Sha256: af8b8da2f0c3901fe818216518ff9d59b221b3149f308c0eb71ab8990cdf04e3
Contents?: true
Size: 1.76 KB
Versions: 10
Compression:
Stored size: 1.76 KB
Contents
<?xml version="1.0" encoding="UTF-8"?>
<ClaimResponse xmlns="http://hl7.org/fhir">
<id value="R3501"/>
<meta>
<security>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
<code value="HTEST"/>
<display value="test health data"/>
</security>
</meta>
<identifier>
<system value="http://www.BenefitsInc.com/fhir/remittance"/>
<value value="R3501"/>
</identifier>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
<code value="oral"/>
</coding>
</type>
<use value="claim"/>
<patient>
<reference value="Patient/1"/>
</patient>
<created value="2014-08-16"/>
<insurer>
<identifier>
<system value="http://www.jurisdiction.org/insurers"/>
<value value="555123"/>
</identifier>
</insurer>
<requestor>
<reference value="Practitioner/1"/>
</requestor>
<request>
<reference value="Claim/100156"/>
</request>
<outcome value="error"/>
<disposition value="Claim could not be processed"/>
<formCode>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/forms-codes"/>
<code value="2"/>
</coding>
</formCode>
<processNote>
<number value="1"/>
<type value="display"/>
<text value="Invalid claim"/>
<language>
<coding>
<system value="urn:ietf:bcp:47"/>
<code value="en-CA"/>
</coding>
</language>
</processNote>
<communicationRequest>
<reference value="CommunicationRequest/fm-solicit"/>
</communicationRequest>
<!-- Detailed error description -->
<error>
<itemSequence value="3"/>
<detailSequence value="2"/>
<code>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/adjudication-error"/>
<code value="a002"/>
</coding>
</code>
</error>
</ClaimResponse>
Version data entries
10 entries across 10 versions & 1 rubygems