Guia de Implementação do Projeto de Padronização e Qualificação dos Dados Assistenciais da Saúde Suplementar (PQDAS)
202309 - CI Build
Guia de Implementação do Projeto de Padronização e Qualificação dos Dados Assistenciais da Saúde Suplementar (PQDAS)
202309 - CI Build
Guia de Implementação do Projeto de Padronização e Qualificação dos Dados Assistenciais da Saúde Suplementar (PQDAS) - Local Development build (v202309). See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "efc9ee1c-1fa3-49f5-9df9-1c8984c14694",
"type" : "transaction",
"timestamp" : "2019-03-20T09:54:08-03:00",
"entry" : [
{
"fullUrl" : "urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906",
"resource" : {
"resourceType" : "Patient",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/paciente"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b></p><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\">Profile: <a href=\"StructureDefinition-paciente.html\">Paciente</a></p></div><p><b>identifier</b>: id:\u00a0<a href="https://rnds.gointerop.com/NamingSystem-cns.html">CNS</a>#700500707677157, id:\u00a0<a href="https://rnds.gointerop.com/NamingSystem-cpf.html">CPF</a>#33718709520</p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1965-06-28</p><p><b>address</b>: 315780 </p></div>"
},
"identifier" : [
{
"system" : "http://rnds.saude.gov.br/fhir/r4/NamingSystem/cns",
"value" : "700500707677157"
},
{
"system" : "http://rnds.saude.gov.br/fhir/r4/NamingSystem/cpf",
"value" : "33718709520"
}
],
"gender" : "female",
"birthDate" : "1965-06-28",
"address" : [
{
"city" : "315780"
}
]
},
"request" : {
"method" : "POST",
"url" : "Patient",
"ifNoneExist" : "identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cns|700500707677157"
}
},
{
"fullUrl" : "urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d",
"resource" : {
"resourceType" : "Organization",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/operadora"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b></p><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\">Profile: <a href=\"StructureDefinition-operadora.html\">Operadora de plano privado de assistência à saúde</a></p></div><p><b>identifier</b>: id:\u00a0<a href="NamingSystem-registro-ans.html">Registro ANS</a>#361011</p></div>"
},
"identifier" : [
{
"system" : "https://fhir.ans.gov.br/sid/registro-ans",
"value" : "361011"
}
]
},
"request" : {
"method" : "POST",
"url" : "Organization",
"ifNoneExist" : "identifier=https://fhir.ans.gov.br/sid/registro-ans|361011"
}
},
{
"fullUrl" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea",
"resource" : {
"resourceType" : "Organization",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/estabelecimento-saude"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b></p><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\">Profile: <a href=\"StructureDefinition-estabelecimento-saude.html\">Estabelecimento de Saúde</a></p></div><p><b>identifier</b>: id:\u00a009140440000119, id:\u00a0<a href="https://rnds.gointerop.com/NamingSystem-cnes.html">CNES</a>#6609732</p><p><b>address</b>: 315780 </p></div>"
},
"identifier" : [
{
"system" : "http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnpj",
"value" : "09140440000119"
},
{
"system" : "http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnes",
"value" : "6609732"
}
],
"address" : [
{
"city" : "315780"
}
]
},
"request" : {
"method" : "POST",
"url" : "Organization",
"ifNoneExist" : "identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnpj|09140440000119"
}
},
{
"fullUrl" : "urn:uuid:16ea92a6-f9ab-400f-8488-8ff2cd9626da",
"resource" : {
"resourceType" : "Practitioner",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/profissional"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b></p><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\">Profile: <a href=\"StructureDefinition-profissional.html\">Profissional prestador do serviço</a></p></div><p><b>identifier</b>: id:\u00a009140440000119, id:\u00a0<a href="https://rnds.gointerop.com/NamingSystem-cnes.html">CNES</a>#6609732</p><p><b>address</b>: 315780 </p></div>"
},
"identifier" : [
{
"system" : "http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnpj",
"value" : "09140440000119"
},
{
"system" : "http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnes",
"value" : "6609732"
}
],
"address" : [
{
"city" : "315780"
}
]
},
"request" : {
"method" : "POST",
"url" : "Practitioner",
"ifNoneExist" : "identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnpj|09140440000119"
}
},
{
"fullUrl" : "urn:uuid:2724c044-e477-4b1c-b5f2-7d70932d2d36",
"resource" : {
