FHIR IG analytics| Package | ndhm.in |
| Resource Type | Bundle |
| Id | Bundle-InsurancePlanBundle-example-01.json |
| FHIR Version | R4 |
No resources found
No resources found
No narrative content found in resource
FHIR
FHIRsmith{
"resourceType": "Bundle",
"id": "InsurancePlanBundle-example-01",
"meta": {
"versionId": "1",
"profile": [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/InsurancePlanBundle"
],
"security": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-Confidentiality",
"code": "V",
"display": "very restricted"
}
]
},
"type": "collection",
"timestamp": "2023-09-11T15:32:26.605+05:30",
"entry": [
{
"fullUrl": "urn:uuid:35d8a525-1878-4342-8ca6-fbaa62245529",
"resource": {
"resourceType": "InsurancePlan",
"id": "35d8a525-1878-4342-8ca6-fbaa62245529",
"meta": {
"versionId": "1",
"profile": [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/InsurancePlan"
]
},
"text": {
"status": "extensions",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"InsurancePlan_35d8a525-1878-4342-8ca6-fbaa62245529\"> </a><p class=\"res-header-id\"><b>Generated Narrative: InsurancePlan 35d8a525-1878-4342-8ca6-fbaa62245529</b></p><a name=\"35d8a525-1878-4342-8ca6-fbaa62245529\"> </a><a name=\"hc35d8a525-1878-4342-8ca6-fbaa62245529\"> </a><a name=\"35d8a525-1878-4342-8ca6-fbaa62245529-hi-IN\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">version: 1</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-InsurancePlan.html\">InsurancePlan</a></p></div><blockquote><p><b>ClaimSupportingInfoRequirement</b></p><ul><li>category: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category POI}\">Proof of identity</span></li><li>code: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code ADN}\">Adhaar number</span></li></ul></blockquote><blockquote><p><b>ClaimSupportingInfoRequirement</b></p><ul><li>category: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category POA}\">Proof of address</span></li><li>code: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0203 PPN}\">Passport number</span></li></ul></blockquote><blockquote><p><b>ClaimExclusion</b></p><ul><li>category: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion Excl01}\">Pre-Existing Diseases</span></li><li>statement: Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded untit the expiry of 48 months</li></ul></blockquote><blockquote><p><b>ClaimExclusion</b></p><ul><li>category: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion Excl02}\">Specified disease/procedure waiting period</span></li><li>statement: Expenses related to the treatment of a listed conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us.</li><li>item: <span title=\"Codes:{http://snomed.info/sct 86077009}\">Operation for glaucoma</span></li></ul></blockquote><p><b>identifier</b>: <code>https://irdai.gov.in</code>/761234556546</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-insuranceplan-type 01}\">Hospitalisation Indemnity Policy</span></p><p><b>name</b>: Active Assure Silver</p><p><b>period</b>: 2023-09-10 --> 2024-09-10</p><p><b>ownedBy</b>: <a href=\"Bundle-InsurancePlanBundle-example-01.html#urn-uuid-ef131456-dc56-4d73-9e88-87d6cb12091e\">Bundle: type = collection; timestamp = 2023-09-11 15:32:26+0530</a></p><p><b>administeredBy</b>: <a href=\"Bundle-InsurancePlanBundle-example-01.html#urn-uuid-ef131456-dc56-4d73-9e88-87d6cb12091e\">Bundle: type = collection; timestamp = 2023-09-11 15:32:26+0530</a></p><blockquote><p><b>coverage</b></p><blockquote><p><b>ClaimCondition</b></p><ul><li>claim-condition: The Hospitalization is medically necessary and follows the written advice of a Medical Practitioner</li></ul></blockquote><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 737481003}\">Inpatient care management (procedure)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 309904001}\">Intensive care unit (environment)</span></p></blockquote><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 87612001}\">Blood</span></p></blockquote><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 24099007}\">Oxygen (substance)</span></p></blockquote></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 710967003}\">Management of health status after discharge from hospital (procedure)</span></p><blockquote><p><b>benefit</b></p><blockquote><p><b>ClaimCondition</b></p><ul><li>claim-condition: Medical Expenses incurred up to 90 days after discharge from the hospital</li></ul></blockquote><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 710967003}\">Management of health status after discharge from hospital (procedure)</span></p><h3>Limits</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td><=90 day</td></tr></table></blockquote></blockquote><blockquote><p><b>coverage</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 409972000}\">Pre-hospital care (situation)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 409972000}\">Pre-hospital care (situation)</span></p><h3>Limits</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td><=60 day</td></tr></table></blockquote></blockquote><blockquote><p><b>coverage</b></p><blockquote><p><b>ClaimCondition</b></p><ul><li>claim-condition: We have accepted a claim for In-patient Hospitalization under Section C.I.