| Package | tw.cathay.fhir.iclaim |
| Type | CapabilityStatement |
| Id | CapabilityStatementiClaimServer |
| FHIR Version | R4 |
| Source | https://claim.cgh.org.tw/iclaim/https://claim.cgh.org.tw/iclaim/1.0.0/CapabilityStatement-CapabilityStatementiClaimServer.html |
| URL | https://claim.cgh.org.tw/iclaim/CapabilityStatement/CapabilityStatementiClaimServer |
| Version | 1.0.0 |
| Status | active |
| Date | 2024-07-19 |
| Name | CapabilityStatementiClaimServer |
| Title | 醫療保險理賠實作指引-伺服端 |
| Realm | tw |
| Description | 醫療保險理賠實作指引-伺服端(Server)之能力聲明 |
| Kind | requirements |
No resources found
| ImplementationGuide | |
| tw.cathay.fhir.iclaim | 醫療保險理賠實作指引 |
| SearchParameter | |
| Bundle-identifier | Bundleidentifier |
| Composition-entry | CompositionEntry |
| Composition-patient | CompositionPatient |
| Encounter-identifier | EncounterIdentifier |
| Patient-identifier | PatientIdentifier |
| StructureDefinition | |
| Organization-co-twcore | TW Core Organization Company |
| Organization-hosp-twcore | TW Core Organization Hospital Department |
| bundle-iclaim | Bundle iClaim |
| claim-iclaim | Claim iClaim |
| composition-iclaim | Composition iClaim |
| condition-iclaim | Condition iClaim |
| coverage-iclaim | Coverage iClaim |
| diagnosticreport-iclaim | DiagnosticReport iClaim |
| encounter-iclaim | Encounter iClaim |
| observation-iclaim | Observation iClaim |
| patient-iclaim | Patient iClaim |
| practitioner-iclaim | Practitioner iClaim |
| practitionerrole-iclaim | PractitionerRole iClaim |
Note: links and images are rebased to the (stated) source
FHIRjson、xmlserver醫療保險理賠實作指引-伺服端(Server)必須(SHALL)：
(1)可透過FHIR RESTful API查詢、新增及刪除Resources
(2)根據FHIR規範實作RESTful API
(3)HTTP回傳狀態碼
①(Status 2xx)：請求成功
②(Status 400)：無效參數（invalid parameter）
③(Status 401/4xx)：未經授權的請求（unauthorized request）
④(Status 403)：未充分授權的資料存取範圍（insufficient premission scope）
⑤(Status 404)：未知的resource（unknown resource）
(4)Server提供的API操作皆支援JSON格式
(5)Server提供的API操作皆支援XML格式
(6)可識別每個新增到Server的實例（instance）之meta.profile是否為醫療保險理賠 Profiles Defining URL，並確認實例是否依循Profile製作。
【註：實例是指依據Profile實作，將真實資料以JSON、XML或Turtle格式存放的檔案】
安全性：
(1)Server必須(SHALL)透過回傳 HTTP 401「未授權」， HTTP 403「禁止」，或 HTTP 404 「未找到」，來拒絕任何未經授權的請求。
共有十二類Resources支援查詢，查詢參數如表列：
| Resource型別 | Profile | Create | conditionalCreate | Update | conditionalUpdate | Read | VRead | Delete | 支援的查詢參數 |
|---|---|---|---|---|---|---|---|---|---|
| Bundle | 理賠用收據-診斷證明-檢驗紀錄(Bundle iClaim) | y | y | y | y | y | y | - | _id, identifier |
| Composition | 理賠用收據-診斷證明-檢驗紀錄(Composition iClaim) | y | y | y | y | y | y | - | _id, patient, entry |
| Claim | 理賠申請書(Claim iClaim) | y | y | y | y | y | y | - | - |
| Condition | 病情、問題或診斷(Condition iClaim) | y | y | y | y | y | y | - | - |
| Coverage | 保險(Coverage iClaim) | y | y | y | y | y | y | - | - |
| DiagnosticReport | 診斷報告(DiagnosticReport iClaim) | y | y | y | y | y | y | - | - |
| Encounter | 就醫事件(Encounter iClaim) | y | y | y | y | y | y | - | identifier |
| Observation | 檢驗檢查(Observation iClaim) | y | y | y | y | y | y | - | - |
| Organization | 支援的Profiles 臺灣核心-醫事機構(TW Core Organization Hospital Department) 臺灣核心-公司行號（TW Core Organization Company) | y | y | y | y | y | y | - | - |
| Patient | 病人資料(Patient iClaim) | y | y | y | y | y | y | - | identifier |
| Practitioner | 健康照護服務提供人員資料(Practitioner iClaim) | y | y | y | y | y | y | - | - |
| PractitionerRole | 健康照護服務提供者角色(PractitionerRole iClaim) | y | y | y | y | y | y | - | - |
| 遵從度 | 參數 | 類型 | 範例 |
|---|---|---|---|
| 必須(SHALL) | _id | token | GET [base]/Bundle?_id=[id]GET [base]/Bundle/[id] |
| 必須(SHALL) | identifier | token | GET [base]/Bundle?identifier={system|}[code] |
| 遵從度 | 參數 | 類型 | 範例 |
|---|---|---|---|
| 必須(SHALL) | _id | token | GET [base]/Composition?_id=[id],GET [base]/Composition/[id] |
| 必須(SHALL) | patient | reference | GET [base]/Composition?patient=[patient],實作請參考Composition-Notes |
| 必須(SHALL) | entry | reference | GET [base]/Composition?entry=[encounter],實作請參考Composition-Notes |
