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 xmlns="http://hl7.org/fhir">
<id value="Bundle-C3"/>
<meta>
<profile
value="https://claim.cgh.org.tw/iclaim/StructureDefinition/bundle-iclaim"/>
</meta>
<identifier>
<system value="https://www.cgh.org.tw"/>
<value value="A0003"/>
</identifier>
<type value="document"/>
<timestamp value="2023-08-21T14:30:00+01:00"/>
<entry>
<fullUrl
value="https://claim.cgh.org.tw/iclaim/Composition/Composition-C3"/>
<resource>
<Composition>
<id value="Composition-C3"/>
<meta>
<profile
value="https://claim.cgh.org.tw/iclaim/StructureDefinition/composition-iclaim"/>
</meta>
<text>
<status value="extensions"/>
<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>
</text>
<identifier>
<system value="https://www.cgh.org.tw"/>
<value value="A0003"/>
</identifier>
<status value="final"/>
<type>
<coding>
<system value="http://loinc.org"/>
<code value="64291-8"/>
</coding>
</type>
<subject>🔗
<reference value="Patient/Patient-C3"/>
</subject>
<date value="2023-08-21T14:30:00+08:00"/>
<author>🔗
<reference value="Organization/Organization-min"/>
</author>
<title value="理賠用收據-診斷證明-檢驗紀錄"/>
<section>
<title value="理賠用收據-診斷證明-檢驗紀錄"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="64291-8"/>
</coding>
</code>
<entry>🔗
<reference value="Claim/Claim-C3"/>
</entry>
<entry>🔗
<reference value="Coverage/Coverage-C3"/>
</entry>
<entry>🔗
<reference value="Organization/Organization-cathay"/>
</entry>
</section>
</Composition>
</resource>
</entry>
<entry>
<fullUrl value="https://claim.cgh.org.tw/iclaim/Claim/Claim-C3"/>
<resource>
<Claim>
<id value="Claim-C3"/>
<meta>
<profile
value="https://claim.cgh.org.tw/iclaim/StructureDefinition/claim-iclaim"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="https://www.cgh.org.tw"/>
<value value="A0003"/>
</identifier>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
<code value="institutional"/>
</coding>
</type>
<use value="claim"/>
<patient>🔗
<reference value="Patient/Patient-C3"/>
</patient>
<created value="2023-08-12"/>
<provider>🔗
<reference value="Organization/Organization-min"/>
</provider>
<priority>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/processpriority"/>
<code value="stat"/>
</coding>
</priority>
<insurance>
<sequence value="1"/>
<focal value="true"/>
<coverage>🔗
<reference value="Coverage/Coverage-C3"/>
</coverage>
</insurance>
</Claim>
</resource>
</entry>
<entry>
<fullUrl value="https://claim.cgh.org.tw/iclaim/Patient/Patient-C3"/>
<resource>
<Patient>
<id value="Patient-C3"/>
<meta>
<profile
value="https://claim.cgh.org.tw/iclaim/StructureDefinition/patient-iclaim"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<extension
url="https://claim.cgh.org.tw/iclaim/StructureDefinition/cathay-occupation">
<valueCodeableConcept>
<coding>
<system
value="https://claim.cgh.org.tw/iclaim/CodeSystem/lia-roc-occupation-values"/>
<code value="00010010"/>
</coding>
</valueCodeableConcept>
</extension>
<identifier>
<use value="official"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="NNxxx">
<extension
url="https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/identifier-suffix">
<extension url="suffix">
<valueString value="TWN"/>
</extension>
<extension url="valueSet">
<valueCanonical
value="http://hl7.org/fhir/ValueSet/iso3166-1-3"/>
</extension>
</extension>
</code>
</coding>
</type>
<system value="http://www.moi.gov.tw"/>
<value value="P137786694"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MR"/>
</coding>
</type>
<system value="https://www.cgh.org.tw"/>
<value value="ADCM9527"/>
</identifier>
<name>
<use value="usual"/>
<text value="玳健康"/>
</name>
<gender value="male"/>
<birthDate value="2002-02-22"/>
<address>
<extension
url="https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/tw-number">
<valueString value="365號"/>
</extension>
<text value="台北市北投區明德路365號"/>
<line value="明德路"/>
<city value="北投區"/>
<district value="台北市"/>
<country value="TW"/>
</address>
</Patient>
</resource>
</entry>
<entry>
<fullUrl
value="https://claim.cgh.org.tw/iclaim/Organization/Organization-min"/>
<resource>
<Organization>
<id value="Organization-min"/>
<meta>
<profile
value="https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/Organization-hosp-twcore"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<use value="official"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="PRN"/>
</coding>
</type>
<system
value="https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/organization-identifier-tw"/>
<value value="1101020018"/>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="prov"/>
</coding>
</type>
<name value="國泰醫療財團法人國泰綜合醫院"/>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="https://claim.cgh.org.tw/iclaim/Coverage/Coverage-C3"/>
<resource>
<Coverage>
<id value="Coverage-C3"/>
<meta>
<profile
value="https://claim.cgh.org.tw/iclaim/StructureDefinition/coverage-iclaim"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<beneficiary>🔗
<reference value="Patient/Patient-C3"/>
</beneficiary>
<payor>🔗
<reference value="Organization/Organization-cathay"/>
</payor>
</Coverage>
</resource>
</entry>
<entry>
<fullUrl
value="https://claim.cgh.org.tw/iclaim/Organization/Organization-cathay"/>
<resource>
<Organization>
<id value="Organization-cathay"/>
<meta>
<profile
value="https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/Organization-co-twcore"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/v2-0203"/>
<code value="UBN"/>
</coding>
</type>
<system value="https://gcis.nat.gov.tw"/>
<value value="03374707"/>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="bus"/>
</coding>
</type>
<name value="國泰人壽保險股份有限公司"/>
</Organization>
</resource>
</entry>
</Bundle>