Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) 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"><a name="MessageHeader_a7e4caf2-0441-40e5-97d2-5ae1802734af"> </a><p class="res-header-id"><b>Generated Narrative: MessageHeader a7e4caf2-0441-40e5-97d2-5ae1802734af</b></p><a name="a7e4caf2-0441-40e5-97d2-5ae1802734af"> </a><a name="hca7e4caf2-0441-40e5-97d2-5ae1802734af"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-message-header.html">Nphies MessageHeaderversion: null0.3.0)</a></p></div><p><b>event</b>: <a href="CodeSystem-ksa-message-events.html#ksa-message-events-claim-response">KSA Message Events claim-response</a>: Claim Response</p><h3>Destinations</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Endpoint</b></td><td><b>Receiver</b></td></tr><tr><td style="display: none">*</td><td><a href="http://saudigeneralhospital.com.sa">http://saudigeneralhospital.com.sa</a></td><td>Identifier: <code>http://nphies.sa/license/provider-license</code>/PR-FHIR</td></tr></table><p><b>sender</b>: Identifier: <code>http://nphies.sa/license/payer-license</code>/INS-FHIR</p><h3>Sources</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Endpoint</b></td></tr><tr><td style="display: none">*</td><td><a href="http://sni.com.sa">http://sni.com.sa</a></td></tr></table><h3>Responses</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Identifier</b></td><td><b>Code</b></td></tr><tr><td style="display: none">*</td><td>a7e4caf2-0441-40e5-97d2-5ae1802730af</td><td>OK</td></tr></table><p><b>focus</b>: <a href="Bundle-c2c63768-a65b-5784-ab91-6c09012c3cbc.html#http-//sni.com.sa/ClaimResponse/48100">Bundle: type = message; timestamp = 2023-12-04 13:39:58+0000</a></p></div>
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<div xmlns="http://www.w3.org/1999/xhtml"><a name="ClaimResponse_48100"> </a><p class="res-header-id"><b>Generated Narrative: ClaimResponse 48100</b></p><a name="48100"> </a><a name="hc48100"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-claim-response.html">Nphies Claim Responseversion: null0.3.0)</a></p></div><p><b>Adjudication Outcome</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/adjudication-outcome approved}">Approved</span></p><p><b>identifier</b>: <code>http://sni.com.sa/identifiers/claimresponse</code>/res_683514</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}">Institutional</span></p><p><b>subType</b>: <span 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<code>http://saudigeneralhospital.com.sa/identifiers/patientInvoice</code>/Invc-20220120/IP-1110987</p><p><b>itemSequence</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}">Eligible Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>5000</td><td>Saudi riyal</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication copay}">CoPay</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>0</td><td>Saudi riyal</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span 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title="Codes:{http://nphies.sa/terminology/CodeSystem/adjudication-outcome approved}">Approved</span></p><p><b>Patient Invoice</b>: <code>http://saudigeneralhospital.com.sa/identifiers/patientInvoice</code>/Invc-20220120/IP-1110987</p><p><b>itemSequence</b>: 2</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}">Eligible Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>300</td><td>Saudi riyal</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication copay}">CoPay</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>0</td><td>Saudi 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<div xmlns="http://www.w3.org/1999/xhtml"><a name="Coverage_1334"> </a><p class="res-header-id"><b>Generated Narrative: Coverage 1334</b></p><a name="1334"> </a><a name="hc1334"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-coverage.html">Nphies Coverageversion: null0.3.0)</a></p></div><p><b>identifier</b>: <code>http://sni.com.sa/identifiers/memberid</code>/0000000002</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/coverage-type EHCPOL}">extended healthcare</span></p><p><b>policyHolder</b>: <a href="Organization-13.html">Organization Policy Holder Organization</a></p><p><b>subscriber</b>: <a href="Patient-123454186.html">Ahmad Khaled Abbas(official) Male, DoB: 1984-12-25 ( Passport Number: G12345678)</a></p><p><b>beneficiary</b>: <a href="Patient-173826788.html">Muhammad Khaled Abbas(official) Male, DoB: 2010-08-21 ( Permanent Resident Card Number: 2000000002)</a></p><p><b>relationship</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship child}">Child</span></p><p><b>payor</b>: <a href="Organization-bff3aa1fbd3648619ac082357bf135db.html">Organization Saudi National Insurance</a></p><h3>Classes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Value</b></td><td><b>Name</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}">Plan</span></td><td>CB135</td><td>Insurance Plan A</td></tr></table><p><b>network</b>: Golden C</p></div>
