# Ví dụ: Kết quả thanh toán tự chi trả — bệnh nhân nước ngoài - Bộ Hướng dẫn Triển khai Core FHIR cho Việt Nam v0.5.0

## Ví dụ ClaimResponse: Ví dụ: Kết quả thanh toán tự chi trả — bệnh nhân nước ngoài

Profile: [Kết quả giải quyết BHYT VN Core — VN Core ClaimResponse Profile](StructureDefinition-vn-core-claim-response.md)

**status**: Active

**type**: Professional

**use**: Claim

**patient**: John Smith (DOB: 1980-07-15, Passport: A12345678)

**created**: 2026-04-15

**insurer**: [Bệnh viện Chợ Rẫy](Organization-ExampleOrganizationChoRay.md)

**request**: [Claim: extension = ,,Phí dịch vụ (FFS); identifier = Mã liên kết hồ sơ BHYT: VNMALK#LK-2026-000103; status = active; type = Professional; subType = Người bệnh không KCB BHYT; use = claim; created = 2026-04-15; priority = Normal](Claim-ExampleClaimSelfPay.md)

**outcome**: Processing Complete

> **item****itemSequence**: 1
> **adjudication****category**: Submitted Amount

### Amounts

| | | |
| :--- | :--- | :--- |
| - | **Value** | **Currency** |
| * | 300000 | Vietnamese đồng |


> **adjudication****category**: Eligible Amount

### Amounts

| | | |
| :--- | :--- | :--- |
| - | **Value** | **Currency** |
| * | 300000 | Vietnamese đồng |


> **adjudication****category**: Benefit Amount

### Amounts

| | | |
| :--- | :--- | :--- |
| - | **Value** | **Currency** |
| * | 0 | Vietnamese đồng |



> **item****itemSequence**: 2
> **adjudication****category**: Submitted Amount

### Amounts

| | | |
| :--- | :--- | :--- |
| - | **Value** | **Currency** |
| * | 250000 | Vietnamese đồng |


> **adjudication****category**: Eligible Amount

### Amounts

| | | |
| :--- | :--- | :--- |
| - | **Value** | **Currency** |
| * | 250000 | Vietnamese đồng |


> **adjudication****category**: Benefit Amount

### Amounts

| | | |
| :--- | :--- | :--- |
| - | **Value** | **Currency** |
| * | 0 | Vietnamese đồng |



> **total****category**: Submitted Amount

### Amounts

| | | |
| :--- | :--- | :--- |
| - | **Value** | **Currency** |
| * | 550000 | Vietnamese đồng |


> **total****category**: Benefit Amount

### Amounts

| | | |
| :--- | :--- | :--- |
| - | **Value** | **Currency** |
| * | 0 | Vietnamese đồng |


> **payment****type**: Complete

### Amounts

| | | |
| :--- | :--- | :--- |
| - | **Value** | **Currency** |
| * | 550000 | Vietnamese đồng |




## Resource Content

```json
{
  "resourceType" : "ClaimResponse",
  "id" : "ExampleClaimResponseSelfPay",
  "meta" : {
    "profile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim-response"]
  },
  "status" : "active",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
      "code" : "professional",
      "display" : "Professional"
    }]
  },
  "use" : "claim",
  "patient" : {
    "display" : "John Smith (DOB: 1980-07-15, Passport: A12345678)"
  },
  "created" : "2026-04-15",
  "insurer" : {
    "reference" : "Organization/ExampleOrganizationChoRay",
    "display" : "Bệnh viện Chợ Rẫy"
  },
  "request" : {
    "reference" : "Claim/ExampleClaimSelfPay"
  },
  "outcome" : "complete",
  "item" : [{
    "itemSequence" : 1,
    "adjudication" : [{
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "submitted",
          "display" : "Submitted Amount"
        }]
      },
      "amount" : {
        "value" : 300000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "eligible",
          "display" : "Eligible Amount"
        }]
      },
      "amount" : {
        "value" : 300000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "benefit",
          "display" : "Benefit Amount"
        }]
      },
      "amount" : {
        "value" : 0,
        "currency" : "VND"
      }
    }]
  },
  {
    "itemSequence" : 2,
    "adjudication" : [{
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "submitted",
          "display" : "Submitted Amount"
        }]
      },
      "amount" : {
        "value" : 250000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "eligible",
          "display" : "Eligible Amount"
        }]
      },
      "amount" : {
        "value" : 250000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "benefit",
          "display" : "Benefit Amount"
        }]
      },
      "amount" : {
        "value" : 0,
        "currency" : "VND"
      }
    }]
  }],
  "total" : [{
    "category" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
        "code" : "submitted",
        "display" : "Submitted Amount"
      }]
    },
    "amount" : {
      "value" : 550000,
      "currency" : "VND"
    }
  },
  {
    "category" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
        "code" : "benefit",
        "display" : "Benefit Amount"
      }]
    },
    "amount" : {
      "value" : 0,
      "currency" : "VND"
    }
  }],
  "payment" : {
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/ex-paymenttype",
        "code" : "complete",
        "display" : "Complete"
      }]
    },
    "amount" : {
      "value" : 550000,
      "currency" : "VND"
    }
  }
}

```
