醫療保險理賠實作指引
0.1.3 - CI Build

This page is part of the 醫療保險理賠實作指引 (v0.1.3: Releases Ballot 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Logical Model: 理賠申請書(ClaimForm)之資料模型

Official URL: https://claim.cgh.org.tw/iclaim/StructureDefinition/ClaimFormModel Version: 0.1.3
Active as of 2023-12-25 Computable Name: ClaimFormModel

理賠申請書(ClaimForm)之資料模型

Usage:

  • This Logical Model Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Base

NameFlagsCard.TypeDescription & Constraintsdoco
.. ClaimFormModel 0..*Base理賠申請書(ClaimForm)之資料模型
Instances of this logical model are not marked to be the target of a Reference
... caseNo 0..1identifier案件編號
... admissionNumber 1..1identifier住院號/就醫號
... patient 1..1BackboneElement病人的基本資料
.... occupation 0..1CodeableConcept職業
.... identifier 1..1identifier身分證字號
.... patientNo 1..1identifier病歷號碼
.... name 1..1HumanName姓名
.... gender 1..1CodeableConcept性別
.... birthDate 1..1dateTime出生日期
.... address 0..1Address居住地址
.... identifier 1..1identifier醫事機構代碼
... certificateOfDiagnosis 0..*BackboneElement診斷證明書
.... patientSource 1..1CodeableConcept病人來源
.... particularDiagnosis 0..1CodeableConcept特殊診斷類別
.... department 1..1string應診科別
.... departmentCode 1..1CodeableConcept應診科別代碼
.... firstExaminationDate 1..1dateTime應診日期(始)
.... endExaminationDate 1..1dateTime應診日期(末)
.... examinationDay 0..1Duration應診天數
.... identifier 1..1identifier診斷證明書序號
.... diagnosis 1..*string診斷(病名)
.... diagnosisCode 1..*CodeableConcept病名代碼
.... recordedDate 1..1dateTime診斷證明書日期
.... primaryPhysician 1..1HumanName主治醫師
.... primaryPhysicianNo 0..1identifier醫師證號
.... medicalSummary 1..1markdown醫療摘要
.... responsiblePhysician 0..1HumanName負責醫師(院長)
... invoice 0..*BackboneElement收據正本及費用明細表
.... chargeItem 0..*CodeableConcept費用項目
.... medicalIdentity 0..1CodeableConcept就醫身分
.... invoiceDate 1..1date收據日期
.... selfPayAmount 0..1Money自付金額
.... discount 0..1Money減免
.... nationalHealthInsuranePoint 0..1Money健保點數
.... invoiceAmount 0..1Money收據金額
... laboratoryReport 0..*BackboneElement相關檢驗/檢查報告
.... laboratoryReportName 1..1CodeableConcept檢驗報告名稱
.... laboratoryReportNo 1..1identifier收件編號(檢驗單號)
.... laboratoryItemName 1..*CodeableConcept檢驗項目名稱
.... samplingDate 1..1dateTime採檢日期
.... reportDate 1..1instant報告日期
.... medicalTechnologist 1..1HumanName醫檢師
.... reporter 1..1HumanName報告者
.... laboratoryValue 1..*BackboneElement檢測值
.... unit 0..1string單位
.... hL 0..1CodeableConceptH/L
.... note 0..1markdown註記
.... bodySite 0..1CodeableConcept檢驗部位
.... referenceRange 1..*BackboneElement參考值
.... recordedPhysician 1..1HumanName開單醫師
.... recordedDepartment 1..1CodeableConcept開單科別

