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: Authorization Institutional Response #1
Generated Narrative: ClaimResponse 483079
Profile: Nphies Authorization Response
Adjudication Outcome: Approved
Adjudication Reissue Reason: Additional adjudication
identifier: http://sni.com.sa/identifiers/claimresponse/res_004512
status: Active
type: Institutional
subType: InPatient
use: Preauthorization
patient: Muhammad Khaled Abbas(official) Male, DoB: 2010-08-21 ( Permanent Resident Card Number: 2000000002)
created: 2023-12-05
insurer: Organization Saudi National Insurance
requestor: Organization Saudi General Hospital
request: Identifier: http://saudigeneralhospital.com.sa/identifiers/authorization/req_1124856069
outcome: Processing Complete
preAuthRef: Auth_455433
preAuthPeriod: 2023-12-04 --> 2023-12-20
item
Adjudication Outcome: Approved
itemSequence: 1
adjudication
category: Eligible Amount
Amounts
Value Currency 300 Saudi riyal adjudication
category: CoPay
Amounts
Value Currency 0 Saudi riyal adjudication
category: Benefit Amount
Amounts
Value Currency 300 Saudi riyal adjudication
category: Approved Quantity
value: 1
total
category: Eligible Amount
Amounts
Value Currency 300 Saudi riyal
total
category: Benefit Amount
Amounts
Value Currency 300 Saudi riyal
total
category: CoPay
Amounts
Value Currency 0 Saudi riyal
Insurances
| Sequence | Focal | Coverage |
| 1 | true | Coverage: identifier = http://sni.com.sa/identifiers/memberid#0000000002; status = active; type = extended healthcare; relationship = Child; network = Golden C |