"resourceType" : "PractitionerRole",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/papel-profissional"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: PractitionerRole</b></p><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\">Profile: <a href=\"StructureDefinition-papel-profissional.html\">Papel do Profissional</a></p></div><p><b>practitioner</b>: <a href=\"#urnuuid16ea92a6-f9ab-400f-8488-8ff2cd9626da\">See above (urn:uuid:16ea92a6-f9ab-400f-8488-8ff2cd9626da)</a></p><p><b>organization</b>: <a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></p></div>"
},
"practitioner" : {
"reference" : "urn:uuid:16ea92a6-f9ab-400f-8488-8ff2cd9626da"
},
"organization" : {
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
}
},
"request" : {
"method" : "POST",
"url" : "PractitionerRole",
"ifNoneExist" : "practitioner.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnpj|09140440000119&organization.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnpj|09140440000119"
}
},
{
"fullUrl" : "urn:uuid:4259f028-450d-4a54-97eb-309238c629b7",
"resource" : {
"resourceType" : "Encounter",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/contato-assistencial-spsadt"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Encounter</b></p><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\">Profile: <a href=\"StructureDefinition-contato-assistencial-spsadt.html\">Contato Assistencial de SPSADT</a></p></div><p><b>identifier</b>: id:\u00a0<a href="NamingSystem-numero-guia-operadora.html">guiaOperadora</a>#TESTESPSADT_221111, id:\u00a0<a href="NamingSystem-numero-guia-prestador.html">guiaPrestador</a>#TESTESPSADT_221111, id:\u00a0<a href="NamingSystem-numero-guia-internacao.html">NumeroGuiaInternacao</a>#TESTE_INT_221111</p><p><b>status</b>: finished</p><p><b>class</b>: Ambulatorial (Details: https://fhir.ans.gov.br/CodeSystem/tuss-76 code 01 = 'Ambulatorial', stated as 'null')</p><p><b>type</b>: Consulta <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-50.html\">Tabela 50 - Tipo de atendimento</a>#04)</span></p><p><b>serviceType</b>: Pré-natal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-52.html\">Tabela 52 - Tipo de consulta</a>#3)</span></p><p><b>priority</b>: Eletivo <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-23.html\">Tabela 23 - Caráter do atendimento</a>#1)</span></p><p><b>subject</b>: <a href=\"#urnuuid2e45a07a-8d35-4a7c-b9b9-18e55d864906\">See above (urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906)</a></p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</td><td>Alta com previsão de retorno para acompanhamento do paciente <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-39.html\">Tabela 39 - Motivo de encerramento</a>#15)</span></td></tr></table><p><b>serviceProvider</b>: <a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></p></div>"
},
"identifier" : [
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-operadora",
"value" : "TESTESPSADT_221111"
},
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-prestador",
"value" : "TESTESPSADT_221111"
},
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-internacao",
"value" : "TESTE_INT_221111"
}
],
"status" : "finished",
"class" : {
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-76",
"code" : "01"
},
"type" : [
{
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-50",
"code" : "04"
}
]
}
],
"serviceType" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-52",
"code" : "3"
}
]
},
"priority" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-23",
"code" : "1"
}
]
},
"subject" : {
"reference" : "urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906"
},
"hospitalization" : {
"dischargeDisposition" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-39",
"code" : "15"
}
]
}
},
"serviceProvider" : {
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
}
},
"request" : {
"method" : "POST",
"url" : "Encounter",
"ifNoneExist" : "identifier=https://fhir.ans.gov.br/sid/numero-guia-operadora|TESTESPSADT_221111&identifier=https://fhir.ans.gov.br/sid/numero-guia-prestador|TESTESPSADT_221111&subject.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cns|700500707677157"
}
},
{
"fullUrl" : "urn:uuid:94bdc5fa-a7ec-4c99-bbc8-79e73abb5881",
"resource" : {
