diff --git a/FHIR/Financial Management/Coverage.json b/FHIR/Financial Management/Coverage.json new file mode 100644 index 0000000..32cb03a --- /dev/null +++ b/FHIR/Financial Management/Coverage.json @@ -0,0 +1,230 @@ +{ + "resourceType" : "Coverage", + "id" : "", + "identifier" : [{ + "use" : "", + "type": { + "coding" : [{ + "system" : "http://terminology.hl7.org/CodeSystem/organization-type", + "version" : "", + "code" : "pay", + "display" : "Payer", + "userSelected" : true + }], + "text" : "" + }, + "system" : "", + "value" : "", + "period" : {"start" : "", "end" : ""}, + "assigner": { + "reference" : "", + "display" : "" + } + }], + "status" : "active", + "kind" : "", + "paymentBy" : [{ + "party" : { + "reference" : "", + "display" : "" + }, + "responsibility": "" + }], + "type" : { + "coding": [{ + "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "version" : "", + "code" : "EHCPOL", + "display" : "extended healthcare", + "userSelected" : "" + }], + "text": "BPJS 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+ "use" : "", + "type": { + "coding" : [{ + "system" : "", + "version" : "", + "code" : "PPU", + "display" : "Pekerja Penerima Upah", + "userSelected" : false + }], + "text" : "Pekerja Penerima Upah" + }, + "system" : "", + "value" : "", + "period" : {"start" : "", "end" : ""}, + "assigner": { + "reference" : "", + "display" : "" + } + }, + "name" : "Pekerja Penerima Upah" + }, + { + "type": { + "coding": [{ + "system" : "http://terminology.hl7.org/CodeSystem/coverage-class", + "version" : "", + "code" : "plan", + "display" : "Plan", + "userSelected" : "" + }], + "text" : "" + }, + "value": { + "use" : "", + "type": { + "coding" : [{ + "system" : "", + "version" : "", + "code" : "", + "display" : "Kelas 2", + "userSelected" : true + }], + "text" : "" + }, + "system" : "", + "value" : "", + "period" : {"start" : "", "end" : ""}, + "assigner": { + "reference" : "", + "display" : "" + } + }, + "name" : "" + }], + "order" : 0, + "network" : "RSUD Dr. Saiful Anwar", + "costToBeneficiary" : 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+ }, + "type" : { + "coding": [{ + "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "version" : "6.3.0", + "code" : "PBILLACCT", + "display" : "patient billing account", + "userSelected" : true + }], + "text" : "Patient Billing Account" + }, + "name" : "BPJS RSSA Billing for Budi Santoso", + "subject" : { + "reference" : "Patient/12345", + "display" : "Budi Santoso" + }, + "servicePeriod" : {"start": "2025-05-01","end": "2025-05-10"}, + "coverage" : [{ + "coverage": { + "reference" : "Coverage/bpjs-rssa-coverage-001", + "display" : "BPJS Kesehatan" + }, + "priority": 1 + }], + "owner" : { + "reference" : "Organization/rssa", + "display" : "RSUD Dr. Saiful Anwar" + }, + "description" : "Akun penagihan pasien BPJS untuk rawat inap di RSSA", + "guarantor" : [{ + "party" : { + "reference" : "Patient/12345", + "display" : "Budi Santoso" + }, + "onHold": false, + "period": {"start": "2025-05-01","end": "2025-05-10"} + }], + "diagnosis" : [{ + "sequence" : 0, + "condition" : { + "concept": { + "coding" : [{ + "system" : "", + "version" : "", + "code" : "", + "display" : "", + "userSelected" : false + }], + "text" : "" + }, + "reference" : { + "reference" : "", + "display" : "" + } + }, + "dateOfDiagnosis": "", + "type" : [{ + "coding" : [{ + "system" : "", + "version" : "", + "code" : "", + "display" : "", + "userSelected" : false + }], + "text" : "" + }], + "onAdmission" : "", + "packageCode" : [{ + "coding" : [{ + "system" : "", + "version" : "", + "code" : "", + "display" : "", + "userSelected" : false + }], + "text" : "" + }], + "device" : { + "reference" : "", + "display" : "" + } + }], + "relatedAccount" : { + "relationship" : { + "coding" : [{ + "system" : "", + "version" : "", + "code" : "", + "display" : "", + "userSelected" : false + }], + "text" : "" + }, + "account" : { + "reference" : "", + "display" : "" + } + }, + "currency" : { + "coding" : [{ + "system" : "", + "version" : "", + "code" : "", + "display" : "", + "userSelected" : false + }], + "text" : "" + }, + "balance": [{ + "aggregate" : { + "coding" : [{ + "system" : "", + "version" : "", + "code" : "", + "display" : "", + "userSelected" : false + }], + "text" : "" + }, + "term" : { + "coding" : [{ + "system" : "", + "version" : "", + "code" : "", + "display" : "", + "userSelected" : false + }], + "text" : "" + }, + "estimate" : false, + "amount" : { + "value" : 0, + "currency" : "" + } + }], + "calculatedAt" : "" +}