HL7 Vietnam VN Core FHIR Implementation Guide

Bộ Hướng dẫn Triển khai Core FHIR cho Việt Nam
0.5.0 - Draft for Community Review

Bộ Hướng dẫn Triển khai Core FHIR cho Việt Nam - Local Development build (v0.5.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## : Ví dụ: Kết quả BHYT — Từ chối một phần (thuốc ngoài danh mục)

Bản thô xml | Tải xuống

    <ClaimResponse xmlns="http://hl7.org/fhir">
      <id value="ExampleClaimResponsePartialDeny"/>
      <meta>
        <profile
                 value="http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim-response"/>
      </meta>
      <language value="vi"/>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ClaimResponse ExampleClaimResponsePartialDeny</b></p><a name="ExampleClaimResponsePartialDeny"> </a><a name="hcExampleClaimResponsePartialDeny"> </a><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"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-vn-core-claim-response.html">Kết quả giải quyết BHYT VN Core — VN Core ClaimResponse Profile</a></p></div><p><b>identifier</b>: Mã phản hồi XML1 của Cổng tiếp nhận BHYT/XML1-20260322-000042</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}">Institutional</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href="Patient-ExamplePatientNguyenVanAn.html">Nguyễn Văn An</a></p><p><b>created</b>: 2026-03-22</p><p><b>insurer</b>: <a href="Organization-ExampleOrganizationBHXH.html">Bảo hiểm xã hội Việt Nam</a></p><p><b>request</b>: <a href="Claim-ExampleClaimBHYT.html">Claim: extension = ,,Phí dịch vụ (FFS); identifier = Mã liên kết hồ sơ BHYT: VNMALK#LK-2026-000101; status = active; type = Institutional; subType = KCB đúng cơ sở nơi đăng ký KCB BHYT ban đầu; use = claim; created = 2026-03-17; priority = Normal</a></p><p><b>outcome</b>: Partial Processing</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}">Submitted Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>150000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}">Eligible Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>150000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication copay}">CoPay</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>30000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}">Benefit Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>120000</td><td>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 2</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}">Submitted Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>850000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}">Eligible Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>850000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication copay}">CoPay</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>170000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}">Benefit Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>680000</td><td>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 3</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}">Submitted Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>3200000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}">Eligible Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>2400000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication copay}">CoPay</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>480000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}">Benefit Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>1920000</td><td>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}">Submitted Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>4200000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}">Eligible Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>3400000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication copay}">CoPay</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>680000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}">Benefit Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>2720000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>payment</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/ex-paymenttype partial}">Partial</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>2720000</td><td>Vietnamese đồng</td></tr></table></blockquote><h3>Errors</h3><table class="grid"><tr><td style="display: none">-</td><td><b>ItemSequence</b></td><td><b>Code</b></td></tr><tr><td style="display: none">*</td><td>3</td><td><span title="Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-review-issue-cs LEGAL_NON_COMPLIANT_COST}">Chi phí không đúng quy định pháp luật</span></td></tr></table></div>
      </text>
      <identifier>
        <type>
          <coding>
            <system
                    value="http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs"/>
            <code value="BHYT_XML1_ID"/>
          </coding>
        </type>
        <system value="http://fhir.hl7.org.vn/core/sid/bhyt-gateway-response-id"/>
        <value value="XML1-20260322-000042"/>
      </identifier>
      <status value="active"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
          <code value="institutional"/>
          <display value="Institutional"/>
        </coding>
      </type>
      <use value="claim"/>
      <patient>🔗
        <reference value="Patient/ExamplePatientNguyenVanAn"/>
        <display value="Nguyễn Văn An"/>
      </patient>
      <created value="2026-03-22"/>
      <insurer>🔗
        <reference value="Organization/ExampleOrganizationBHXH"/>
        <display value="Bảo hiểm xã hội Việt Nam"/>
      </insurer>
      <request>🔗
        <reference value="Claim/ExampleClaimBHYT"/>
      </request>
      <outcome value="partial"/>
      <item>
        <itemSequence value="1"/>
        <adjudication>
          <category>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="submitted"/>
              <display value="Submitted Amount"/>
            </coding>
          </category>