"resourceType" : "ServiceRequest",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/requisicao"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ServiceRequest</b></p><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\">Profile: <a href=\"StructureDefinition-requisicao.html\">Requisição de Serviço</a></p></div><p><b>identifier</b>: id:\u00a0<a href="NamingSystem-numero-guia-operadora.html">guiaOperadora</a>#TESTESPSADT_221111, id:\u00a0<a href="NamingSystem-numero-guia-prestador.html">guiaPrestador</a>#TESTESPSADT_221111</p><p><b>status</b>: completed</p><p><b>intent</b>: order</p><p><b>code</b>: ANATOMIA PATOLÓGICA E CITOPATOLOGIA <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-63.html\">Tabela 63 - Grupos de procedimentos e itens assistenciais para envio para ANS</a>#001)</span></p><p><b>quantity</b>: 3</p><p><b>subject</b>: <a href=\"#urnuuid2e45a07a-8d35-4a7c-b9b9-18e55d864906\">See above (urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906)</a></p><p><b>occurrence</b>: 2018-08-03</p><p><b>authoredOn</b>: 2018-08-01</p><p><b>requester</b>: <a href=\"#urnuuida53c1340-5f3c-4f1d-9507-869f79fa5d3d\">See above (urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d)</a></p><p><b>performer</b>: <a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></p><p><b>insurance</b>: <a href=\"#urnuuidc4607cf7-d1a4-4044-b2dd-f05abc138fb9\">See above (urn:uuid:c4607cf7-d1a4-4044-b2dd-f05abc138fb9)</a></p></div>"
},
"identifier" : [
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-operadora",
"value" : "TESTESPSADT_221111"
},
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-prestador",
"value" : "TESTESPSADT_221111"
}
],
"status" : "completed",
"intent" : "order",
"code" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-63",
"code" : "001"
}
]
},
"quantityQuantity" : {
"value" : 3
},
"subject" : {
"reference" : "urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906"
},
"occurrenceDateTime" : "2018-08-03",
"authoredOn" : "2018-08-01",
"requester" : {
"reference" : "urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d"
},
"performer" : [
{
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
}
],
"insurance" : [
{
"reference" : "urn:uuid:c4607cf7-d1a4-4044-b2dd-f05abc138fb9"
}
]
},
"request" : {
"method" : "POST",
"url" : "ServiceRequest",
"ifNoneExist" : "identifier=https://fhir.ans.gov.br/sid/numero-guia-operadora|TESTESPSADT_221111&identifier=https://fhir.ans.gov.br/sid/numero-guia-prestador|TESTESPSADT_221111&requester.identifier=https://fhir.ans.gov.br/sid/registro-ans|361011&performer.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnes|6609732&subject.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cns|700500707677157&code=https://fhir.ans.gov.br/CodeSystem/tuss-63|001"
}
},
{
"fullUrl" : "urn:uuid:2e0b5f47-b2af-4669-8fee-77e31c47ca21",
"resource" : {
"resourceType" : "Procedure",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/procedimento"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Procedure</b></p><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\">Profile: <a href=\"StructureDefinition-procedimento.html\">Procedimento realizado</a></p></div><p><b>identifier</b>: id:\u00a0<a href="NamingSystem-numero-guia-operadora.html">guiaOperadora</a>#TESTESPSADT_221111, id:\u00a0<a href="NamingSystem-numero-guia-prestador.html">guiaPrestador</a>#TESTESPSADT_221111</p><p><b>basedOn</b>: <a href=\"#urnuuid94bdc5fa-a7ec-4c99-bbc8-79e73abb5881\">See above (urn:uuid:94bdc5fa-a7ec-4c99-bbc8-79e73abb5881)</a></p><p><b>status</b>: completed</p><p><b>code</b>: ANATOMIA PATOLÓGICA E CITOPATOLOGIA <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-63.html\">Tabela 63 - Grupos de procedimentos e itens assistenciais para envio para ANS</a>#001)</span></p><p><b>subject</b>: <a href=\"#urnuuid2e45a07a-8d35-4a7c-b9b9-18e55d864906\">See above (urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906)</a></p><p><b>performed</b>: 2018-08-03</p><h3>Performers</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Actor</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></td></tr></table></div>"
},
"identifier" : [
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-operadora",
"value" : "TESTESPSADT_221111"
},
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-prestador",
"value" : "TESTESPSADT_221111"
}
],
"basedOn" : [
{
"reference" : "urn:uuid:94bdc5fa-a7ec-4c99-bbc8-79e73abb5881"
}
],
"status" : "completed",
"code" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-63",
"code" : "001"
}
]
},
"subject" : {
"reference" : "urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906"
},
"performedDateTime" : "2018-08-03",
"performer" : [
{
"actor" : {
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
}
}
]
},
"request" : {
"method" : "POST",
"url" : "Procedure",
