15a - Eligibilty Request Discovery.json

{
	"resourceType": "Bundle",
	"id": "4350490e-98f0-4c23-9e7d-4cd2c7012518",
	"meta": {
		"profile": [
			"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
		]
	},
	"type": "message",
	"timestamp": "2021-07-15T14:56:49.034+03:00",
	"entry": [
		{
			"fullUrl": "urn:uuid:c19c71dc-cfad-4401-b5b0-c0f20e8f2518",
			"resource": {
				"resourceType": "MessageHeader",
				"id": "c19c71dc-cfad-4401-b5b0-c0f20e8f2518",
				"meta": {
					"profile": [
						"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
					]
				},
				"eventCoding": {
					"system": "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
					"code": "eligibility-request"
				},
				"destination": [
					{
						"endpoint": "http://nphies.sa/license/payer-license/N-I-00001",
						"receiver": {
							"type": "Organization",
							"identifier": {
								"system": "http://nphies.sa/license/payer-license",
								"value": "N-I-00001"
							}
						}
					}
				],
				"sender": {
					"type": "Organization",
					"identifier": {
						"system": "http://nphies.sa/license/provider-license",
						"value": "N-F-00001"
					}
				},
				"source": {
					"endpoint": "http://sgh.com.sa"
				},
				"focus": [
					{
						"reference": "http://sgh.com.sa/Coverageeligibilityrequest/62518"
					}
				]
			}
		},
		{
			"fullUrl": "http://sgh.com.sa/Coverageeligibilityrequest/62518",
			"resource": {
				"resourceType": "CoverageEligibilityRequest",
				"id": "62518",
				"meta": {
					"profile": [
						"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/eligibility-request|1.0.0"
					]
				},
				"identifier": [
					{
						"system": "http://sgh.com.sa/identifier/coverageeligibilityrequest",
						"value": "req_162518"
					}
				],
				"status": "active",
				"priority": {
					"coding": [
						{
							"system": "http://terminology.hl7.org/CodeSystem/processpriority",
							"code": "normal"
						}
					]
				},
				"purpose": [
					"discovery"
				],
				"patient": {
					"reference": "http://sgh.com.sa/Patient/123456788"
				},
				"servicedPeriod": {
					"start": "2021-07-15",
					"end": "2021-07-16"
				},
				"created": "2021-07-15",
				"provider": {
					"reference": "http://sgh.com.sa/Organization/b1b3432921324f97af3be9fd0b1a14ae"
				},
				"insurer": {
					"reference": "http://sgh.com.sa/Organization/bff3aa1fbd3648619ac082357bf135db"
				},
				"facility": {
					"reference": "http://sgh.com.sa/Location/2be1133308ed422a9923931c5a475f63"
				}
			}
		},
		{
			"fullUrl": "http://sgh.com.sa/Organization/b1b3432921324f97af3be9fd0b1a14ae",
			"resource": {
				"resourceType": "Organization",
				"id": "b1b3432921324f97af3be9fd0b1a14ae",
				"meta": {
					"profile": [
						"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
					]
				},
				"identifier": [
					{
						"system": "http://nphies.sa/license/provider-license",
						"value": "N-F-00001"
					}
				],
				"active": true,
				"type": [
					{
						"coding": [
							{
								"system": "http://nphies.sa/terminology/CodeSystem/organization-type",
								"code": "prov"
							}
						]
					}
				],
				"name": "Saudi General Hospital"
			}
		},
		{
			"fullUrl": "http://sgh.com.sa/Patient/123456788",
			"resource": {
				"resourceType": "Patient",
				"id": "123456788",
				"meta": {
					"profile": [
						"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
					]
				},
				"identifier": [
					{
						"type": {
							"coding": [
								{
									"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
									"code": "PRC",
									"display": "iqama"
								}
							]
						},
						"system": "http://nphies.sa/identifier/iqama",
						"value": "0000000002"
					}
				],
				"active": true,
				"name": [
					{
						"use": "official",
						"text": "Muhammad Ali Abbas",
						"family": "Abbas",
						"given": [
							"Muhammad",
							"Ali"
						]
					}
				],
				"telecom": [
					{
						"system": "phone",
						"value": "+966512345691"
					}
				],
				"gender": "male",
				"_gender": {
					"extension": [
						{
							"url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
							"valueCodeableConcept": {
								"coding": [
									{
										"system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
										"code": "male",
										"display": "Male"
									}
								]
							}
						}
					]
				},
				"birthDate": "2010-08-21"
			}
		},
		{
			"fullUrl": "http://sgh.com.sa/Organization/bff3aa1fbd3648619ac082357bf135db",
			"resource": {
				"resourceType": "Organization",
				"id": "bff3aa1fbd3648619ac082357bf135db",
				"meta": {
					"profile": [
						"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|1.0.0"
					]
				},
				"identifier": [
					{
						"system": "http://nphies.sa/license/payer-license",
						"value": "N-I-00001"
					}
				],
				"active": true,
				"type": [
					{
						"coding": [
							{
								"system": "http://nphies.sa/terminology/CodeSystem/organization-type",
								"code": "ins"
							}
						]
					}
				],
				"name": "Saudi National Insurance"
			}
		},
		{
			"fullUrl": "http://sgh.com.sa/Location/2be1133308ed422a9923931c5a475f63",
			"resource": {
				"resourceType": "Location",
				"id": "2be1133308ed422a9923931c5a475f63",
				"meta": {
					"profile": [
						"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/location|1.0.0"
					]
				},
				"identifier": [
					{
						"system": "http://nphies.sa/license/location-license",
						"value": "GACH"
					}
				],
				"status": "active",
				"name": "Saudi General Hospital",
				"type": [
					{
						"coding": [
							{
								"system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
								"code": "GACH"
							}
						]
					}
				],
				"managingOrganization": {
					"reference": "http://sgh.com.sa/Organization/b1b3432921324f97af3be9fd0b1a14ae"
				}
			}
		}
	]
}