醫療保險理賠實作指引
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: Bundle-C3 - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "Bundle-C3",
  "meta" : {
    "profile" : [
      🔗 "https://claim.cgh.org.tw/iclaim/StructureDefinition/bundle-iclaim"
    ]
  },
  "identifier" : {
    "system" : "https://www.cgh.org.tw",
    "value" : "A0003"
  },
  "type" : "document",
  "timestamp" : "2023-08-21T14:30:00+01:00",
  "entry" : [
    {
      "fullUrl" : "https://claim.cgh.org.tw/iclaim/Composition/Composition-C3",
      "resource" : {
        "resourceType" : "Composition",
        "id" : "Composition-C3",
        "meta" : {
          "profile" : [
            🔗 "https://claim.cgh.org.tw/iclaim/StructureDefinition/composition-iclaim"
          ]
        },
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3><b>Composition</b></h3><p><b>文件識別碼</b>:A0003 (https://www.cgh.org.tw)</p><p><b>文件狀態</b>:Final <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">(<a href=\"http://hl7.org/fhir/R4/valueset-composition-status.html\">CompositionStatus</a>#final)</span></p><p><b>文件種類</b>:Charge ticket or encounter form <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"https://loinc.org/\">LOINC</a>#64291-8)</span></p><p><b>文件創建日期</b>:2023-08-21T14:30:00+08:00</p><p><b>文件創建單位</b>:<a href=\"Organization-Organization-min.html\">Organization/Organization-min</a> \"國泰醫療財團法人國泰綜合醫院\"</p><p><b>病人</b>:<a href=\"Patient-Patient-C3.html\">Patient/Patient-C3</a> \"玳健康\"</p><p><b>section.entry[iClaim]</b>:<a href=\"Claim-Claim-C3.html\">Claim/Claim-C3</a></p><p><b>section.entry[coverage]</b>:<a href=\"Coverage-Coverage-C3.html\">Coverage/Coverage-C3</a></p><p><b>section.entry[payor]</b>:<a href=\"Organization-Organization-cathay.html\">Organization/Organization-cathay</a></p></div>"
        },
        "identifier" : {
          "system" : "https://www.cgh.org.tw",
          "value" : "A0003"
        },
        "status" : "final",
        "type" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "64291-8"
            }
          ]
        },
        "subject" : {
          🔗 "reference" : "Patient/Patient-C3"
        },
        "date" : "2023-08-21T14:30:00+08:00",
        "author" : [
          {
            🔗 "reference" : "Organization/Organization-min"
          }
        ],
        "title" : "理賠用收據-診斷證明-檢驗紀錄",
        "section" : [
          {
            "title" : "理賠用收據-診斷證明-檢驗紀錄",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "64291-8"
                }
              ]
            },
            "entry" : [
              {
                🔗 "reference" : "Claim/Claim-C3"
              },
              {
                🔗 "reference" : "Coverage/Coverage-C3"
              },
              {
                🔗 "reference" : "Organization/Organization-cathay"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "https://claim.cgh.org.tw/iclaim/Claim/Claim-C3",
      "resource" : {
        "resourceType" : "Claim",
        "id" : "Claim-C3",
        "meta" : {
          "profile" : [
            🔗 "https://claim.cgh.org.tw/iclaim/StructureDefinition/claim-iclaim"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>理賠申請書編號</b>:A0003 (https://www.cgh.org.tw)</p><p><b>理賠申請書狀態</b>: Active <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">(<a href=\"http://hl7.org/fhir/R4/codesystem-fm-status.html\">Financial Resource Status Codes</a>#active)</span></p><p><b>理賠申請書類別</b>: Institutional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">(<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#institutional)</span></p><p><b>理賠申請書用途</b>: Claim <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">(<a href=\"http://hl7.org/fhir/R4/codesystem-claim-use.html\">Use</a>#claim)</span></p><p><b>病人</b>: <a href=\"Patient-Patient-C3.html\">Patient/Patient-C3</a> \"康美女\"</p><p><b>理賠申請書日期</b>: 2023-08-12</p><p><b>醫院</b>: <a href=\"Organization-Organization-min.html\">Organization/Organization-min</a> \"國泰醫療財團法人國泰綜合醫院\"</p><p><b>處理優先順序</b>: Immediate <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">(<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#stat)</span></p><p><b>保險</b>:</p><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>順序</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=\"Coverage-Coverage-C3.html\">Coverage/Coverage-C3</a></td></tr></table></div>"
        },