"ifNoneExist" : "identifier=https://fhir.ans.gov.br/sid/numero-guia-operadora|TESTESPSADT_221111&identifier=https://fhir.ans.gov.br/sid/numero-guia-prestador|TESTESPSADT_221111&performer.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnes|6609732&subject.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cns|700500707677157&code=https://fhir.ans.gov.br/CodeSystem/tuss-63|001"
}
},
{
"fullUrl" : "urn:uuid:c06038e6-7408-4cd3-937e-bad56687e5ac",
"resource" : {
"resourceType" : "InsurancePlan",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/plano-saude"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: InsurancePlan</b></p><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\">Profile: <a href=\"StructureDefinition-plano-saude.html\">Plano de Saúde</a></p></div><p><b>identifier</b>: id:\u00a0<a href="NamingSystem-registro-rps-scpa.html">Registro ANS</a>#437257023</p><p><b>ownedBy</b>: <a href=\"#urnuuida53c1340-5f3c-4f1d-9507-869f79fa5d3d\">See above (urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d)</a></p></div>"
},
"identifier" : [
{
"system" : "https://fhir.ans.gov.br/sid/registro-rps-scpa",
"value" : "437257023"
}
],
"ownedBy" : {
"reference" : "urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d"
}
},
"request" : {
"method" : "POST",
"url" : "InsurancePlan",
"ifNoneExist" : "identifier=https://fhir.ans.gov.br/sid/registro-rps-scpa|437257023&owned-by.identifier=https://fhir.ans.gov.br/sid/registro-ans|361011"
}
},
{
"fullUrl" : "urn:uuid:d298ff17-134d-4170-b5e9-7c835554e121",
"resource" : {
"resourceType" : "Coverage",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/cobertura"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b></p><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\">Profile: <a href=\"StructureDefinition-cobertura.html\">Cobertura</a></p></div><p><b>identifier</b>: id:\u00a0<a href="NamingSystem-registro-rps-scpa.html">Registro ANS</a>#437257023</p><p><b>status</b>: active</p><p><b>policyHolder</b>: <a href=\"#urnuuida53c1340-5f3c-4f1d-9507-869f79fa5d3d\">See above (urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d)</a></p><p><b>beneficiary</b>: <a href=\"#urnuuid2e45a07a-8d35-4a7c-b9b9-18e55d864906\">See above (urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906)</a></p><p><b>payor</b>: <a href=\"#urnuuida53c1340-5f3c-4f1d-9507-869f79fa5d3d\">See above (urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d)</a></p></div>"
},
"identifier" : [
{
"system" : "https://fhir.ans.gov.br/sid/registro-rps-scpa",
"value" : "437257023"
}
],
"status" : "active",
"policyHolder" : {
"reference" : "urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d"
},
"beneficiary" : {
"reference" : "urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906"
},
"payor" : [
{
"reference" : "urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d"
}
]
},
"request" : {
"method" : "POST",
"url" : "Coverage",
"ifNoneExist" : "identifier=https://fhir.ans.gov.br/sid/registro-rps-scpa|437257023&beneficiary.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cns|700500707677157&payor.identifier=https://fhir.ans.gov.br/sid/registro-ans|361011&policy-holder.identifier=https://fhir.ans.gov.br/sid/registro-ans|361011"
}
},
{
"fullUrl" : "urn:uuid:78f9c56e-547c-4cc4-811d-561329296fc8",
"resource" : {
"resourceType" : "Claim",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/guia-spsadt"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Claim</b></p><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\">Profile: <a href=\"StructureDefinition-guia-spsadt.html\">Guia de SPSADT</a></p></div><p><b>Versão do componente de comunicação para o envio de dados para a ANS</b>: 1.03.00</p><p><b>Versão do componente de comunicação utilizada pelo prestador</b>: 024</p><p><b>Indicador de recém-nascido</b>: N</p><p><b>Forma de Envio</b>: Webservice <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-70.html\">Tabela 70 - Forma de envio de padrão</a>#3)</span></p><p><b>Operatora Intermediária</b>: id:\u00a0<a href="NamingSystem-registro-ans.html">Registro ANS</a>#005711</p><p><b>Tipo de contato assistencial da Operatora Intermediária</b>: Atendimento eventual <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-71.html\">Tabela 71 - Tipo de atendimento por operadora intermediária</a>#1)</span></p><p><b>Origem da guia</b>: Rede Contratada, referenciada ou credenciada <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-40.html\">Tabela 40 - Origem da guia</a>#1)</span></p><p><b>Competência</b>: 2018-08-06</p><p><b>Data de processamento da guia</b>: 2018-08-08</p><p><b>identifier</b>: id:\u00a0<a href="NamingSystem-numero-guia-internacao.html">NumeroGuiaInternacao</a>#TESTE_INT_221111, id:\u00a0<a