/CodeSystem/be-cs-etariff-types",
"code" : "dentistry"
}
]
},
"use" : "predetermination",
"patient" : {
"reference" : "urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"
},
"created" : "2015-07-14T11:15:30+02:00",
"insurer" : {
"reference" : "urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"
},
"requestor" : {
"reference" : "urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"
},
"outcome" : "complete",
"addItem" : [
{
"extension" : [
{
"url" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-mycarenet-item-reimbursement",
"valueMoney" : // reimbursement for item
{
"value" : 15.00,
"currency" : "EUR"
}
},
{
"url" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-mycarenet-item-patientfee",
"valueMoney" : // patientfee for item
{
"value" : 10.00,
"currency" : "EUR"
}
},
{
"url" : "https://www.ehealth.fgov.be/standards/fhir/etariff/StructureDefinition/be-ext-etariff-item-commitment",
"valueString" : "123456789012345678901234567890120000000000002000"
}
],
"itemSequence" : [
1
],
"provider" : [
// commitment for item
{
"reference" : "urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"
}
],
"productOrService" : // healthcare provider
{
"coding" : [
// service identifier for item
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature",
"code" : "373590"
}
]
},
"servicedDate" : "2013-01-12",
"quantity" : // date for item
// count for item
{
"value" : 1
},
"unitPrice" : {
"value" : 25,
"currency" : "EUR"
},
"net" : {
"value" : 25,
"currency" : "EUR"
},
"adjudication" : [
// fee for item
{
"category" : {
"coding" : [
{
"system" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/decision-values",
"code" : "tariff"
}
]
}
}
]
}
],
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
"reference" : "urn:uuid:5330da7f-db68-4380-a265-d364aeed8653"
}
}
]
}
}
]
}
IG © 2022+ eHealth Platform. Package hl7.fhir.be.etariff#1.0.0 based on FHIR 4.0.1. Generated 2024-10-02
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