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<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_13"> </a><p class="res-header-id"><b>Generated Narrative: Organization 13</b></p><a name="13"> </a><a name="hc13"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-policyholder-organization.html">Nphies Policy Holder Organizationversion: null0.3.0)</a></p></div><p><b>identifier</b>: <code>http://nphies.sa/identifiers/organization</code>/5009</p><p><b>active</b>: true</p><p><b>name</b>: Policy Holder Organization</p></div>
</text>
<identifier>
<system value="http://nphies.sa/identifiers/organization"/>
<value value="5009"/>
</identifier>
<active value="true"/>
<name value="Policy Holder Organization"/>
</Organization>
</resource>
</entry>
<entry>
<fullUrl
value="http://sni.com.sa/Organization/b1b3432921324f97af3be9fd0b1a14ae"/>
<resource>
<Organization>
<id value="b1b3432921324f97af3be9fd0b1a14ae"/>
<meta>
<profile
value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|0.3.0"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_b1b3432921324f97af3be9fd0b1a14ae"> </a><p class="res-header-id"><b>Generated Narrative: Organization b1b3432921324f97af3be9fd0b1a14ae</b></p><a name="b1b3432921324f97af3be9fd0b1a14ae"> </a><a name="hcb1b3432921324f97af3be9fd0b1a14ae"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-provider-organization.html">Nphies Provider Organizationversion: null0.3.0)</a></p></div><p><b>Provider Type</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/provider-type 1}">Hospital</span></p><p><b>identifier</b>: <code>http://nphies.sa/license/provider-license</code>/PR-FHIR</p><p><b>active</b>: true</p><p><b>type</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/organization-type prov}">Healthcare Provider</span></p><p><b>name</b>: Saudi General Hospital</p><p><b>address</b>: Salamah Street, Building 25, Suite 2, Riyadh Saudi Arabia(work)</p></div>
</text>
<extension
url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type">
<valueCodeableConcept>
<coding>
<system
value="http://nphies.sa/terminology/CodeSystem/provider-type"/>
<code value="1"/>
<display value="Hospital"/>
</coding>
</valueCodeableConcept>
</extension>
<identifier>
<system value="http://nphies.sa/license/provider-license"/>
<value value="PR-FHIR"/>
</identifier>
<active value="true"/>
<type>
<coding>
<system
value="http://nphies.sa/terminology/CodeSystem/organization-type"/>
<code value="prov"/>
</coding>
</type>
<name value="Saudi General Hospital"/>
<address>
<use value="work"/>
<text
value="Salamah Street, Building 25, Suite 2, Riyadh Saudi Arabia"/>
<line value="Salamah Street, Building 25, Suite 2"/>
<line value="Al Malga District"/>
<city value="Riyadh"/>
<country value="Saudi Arabia"/>
</address>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="http://sni.com.sa/Patient/173826788"/>
<resource>
<Patient>
<id value="173826788"/>
<meta>
<profile
value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|0.3.0"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_173826788"> </a><p class="res-header-id"><b>Generated Narrative: Patient 173826788</b></p><a name="173826788"> </a><a name="hc173826788"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-patient.html">Nphies Patientversion: null0.3.0)</a></p></div><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Muhammad Khaled Abbas(official) Male, DoB: 2010-08-21 ( Permanent Resident Card Number: 2000000002)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td>true</td><td style="background-color: #f3f5da" title="Known Marital status of Patient">Marital Status:</td><td colspan="3"><span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-MaritalStatus U}">unmarried</span></td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td><td colspan="3"><a href="tel:+966517382691">+966517382691</a></td></tr><tr><td style="background-color: #f3f5da" title="Patient occupation as per the nphies adopted list of occupations."><a href="StructureDefinition-extension-occupation.html">Patient Occupation</a></td><td colspan="3"><span title="Codes:{http://nphies.sa/terminology/CodeSystem/occupation student}">Student</span></td></tr></table></div>
</text>
<extension
url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation">
<valueCodeableConcept>
<coding>
<system
value="http://nphies.sa/terminology/CodeSystem/occupation"/>
<code value="student"/>
</coding>
</valueCodeableConcept>
</extension>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="PRC"/>
<display value="Permanent Resident Card Number"/>
</coding>
</type>
<system value="http://nphies.sa/identifier/iqama"/>
<value value="2000000002"/>
</identifier>
<active value="true"/>
<name>
<use value="official"/>
<text value="Muhammad Khaled Abbas"/>
<family value="Abbas"/>
<given value="Muhammad"/>
<given value="Khaled"/>
</name>
<telecom>
<system value="phone"/>
<value value="+966517382691"/>
</telecom>
<gender value="male">
<extension
url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender">
<valueCodeableConcept>
<coding>
<system
value="http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender"/>
<code value="male"/>
</coding>
</valueCodeableConcept>
</extension>
</gender>
<birthDate value="2010-08-21"/>
<maritalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-MaritalStatus"/>