href="NamingSystem-numero-guia-operadora.html">guiaOperadora</a>#TESTESPSADT_221111, id:\u00a0<a href="NamingSystem-numero-guia-prestador.html">guiaPrestador</a>#TESTESPSADT_221111, id:\u00a0<a href="NamingSystem-numero-lote.html">Número de lote da operadora</a>#3, id:\u00a0<a href="NamingSystem-numero-guia-internacao.html">NumeroGuiaInternacao</a>#TESTE_INT_221111</p><p><b>status</b>: active</p><p><b>type</b>: SP/SADT <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-54.html\">Tabela 54 - Tipo de guia</a>#2)</span></p><p><b>subType</b>: Pré-natal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-52.html\">Tabela 52 - Tipo de consulta</a>#3)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <a href=\"#urnuuid2e45a07a-8d35-4a7c-b9b9-18e55d864906\">See above (urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906)</a></p><p><b>created</b>: 2018-08-02</p><p><b>insurer</b>: <a href=\"#urnuuida53c1340-5f3c-4f1d-9507-869f79fa5d3d\">See above (urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d)</a></p><p><b>provider</b>: <a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><h3>Procedures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Date</b></td><td><b>Procedure[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>2018-08-03</td><td><a href=\"#urnuuid2e0b5f47-b2af-4669-8fee-77e31c47ca21\">See above (urn:uuid:2e0b5f47-b2af-4669-8fee-77e31c47ca21)</a></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><td><b>ClaimResponse</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"#urnuuidd298ff17-134d-4170-b5e9-7c835554e121\">See above (urn:uuid:d298ff17-134d-4170-b5e9-7c835554e121)</a></td><td><a href=\"#urnuuidc4607cf7-d1a4-4044-b2dd-f05abc138fb9\">See above (urn:uuid:c4607cf7-d1a4-4044-b2dd-f05abc138fb9)</a></td></tr></table><h3>Accidents</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Date</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>2018-08-03</td><td>Não Acidente <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-36.html\">Tabela 36 - Indicador de acidente</a>#9)</span></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: ANATOMIA PATOLÓGICA E CITOPATOLOGIA <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-63.html\">Tabela 63 - Grupos de procedimentos e itens assistenciais para envio para ANS</a>#001)</span></p><p><b>serviced</b>: 2018-08-03</p><p><b>quantity</b>: 3 UN</p><h3>UnitPrices</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>750</td><td>BRL</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td>750</td></tr></table></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>750</td><td>BRL</td></tr></table></div>"
},
"extension" : [
{
"url" : "https://fhir.ans.gov.br/StructureDefinition/versao-padrao",
"valueString" : "1.03.00"
},
{
"url" : "https://fhir.ans.gov.br/StructureDefinition/versao-tiss-prestador",
"valueString" : "024"
},
{
"url" : "https://fhir.ans.gov.br/StructureDefinition/indicacao-recem-nato",
"valueString" : "N"
},
{
"url" : "https://fhir.ans.gov.br/StructureDefinition/forma-envio",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-70",
"code" : "3"
}
]
}
},
{
"url" : "https://fhir.ans.gov.br/StructureDefinition/operadora-intermediaria",
"valueIdentifier" : {
"system" : "https://fhir.ans.gov.br/sid/registro-ans",
"value" : "005711"
}
},
{
"url" : "https://fhir.ans.gov.br/StructureDefinition/tipo-atendimento-operadora-intermediaria",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-71",
"code" : "1"
}
]
}
},
{
"url" : "https://fhir.ans.gov.br/StructureDefinition/origem-guia",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-40",
"code" : "1"
}
]
}
},
{
"url" : "https://fhir.ans.gov.br/StructureDefinition/data-protocolo-cobranca",
"valueDateTime" : "2018-08-06"
},
{
"url" : "https://fhir.ans.gov.br/StructureDefinition/data-processamento",
"valueDateTime" : "2018-08-08"
}
],
"identifier" : [
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-internacao",
"value" : "TESTE_INT_221111"
},
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-operadora",
"value" : "TESTESPSADT_221111"
},
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-prestador",
"value" : "TESTESPSADT_221111"
},
{
"system" : "https://fhir.ans.gov.br/sid/numero-lote",
"value" : "3"
},
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-internacao",
"value" : "TESTE_INT_221111"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-54",
"code" : "2"
}
]
},
"subType" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-52",
"code" : "3"
}
]
},
"use" : "claim",
"patient" : {
"reference" : "urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906"
},
"created" : "2018-08-02",
"insurer" : {