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. ClaimFormModel 0..*Base理賠申請書(ClaimForm)之資料模型
Instances of this logical model are not marked to be the target of a Reference
... caseNo 0..1identifier案件編號
... admissionNumber 1..1identifier住院號/就醫號
... patient 1..1BackboneElement病人的基本資料
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... occupation 0..1CodeableConcept職業
.... identifier 1..1identifier身分證字號
.... patientNo 1..1identifier病歷號碼
.... name 1..1HumanName姓名
.... gender 1..1CodeableConcept性別
.... birthDate 1..1dateTime出生日期
.... address 0..1Address居住地址
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier 1..1identifier醫事機構代碼
... certificateOfDiagnosis 0..*BackboneElement診斷證明書
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... patientSource 1..1CodeableConcept病人來源
.... particularDiagnosis 0..1CodeableConcept特殊診斷類別
.... department 1..1string應診科別
.... departmentCode 1..1CodeableConcept應診科別代碼
.... firstExaminationDate 1..1dateTime應診日期(始)
.... endExaminationDate 1..1dateTime應診日期(末)
.... examinationDay 0..1Duration應診天數
.... identifier 1..1identifier診斷證明書序號
.... diagnosis 1..*string診斷(病名)
.... diagnosisCode 1..*CodeableConcept病名代碼
.... recordedDate 1..1dateTime診斷證明書日期
.... primaryPhysician 1..1HumanName主治醫師
.... primaryPhysicianNo 0..1identifier醫師證號
.... medicalSummary 1..1markdown醫療摘要
.... responsiblePhysician 0..1HumanName負責醫師(院長)
... invoice 0..*BackboneElement收據正本及費用明細表
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... chargeItem 0..*CodeableConcept費用項目
.... medicalIdentity 0..1CodeableConcept就醫身分
.... invoiceDate 1..1date收據日期
.... selfPayAmount 0..1Money自付金額
.... discount 0..1Money減免
.... nationalHealthInsuranePoint 0..1Money健保點數
.... invoiceAmount 0..1Money收據金額
... laboratoryReport 0..*BackboneElement相關檢驗/檢查報告
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... laboratoryReportName 1..1CodeableConcept檢驗報告名稱
.... laboratoryReportNo 1..1identifier收件編號(檢驗單號)
.... laboratoryItemName 1..*CodeableConcept檢驗項目名稱
.... samplingDate 1..1dateTime採檢日期
.... reportDate 1..1instant報告日期
.... medicalTechnologist 1..1HumanName醫檢師
.... reporter 1..1HumanName報告者
.... laboratoryValue 1..*BackboneElement檢測值
.... unit 0..1string單位
.... hL 0..1CodeableConceptH/L
.... note 0..1markdown註記
.... bodySite 0..1CodeableConcept檢驗部位
.... referenceRange 1..*BackboneElement參考值
.... recordedPhysician 1..1HumanName開單醫師
.... recordedDepartment 1..1CodeableConcept開單科別

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. ClaimFormModel 0..*Base理賠申請書(ClaimForm)之資料模型
Instances of this logical model are not marked to be the target of a Reference
... caseNo 0..1identifier案件編號
... admissionNumber 1..1identifier住院號/就醫號
... patient 1..1BackboneElement病人的基本資料
.... @id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... occupation 0..1CodeableConcept職業
.... identifier 1..1identifier身分證字號
.... patientNo 1..1identifier病歷號碼
.... name 1..1HumanName姓名
.... gender 1..1CodeableConcept性別
.... birthDate 1..1dateTime出生日期
.... address 0..1Address居住地址
.... @id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier 1..1identifier醫事機構代碼
... certificateOfDiagnosis 0..*BackboneElement診斷證明書
.... @id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... patientSource 1..1CodeableConcept病人來源
.... particularDiagnosis 0..1CodeableConcept特殊診斷類別
.... department 1..1string應診科別
.... departmentCode 1..1CodeableConcept應診科別代碼
.... firstExaminationDate 1..1dateTime應診日期(始)
.... endExaminationDate 1..1dateTime應診日期(末)
.... examinationDay 0..1Duration應診天數
.... identifier 1..1identifier診斷證明書序號
.... diagnosis 1..*string診斷(病名)
.... diagnosisCode 1..*CodeableConcept病名代碼
.... recordedDate 1..1dateTime診斷證明書日期
.... primaryPhysician 1..1HumanName主治醫師
.... primaryPhysicianNo 0..1identifier醫師證號
.... medicalSummary 1..1markdown醫療摘要
.... responsiblePhysician 0..1HumanName負責醫師(院長)
... invoice 0..*BackboneElement收據正本及費用明細表
.... @id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... chargeItem 0..*CodeableConcept費用項目
.... medicalIdentity 0..1CodeableConcept就醫身分
.... invoiceDate 1..1date收據日期
.... selfPayAmount 0..1Money自付金額
.... discount 0..1Money減免
.... nationalHealthInsuranePoint 0..1Money健保點數
.... invoiceAmount 0..1Money收據金額
... laboratoryReport 0..*BackboneElement相關檢驗/檢查報告
.... @id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... laboratoryReportName 1..1CodeableConcept檢驗報告名稱
.... laboratoryReportNo 1..1identifier收件編號(檢驗單號)
.... laboratoryItemName 1..*CodeableConcept檢驗項目名稱
.... samplingDate 1..1dateTime採檢日期
.... reportDate 1..1instant報告日期
.... medicalTechnologist 1..1HumanName醫檢師
.... reporter 1..1HumanName報告者
.... laboratoryValue 1..*BackboneElement檢測值
.... unit 0..1string單位
.... hL 0..1CodeableConceptH/L
.... note 0..1markdown註記
.... bodySite 0..1CodeableConcept檢驗部位
.... referenceRange 1..*BackboneElement參考值
.... recordedPhysician 1..1HumanName開單醫師
.... recordedDepartment 1..1CodeableConcept開單科別

doco Documentation for this format

This structure is derived from Base

Summary

Mandatory: 0 element (32 nested mandatory elements)

