FHIR IG analytics| Package | tw.iii.ltc |
| Resource Type | ClaimResponse |
| Id | ClaimResponse-ltc-claimresponse-feeaudit-example.json |
| FHIR Version | R4 |
No resources found
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Note: links and images are rebased to the (stated) source
Generated Narrative: ClaimResponse ltc-claimresponse-feeaudit-example
Profile: 長照支付審查－分案審核明細
長照支付審查－分案審核統計與承辦資訊
- records: 3
- cases: 2
- approveCaseNum: 2
- approveRecordCount: 1
- tempPaymentStatus: 1: 等待暫付總表
- transNo: 00106
- auditMan: CG碼承辦人
長照支付審查－清冊文件下載路徑
- docType: 暫付總表
- url: http://url/download/doc/dc6a
長照支付審查－清冊文件下載路徑
- docType: 總表
- url: http://url/download/doc/dc6adc6a
長照支付審查－清冊文件下載路徑
- docType: 清冊
- url: http://url/download/doc/dc6afa306c
長照支付審查－清冊文件下載路徑
- docType: 清冊EXCEL
- url: http://url/download/doc/dc6a6c
長照支付審查－清冊文件下載路徑
- docType: A碼清冊
- url: http://url/download/doc/dc6afa306cc554311c
長照支付審查－清冊文件下載路徑
- docType: A碼清冊EXCEL
- url: http://url/download/doc9967-7bddc554311c
長照支付審查－清冊文件下載路徑
- docType: 申請記錄不通過清冊
- url: http://url/download/doc/dc6afa306cc-5ce29d30f843
長照支付審查－清冊文件下載路徑
- docType: 申請記錄不通過EXCEL清冊
- url: http://url/download/doc/dc6afa306c-5ce29d30f843
identifier: http://ltc-ig.fhir.tw/identifier/feeaudit/case-no/201907C010163, http://ltc-ig.fhir.tw/identifier/feeaudit/doc-ver/006, http://ltc-ig.fhir.tw/identifier/feeaudit/yyyymm/201907
status: Active
type: Professional
use: Claim
patient: 陳明慧 Female, DoB: 1945-03-15 ( National Person Identifier (TWN): A123456789 (use: official, ))
created: 2019-07-23 15:43:51+0800
insurer: Organization 新北市政府衛生局
outcome: Partial Processing
disposition: 請長照機構於5日內將總表送至本局
item
長照支付審查－服務記錄識別資訊
- objid: 882601915
- sourceSystem: TranCareCenter
- transNo: A123456789
itemSequence: 1
adjudication
category: 單價
Amounts
Value Currency 400 New Taiwan dollar adjudication
category: 自付額
Amounts
Value Currency 85 New Taiwan dollar
addItem
長照支付審查－服務記錄識別資訊
- objid: 882601915
- sourceSystem: TranCareCenter
itemSequence: 1
productOrService: 照顧困難之服務加計
adjudication
category: 單價
Amounts
Value Currency 200 New Taiwan dollar
total
category: 申請核銷金額
Amounts
Value Currency 4500 New Taiwan dollar
total
category: 核定金額
Amounts
Value Currency 1596 New Taiwan dollar
total
category: 政策鼓勵金額
Amounts
Value Currency 400 New Taiwan dollar
total
category: 分案暫付金額
Amounts
Value Currency 17500 New Taiwan dollar
total
category: 核增金額
Amounts
Value Currency 4000 New Taiwan dollar
total
category: 核減金額
Amounts
Value Currency 500 New Taiwan dollar
processNote
number: 1
type: Display
text: 核增原因（inc_in_reason）：因個案身分異動
processNote
number: 2
type: Display
text: 核減原因（dec_in_reason）：因個案CMS等級異動
FHIR
FHIRsmith{
"resourceType": "ClaimResponse",
"id": "ltc-claimresponse-feeaudit-example",
"meta": {
"profile": [
"http://ltc-ig.fhir.tw/StructureDefinition/LTCClaimResponseFeeAudit"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"extension": [
{
"url": "records",
"valueInteger": 3
},
{
"url": "cases",
"valueInteger": 2
},
{
"url": "approveCaseNum",
"valueInteger": 2
},
{
"url": "approveRecordCount",
"valueInteger": 1
},
{
"url": "tempPaymentStatus",
"valueString": "1: 等待暫付總表"
},
{
"url": "transNo",
"valueString": "00106"
},
{
"url": "auditMan",
"valueString": "CG碼承辦人"
}
],
"url": "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-AuditSummary"
},
{
"extension": [
{
"url": "docType",
"valueCodeableConcept": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type",
"code": "tempPaymentDoc",
"display": "暫付總表"
}
]
}
},
{
"url": "url",
"valueUrl": "http://url/download/doc/dc6a"
}
],
"url": "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl"
},
{
"extension": [
{
"url": "docType",
"valueCodeableConcept": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type",
"code": "caseSummaryNotice",
"display": "總表"
}
]
}
},
{
"url": "url",
"valueUrl": "http://url/download/doc/dc6adc6a"
}
],
"url": "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl"
},
{
"extension": [
{
"url": "docType",
"valueCodeableConcept": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type",
"code": "caseSvcList",
"display": "清冊"
}
]
}
},
{
"url": "url",
"valueUrl": "http://url/download/doc/dc6afa306c"
}
],
"url": "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl"
},
{
"extension": [
{
"url": "docType",
"valueCodeableConcept": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type",
"code": "caseSvcListExcel",
"display": "清冊EXCEL"
}
]
}
},
{
"url": "url",
