臺灣健保癌症用藥事前審查實作指引
1.0.1 - release

This page is part of the 臺灣癌症用藥事前審查實作指引(TWPAS IG) (v1.0.1: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: 事前審查回覆 - JSON Representation

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{
  "resourceType" : "ClaimResponse",
  "id" : "claim-response-example",
  "meta" : {
    "profile" : [
      🔗 "https://twcore.mohw.gov.tw/ig/pas/StructureDefinition/ClaimResponse-twpas"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><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\">Profile: <a href=\"StructureDefinition-ClaimResponse-twpas.html\">事前審查結果-ClaimResponse TWPAS</a></p></div><p><b>狀態</b>：Active</p><p><b>類型</b>：<span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}\">Institutional</span></p><p><b>用途</b>：Preauthorization</p><p><b>病人</b>：<a href=\"Patient-pat-min.html\">Patient/pat-min</a></p><p><b>核定日期</b>：2024-07-30</p><p><b>關聯的事前審查</b>：<a href=\"Claim-cla-1.html\">Claim/cla-1</a></p><p><b>保險商</b>：<a href=\"Organization-org-nhi.html\">Organization 衛生福利部中央健康保險署</a></p><p><b>處置狀態</b>：Processing Complete</p><p><b>案件受理狀態</b>：審畢結果</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>：1</p><h3>Adjudications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>類型</b></td><td><b>核定註記</b></td><td><b>核定數量</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></td><td><span title=\"Codes:{https://twcore.mohw.gov.tw/ig/pas/CodeSystem/nhi-approve-comment 1}\">同意備查</span></td><td>5</td></tr></table></blockquote></div>"
  },
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "code" : "institutional"
      }
    ]
  },
  "use" : "preauthorization",
  "patient" : {
    🔗 "reference" : "Patient/pat-min"
  },
  "created" : "2024-07-30",
  "insurer" : {
    🔗 "reference" : "Organization/org-nhi"
  },
  "request" : {
    🔗 "reference" : "Claim/cla-1"
  },
  "outcome" : "complete",
  "disposition" : "審畢結果",
  "item" : [
    {
      "itemSequence" : 1,
      "adjudication" : [
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "submitted"
              }
            ]
          },
          "reason" : {
            "coding" : [
              {
                "system" : "https://twcore.mohw.gov.tw/ig/pas/CodeSystem/nhi-approve-comment",
                "code" : "1"
              }
            ]
          },
          "value" : 5
        }
      ]
    }
  ]
}