          <amount>
            <value value="150000"/>
            <currency value="VND"/>
          </amount>
        </adjudication>
        <adjudication>
          <category>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="eligible"/>
              <display value="Eligible Amount"/>
            </coding>
          </category>
          <amount>
            <value value="150000"/>
            <currency value="VND"/>
          </amount>
        </adjudication>
        <adjudication>
          <category>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="copay"/>
              <display value="CoPay"/>
            </coding>
          </category>
          <amount>
            <value value="30000"/>
            <currency value="VND"/>
          </amount>
        </adjudication>
        <adjudication>
          <category>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="benefit"/>
              <display value="Benefit Amount"/>
            </coding>
          </category>
          <amount>
            <value value="120000"/>
            <currency value="VND"/>
          </amount>
        </adjudication>
      </item>
      <item>
        <itemSequence value="2"/>
        <adjudication>
          <category>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="submitted"/>
              <display value="Submitted Amount"/>
            </coding>
          </category>
          <amount>
            <value value="850000"/>
            <currency value="VND"/>
          </amount>
        </adjudication>
        <adjudication>
          <category>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="eligible"/>
              <display value="Eligible Amount"/>
            </coding>
          </category>
          <amount>
            <value value="850000"/>
            <currency value="VND"/>
          </amount>
        </adjudication>
        <adjudication>
          <category>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="copay"/>
              <display value="CoPay"/>
            </coding>
          </category>
          <amount>
            <value value="170000"/>
            <currency value="VND"/>
          </amount>
        </adjudication>
        <adjudication>
          <category>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="benefit"/>
              <display value="Benefit Amount"/>
            </coding>
          </category>
          <amount>
            <value value="680000"/>
            <currency value="VND"/>
          </amount>
        </adjudication>
      </item>
      <item>
        <itemSequence value="3"/>
        <adjudication>
          <category>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="submitted"/>
              <display value="Submitted Amount"/>
            </coding>
          </category>
          <amount>
            <value value="3200000"/>
            <currency value="VND"/>
          </amount>
        </adjudication>
        <adjudication>
          <category>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="eligible"/>
              <display value="Eligible Amount"/>
            </coding>
          </category>
          <amount>
            <value value="2400000"/>
            <currency value="VND"/>
          </amount>
        </adjudication>
        <adjudication>
          <category>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="copay"/>
              <display value="CoPay"/>
            </coding>
          </category>
          <amount>
            <value value="480000"/>
            <currency value="VND"/>
          </amount>
        </adjudication>
        <adjudication>
          <category>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="benefit"/>
              <display value="Benefit Amount"/>
            </coding>
          </category>
          <amount>
            <value value="1920000"/>
            <currency value="VND"/>
          </amount>
        </adjudication>
      </item>
      <total>
        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
            <code value="submitted"/>
            <display value="Submitted Amount"/>
          </coding>
        </category>
        <amount>
          <value value="4200000"/>
          <currency value="VND"/>
        </amount>
      </total>
      <total>
        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
            <code value="eligible"/>
            <display value="Eligible Amount"/>
          </coding>
        </category>
        <amount>
          <value value="3400000"/>
          <currency value="VND"/>
        </amount>
      </total>
      <total>
        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
            <code value="copay"/>
            <display value="CoPay"/>
          </coding>
        </category>
        <amount>
          <value value="680000"/>
          <currency value="VND"/>
        </amount>
      </total>
      <total>
        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
            <code value="benefit"/>
            <display value="Benefit Amount"/>
          </coding>
        </category>
        <amount>
          <value value="2720000"/>
          <currency value="VND"/>
        </amount>
      </total>
      <payment>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/ex-paymenttype"/>
            <code value="partial"/>
            <display value="Partial"/>
          </coding>
        </type>
        <amount>
          <value value="2720000"/>
          <currency value="VND"/>
        </amount>
      </payment>
      <error>
        <itemSequence value="3"/>
        <code>
          <coding>
            <system
                    value="http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-review-issue-cs"/>
            <code value="LEGAL_NON_COMPLIANT_COST"/>
            <display value="Chi phí không đúng quy định pháp luật"/>
          </coding>
        </code>
      </error>
    </ClaimResponse>