        "identifier" : [
          {
            "system" : "https://www.cgh.org.tw",
            "value" : "A0003"
          }
        ],
        "status" : "active",
        "type" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
              "code" : "institutional"
            }
          ]
        },
        "use" : "claim",
        "patient" : {
          🔗 "reference" : "Patient/Patient-C3"
        },
        "created" : "2023-08-12",
        "provider" : {
          🔗 "reference" : "Organization/Organization-min"
        },
        "priority" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
              "code" : "stat"
            }
          ]
        },
        "insurance" : [
          {
            "sequence" : 1,
            "focal" : true,
            "coverage" : {
              🔗 "reference" : "Coverage/Coverage-C3"
            }
          }
        ]
      }
    },
    {
      "fullUrl" : "https://claim.cgh.org.tw/iclaim/Patient/Patient-C3",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "Patient-C3",
        "meta" : {
          "profile" : [
            🔗 "https://claim.cgh.org.tw/iclaim/StructureDefinition/patient-iclaim"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3><b>病人基本資料</b></h3><blockquote><p><b>識別碼型別</b>:National Person Identifier <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"http://terminology.hl7.org/CodeSystem/v2-0203\">Identifier Type Codes</a>#NNxxx <b>[extension: <a href=\"https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/identifier-suffix\">Identifier Suffix</a>]:</b>TWN)</span><br/><b>身分證字號(official)</b>P137786694 (http://www.moi.gov.tw)</p></blockquote><blockquote><p><b>識別碼型別</b>:Medical record number <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"http://terminology.hl7.org/CodeSystem/v2-0203\">Identifier Type Codes</a>#MR)</span><br/><b>病歷號(official)</b>:ADCM9527 (https://www.cgh.org.tw)</p></blockquote><p><b>姓名(official)</b>:玳健康</p><p><b>性別</b>:Male <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"http://hl7.org/fhir/R4/codesystem-administrative-gender.html\">AdministrativeGender</a>#male)</span></p><p><b>出生日期</b>:2002-02-22</p><p><b>職業[extension: <a href=\"StructureDefinition-cathay-occupation.html\">Occupation</a>]</b>:內勤人員 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"CodeSystem-lia-roc-occupation-values.html\">Occupation</a>#00010010)</span></p><p><b>聯絡地址</b>:台北市北投區明德路365號<br/><b>\u3000縣/市(district)</b>:台北市<br/><b>\u3000鄉/鎮/市/區(city)</b>:北投區<br/><b>\u3000路/街(line)</b>:明德路<br/><b>\u3000號(number)</b>[extension: <a href=\"https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/tw-number\">tw-number</a>]:365號<br/><b>\u3000國家(country)</b>:臺灣<br/></p></div>"
        },
        "extension" : [
          {
            "url" : "https://claim.cgh.org.tw/iclaim/StructureDefinition/cathay-occupation",
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "https://claim.cgh.org.tw/iclaim/CodeSystem/lia-roc-occupation-values",
                  "code" : "00010010"
                }
              ]
            }
          }
        ],
        "identifier" : [
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "NNxxx",
                  "_code" : {
                    "extension" : [
                      {
                        "extension" : [
                          {
                            "url" : "suffix",
                            "valueString" : "TWN"
                          },
                          {
                            "url" : "valueSet",
                            "valueCanonical" : "http://hl7.org/fhir/ValueSet/iso3166-1-3"
                          }
                        ],
                        "url" : "https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/identifier-suffix"
                      }
                    ]
                  }
                }
              ]
            },
            "system" : "http://www.moi.gov.tw",
            "value" : "P137786694"
          },
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "MR"
                }
              ]
            },
            "system" : "https://www.cgh.org.tw",
            "value" : "ADCM9527"
          }
        ],
        "name" : [
          {
            "use" : "usual",
            "text" : "玳健康"
          }
        ],
        "gender" : "male",