(a) above for the same Illness/ Injur</li></ul></blockquote><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 49122002}\">Ambulance, device (physical object)</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td/><td><span title=\"Codes:{http://snomed.info/sct 49122002}\">Ambulance, device (physical object)</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><blockquote><p><b>ClaimCondition</b></p><ul><li>claim-condition: The Medical Expenses are incurred, including for any procedure which requires a period of specialized observation or care after completion of the procedure undertaken by an Insured Person as Day Care Treatment</li></ul></blockquote><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 737850002}\">Day care case management</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://snomed.info/sct 737850002}\">Day care case management</span></td></tr></table></blockquote><blockquote><p><b>coverage</b></p><blockquote><p><b>ClaimCondition</b></p><ul><li>claim-condition: The donation conforms to The Transplantation of Human Organs Act 1994 and the organ is for the use of the Insured Person</li></ul></blockquote><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 105461009}\">Organ donor</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td/><td><span title=\"Codes:{http://snomed.info/sct 105461009}\">Organ donor</span></td></tr></table></blockquote><blockquote><p><b>plan</b></p><p><b>identifier</b>: Active Assure Silver (use: official, )</p><p><b>type</b>: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-plan-type 01}\">Individual</span></p><blockquote><p><b>generalCost</b></p><h3>Costs</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>200000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: <span title=\"Codes:{http://snomed.info/sct 49122002}\">Ambulance, device (physical object)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 49122002}\">Ambulance, device (physical object)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">fullcoverage</span></td><td>2000 INR</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: <span title=\"Codes:{http://snomed.info/sct 224663004}\">Single room (environment)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 224663004}\">Single room (environment)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">fullcoverage</span></td><td>2000 INR</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: <span title=\"Codes:{http://snomed.info/sct 309904001}\">Intensive care unit (environment)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 309904001}\">Intensive care unit (environment)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">fullcoverage</span></td><td>4000 INR</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: <span title=\"Codes:{http://snomed.info/sct 60689008}\">Home care of patient</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 60689008}\">Home care of patient</span></p><h3>Costs</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">fullcoverage</span></td><td>20000 INR</td></tr></table></blockquote></blockquote></blockquote><blockquote><p><b>plan</b></p><p><b>identifier</b>: Active Assure Silver (use: official, )</p><p><b>type</b>: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-plan-type 01}\">Individual</span></p><blockquote><p><b>generalCost</b></p><h3>Costs</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>700000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: <span title=\"Codes:{http://snomed.info/sct 49122002}\">Ambulance, device (physical object)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 49122002}\">Ambulance, device (physical object)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">fullcoverage</span></td><td>2000 INR</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: <span title=\"Codes:{http://snomed.info/sct 224663004}\">Single room (environment)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 224663004}\">Single room (environment)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">fullcoverage</span></td><td>7000 INR</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: <span title=\"Codes:{http://snomed.info/sct 309904001}\">Intensive care unit (environment)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 309904001}\">Intensive care unit (environment)</span></p><h3>Costs</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">fullcoverage</span></td><td>14000 INR</td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: <span title=\"Codes:{http://snomed.info/sct 60689008}\">Home care of patient</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 60689008}\">Home care of patient</span></p><h3>Costs</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:\">fullcoverage</span></td><td>70000 INR</td></tr></table></blockquote></blockquote></blockquote></div>"
},
"extension": [
{
"extension": [
{
"url": "category",
"valueCodeableConcept": {
"coding": [
{
"system": "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category",
"code": "POI",
"display": "Proof of identity"
}
]
}
},
{
"url": "code",
"valueCodeableConcept": {
"coding": [
{
"system": "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code",
"code": "ADN",
"display": "Adhaar number"
}
]
}
}
],
"url": "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement"
},
{
"extension": [
{
"url": "category",
"valueCodeableConcept": {
"coding": [
{
"system": "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category",
"code": "POA",
"display": "Proof of address"
}
]
}
},
{
"url": "code",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "PPN",
"display": "Passport number"
}
]
}
}
],
"url": "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement"
},
{
"extension": [
{
"url": "category",
"valueCodeableConcept": {
"coding": [
{
"system": "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion",
"code": "Excl01",
"display": "Pre-Existing Diseases"
}
]
}
},
{
"url": "statement",
"valueString": "Expenses related to the treatment of a pre-existing Disease (PED) and its direct complications shall be excluded untit the expiry of 48 months"
}
],
"url": "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Exclusion"
},
{
"extension": [
{
"url": "category",
"valueCodeableConcept": {
"coding": [
{
"system": "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-claim-exclusion",
"code": "Excl02",
"display": "Specified disease/procedure waiting period"
}
]
}
},
{
"url": "statement",
"valueString": "Expenses related to the treatment of a listed conditions, surgeries/treatments shall be excluded until the expiry of 24 months of continuous coverage after the date of inception of the first policy with us."