"valueUrl": "http://url/download/doc/dc6a6c"
}
],
"url": "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl"
},
{
"extension": [
{
"url": "docType",
"valueCodeableConcept": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type",
"code": "caseASvcList",
"display": "A碼清冊"
}
]
}
},
{
"url": "url",
"valueUrl": "http://url/download/doc/dc6afa306cc554311c"
}
],
"url": "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl"
},
{
"extension": [
{
"url": "docType",
"valueCodeableConcept": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type",
"code": "caseASvcListExcel",
"display": "A碼清冊EXCEL"
}
]
}
},
{
"url": "url",
"valueUrl": "http://url/download/doc9967-7bddc554311c"
}
],
"url": "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl"
},
{
"extension": [
{
"url": "docType",
"valueCodeableConcept": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type",
"code": "caseErrList",
"display": "申請記錄不通過清冊"
}
]
}
},
{
"url": "url",
"valueUrl": "http://url/download/doc/dc6afa306cc-5ce29d30f843"
}
],
"url": "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl"
},
{
"extension": [
{
"url": "docType",
"valueCodeableConcept": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-doc-type",
"code": "caseErrListExcel",
"display": "申請記錄不通過EXCEL清冊"
}
]
}
},
{
"url": "url",
"valueUrl": "http://url/download/doc/dc6afa306c-5ce29d30f843"
}
],
"url": "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-DocUrl"
}
],
"identifier": [
{
"system": "http://ltc-ig.fhir.tw/identifier/feeaudit/case-no",
"value": "201907C010163"
},
{
"system": "http://ltc-ig.fhir.tw/identifier/feeaudit/doc-ver",
"value": "006"
},
{
"system": "http://ltc-ig.fhir.tw/identifier/feeaudit/yyyymm",
"value": "201907"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional",
"display": "Professional"
}
]
},
"use": "claim",
"patient": {
"reference": "Patient/ltc-patient-chen-ming-hui"
},
"created": "2019-07-23T15:43:51+08:00",
"insurer": {
"reference": "Organization/ltc-organization-feeaudit-authority-example"
},
"outcome": "partial",
"disposition": "請長照機構於5日內將總表送至本局",
"item": [
{
"extension": [
{
"extension": [
{
"url": "objid",
"valueString": "882601915"
},
{
"url": "sourceSystem",
"valueString": "TranCareCenter"
},
{
"url": "transNo",
"valueString": "A123456789"
}
],
"url": "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-RecordRef"
}
],
"itemSequence": 1,
"adjudication": [
{
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication",
"code": "price",
"display": "單價"
}
]
},
"amount": {
"value": 400,
"currency": "TWD"
}
},
{
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication",
"code": "copayment",
"display": "自付額"
}
]
},
"amount": {
"value": 85,
"currency": "TWD"
}
}
]
}
],
"addItem": [
{
"extension": [
{
"extension": [
{
"url": "objid",
"valueString": "882601915"
},
{
"url": "sourceSystem",
"valueString": "TranCareCenter"
}
],
"url": "http://ltc-ig.fhir.tw/StructureDefinition/Ext-TW-LTC-FeeAudit-RecordRef"
}
],
"itemSequence": [
1
],
"productOrService": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-service-item",
"code": "AA05",
"display": "照顧困難之服務加計"
}
]
},
"adjudication": [
{
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication",
"code": "price",
"display": "單價"
}
]
},
"amount": {
"value": 200,
"currency": "TWD"
}
}
]
}
],
"total": [
{
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication",
"code": "submitted",
"display": "申請核銷金額"
}
]
},
"amount": {
"value": 4500,
"currency": "TWD"
}
},
{
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication",
"code": "approveFee",
"display": "核定金額"
}
]
},
"amount": {
"value": 1596,
"currency": "TWD"
}
},
{
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication",
"code": "aSvcFee",
"display": "政策鼓勵金額"
}
]
},
"amount": {
"value": 400,
"currency": "TWD"
}
},
{
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication",
"code": "tempPaymentFee",
"display": "分案暫付金額"
}
]
},
"amount": {
"value": 17500,
"currency": "TWD"
}
},
{
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication",
"code": "incInAcc",
"display": "核增金額"
}
]
},
"amount": {
"value": 4000,
"currency": "TWD"
}
},
{
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-adjudication",
"code": "decInAcc",
"display": "核減金額"
}
]
},
"amount": {
"value": 500,
"currency": "TWD"
}
}
],
"processNote": [
{
"number": 1,
"type": "display",
"text": "核增原因（inc_in_reason）：因個案身分異動"
},
{
"number": 2,
"type": "display",
"text": "核減原因（dec_in_reason）：因個案CMS等級異動"
}
]
}