Ví dụ: Đề nghị thanh toán BHYT cho khám sức khỏe định kỳ (hưởng 100%) — Example: insured periodic health check-up claim - JSON Representation - Hướng dẫn triển khai FHIR cốt lõi Việt Nam

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: Ví dụ: Đề nghị thanh toán BHYT cho khám sức khỏe định kỳ (hưởng 100%) — Example: insured periodic health check-up claim

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{
  "resourceType" : "Claim",
  "id" : "ExampleClaimHealthCheckupBHYT",
  "meta" : {
    "profile" : [
      🔗 "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim"
    ]
  },
  "language" : "vi",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim ExampleClaimHealthCheckupBHYT</b></p><a name=\"ExampleClaimHealthCheckupBHYT\"> </a><a name=\"hcExampleClaimHealthCheckupBHYT\"> </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.html\">Yêu cầu thanh toán KCB VN Core — VN Core Claim Profile</a></p></div><blockquote><p><b>Tổng chi phí theo nhóm — Claim Cost Summary Extension</b></p><ul><li>totalInsurance: <span title=\"Vietnamese Dong\">₫400.000</span> (VND)</li><li>totalPatientCopay: <span title=\"Vietnamese Dong\">₫0</span> (VND)</li><li>totalPatientSelfPay: <span title=\"Vietnamese Dong\">₫0</span> (VND)</li><li>totalOtherFund: <span title=\"Vietnamese Dong\">₫0</span> (VND)</li></ul></blockquote><blockquote><p><b>Kỳ thanh toán — Claim Payment Period Extension</b></p><ul><li>year: 2026</li><li>month: 7</li></ul></blockquote><p><b>Phương thức thanh toán — Payment Method Extension</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-payment-method-cs 1}\">Phí dịch vụ (FFS)</span></p><p><b>identifier</b>: Mã liên kết hồ sơ BHYT/LK-2026-000512</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}\">Professional</span></p><p><b>subType</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-patient-visit-type-cs 1.1}\">KCB đúng cơ sở nơi đăng ký KCB BHYT ban đầu</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>: 2026-07-20</p><p><b>provider</b>: <a href=\"Organization-ExampleOrganizationChoRay.html\">Bệnh viện Chợ Rẫy</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 Z00.0}\">Khám sức khoẻ tổng quát</span></td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-diagnosistype principal}\">Principal Diagnosis</span></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Coverage-ExampleCoverageBHYTNew.html\">BHYT Nguyễn Văn An</a></td></tr></table><blockquote><p><b>item</b></p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 100</li><li>benefitLevel: 100</li></ul></blockquote><p><b>sequence</b>: 1</p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs 1}\">Khám bệnh</span></p><p><b>productOrService</b>: <span title=\"Codes:\">Khám sức khỏe định kỳ — khám lâm sàng tổng quát</span></p><h3>Nets</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><p><b>encounter</b>: <a href=\"Encounter-ExampleEncounterHealthCheckup.html\">Encounter: extension = Đúng tuyến; identifier = Mã lượt khám chữa bệnh: VNMaLuotKCB#LK-2026-07-20-KSK-0031; status = finished; class = ambulatory (ActCode#AMB); type = Khám sức khoẻ định kỳ; period = 2026-07-20 08:00:00+0700 --&gt; 2026-07-20 10:30:00+0700; reasonCode = General medical examination</a></p></blockquote><blockquote><p><b>item</b></p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 100</li><li>benefitLevel: 100</li></ul></blockquote><p><b>sequence</b>: 2</p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs 3}\">Xét nghiệm</span></p><p><b>productOrService</b>: <span title=\"Codes:\">Xét nghiệm cơ bản đợt khám sức khỏe định kỳ (công thức máu, đường máu, chức năng gan thận)</span></p><h3>Nets</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>250000</td><td>Vietnamese đồng</td></tr></table><p><b>encounter</b>: <a href=\"Encounter-ExampleEncounterHealthCheckup.html\">Encounter: extension = Đúng tuyến; identifier = Mã lượt khám chữa bệnh: VNMaLuotKCB#LK-2026-07-20-KSK-0031; status = finished; class = ambulatory (ActCode#AMB); type = Khám sức khoẻ định kỳ; period = 2026-07-20 08:00:00+0700 --&gt; 2026-07-20 10:30:00+0700; reasonCode = General medical examination</a></p></blockquote><h3>Totals</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>400000</td><td>Vietnamese đồng</td></tr></table></div>"
  },
  "extension" : [
    {
      "extension" : [
        {
          "url" : "totalInsurance",
          "valueMoney" : {
            "value" : 400000,
            "currency" : "VND"
          }
        },
        {
          "url" : "totalPatientCopay",
          "valueMoney" : {
            "value" : 0,
            "currency" : "VND"
          }
        },
        {
          "url" : "totalPatientSelfPay",
          "valueMoney" : {
            "value" : 0,
            "currency" : "VND"
          }
        },
        {
          "url" : "totalOtherFund",
          "valueMoney" : {
            "value" : 0,
            "currency" : "VND"