<code value="U"/>
</coding>
</maritalStatus>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="http://sni.com.sa/Patient/123454186"/>
<resource>
<Patient>
<id value="123454186"/>
<meta>
<profile
value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|0.3.0"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_123454186"> </a><p class="res-header-id"><b>Generated Narrative: Patient 123454186</b></p><a name="123454186"> </a><a name="hc123454186"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-patient.html">Nphies Patientversion: null0.3.0)</a></p></div><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Ahmad Khaled Abbas(official) Male, DoB: 1984-12-25 ( Passport Number: G12345678)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td>true</td><td style="background-color: #f3f5da" title="Known status of Patient">Deceased:</td><td>false</td></tr><tr><td style="background-color: #f3f5da" title="Known Marital status of Patient">Marital Status:</td><td colspan="3"><span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}">Married</span></td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td><td colspan="3"><ul><li><a href="tel:+966512345691">+966512345691</a></li><li>Salamah Street, Building 25, Suite 2, Saudi Arabia(home)</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Patient occupation as per the nphies adopted list of occupations."><a href="StructureDefinition-extension-occupation.html">Patient Occupation</a></td><td colspan="3"><span title="Codes:{http://nphies.sa/terminology/CodeSystem/occupation business}">Business</span></td></tr></table></div>
</text>
<extension
url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation">
<valueCodeableConcept>
<coding>
<system
value="http://nphies.sa/terminology/CodeSystem/occupation"/>
<code value="business"/>
</coding>
</valueCodeableConcept>
</extension>
<identifier>
<extension
url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-identifier-country">
<valueCodeableConcept>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="SAU"/>
<display value="Saudi Arabia"/>
</coding>
</valueCodeableConcept>
</extension>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="PPN"/>
<display value="Passport Number"/>
</coding>
</type>
<system value="http://nphies.sa/identifier/passportnumber"/>
<value value="G12345678"/>
</identifier>
<active value="true"/>
<name>
<use value="official"/>
<text value="Ahmad Khaled Abbas"/>
<family value="Ahmad"/>
<given value="Khaled"/>
<given value="Abbas"/>
</name>
<telecom>
<system value="phone"/>
<value value="+966512345691"/>
</telecom>
<gender value="male">
<extension
url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender">
<valueCodeableConcept>
<coding>
<system
value="http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender"/>
<code value="male"/>
</coding>
</valueCodeableConcept>
</extension>
</gender>
<birthDate value="1984-12-25"/>
<deceasedBoolean value="false"/>
<address>
<use value="home"/>
<text value="Salamah Street, Building 25, Suite 2, Saudi Arabia"/>
<line value="Salamah Street, Building 25, Suite 2"/>
<line value="Al Malga District"/>
<city value="Riyadh"/>
<country value="Saudi Arabia"/>
</address>
<maritalStatus>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-MaritalStatus"/>
<code value="M"/>
</coding>
</maritalStatus>
</Patient>
</resource>
</entry>
<entry>
<fullUrl
value="http://sni.com.sa/Organization/bff3aa1fbd3648619ac082357bf135db"/>
<resource>
<Organization>
<id value="bff3aa1fbd3648619ac082357bf135db"/>
<meta>
<profile
value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|0.3.0"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_bff3aa1fbd3648619ac082357bf135db"> </a><p class="res-header-id"><b>Generated Narrative: Organization bff3aa1fbd3648619ac082357bf135db</b></p><a name="bff3aa1fbd3648619ac082357bf135db"> </a><a name="hcbff3aa1fbd3648619ac082357bf135db"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-insurer-organization.html">Nphies Insurer Organizationversion: null0.3.0)</a></p></div><p><b>identifier</b>: National Insurance Organization Identifier/INS-FHIR (use: official, )</p><p><b>active</b>: true</p><p><b>type</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/organization-type ins}">Insurance Company</span></p><p><b>name</b>: Saudi National Insurance</p><p><b>address</b>: Olaya Street, Building 70, Riyadh Saudi Arabia(work)</p></div>
</text>
<identifier>
<use value="official"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="NII"/>
</coding>
</type>
<system value="http://nphies.sa/license/payer-license"/>
<value value="INS-FHIR"/>
</identifier>
<active value="true"/>
<type>
<coding>
<system
value="http://nphies.sa/terminology/CodeSystem/organization-type"/>
<code value="ins"/>
</coding>
</type>
<name value="Saudi National Insurance"/>
<address>
<use value="work"/>
<text value="Olaya Street, Building 70, Riyadh Saudi Arabia"/>
<line value="Olaya Street, Building 70"/>
<line value="Al Olaya District"/>
<city value="Riyadh"/>
<country value="Saudi Arabia"/>
</address>
</Organization>
</resource>
</entry>
</Bundle>