PackagesCanonicalsLogsProblems
    Packages
    rs/ch.fhir.ig.ch@core-6.0.0-ballot
    http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-claim
description: Base definition of the claim resource for the representation of a list of professional services (e.g. doctor's visit) and products (e.g. medication) that have been or are to be provided for a patient. The profile defines general basic elements that can occur in Swiss use cases. In Switzerland, there are external standards for administrative processes between service providers and payers (e.g. Forum Datenaustausch, SHIP, eCH), therefore see the corresponding mapping.
package_name: rs/ch.fhir.ig.ch
derivation: constraint
name: CHCoreClaim
type: Claim
elements:
  patient:
    type: Reference
    refers: ['http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-patient']
    index: 4
  insurance:
    elements:
      coverage:
        type: Reference
        refers: ['http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-coverage']
        index: 20
  diagnosis:
    elements:
      diagnosis:
        choices: []
        index: 19
  supportingInfo:
    index: 7
    slicing:
      rules: open
      discriminator:
      - {path: category, type: value}
      min: null
      slices:
        treatmentReason:
          match:
            category:
              coding:
              - {code: patientreasonforvisit, system: 'http://terminology.hl7.org/CodeSystem/claiminformationcategory'}
          schema:
            index: 8
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: patientreasonforvisit, system: 'http://terminology.hl7.org/CodeSystem/claiminformationcategory'}
                type: CodeableConcept
                index: 9
              code:
                short: Treatment reason
                binding: {strength: preferred, valueSet: 'http://fhir.ch/ig/ch-term/ValueSet/treatmentreason'}
                index: 10
            required: [code]
        remark:
          match:
            category:
              coding:
              - {code: info, system: 'http://terminology.hl7.org/CodeSystem/claiminformationcategory'}
          schema:
            index: 11
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: info, system: 'http://terminology.hl7.org/CodeSystem/claiminformationcategory'}
                type: CodeableConcept
                index: 12
              value:
                choices: []
                index: 14
                slicing:
                  rules: open
                  ordered: false
                  discriminator:
                  - {path: $this, type: type}
                  min: 1
                  slices:
                    valueString:
                      match: {}
                      schema:
                        short: Remark
                        choices: [valueString]
                        _required: true
                        index: 16
                      min: 1
                      max: 1
              valueString:
                short: Remark
                type: string
                choiceOf: value
                index: 17
                slicing:
                  slices:
                    valueString:
                      match: {}
                      schema: {short: Remark, type: string, _required: true, choiceOf: value, index: 17}
                      min: 1
                      max: 1
            required: [value, valueString]
  item:
    extensions:
      responsible: {url: 'http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-responsible', min: 0, max: 1, type: Extension, short: Responsible for the service or product provided, index: 22}
    elements:
      extension:
        index: 21
        slicing:
          rules: open
          ordered: false
          discriminator:
          - {path: url, type: value}
          min: null
          slices:
            responsible:
              match: {url: null}
              schema: {type: Extension, short: Responsible for the service or product provided, url: 'http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-responsible', index: 22}
              min: 0
              max: 1
      sequence: {index: 23}
      category:
        elements:
          coding:
            index: 24
            slicing:
              rules: open
              discriminator:
              - {path: system, type: value}
              min: null
              slices:
                tariff:
                  match: {system: 'http://forum-datenaustausch.ch/tariff'}
                  schema:
                    short: Tariff
                    index: 25
                    elements:
                      system:
                        pattern: {type: uri, value: 'http://forum-datenaustausch.ch/tariff'}
                        type: uri
                        index: 26
                      code: {index: 27}
                    required: [system]
      productOrService:
        short: Tariff number
        index: 28
        elements:
          coding:
            index: 29
            elements:
              code: {index: 30}
              display: {index: 31}
            slicing:
              rules: open
              discriminator:
              - {path: system, type: value}
              min: null
              slices:
                GTIN:
                  match: {system: 'urn:oid:2.51.1.1'}
                  schema:
                    index: 32
                    elements:
                      system:
                        pattern: {type: uri, value: 'urn:oid:2.51.1.1'}
                        type: uri
                        index: 33
                    required: [system]
                TARMED:
                  match: {system: 'urn:oid:2.16.756.5.30.1.129.1.4'}
                  schema:
                    index: 34
                    elements:
                      system:
                        pattern: {type: uri, value: 'urn:oid:2.16.756.5.30.1.129.1.4'}
                        type: uri
                        index: 35
                    required: [system]
      serviced:
        choices: []
        index: 37
      quantity:
        elements:
          value: {index: 38}
  type:
    binding: {strength: extensible, valueSet: 'http://fhir.ch/ig/ch-core/ValueSet/bfs-medstats-20-encounterclass'}
    index: 3
  created: {index: 5}
  extension:
    index: 0
    slicing:
      rules: open
      ordered: false
      discriminator:
      - {path: url, type: value}
      min: null
      slices:
        biller:
          match: {url: null}
          schema: {type: Extension, short: Biller in the case of a professional service or poduct provided., url: 'http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-biller', index: 1}
          min: 0
          max: 1
  identifier: {index: 2}
  provider:
    type: Reference
    refers: ['http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-organization', 'http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitioner', 'http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-practitionerrole']
    index: 6
package_version: core-6.0.0-ballot
extensions:
  biller: {url: 'http://fhir.ch/ig/ch-core/StructureDefinition/ch-ext-biller', min: 0, max: 1, type: Extension, short: Biller in the case of a professional service or poduct provided., index: 1}
class: profile
kind: resource
url: http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-claim
base: http://hl7.org/fhir/StructureDefinition/Claim
version: 6.0.0-ballot