          }
        }
      ],
      "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary"
    },
    {
      "extension" : [
        {
          "url" : "year",
          "valueInteger" : 2026
        },
        {
          "url" : "month",
          "valueInteger" : 7
        }
      ],
      "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period"
    },
    {
      "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method",
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-payment-method-cs",
            "code" : "1",
            "display" : "Phí dịch vụ (FFS)"
          }
        ]
      }
    }
  ],
  "identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs",
            "code" : "MA_LK",
            "display" : "Mã liên kết hồ sơ BHYT"
          }
        ]
      },
      "system" : "http://fhir.hl7.org.vn/core/sid/ma-lk",
      "value" : "LK-2026-000512"
    }
  ],
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "code" : "professional",
        "display" : "Professional"
      }
    ]
  },
  "subType" : {
    "coding" : [
      {
        "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-patient-visit-type-cs",
        "code" : "1.1",
        "display" : "KCB đúng cơ sở nơi đăng ký KCB BHYT ban đầu"
      }
    ]
  },
  "use" : "claim",
  "patient" : {
    🔗 "reference" : "Patient/ExamplePatientNguyenVanAn",
    "display" : "Nguyễn Văn An"
  },
  "created" : "2026-07-20",
  "provider" : {
    🔗 "reference" : "Organization/ExampleOrganizationChoRay",
    "display" : "Bệnh viện Chợ Rẫy"
  },
  "priority" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
        "code" : "normal",
        "display" : "Normal"
      }
    ]
  },
  "diagnosis" : [
    {
      "sequence" : 1,
      "diagnosisCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/sid/icd-10",
            "code" : "Z00.0",
            "display" : "General medical examination"
          }
        ],
        "text" : "Khám sức khoẻ tổng quát"
      },
      "type" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
              "code" : "principal",
              "display" : "Principal Diagnosis"
            }
          ]
        }
      ]
    }
  ],
  "insurance" : [
    {
      "sequence" : 1,
      "focal" : true,
      "coverage" : {
        🔗 "reference" : "Coverage/ExampleCoverageBHYTNew",
        "display" : "BHYT Nguyễn Văn An"
      }
    }
  ],
  "item" : [
    {
      "extension" : [
        {
          "extension" : [
            {
              "url" : "scope",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs",
                    "code" : "1",
                    "display" : "Trong phạm vi hưởng BHYT"
                  }
                ]
              }
            },
            {
              "url" : "paymentRatio",
              "valueDecimal" : 100
            },
            {
              "url" : "benefitLevel",
              "valueDecimal" : 100
            }
          ],
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
        }
      ],
      "sequence" : 1,
      "category" : {
        "coding" : [
          {
            "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs",
            "code" : "1",
            "display" : "Khám bệnh"
          }
        ]
      },
      "productOrService" : {
        "text" : "Khám sức khỏe định kỳ — khám lâm sàng tổng quát"
      },
      "net" : {
        "value" : 150000,
        "currency" : "VND"
      },
      "encounter" : [
        {
          🔗 "reference" : "Encounter/ExampleEncounterHealthCheckup"
        }
      ]
    },
    {
      "extension" : [
        {
          "extension" : [
            {
              "url" : "scope",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs",
                    "code" : "1",
                    "display" : "Trong phạm vi hưởng BHYT"
                  }
                ]
              }
            },
            {
              "url" : "paymentRatio",
              "valueDecimal" : 100
            },
            {
              "url" : "benefitLevel",
              "valueDecimal" : 100
            }
          ],
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
        }
      ],
      "sequence" : 2,
      "category" : {
        "coding" : [
          {
            "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs",
            "code" : "3",
            "display" : "Xét nghiệm"
          }
        ]
      },
      "productOrService" : {
        "text" : "Xét nghiệm cơ bản đợt khám sức khỏe định kỳ (công thức máu, đường máu, chức năng gan thận)"
      },
      "net" : {
        "value" : 250000,
        "currency" : "VND"
      },
      "encounter" : [
        {
          🔗 "reference" : "Encounter/ExampleEncounterHealthCheckup"
        }
      ]
    }
  ],
  "total" : {
    "value" : 400000,
    "currency" : "VND"
  }
}
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