| 遵從度 | 參數 | 類型 | 範例 |
|---|---|---|---|
| 必須(SHALL) | identifier | token | GET [base]/Encounter?identifier=[identifier],實作請參考Composition-Notes |
resolves| 遵從度 | 參數 | 類型 | 範例 |
|---|---|---|---|
| 必須(SHALL) | identifier | token | GET [base]/Patient?identifier=[identifier],實作請參考Composition-Notes |
{
"resourceType": "CapabilityStatement",
"id": "CapabilityStatementiClaimServer",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"url": "https://claim.cgh.org.tw/iclaim/CapabilityStatement/CapabilityStatementiClaimServer",
"version": "1.0.0",
"name": "CapabilityStatementiClaimServer",
"title": "醫療保險理賠實作指引-伺服端",
"status": "active",
"experimental": false,
"date": "2024-07-19",
"publisher": "國泰金控",
"contact": [
{
"name": "國泰金控",
"telecom": [
{
"system": "url",
"value": "https://www.cathayholdings.com/holdings/"
}
]
}
],
"description": "醫療保險理賠實作指引-伺服端(Server)之能力聲明",
"kind": "requirements",
"fhirVersion": "4.0.1",
"format": [
"xml",
"json"
],
"patchFormat": [
"application/json-patch+json"
],
"implementationGuide": [
"https://claim.cgh.org.tw/iclaim/ImplementationGuide/tw.cathay.fhir.iclaim"
],
"rest": [
{
"mode": "server",
"documentation": "醫療保險理賠實作指引-伺服端(Server)必須(SHALL)：(1)支援本實作指引中所有profiles (2)根據FHIR規範實作RESTful (3)回傳狀態碼-①(Status 400)：無效參數(invalid parameter)、②(Status 401/4xx)：未經授權的請求(unauthorized request)、③(Status 403)：未充分授權的資料存取範圍(insufficient premission scope)、④(Status 404)：未知的resource(unknown resource) (4)支援JSON格式 (5)支援XML格式 (6)可識別每個新增到Server的實例(instance)之meta.profile是否為醫療保險理賠Profiles Defining URL，並確認實例是否依循Profile製作。",
"resource": [
{
"type": "Bundle",
"profile": "https://claim.cgh.org.tw/iclaim/StructureDefinition/bundle-iclaim",
"_profile": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
]
},
"interaction": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "create"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "update"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "read"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "vread"
}
],
"conditionalCreate": true,
"conditionalUpdate": true,
"referencePolicy": [
"resolves"
],
"searchParam": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"name": "Bundleidentifier",
"definition": "https://claim.cgh.org.tw/iclaim/SearchParameter/Bundle-identifier",
"type": "token"
}
]
},
{
"type": "Composition",
"profile": "https://claim.cgh.org.tw/iclaim/StructureDefinition/composition-iclaim",
"_profile": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
]
},
"interaction": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "create"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "update"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "read"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "vread"
}
],
"conditionalCreate": true,
"conditionalUpdate": true,
"referencePolicy": [
"resolves"
],
"searchParam": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"name": "patient",
"definition": "https://claim.cgh.org.tw/iclaim/SearchParameter/Composition-patient",
"type": "reference"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"name": "entry",
"definition": "https://claim.cgh.org.tw/iclaim/SearchParameter/Composition-entry",
"type": "reference"
}
]
},
{
"type": "Claim",
"profile": "https://claim.cgh.org.tw/iclaim/StructureDefinition/claim-iclaim",
"_profile": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
]
},
"interaction": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "create"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "update"
}
],
"conditionalCreate": true,
"conditionalUpdate": true,
"referencePolicy": [
"resolves"
]
},
{
"type": "Condition",
"profile": "https://claim.cgh.org.tw/iclaim/StructureDefinition/condition-iclaim",
"_profile": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
]
},
"interaction": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "create"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "update"
}
],
"conditionalCreate": true,