Structures

This structure refers to these other structures:

Differential View

This structure is derived from Base

NameFlagsCard.TypeDescription & Constraintsdoco
.. ClaimFormModel 0..*Base理賠申請書(ClaimForm)之資料模型
Instances of this logical model are not marked to be the target of a Reference
... caseNo 0..1identifier案件編號
... admissionNumber 1..1identifier住院號/就醫號
... patient 1..1BackboneElement病人的基本資料
.... occupation 0..1CodeableConcept職業
.... identifier 1..1identifier身分證字號
.... patientNo 1..1identifier病歷號碼
.... name 1..1HumanName姓名
.... gender 1..1CodeableConcept性別
.... birthDate 1..1dateTime出生日期
.... address 0..1Address居住地址
.... identifier 1..1identifier醫事機構代碼
... certificateOfDiagnosis 0..*BackboneElement診斷證明書
.... patientSource 1..1CodeableConcept病人來源
.... particularDiagnosis 0..1CodeableConcept特殊診斷類別
.... department 1..1string應診科別
.... departmentCode 1..1CodeableConcept應診科別代碼
.... firstExaminationDate 1..1dateTime應診日期(始)
.... endExaminationDate 1..1dateTime應診日期(末)
.... examinationDay 0..1Duration應診天數
.... identifier 1..1identifier診斷證明書序號
.... diagnosis 1..*string診斷(病名)
.... diagnosisCode 1..*CodeableConcept病名代碼
.... recordedDate 1..1dateTime診斷證明書日期
.... primaryPhysician 1..1HumanName主治醫師
.... primaryPhysicianNo 0..1identifier醫師證號
.... medicalSummary 1..1markdown醫療摘要
.... responsiblePhysician 0..1HumanName負責醫師(院長)
... invoice 0..*BackboneElement收據正本及費用明細表
.... chargeItem 0..*CodeableConcept費用項目
.... medicalIdentity 0..1CodeableConcept就醫身分
.... invoiceDate 1..1date收據日期
.... selfPayAmount 0..1Money自付金額
.... discount 0..1Money減免
.... nationalHealthInsuranePoint 0..1Money健保點數
.... invoiceAmount 0..1Money收據金額
... laboratoryReport 0..*BackboneElement相關檢驗/檢查報告
.... laboratoryReportName 1..1CodeableConcept檢驗報告名稱
.... laboratoryReportNo 1..1identifier收件編號(檢驗單號)
.... laboratoryItemName 1..*CodeableConcept檢驗項目名稱
.... samplingDate 1..1dateTime採檢日期
.... reportDate 1..1instant報告日期
.... medicalTechnologist 1..1HumanName醫檢師
.... reporter 1..1HumanName報告者
.... laboratoryValue 1..*BackboneElement檢測值
.... unit 0..1string單位
.... hL 0..1CodeableConceptH/L
.... note 0..1markdown註記
.... bodySite 0..1CodeableConcept檢驗部位
.... referenceRange 1..*BackboneElement參考值
.... recordedPhysician 1..1HumanName開單醫師
.... recordedDepartment 1..1CodeableConcept開單科別

