StructureDefinition-explanationofbenefit-medicare

Sourceau.digitalhealth.stu3.medicare-records#current:Australian Digital Health Agency Medicare Records FHIR Implementation Guide (v3.0.2)
resourceTypeStructureDefinition
idexplanationofbenefit-medicare
canonicalhttp://ns.electronichealth.net.au/ci/fhir/StructureDefinition/explanationofbenefit-medicare
version1.1.0
statusactive
publisherAustralian Digital Health Agency
nameADHAExplanationofBenefitMedicare
titleADHA Medicare ExplanationOfBenefit
date2023-07-17T22:15:24+00:00
experimentalfalse
descriptionThe purpose of this profile is to define a representation of a record of a claim against the Medicare Benefits Schedule (MBS), Department of Veterans’ Affairs (DVA), Pharmaceutical Benefits Schedule (PBS) or Repatriation Pharmaceutical Benefits Scheme (RPBS) for the electronic exchange of digital health information between Medicare repositories and the My Health Record system infrastructure in Australia.
copyrightCopyright © 2022 Australian Digital Health Agency - All rights reserved. This content is licensed under a Creative Commons Attribution 4.0 International License. See https://creativecommons.org/licenses/by/4.0/.
fhirVersion3.0.2
kindresource
abstractfalse
sdTtypeExplanationOfBenefit
derivationconstraint
basehttp://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit
Usages(none)
Name Flags Card. Type Description & Constraints doco
. . ExplanationOfBenefit C ExplanationOfBenefit inv-dh-eob-01: A PBS or RPBS claim SHALL include a prescription.
inv-dh-eob-02: A MBS or DVABS claim SHALL NOT include a prescription.
inv-dh-eob-03: One of subType or item.category SHALL be present.
inv-dh-eob-04: A PBS claim SHALL be of type 'Pharmacy' (type='pharmacy').
inv-dh-eob-05: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/explanationofbenefit-medicare'.
. . . meta 1..
. . . . profile 1..
. . . identifier S 1..1
. . . status S Fixed Value: active
. . . type S
. . . subType S Binding: todo ( required )
. . . patient S 1.. Reference (AU Base Patient)
. . . created S 1..
. . . insurer Reference (http://hl7.org.au/fhir/StructureDefinition/au-organisation)
. . . provider S Reference (AU Base Practitioner)
. . . organization Reference (http://hl7.org.au/fhir/StructureDefinition/au-organisation)
. . . prescription S Reference (ADHA PBS MedicationRequest) { c }
. . . item S 1..1
. . . . sequence S Fixed Value: 1
. . . . category S Binding: todo ( extensible )
. . . . service S 1.. Binding: todo ( required )
. . . . serviced[x] S 1..
. . . . quantity S

doco Documentation for this format

Produced 08 Sep 2023