"reference" : "urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d"
},
"provider" : {
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
},
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "normal"
}
]
},
"procedure" : [
{
"sequence" : 1,
"date" : "2018-08-03",
"procedureReference" : {
"reference" : "urn:uuid:2e0b5f47-b2af-4669-8fee-77e31c47ca21"
}
}
],
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
"reference" : "urn:uuid:d298ff17-134d-4170-b5e9-7c835554e121"
},
"claimResponse" : {
"reference" : "urn:uuid:c4607cf7-d1a4-4044-b2dd-f05abc138fb9"
}
}
],
"accident" : {
"date" : "2018-08-03",
"type" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-36",
"code" : "9"
}
]
}
},
"item" : [
{
"sequence" : 1,
"productOrService" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-63",
"code" : "001"
}
]
},
"servicedDate" : "2018-08-03",
"quantity" : {
"value" : 3,
"unit" : "UN"
},
"unitPrice" : {
"value" : 750,
"currency" : "BRL"
},
"net" : {
"value" : 750
}
}
],
"total" : {
"value" : 750,
"currency" : "BRL"
}
},
"request" : {
"method" : "POST",
"url" : "Claim",
"ifNoneExist" : "identifier=https://fhir.ans.gov.br/sid/numero-guia-operadora|TESTESPSADT_221111&identifier=https://fhir.ans.gov.br/sid/numero-guia-prestador|TESTESPSADT_221111&identifier=https://fhir.ans.gov.br/sid/numero-lote|3&patient.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cns|700500707677157&insurer.identifier=https://fhir.ans.gov.br/sid/registro-ans|361011&provider.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnes|6609732"
}
},
{
"fullUrl" : "urn:uuid:c4607cf7-d1a4-4044-b2dd-f05abc138fb9",
"resource" : {
"resourceType" : "ClaimResponse",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/resposta-guia"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ClaimResponse</b></p><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\">Profile: <a href=\"StructureDefinition-resposta-guia.html\">RespostaGuia</a></p></div><p><b>identifier</b>: id:\u00a0<a href="NamingSystem-numero-guia-operadora.html">guiaOperadora</a>#TESTESPSADT_221111, id:\u00a0<a href="NamingSystem-numero-guia-prestador.html">guiaPrestador</a>#TESTESPSADT_221111, id:\u00a0<a href="NamingSystem-numero-lote.html">Número de lote da operadora</a>#3</p><p><b>status</b>: active</p><p><b>type</b>: SP/SADT <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-54.html\">Tabela 54 - Tipo de guia</a>#2)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <a href=\"#urnuuid2e45a07a-8d35-4a7c-b9b9-18e55d864906\">See above (urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906)</a></p><p><b>created</b>: 2018-08-01</p><p><b>insurer</b>: <a href=\"#urnuuida53c1340-5f3c-4f1d-9507-869f79fa5d3d\">See above (urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d)</a></p><p><b>requestor</b>: <a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></p><p><b>request</b>: <a href=\"#urnuuid78f9c56e-547c-4cc4-811d-561329296fc8\">See above (urn:uuid:78f9c56e-547c-4cc4-811d-561329296fc8)</a></p><p><b>outcome</b>: complete</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: Submitted Amount <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-adjudication.html\">Adjudication Value Codes</a>#submitted)</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>750</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: Eligible Amount <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-adjudication.html\">Adjudication Value Codes</a>#eligible)</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>750</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: CoPay <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-adjudication.html\">Adjudication Value Codes</a>#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>0</td><td>BRL</td></tr></table></blockquote></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor informado <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-adjudication.html\">Adjudication Value Codes</a>#submitted)</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>750</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor processado <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</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>750</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor total pago procedimentos <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</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>750</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor total diarias <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</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>0</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor