Health New Zealand Te Whatu Ora Shared Care FHIR API
0.4.5 - release

Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v0.4.5) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## : NZ Telehealth Claim Response Example - JSON Representation

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    {
      "resourceType" : "ClaimResponse",
      "meta" : {
        "source" : "https://standards.digital.health.nz/ns/hpi-facility-id/F12345-A",
        "profile" : [
          🔗 "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/SharedCareClaimResponse"
        ],
        "tag" : [
          {
            "system" : "https://hub.services.digital.health.nz/ns/correlation-id",
            "code" : "xxxxxxxx-xxxx-xxxx-xxxx-xxxxxxxxxxxx"
          }
        ]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse NzTelehealthClaimResponseExample</b></p><a name=\"NzTelehealthClaimResponseExample\"> </a><a name=\"hcNzTelehealthClaimResponseExample\"> </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\">Information Source: <a href=\"https://standards.digital.health.nz/ns/hpi-facility-id/F12345-A\">https://standards.digital.health.nz/ns/hpi-facility-id/F12345-A</a></p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-SharedCareClaimResponse.html\">NZ SharedCare Claim Response</a></p><p style=\"margin-bottom: 0px\">Tag: xxxxxxxx-xxxx-xxxx-xxxx-xxxxxxxxxxxx (Details: correlation-id code xxxxxxxx-xxxx-xxxx-xxxx-xxxxxxxxxxxx)</p></div><p><b>identifier</b>: <code>https://standards.digital.health.nz/ns/claim-response-identifier</code>/a1b2c3d4-e5f6-7890-abcd-ef1234567890\u00a0(use:\u00a0official,\u00a0)</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}\">Professional</span></p><p><b>subType</b>: <span title=\"Codes:{https://fhir-ig.digital.health.nz/shared-care/CodeSystem/nz-claim-subtype-cs telehealth}\">Telehealth</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: Identifier: <a href=\"http://fhir.org.nz/ig/base/NamingSystem-nhi.html\" title=\"NHI number\">NHI</a>/ZZZ0008</p><p><b>created</b>: 2025-01-15 10:30:00+0000</p><p><b>insurer</b>: Identifier: <a href=\"http://fhir.org.nz/ig/base/NamingSystem-hpiOrganization.html\" title=\"HPI organizations\">HPIOrganization</a>/G0K357-H</p><p><b>requestor</b>: Identifier: <a href=\"http://fhir.org.nz/ig/base/NamingSystem-hpiOrganization.html\" title=\"HPI organizations\">HPIOrganization</a>/GZZ999-J\u00a0(use:\u00a0official,\u00a0)</p><p><b>request</b>: <a href=\"Claim-NzTelehealthClaimExample.html\">Claim: extension = AGRS-202sdfg4-00121,https://example.org/fhir/trace-number#7890; identifier = https://provider-org-name.co.nz/ns/claim-identifier#C123456\u00a0(use:\u00a0official,\u00a0); status = active; type = Professional; subType = Telehealth; use = claim; billablePeriod = 2025-01-01 00:00:00+1300 --&gt; 2025-01-02 00:00:00+1300; created = 2025-01-01 00:00:00+1300; priority = Normal</a></p><p><b>outcome</b>: Processing Complete</p><blockquote><p><b>item</b></p><p><b>Shared Care Product Or Service</b>: <span title=\"Codes:{https://standards.digital.health.nz/ns/purchase-unit COGP0068}\">COGP0068</span></p><p><b>Shared Care Claim Trace Number</b>: <code>https://standards.digital.health.nz/ns/claim-response-item-identifier</code>/cd7b6e0d-c554-4786-a52d-3efd1c187c1a</p><blockquote><p><b>Shared Care Review Outcome</b></p><ul><li>decision: <span title=\"Codes:{https://fhir-ig.digital.health.nz/shared-care/CodeSystem/claim-decision-cs approved}\">Approved</span></li><li>reason: <span title=\"Codes:{https://fhir-ig.digital.health.nz/shared-care/CodeSystem/claim-decision-reason-cs DET064.001}\">Record of encounter was found in our system.</span></li></ul></blockquote><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 benefit}\">Benefit Amount</span></p><p><b>reason</b>: <span title=\"Codes:{https://standards.digital.health.nz/ns/adjudication-reason-code policy}\">policy</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>100</td><td>New Zealand dollar</td></tr></table><p><b>value</b>: 1</p></blockquote></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit 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>100</td><td>New Zealand dollar</td></tr></table></blockquote><blockquote><p><b>payment</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-paymenttype complete}\">Complete</span></p><p><b>date</b>: 2025-01-01</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>100</td><td>New Zealand dollar</td></tr></table></blockquote><h3>Errors</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication-error a001}\">Claim validation failed: Missing required service date</span></td></tr></table></div>"
      },
      "identifier" : [
