Bundle-C3 - TTL Representation - 醫療保險理賠實作指引 v1.0.0

醫療保險理賠實作指引 - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
: Bundle-C3 - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <https://loinc.org/rdf/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Bundle ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "Bundle-C3"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://claim.cgh.org.tw/iclaim/StructureDefinition/bundle-iclaim"^^xsd:anyURI ;
fhir:link <https://claim.cgh.org.tw/iclaim/StructureDefinition/bundle-iclaim>     ] )
  ] ; # 
  fhir:identifier [
fhir:system [ fhir:v "https://www.cgh.org.tw"^^xsd:anyURI ] ;
fhir:value [ fhir:v "A0003" ]
  ] ; # 
  fhir:type [ fhir:v "document"] ; # 
  fhir:timestamp [ fhir:v "2023-08-21T14:30:00+01:00"^^xsd:dateTime] ; # 
  fhir:entry ( [
fhir:fullUrl [ fhir:v "https://claim.cgh.org.tw/iclaim/Composition/Composition-C3"^^xsd:anyURI ] ;
    ( fhir:resource <https://claim.cgh.org.tw/iclaim/Composition/Composition-C3> )
  ] [
fhir:fullUrl [ fhir:v "https://claim.cgh.org.tw/iclaim/Claim/Claim-C3"^^xsd:anyURI ] ;
    ( fhir:resource <https://claim.cgh.org.tw/iclaim/Claim/Claim-C3> )
  ] [
fhir:fullUrl [ fhir:v "https://claim.cgh.org.tw/iclaim/Patient/Patient-C3"^^xsd:anyURI ] ;
    ( fhir:resource <https://claim.cgh.org.tw/iclaim/Patient/Patient-C3> )
  ] [
fhir:fullUrl [ fhir:v "https://claim.cgh.org.tw/iclaim/Organization/Organization-min"^^xsd:anyURI ] ;
    ( fhir:resource <https://claim.cgh.org.tw/iclaim/Organization/Organization-min> )
  ] [
fhir:fullUrl [ fhir:v "https://claim.cgh.org.tw/iclaim/Coverage/Coverage-C3"^^xsd:anyURI ] ;
    ( fhir:resource <https://claim.cgh.org.tw/iclaim/Coverage/Coverage-C3> )
  ] [
fhir:fullUrl [ fhir:v "https://claim.cgh.org.tw/iclaim/Organization/Organization-cathay"^^xsd:anyURI ] ;
    ( fhir:resource <https://claim.cgh.org.tw/iclaim/Organization/Organization-cathay> )
  ] ) . # 

<https://claim.cgh.org.tw/iclaim/Composition/Composition-C3> a fhir:Composition ;
  fhir:id [ fhir:v "Composition-C3"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://claim.cgh.org.tw/iclaim/StructureDefinition/composition-iclaim"^^xsd:anyURI ;
fhir:link <https://claim.cgh.org.tw/iclaim/StructureDefinition/composition-iclaim>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir: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>"
  ] ; # 
  fhir:identifier [
fhir:system [ fhir:v "https://www.cgh.org.tw"^^xsd:anyURI ] ;
fhir:value [ fhir:v "A0003" ]
  ] ; # 
  fhir:status [ fhir:v "final"] ; # 
  fhir:type [
    ( fhir:coding [
a loinc:64291-8 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "64291-8" ]     ] )
  ] ; # 
  fhir:subject [
fhir:reference [ fhir:v "Patient/Patient-C3" ]
  ] ; # 
  fhir:date [ fhir:v "2023-08-21T14:30:00+08:00"^^xsd:dateTime] ; # 
  fhir:author ( [
fhir:reference [ fhir:v "Organization/Organization-min" ]
  ] ) ; # 
  fhir:title [ fhir:v "理賠用收據-診斷證明-檢驗紀錄"] ; # 
  fhir:section ( [
fhir:title [ fhir:v "理賠用收據-診斷證明-檢驗紀錄" ] ;
fhir:code [
      ( fhir:coding [
a loinc:64291-8 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "64291-8" ]       ] )     ] ;
    ( fhir:entry [
fhir:reference [ fhir:v "Claim/Claim-C3" ]     ] [
fhir:reference [ fhir:v "Coverage/Coverage-C3" ]     ] [
fhir:reference [ fhir:v "Organization/Organization-cathay" ]     ] )
  ] ) . # 

<https://claim.cgh.org.tw/iclaim/Claim/Claim-C3> a fhir:Claim ;
  fhir:id [ fhir:v "Claim-C3"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://claim.cgh.org.tw/iclaim/StructureDefinition/claim-iclaim"^^xsd:anyURI ;
fhir:link <https://claim.cgh.org.tw/iclaim/StructureDefinition/claim-iclaim>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>"
  ] ; # 
  fhir:identifier ( [
fhir:system [ fhir:v "https://www.cgh.org.tw"^^xsd:anyURI ] ;
fhir:value [ fhir:v "A0003" ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "institutional" ]     ] )
  ] ; # 
  fhir:use [ fhir:v "claim"] ; # 
  fhir:patient [
fhir:reference [ fhir:v "Patient/Patient-C3" ]
  ] ; # 
  fhir:created [ fhir:v "2023-08-12"^^xsd:date] ; # 
  fhir:provider [
fhir:reference [ fhir:v "Organization/Organization-min" ]
  ] ; # 
  fhir:priority [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ] ;
fhir:code [ fhir:v "stat" ]     ] )
  ] ; # 
  fhir:insurance ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:focal [ fhir:v "true"^^xsd:boolean ] ;
fhir:coverage [
fhir:reference [ fhir:v "Coverage/Coverage-C3" ]     ]
  ] ) . # 

