Healthcare Financial Services IG Edition 1
0.3.0 - ci-build
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
Example ClaimResponse: Professional Authorization Response #1
Generated Narrative: ClaimResponse 173087
Profile: Nphies Authorization Response
Adjudication Outcome: Approved
identifier: http://sni.com.sa/identifiers/claimresponse/res_470333
status: Active
type: Professional
subType: Emergency
use: Preauthorization
patient: Ahmad Khaled Abbas(official) Male, DoB: 1984-12-25 ( Passport Number: G12345678)
created: 2023-12-05
insurer: Organization Saudi National Insurance
requestor: Organization Saudi Professional Clinic
request: Identifier: http://saudiprofessionalclinic.com.sa/identifiers/authorization/req_17308886
outcome: Processing Complete
preAuthRef: Auth13234434
preAuthPeriod: 2023-12-05 --> 2023-12-20
item
Adjudication Outcome: Approved
itemSequence: 1
adjudication
category: Eligible Amount
Amounts
Value Currency 120 Saudi riyal adjudication
category: CoPay
Amounts
Value Currency 0 Saudi riyal adjudication
category: Benefit Amount
Amounts
Value Currency 120 Saudi riyal adjudication
category: Approved Quantity
value: 1
total
category: Eligible Amount
Amounts
Value Currency 120 Saudi riyal
total
category: Benefit Amount
Amounts
Value Currency 120 Saudi riyal
total
category: CoPay
Amounts
Value Currency 0 Saudi riyal