        {
          "use" : "official",
          "system" : "https://standards.digital.health.nz/ns/claim-response-identifier",
          "value" : "a1b2c3d4-e5f6-7890-abcd-ef1234567890"
        }
      ],
      "status" : "active",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
            "code" : "professional"
          }
        ]
      },
      "subType" : {
        "coding" : [
          {
            "system" : "https://fhir-ig.digital.health.nz/shared-care/CodeSystem/nz-claim-subtype-cs",
            "code" : "telehealth"
          }
        ]
      },
      "use" : "claim",
      "patient" : {
        "type" : "Patient",
        "identifier" : {
          "system" : "https://standards.digital.health.nz/ns/nhi-id",
          "value" : "ZZZ0008"
        }
      },
      "created" : "2025-01-15T10:30:00-00:00",
      "insurer" : {
        "type" : "Organization",
        "identifier" : {
          "system" : "https://standards.digital.health.nz/ns/hpi-organisation-id",
          "value" : "G0K357-H"
        }
      },
      "requestor" : {
        "type" : "Organization",
        "identifier" : {
          "use" : "official",
          "system" : "https://standards.digital.health.nz/ns/hpi-organisation-id",
          "value" : "GZZ999-J"
        }
      },
      "request" : {
        🔗 "reference" : "Claim/NzTelehealthClaimExample"
      },
      "outcome" : "complete",
      "item" : [
        {
          "extension" : [
            {
              "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/shared-care-product-or-service",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "https://standards.digital.health.nz/ns/purchase-unit",
                    "code" : "COGP0068"
                  }
                ]
              }
            },
            {
              "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/shared-care-trace-number",
              "valueIdentifier" : {
                "system" : "https://standards.digital.health.nz/ns/claim-response-item-identifier",
                "value" : "cd7b6e0d-c554-4786-a52d-3efd1c187c1a"
              }
            },
            {
              "extension" : [
                {
                  "url" : "decision",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "https://fhir-ig.digital.health.nz/shared-care/CodeSystem/claim-decision-cs",
                        "code" : "approved",
                        "display" : "Approved"
                      }
                    ]
                  }
                },
                {
                  "url" : "reason",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "https://fhir-ig.digital.health.nz/shared-care/CodeSystem/claim-decision-reason-cs",
                        "code" : "DET064.001",
                        "display" : "Passed"
                      }
                    ],
                    "text" : "Record of encounter was found in our system."
                  }
                }
              ],
              "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/shared-care-review-outcome"
            }
          ],
          "itemSequence" : 1,
          "adjudication" : [
            {
              "category" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                    "code" : "benefit"
                  }
                ]
              },
              "reason" : {
                "coding" : [
                  {
                    "system" : "https://standards.digital.health.nz/ns/adjudication-reason-code",
                    "code" : "policy"
                  }
                ]
              },
              "amount" : {
                "value" : 100,
                "currency" : "NZD"
              },
              "value" : 1
            }
          ]
        }
      ],
      "total" : [
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "benefit"
              }
            ]
          },
          "amount" : {
            "value" : 100,
            "currency" : "NZD"
          }
        }
      ],
      "payment" : {
        "type" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/ex-paymenttype",
              "code" : "complete"
            }
          ]
        },
        "date" : "2025-01-01",
        "amount" : {
          "value" : 100,
          "currency" : "NZD"
        }
      },
      "error" : [
        {
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication-error",
                "code" : "a001",
                "display" : "Invalid claim"
              }
            ],
            "text" : "Claim validation failed: Missing required service date"
          }
        }
      ]
    }