Release 4

Contract-example-ins-policy.ttl

Financial Management Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Not linked to any defined compartments

Raw Turtle (+ also see Turtle/RDF Format Specification)

Health Insurance Policy

@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/Contract/INS-101> a fhir:Contract;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "INS-101"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n         <p>Plan: Your Choice Split Copay (Non-Grandfathered)</p>\n         <p>Certificate Form Number: YCSCWLN (01-2017)</p>\n      </div>"
  ];
  fhir:Contract.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "http://xyz-insurance.com/forms" ];
     fhir:Identifier.value [ fhir:value "YCSCWLN(01-2017)" ]
  ];
  fhir:Contract.applies [
     fhir:Period.start [ fhir:value "2017-01-01"^^xsd:date ]
  ];
  fhir:Contract.subject [
     fhir:index 0;
     fhir:link <http://hl7.org/fhir/Patient/1>;
     fhir:Reference.reference [ fhir:value "Patient/1" ]
  ];
  fhir:Contract.type [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/contract-type" ];
       fhir:Coding.code [ fhir:value "healthinsurance" ];
       fhir:Coding.display [ fhir:value "Health Insurance" ]
     ]
  ];
  fhir:Contract.term [
     fhir:index 0;
     fhir:Contract.term.offer [
       fhir:Contract.term.offer.text [ fhir:value "The benefits, limitations, exclusions and other coverage provisions in this booklet are subject to the terms of our contract with the Group. This booklet is a part of that contract, which is on file in the Group's office." ]
     ];
     fhir:Contract.term.asset [
       fhir:index 0;
       fhir:Contract.term.asset.type [
         fhir:index 0;
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "urn:ietf:rfc:3986" ];
           fhir:Coding.code [ fhir:value "RicardianContract" ]
         ]
       ];
       fhir:Contract.term.asset.subtype [
         fhir:index 0;
         fhir:CodeableConcept.text [ fhir:value "sample" ]
       ];
       fhir:Contract.term.asset.period [
         fhir:index 0;
         fhir:Period.start [ fhir:value "2017-06-01"^^xsd:date ]
       ];
       fhir:Contract.term.asset.valuedItem [
         fhir:index 0;
         fhir:Contract.term.asset.valuedItem.entityCodeableConcept [
           fhir:CodeableConcept.text [ fhir:value "Ford Bobcat" ]
         ];
         fhir:Contract.term.asset.valuedItem.identifier [
           fhir:Identifier.system [ fhir:value "http://somewhere.motor-vehicle.com/vin" ];
           fhir:Identifier.value [ fhir:value "XXSVT34-7665t952236" ]
         ];
         fhir:Contract.term.asset.valuedItem.effectiveTime [ fhir:value "1995"^^xsd:gYear ];
         fhir:Contract.term.asset.valuedItem.quantity [
           fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ]
         ];
         fhir:Contract.term.asset.valuedItem.unitPrice [
           fhir:Money.value [ fhir:value "200.00"^^xsd:decimal ];
           fhir:Money.currency [ fhir:value "CAD" ]
         ];
         fhir:Contract.term.asset.valuedItem.factor [ fhir:value "1.0"^^xsd:decimal ];
         fhir:Contract.term.asset.valuedItem.points [ fhir:value "1.0"^^xsd:decimal ];
         fhir:Contract.term.asset.valuedItem.net [
           fhir:Money.value [ fhir:value "200.00"^^xsd:decimal ];
           fhir:Money.currency [ fhir:value "CAD" ]
         ]
       ]
     ];
     fhir:Contract.term.group [
       fhir:index 0;
       fhir:Contract.term.offer [
         fhir:Contract.term.offer.text [ fhir:value "Eligible Providers" ]
       ]
     ], [
       fhir:index 1;
       fhir:Contract.term.offer [
         fhir:Contract.term.offer.text [ fhir:value "Responsibility for Payment" ]
       ]
     ], [
       fhir:index 2;
       fhir:Contract.term.offer [
         fhir:Contract.term.offer.text [ fhir:value "List of Benefits" ]
       ];
       fhir:Contract.term.group [
         fhir:index 0;
         fhir:Contract.term.offer [
           fhir:Contract.term.offer.text [ fhir:value "Copays" ]
         ];
         fhir:Contract.term.group [
           fhir:index 0;
           fhir:Contract.term.offer [
             fhir:Contract.term.offer.text [ fhir:value "Emergency Room Copay" ]
           ]
         ], [
           fhir:index 1;
           fhir:Contract.term.offer [
             fhir:Contract.term.offer.text [ fhir:value "Professional Visit Copay" ]
           ]
         ]
       ], [
         fhir:index 1;
         fhir:Contract.term.offer [
           fhir:Contract.term.offer.text [ fhir:value "Calendar Year Deductible" ]
         ]
       ], [
         fhir:index 2;
         fhir:Contract.term.offer [
           fhir:Contract.term.offer.text [ fhir:value "Out-Of-Pocket Maximum" ]
         ]
       ], [
         fhir:index 3;
         fhir:Contract.term.offer [
           fhir:Contract.term.offer.text [ fhir:value "Medical Services" ]
         ];
         fhir:Contract.term.group [
           fhir:index 0;
           fhir:Contract.term.offer [
             fhir:Contract.term.offer.text [ fhir:value "Ambulance Services" ]
           ]
         ], [
           fhir:index 1;
           fhir:Contract.term.offer [
             fhir:Contract.term.offer.text [ fhir:value "Dental Services" ]
           ]
         ], [
           fhir:index 2;
           fhir:Contract.term.offer [
             fhir:Contract.term.offer.text [ fhir:value "Diagnostic Services" ]
           ]
         ], [
           fhir:index 3;
           fhir:Contract.term.offer [
             fhir:Contract.term.offer.text [ fhir:value "Emergency Room Services" ]
           ]
         ], [
           fhir:index 4;
           fhir:Contract.term.offer [
             fhir:Contract.term.offer.text [ fhir:value "Hospital Inpatient Care" ]
           ]
         ]
       ]
     ]
  ] .

<http://hl7.org/fhir/Patient/1> a fhir:Patient .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/Contract/INS-101.ttl> a owl:Ontology;
  owl:imports fhir:fhir.ttl;
  owl:versionIRI <http://build.fhir.org/Contract/INS-101.ttl> .

# -------------------------------------------------------------------------------------


Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.