<https://claim.cgh.org.tw/iclaim/Patient/Patient-C3> a fhir:Patient ;
  fhir:id [ fhir:v "Patient-C3"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://claim.cgh.org.tw/iclaim/StructureDefinition/patient-iclaim"^^xsd:anyURI ;
fhir:link <https://claim.cgh.org.tw/iclaim/StructureDefinition/patient-iclaim>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>　縣/市（district）</b>：台北市<br/><b>　鄉/鎮/市/區（city）</b>：北投區<br/><b>　路/街（line）</b>：明德路<br/><b>　號（number）</b>[extension: <a href=\"https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/tw-number\">tw-number</a>]：365號<br/><b>　國家（country）</b>：臺灣<br/></p></div>"
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "https://claim.cgh.org.tw/iclaim/StructureDefinition/cathay-occupation"^^xsd:anyURI ] ;
fhir:value [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [ fhir:v "https://claim.cgh.org.tw/iclaim/CodeSystem/lia-roc-occupation-values"^^xsd:anyURI ] ;
fhir:code [ fhir:v "00010010" ]       ] )     ]
  ] ) ; # 
  fhir:identifier ( [
fhir:use [ fhir:v "official" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [
fhir:v "NNxxx" ;
          ( fhir:extension [
            ( fhir:extension [
fhir:url [ fhir:v "suffix"^^xsd:anyURI ] ;
fhir:value [ fhir:v "TWN" ]             ] [
fhir:url [ fhir:v "valueSet"^^xsd:anyURI ] ;
fhir:value [
fhir:v "http://hl7.org/fhir/ValueSet/iso3166-1-3"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/ValueSet/iso3166-1-3>               ]             ] ) ;
fhir:url [ fhir:v "https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/identifier-suffix"^^xsd:anyURI ]           ] )         ]       ] )     ] ;
fhir:system [ fhir:v "http://www.moi.gov.tw"^^xsd:anyURI ] ;
fhir:value [ fhir:v "P137786694" ]
  ] [
fhir:use [ fhir:v "official" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MR" ]       ] )     ] ;
fhir:system [ fhir:v "https://www.cgh.org.tw"^^xsd:anyURI ] ;
fhir:value [ fhir:v "ADCM9527" ]
  ] ) ; # 
  fhir:name ( [
fhir:use [ fhir:v "usual" ] ;
fhir:text [ fhir:v "玳健康" ]
  ] ) ; # 
  fhir:gender [ fhir:v "male"] ; # 
  fhir:birthDate [ fhir:v "2002-02-22"^^xsd:date] ; # 
  fhir:address ( [
    ( fhir:extension [
fhir:url [ fhir:v "https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/tw-number"^^xsd:anyURI ] ;
fhir:value [ fhir:v "365號" ]     ] ) ;
fhir:text [ fhir:v "台北市北投區明德路365號" ] ;
    ( fhir:line [ fhir:v "明德路" ] ) ;
fhir:city [ fhir:v "北投區" ] ;
fhir:district [ fhir:v "台北市" ] ;
fhir:country [ fhir:v "TW" ]
  ] ) . # 

<https://claim.cgh.org.tw/iclaim/Organization/Organization-min> a fhir:Organization ;
  fhir:id [ fhir:v "Organization-min"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/Organization-hosp-twcore"^^xsd:anyURI ;
fhir:link <https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/Organization-hosp-twcore>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>"
  ] ; # 
  fhir:identifier ( [
fhir:use [ fhir:v "official" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "PRN" ]       ] )     ] ;
fhir:system [ fhir:v "https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/organization-identifier-tw"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1101020018" ]
  ] ) ; # 
  fhir:type ( [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/organization-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "prov" ]     ] )
  ] ) ; # 
  fhir:name [ fhir:v "國泰醫療財團法人國泰綜合醫院"] . # 

<https://claim.cgh.org.tw/iclaim/Coverage/Coverage-C3> a fhir:Coverage ;
  fhir:id [ fhir:v "Coverage-C3"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://claim.cgh.org.tw/iclaim/StructureDefinition/coverage-iclaim"^^xsd:anyURI ;
fhir:link <https://claim.cgh.org.tw/iclaim/StructureDefinition/coverage-iclaim>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>"
  ] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:beneficiary [
fhir:reference [ fhir:v "Patient/Patient-C3" ]
  ] ; # 
  fhir:payor ( [
fhir:reference [ fhir:v "Organization/Organization-cathay" ]
  ] ) . # 

<https://claim.cgh.org.tw/iclaim/Organization/Organization-cathay> a fhir:Organization ;
  fhir:id [ fhir:v "Organization-cathay"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/Organization-co-twcore"^^xsd:anyURI ;
fhir:link <https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/Organization-co-twcore>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>"
  ] ; # 
  fhir:identifier ( [
fhir:use [ fhir:v "official" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "UBN" ]       ] )     ] ;
fhir:system [ fhir:v "https://gcis.nat.gov.tw"^^xsd:anyURI ] ;
fhir:value [ fhir:v "03374707" ]
  ] ) ; # 
  fhir:type ( [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/organization-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "bus" ]     ] )
  ] ) ; # 
  fhir:name [ fhir:v "國泰人壽保險股份有限公司"] . #