Belgian MyCareNet Profiles
2.1.0 - STU Belgium flag

Belgian MyCareNet Profiles, published by eHealth Platform. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/mycarenet/ and changes regularly. See the Directory of published versions

Resource Profile: MyCareNet eAgreement Claim Kine BE profile

Official URL: https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementclaim-kine Version: 2.1.0
Draft as of 2025-01-22 Computable Name: MyBeMyCareNetEagreementClaimKine

Claim profile for use in the different eAgreement flow from MyCareNet for kine. This profile is a diff on the general be-eagreementclaim.

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. Claim C 0..* BeMyCareNetEagreementClaim Claim, Pre-determination or Pre-authorization
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
be-rule-eagreementclaim-1: Billable period start and end SHALL be YYYY-MM-DD
be-rule-eagreementclaim-2: Created SHALL be YYYY-MM-DDThh:mm:ss+zz:zz
be-rule-eagreementclaim-3: Procedure.date SHALL be YYYY-MM-DD
... id SΣ 1..1 id Logical id of this artifact
... meta SΣ 1..1 Meta Metadata about the resource
ele-1: All FHIR elements must have a @value or children
.... profile Σ 1..1 canonical(StructureDefinition) Profiles this resource claims to conform to
ele-1: All FHIR elements must have a @value or children
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... status ?!SΣ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.


ele-1: All FHIR elements must have a @value or children
Fixed Value: active
... type SΣ 1..1 CodeableConcept Category or discipline
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.


ele-1: All FHIR elements must have a @value or children
.... coding Σ 1..1 Coding Code defined by a terminology system
ele-1: All FHIR elements must have a @value or children
..... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
..... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
... subType S 1..1 CodeableConcept More granular claim type
Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode.


ele-1: All FHIR elements must have a @value or children
.... coding Σ 1..1 Coding Code defined by a terminology system
ele-1: All FHIR elements must have a @value or children
..... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Required Pattern: https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/agreement-types
..... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
... use SΣ 1..1 code claim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.


ele-1: All FHIR elements must have a @value or children
Fixed Value: preauthorization
... patient SΣ 1..1 Reference(BePatient) The recipient of the products and services
ele-1: All FHIR elements must have a @value or children
... billablePeriod SΣ 0..1 Period Relevant time frame for the claim
ele-1: All FHIR elements must have a @value or children
... created SΣ 1..1 dateTime Resource creation date
ele-1: All FHIR elements must have a @value or children
... enterer S 1..1 Reference(BePractitionerRole) Author of the claim
ele-1: All FHIR elements must have a @value or children
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
ele-1: All FHIR elements must have a @value or children
... provider SΣ 1..1 Reference(BeOrganization | BePractitionerRole) Party responsible for the claim
ele-1: All FHIR elements must have a @value or children
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
ele-1: All FHIR elements must have a @value or children
... priority SΣ 1..1 CodeableConcept Desired processing ugency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.


ele-1: All FHIR elements must have a @value or children
.... coding Σ 1..1 Coding Code defined by a terminology system
ele-1: All FHIR elements must have a @value or children
..... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: http://terminology.hl7.org/CodeSystem/processpriority
..... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
... referral S 0..1 Reference(ServiceRequest) Treatment referral
ele-1: All FHIR elements must have a @value or children
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
ele-1: All FHIR elements must have a @value or children
... supportingInfo S 0..* BackboneElement Supporting information
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... sequence 1..1 positiveInt Information instance identifier
ele-1: All FHIR elements must have a @value or children
.... category S 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.


ele-1: All FHIR elements must have a @value or children
..... coding Σ 1..1 Coding Code defined by a terminology system
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children
... insurance SΣ 1..1 BackboneElement Patient insurance information
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... sequence Σ 1..1 positiveInt Insurance instance identifier
ele-1: All FHIR elements must have a @value or children
Fixed Value: 1
.... focal Σ 1..1 boolean Coverage to be used for adjudication
ele-1: All FHIR elements must have a @value or children
Fixed Value: true
.... coverage Σ 1..1 Reference(Coverage) Insurance information
ele-1: All FHIR elements must have a @value or children
..... display Σ 1..1 string Text alternative for the resource
ele-1: All FHIR elements must have a @value or children
... item S 0..* BackboneElement Product or service provided
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... sequence 1..1 positiveInt Item instance identifier
ele-1: All FHIR elements must have a @value or children
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.


ele-1: All FHIR elements must have a @value or children
..... coding Σ 1..1 Coding Code defined by a terminology system
Binding: ValueSet product or service (extensible)
ele-1: All FHIR elements must have a @value or children
...... system Σ 1..1 uri Identity of the terminology system
ele-1: All FHIR elements must have a @value or children
Fixed Value: https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/nihdi-physiotherapy-pathologysituationcode
...... code Σ 1..1 code Symbol in syntax defined by the system
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Claim.statusrequiredFixed Value: 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.subTypeexampleExampleClaimSubTypeCodes
http://hl7.org/fhir/ValueSet/claim-subtype
from the FHIR Standard
Claim.userequiredFixed Value: preauthorization
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.supportingInfo.categoryexampleClaimInformationCategoryCodes
http://hl7.org/fhir/ValueSet/claim-informationcategory
from the FHIR Standard
Claim.item.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard
Claim.item.productOrService.codingextensibleBeProductOrServiceNihdiEAgreement
https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/eagreementproductorservice
from this IG

Constraints

IdGradePath(s)DetailsRequirements
be-rule-eagreementclaim-1errorClaimBillable period start and end SHALL be YYYY-MM-DD
: (Claim.billablePeriod.start.exists() implies Claim.billablePeriod.start.toString().length()=10) and (Claim.billablePeriod.end.exists() implies Claim.billablePeriod.end.toString().length()=10)
be-rule-eagreementclaim-2errorClaimCreated SHALL be YYYY-MM-DDThh:mm:ss+zz:zz
: Claim.created.toString().length()=25
be-rule-eagreementclaim-3errorClaimProcedure.date SHALL be YYYY-MM-DD
: Claim.procedure.date.exists() implies Claim.procedure.date.select(toString().length()=10).allTrue()
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()

 

Other representations of profile: CSV, Excel, Schematron