"conditionalUpdate": true,
"referencePolicy": [
"resolves"
]
},
{
"type": "Coverage",
"profile": "https://claim.cgh.org.tw/iclaim/StructureDefinition/coverage-iclaim",
"_profile": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
]
},
"interaction": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "create"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "update"
}
],
"conditionalCreate": true,
"conditionalUpdate": true,
"referencePolicy": [
"resolves"
]
},
{
"type": "DiagnosticReport",
"profile": "https://claim.cgh.org.tw/iclaim/StructureDefinition/diagnosticreport-iclaim",
"_profile": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
]
},
"interaction": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "create"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "update"
}
],
"conditionalCreate": true,
"conditionalUpdate": true,
"referencePolicy": [
"resolves"
]
},
{
"type": "Encounter",
"profile": "https://claim.cgh.org.tw/iclaim/StructureDefinition/encounter-iclaim",
"_profile": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
]
},
"interaction": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "create"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "update"
}
],
"conditionalCreate": true,
"conditionalUpdate": true,
"referencePolicy": [
"resolves"
],
"searchParam": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"name": "EncounterIdentifier",
"definition": "https://claim.cgh.org.tw/iclaim/SearchParameter/Encounter-identifier",
"type": "token"
}
]
},
{
"type": "Observation",
"profile": "https://claim.cgh.org.tw/iclaim/StructureDefinition/observation-iclaim",
"_profile": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
]
},
"interaction": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "create"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "update"
}
],
"conditionalCreate": true,
"conditionalUpdate": true,
"referencePolicy": [
"resolves"
]
},
{
"type": "Organization",
"_profile": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
]
},
"supportedProfile": [
"https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/Organization-hosp-twcore",
"https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/Organization-co-twcore"
],
"interaction": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "create"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "update"
}
],
"conditionalCreate": true,
"conditionalUpdate": true,
"referencePolicy": [
"resolves"
]
},
{
"type": "Patient",
"profile": "https://claim.cgh.org.tw/iclaim/StructureDefinition/patient-iclaim",
"_profile": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
]
},
"interaction": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "create"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "update"
}
],
"conditionalCreate": true,
"conditionalUpdate": true,
"referencePolicy": [
"resolves"
],
"searchParam": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"name": "PatientIdentifier",
"definition": "https://claim.cgh.org.tw/iclaim/SearchParameter/Patient-identifier",
"type": "token"
}
]
},
{
"type": "Practitioner",
"profile": "https://claim.cgh.org.tw/iclaim/StructureDefinition/practitioner-iclaim",
"_profile": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
]
},
"interaction": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "create"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "update"
}
],
"conditionalCreate": true,
"conditionalUpdate": true,
"referencePolicy": [
"resolves"
]
},
{
"type": "PractitionerRole",
"profile": "https://claim.cgh.org.tw/iclaim/StructureDefinition/practitionerrole-iclaim",
"_profile": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
]
},
"interaction": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "create"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation",
"valueCode": "SHALL"
}
],
"code": "update"
}
],
"conditionalCreate": true,
"conditionalUpdate": true,
"referencePolicy": [
"resolves"
]
}
]
}
]
}