total taxas <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</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>0</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor total materiais <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</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>0</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor total opme <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</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>0</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor total medicamentos <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</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>750</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor total glosa guia <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</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>0</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor pago guia <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-adjudication.html\">Adjudication Value Codes</a>#benefit)</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>750</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor pago fornecedores <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</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>45.55</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor pago tabela propria <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</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>0</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: Valor pago coparticipação <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-adjudication.html\">Adjudication Value Codes</a>#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>0</td><td>BRL</td></tr></table></blockquote><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=\"#urnuuidd298ff17-134d-4170-b5e9-7c835554e121\">See above (urn:uuid:d298ff17-134d-4170-b5e9-7c835554e121)</a></td></tr></table></div>"
},
"identifier" : [
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-operadora",
"value" : "TESTESPSADT_221111"
},
{
"system" : "https://fhir.ans.gov.br/sid/numero-guia-prestador",
"value" : "TESTESPSADT_221111"
},
{
"system" : "https://fhir.ans.gov.br/sid/numero-lote",
"value" : "3"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-54",
"code" : "2"
}
]
},
"use" : "claim",
"patient" : {
"reference" : "urn:uuid:2e45a07a-8d35-4a7c-b9b9-18e55d864906"
},
"created" : "2018-08-01",
"insurer" : {
"reference" : "urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d"
},
"requestor" : {
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
},
"request" : {
"reference" : "urn:uuid:78f9c56e-547c-4cc4-811d-561329296fc8"
},
"outcome" : "complete",
"item" : [
{
"itemSequence" : 1,
"adjudication" : [
{
"category" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/adjudication",
"code" : "submitted"
}
]
},
"amount" : {
"value" : 750,
"currency" : "BRL"
}
},
{
"category" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/adjudication",
"code" : "eligible"
}
]
},
"amount" : {
"value" : 750,
"currency" : "BRL"
}
},
{
"category" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/adjudication",
"code" : "copay"
}
]
},
"amount" : {
"value" : 0,
"currency" : "BRL"
}
}
]
}
],
"total" : [
{
"category" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/adjudication",
"code" : "submitted"
}
],
"text" : "Valor informado"
},
"amount" : {
"value" : 750,
"currency" : "BRL"
}
},
{
"category" : {
"text" : "Valor processado"
},
"amount" : {
"value" : 750,
"currency" : "BRL"
}
},
{
"category" : {
"text" : "Valor total pago procedimentos"
},
"amount" : {
"value" : 750,
"currency" : "BRL"
}
},
{
"category" : {
"text" : "Valor total diarias"
},
"amount" : {
"value" : 0,
"currency" : "BRL"
}
},
{
"category" : {
"text" : "Valor total taxas"
},
"amount" : {
"value" : 0,
"currency" : "BRL"
}
},
{
"category" : {
"text" : "Valor total materiais"
},
"amount" : {
"value" : 0,
"currency" : "BRL"
}
},
{
"category" : {
"text" : "Valor total opme"
},
"amount" : {
"value" : 0,
"currency" : "BRL"
}
},
{
"category" : {
"text" : "Valor total medicamentos"
},
"amount" : {
"value" : 750,
"currency" : "BRL"
}
},
{
"category" : {
"text" : "Valor total glosa guia"
},
"amount" : {
"value" : 0,
"currency" : "BRL"
}
},
{
"category" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/adjudication",
"code" : "benefit"
}
],
"text" : "Valor pago guia"
},
"amount" : {
"value" : 750,
"currency" : "BRL"
}
},
{
"category" : {
"text" : "Valor pago fornecedores"
},
"amount" : {
"value" : 45.55,
"currency" : "BRL"
}
},