},
{
"url": "item",
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "86077009",
"display": "Operation for glaucoma"
}
]
}
}
],
"url": "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Exclusion"
}
],
"identifier": [
{
"system": "https://irdai.gov.in",
"value": "761234556546"
}
],
"status": "active",
"type": [
{
"coding": [
{
"system": "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-insuranceplan-type",
"code": "01",
"display": "Hospitalisation Indemnity Policy"
}
]
}
],
"name": "Active Assure Silver",
"period": {
"start": "2023-09-10",
"end": "2024-09-10"
},
"ownedBy": {
"reference": "urn:uuid:ef131456-dc56-4d73-9e88-87d6cb12091e"
},
"administeredBy": {
"reference": "urn:uuid:ef131456-dc56-4d73-9e88-87d6cb12091e"
},
"coverage": [
{
"extension": [
{
"extension": [
{
"url": "claim-condition",
"valueString": "The Hospitalization is medically necessary and follows the written advice of a Medical Practitioner"
}
],
"url": "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Condition"
}
],
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "737481003",
"display": "Inpatient care management (procedure)"
}
]
},
"benefit": [
{
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "309904001",
"display": "Intensive care unit (environment)"
}
]
}
},
{
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "87612001",
"display": "Blood"
}
]
}
},
{
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "24099007",
"display": "Oxygen (substance)"
}
]
}
}
]
},
{
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "710967003",
"display": "Management of health status after discharge from hospital (procedure)"
}
]
},
"benefit": [
{
"extension": [
{
"extension": [
{
"url": "claim-condition",
"valueString": "Medical Expenses incurred up to 90 days after discharge from the hospital"
}
],
"url": "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Condition"
}
],
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "710967003",
"display": "Management of health status after discharge from hospital (procedure)"
}
]
},
"limit": [
{
"value": {
"value": 90,
"comparator": "<=",
"unit": "day"
}
}
]
}
]
},
{
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "409972000",
"display": "Pre-hospital care (situation)"
}
]
},
"benefit": [
{
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "409972000",
"display": "Pre-hospital care (situation)"
}
]
},
"limit": [
{
"value": {
"value": 60,
"comparator": "<=",
"unit": "day"
}
}
]
}
]
},
{
"extension": [
{
"extension": [
{
"url": "claim-condition",
"valueString": "We have accepted a claim for In-patient Hospitalization under Section C.I.(a) above for the same Illness/ Injur"
}
],
"url": "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Condition"
}
],
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "49122002",
"display": "Ambulance, device (physical object)"
}
]
},
"benefit": [
{
"extension": [
{
"extension": [
{
"url": "claim-condition",
"valueString": "Per policy limits is up to 10% of the Sum Insured."
}
],
"url": "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Condition"
}
],
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "49122002",
"display": "Ambulance, device (physical object)"
}
]
}
}
]
},
{
"extension": [
{
"extension": [
{
"url": "claim-condition",
"valueString": "The Medical Expenses are incurred, including for any procedure which requires a period of specialized observation or care after completion of the procedure undertaken by an Insured Person as Day Care Treatment"
}
],
"url": "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Condition"
}
],
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "737850002",
"display": "Day care case management"
}
]
},
"benefit": [
{
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "737850002",
"display": "Day care case management"
}
]
}
}
]
},
{
"extension": [
{
"extension": [
{
"url": "claim-condition",
"valueString": "The donation conforms to The Transplantation of Human Organs Act 1994 and the organ is for the use of the Insured Person"
}
],
"url": "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Condition"
}
],
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "105461009",
"display": "Organ donor"
}
]
},
"benefit": [
{
"extension": [
{
"extension": [
{
"url": "claim-condition",
"valueString": "This coverage is subject to a limit of 10% of the Sum Insured or Rupees One Lakh whichever is less."
}
],
"url": "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Condition"
}
],
"type": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "105461009",
"display": "Organ donor"
}
]
}
}
]
}
],
"plan": [
{
"identifier": [
{
"use": "official",
"value": "Active Assure Silver"
}
],
"type": {
"coding": [
{
"system": "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-plan-type",
"code": "01",
"display": "Individual"
}
]
},
"generalCost": [
{
"cost": {
"value": 200000,
"currency": "INR"
}
}
],
"specificCost": [
{
"category": {
"coding": [
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