醫療保險理賠實作指引
1.0.0 - CI Build
醫療保險理賠實作指引
1.0.0 - CI Build
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
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<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>
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<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>
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<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>
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<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>
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<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>
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<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>
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