        "birthDate" : "2002-02-22",
        "address" : [
          {
            "extension" : [
              {
                "url" : "https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/tw-number",
                "valueString" : "365號"
              }
            ],
            "text" : "台北市北投區明德路365號",
            "line" : [
              "明德路"
            ],
            "city" : "北投區",
            "district" : "台北市",
            "country" : "TW"
          }
        ]
      }
    },
    {
      "fullUrl" : "https://claim.cgh.org.tw/iclaim/Organization/Organization-min",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "Organization-min",
        "meta" : {
          "profile" : [
            🔗 "https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/Organization-hosp-twcore"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3><b>醫事機構基本資料</b></h3><p><b>機構名稱</b>:國泰醫療財團法人國泰綜合醫院</p><p><b>識別碼型別</b>:Provider number<span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"http://terminology.hl7.org/CodeSystem/v2-0203\">IdentifierType</a>#PRN)</span><br/><b>機構代碼(official)</b>:1101020018 (https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/organization-identifier-tw)</p><p><b>機構種類</b>:Healthcare Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"http://hl7.org/fhir/R4/codesystem-organization-type.html\">OrganizationType</a>#prov)</span></p></div>"
        },
        "identifier" : [
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "PRN"
                }
              ]
            },
            "system" : "https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/organization-identifier-tw",
            "value" : "1101020018"
          }
        ],
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
                "code" : "prov"
              }
            ]
          }
        ],
        "name" : "國泰醫療財團法人國泰綜合醫院"
      }
    },
    {
      "fullUrl" : "https://claim.cgh.org.tw/iclaim/Coverage/Coverage-C3",
      "resource" : {
        "resourceType" : "Coverage",
        "id" : "Coverage-C3",
        "meta" : {
          "profile" : [
            🔗 "https://claim.cgh.org.tw/iclaim/StructureDefinition/coverage-iclaim"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>status</b>: active <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"https://hl7.org/fhir/R4/codesystem-fm-status.html\">FinancialResourceStatusCodes</a>#active )</span></p><p><b>beneficiary</b>: <a href=\"Patient-Patient-C3.html\">Patient/Patient-C3</a> \"玳健康\"</p><p><b>payor</b>: <a href=\"Organization-Organization-cathay.html\">Organization/Organization-cathay</a> \"國泰人壽保險股份有限公司\"</p></div>"
        },
        "status" : "active",
        "beneficiary" : {
          🔗 "reference" : "Patient/Patient-C3"
        },
        "payor" : [
          {
            🔗 "reference" : "Organization/Organization-cathay"
          }
        ]
      }
    },
    {
      "fullUrl" : "https://claim.cgh.org.tw/iclaim/Organization/Organization-cathay",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "Organization-cathay",
        "meta" : {
          "profile" : [
            🔗 "https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/Organization-co-twcore"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3><b>公司行號基本資料</b></h3><p><b>機構名稱</b>:國泰人壽保險股份有限公司</p><p><b>識別碼型別</b>:Unified Business number<span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/v2-0203\">臺灣識別碼類型</a>#UBN)</span><br/><b>公司或企業統一編號(official)</b>:03374707 (https://gcis.nat.gov.tw)</p><p><b>機構種類</b>:Non-Healthcare Business or Corporation <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"http://hl7.org/fhir/R4/codesystem-organization-type.html\">OrganizationType</a>#bus)</span></p></div>"
        },
        "identifier" : [
          {
            "use" : "official",
            "type" : {
              "coding" : [
                {
                  "system" : "https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/v2-0203",
                  "code" : "UBN"
                }
              ]
            },
            "system" : "https://gcis.nat.gov.tw",
            "value" : "03374707"
          }
        ],
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
                "code" : "bus"
              }
            ]
          }
        ],
        "name" : "國泰人壽保險股份有限公司"
      }
    }
  ]
}