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ClaimFormModel 0..*Base理賠申請書(ClaimForm)之資料模型
Instances of this logical model are not marked to be the target of a Reference
... caseNo 0..1identifier案件編號
... admissionNumber 1..1identifier住院號/就醫號
... patient 1..1BackboneElement病人的基本資料
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... occupation 0..1CodeableConcept職業
.... identifier 1..1identifier身分證字號
.... patientNo 1..1identifier病歷號碼
.... name 1..1HumanName姓名
.... gender 1..1CodeableConcept性別
.... birthDate 1..1dateTime出生日期
.... address 0..1Address居住地址
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier 1..1identifier醫事機構代碼
... certificateOfDiagnosis 0..*BackboneElement診斷證明書
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... patientSource 1..1CodeableConcept病人來源
.... particularDiagnosis 0..1CodeableConcept特殊診斷類別
.... department 1..1string應診科別
.... departmentCode 1..1CodeableConcept應診科別代碼
.... firstExaminationDate 1..1dateTime應診日期(始)
.... endExaminationDate 1..1dateTime應診日期(末)
.... examinationDay 0..1Duration應診天數
.... identifier 1..1identifier診斷證明書序號
.... diagnosis 1..*string診斷(病名)
.... diagnosisCode 1..*CodeableConcept病名代碼
.... recordedDate 1..1dateTime診斷證明書日期
.... primaryPhysician 1..1HumanName主治醫師
.... primaryPhysicianNo 0..1identifier醫師證號
.... medicalSummary 1..1markdown醫療摘要
.... responsiblePhysician 0..1HumanName負責醫師(院長)
... invoice 0..*BackboneElement收據正本及費用明細表
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... chargeItem 0..*CodeableConcept費用項目
.... medicalIdentity 0..1CodeableConcept就醫身分
.... invoiceDate 1..1date收據日期
.... selfPayAmount 0..1Money自付金額
.... discount 0..1Money減免
.... nationalHealthInsuranePoint 0..1Money健保點數
.... invoiceAmount 0..1Money收據金額
... laboratoryReport 0..*BackboneElement相關檢驗/檢查報告
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... laboratoryReportName 1..1CodeableConcept檢驗報告名稱
.... laboratoryReportNo 1..1identifier收件編號(檢驗單號)
.... laboratoryItemName 1..*CodeableConcept檢驗項目名稱
.... samplingDate 1..1dateTime採檢日期
.... reportDate 1..1instant報告日期
.... medicalTechnologist 1..1HumanName醫檢師
.... reporter 1..1HumanName報告者
.... laboratoryValue 1..*BackboneElement檢測值
.... unit 0..1string單位
.... hL 0..1CodeableConceptH/L
.... note 0..1markdown註記
.... bodySite 0..1CodeableConcept檢驗部位
.... referenceRange 1..*BackboneElement參考值
.... recordedPhysician 1..1HumanName開單醫師
.... recordedDepartment 1..1CodeableConcept開單科別

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ClaimFormModel 0..*Base理賠申請書(ClaimForm)之資料模型
Instances of this logical model are not marked to be the target of a Reference
... caseNo 0..1identifier案件編號
... admissionNumber 1..1identifier住院號/就醫號
... patient 1..1BackboneElement病人的基本資料
.... @id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... occupation 0..1CodeableConcept職業
.... identifier 1..1identifier身分證字號
.... patientNo 1..1identifier病歷號碼
.... name 1..1HumanName姓名
.... gender 1..1CodeableConcept性別
.... birthDate 1..1dateTime出生日期
.... address 0..1Address居住地址
.... @id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... identifier 1..1identifier醫事機構代碼
... certificateOfDiagnosis 0..*BackboneElement診斷證明書
.... @id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... patientSource 1..1CodeableConcept病人來源
.... particularDiagnosis 0..1CodeableConcept特殊診斷類別
.... department 1..1string應診科別
.... departmentCode 1..1CodeableConcept應診科別代碼
.... firstExaminationDate 1..1dateTime應診日期(始)
.... endExaminationDate 1..1dateTime應診日期(末)
.... examinationDay 0..1Duration應診天數
.... identifier 1..1identifier診斷證明書序號
.... diagnosis 1..*string診斷(病名)
.... diagnosisCode 1..*CodeableConcept病名代碼
.... recordedDate 1..1dateTime診斷證明書日期
.... primaryPhysician 1..1HumanName主治醫師
.... primaryPhysicianNo 0..1identifier醫師證號
.... medicalSummary 1..1markdown醫療摘要
.... responsiblePhysician 0..1HumanName負責醫師(院長)
... invoice 0..*BackboneElement收據正本及費用明細表
.... @id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... chargeItem 0..*CodeableConcept費用項目
.... medicalIdentity 0..1CodeableConcept就醫身分
.... invoiceDate 1..1date收據日期
.... selfPayAmount 0..1Money自付金額
.... discount 0..1Money減免
.... nationalHealthInsuranePoint 0..1Money健保點數
.... invoiceAmount 0..1Money收據金額
... laboratoryReport 0..*BackboneElement相關檢驗/檢查報告
.... @id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... laboratoryReportName 1..1CodeableConcept檢驗報告名稱
.... laboratoryReportNo 1..1identifier收件編號(檢驗單號)
.... laboratoryItemName 1..*CodeableConcept檢驗項目名稱
.... samplingDate 1..1dateTime採檢日期
.... reportDate 1..1instant報告日期
.... medicalTechnologist 1..1HumanName醫檢師
.... reporter 1..1HumanName報告者
.... laboratoryValue 1..*BackboneElement檢測值
.... unit 0..1string單位
.... hL 0..1CodeableConceptH/L
.... note 0..1markdown註記
.... bodySite 0..1CodeableConcept檢驗部位
.... referenceRange 1..*BackboneElement參考值
.... recordedPhysician 1..1HumanName開單醫師
.... recordedDepartment 1..1CodeableConcept開單科別

doco Documentation for this format

This structure is derived from Base

Summary

Mandatory: 0 element (32 nested mandatory elements)

Structures

This structure refers to these other structures:

 

Other representations of profile: CSV, Excel