{
"category" : {
"text" : "Valor pago tabela propria"
},
"amount" : {
"value" : 0,
"currency" : "BRL"
}
},
{
"category" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/adjudication",
"code" : "copay"
}
],
"text" : "Valor pago coparticipação"
},
"amount" : {
"value" : 0,
"currency" : "BRL"
}
}
],
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
"reference" : "urn:uuid:d298ff17-134d-4170-b5e9-7c835554e121"
}
}
]
},
"request" : {
"method" : "POST",
"url" : "ClaimResponse",
"ifNoneExist" : "identifier=https://fhir.ans.gov.br/sid/numero-guia-operadora|TESTESPSADT_221111&identifier=https://fhir.ans.gov.br/sid/numero-guia-prestador|TESTESPSADT_221111&identifier=https://fhir.ans.gov.br/sid/numero-lote|3&patient.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cns|700500707677157&insurer.identifier=https://fhir.ans.gov.br/sid/registro-ans|361011&requestor.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnes|6609732"
}
},
{
"fullUrl" : "urn:uuid:b544a264-a2f7-4eed-92fb-62f03a7a47b4",
"resource" : {
"resourceType" : "PaymentReconciliation",
"meta" : {
"profile" : [
🔗 "https://fhir.ans.gov.br/StructureDefinition/reconciliacao-pagamento"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: PaymentReconciliation</b></p><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\">Profile: <a href=\"StructureDefinition-reconciliacao-pagamento.html\">Reconciliação de Pagamento (e modelos de remuneração)</a></p></div><p><b>status</b>: active</p><p><b>created</b>: 2018-08-04</p><p><b>paymentIssuer</b>: <a href=\"#urnuuida53c1340-5f3c-4f1d-9507-869f79fa5d3d\">See above (urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d)</a></p><p><b>requestor</b>: <a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></p><p><b>outcome</b>: complete</p><p><b>paymentDate</b>: 2018-08-07</p><h3>PaymentAmounts</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>750</td><td>BRL</td></tr></table><blockquote><p><b>detail</b></p><p><b>type</b>: Por procedimento (Fee for Service) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-79.html\">Tabela 79 - Modelos de Remuneração entre Operadoras e Prestadores</a>#01)</span></p><p><b>request</b>: <a href=\"#urnuuid78f9c56e-547c-4cc4-811d-561329296fc8\">See above (urn:uuid:78f9c56e-547c-4cc4-811d-561329296fc8)</a></p><p><b>submitter</b>: <a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></p><p><b>response</b>: <a href=\"#urnuuidc4607cf7-d1a4-4044-b2dd-f05abc138fb9\">See above (urn:uuid:c4607cf7-d1a4-4044-b2dd-f05abc138fb9)</a></p><p><b>date</b>: 2018-08-07</p><p><b>payee</b>: <a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></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>100</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>detail</b></p><p><b>type</b>: Pacote <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-79.html\">Tabela 79 - Modelos de Remuneração entre Operadoras e Prestadores</a>#02)</span></p><p><b>request</b>: <a href=\"#urnuuid78f9c56e-547c-4cc4-811d-561329296fc8\">See above (urn:uuid:78f9c56e-547c-4cc4-811d-561329296fc8)</a></p><p><b>submitter</b>: <a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></p><p><b>response</b>: <a href=\"#urnuuidc4607cf7-d1a4-4044-b2dd-f05abc138fb9\">See above (urn:uuid:c4607cf7-d1a4-4044-b2dd-f05abc138fb9)</a></p><p><b>date</b>: 2018-08-07</p><p><b>payee</b>: <a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></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>200</td><td>BRL</td></tr></table></blockquote><blockquote><p><b>detail</b></p><p><b>type</b>: Orçamentação <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tuss-79.html\">Tabela 79 - Modelos de Remuneração entre Operadoras e Prestadores</a>#03)</span></p><p><b>request</b>: <a href=\"#urnuuid78f9c56e-547c-4cc4-811d-561329296fc8\">See above (urn:uuid:78f9c56e-547c-4cc4-811d-561329296fc8)</a></p><p><b>submitter</b>: <a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></p><p><b>response</b>: <a href=\"#urnuuidc4607cf7-d1a4-4044-b2dd-f05abc138fb9\">See above (urn:uuid:c4607cf7-d1a4-4044-b2dd-f05abc138fb9)</a></p><p><b>date</b>: 2018-08-07</p><p><b>payee</b>: <a href=\"#urnuuida0bdc6bc-bfd8-4126-bf79-3231b82786ea\">See above (urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea)</a></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>200</td><td>BRL</td></tr></table></blockquote></div>"
},
"status" : "active",
"created" : "2018-08-04",
"paymentIssuer" : {
"reference" : "urn:uuid:a53c1340-5f3c-4f1d-9507-869f79fa5d3d"
},
"requestor" : {
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
},
"outcome" : "complete",
"paymentDate" : "2018-08-07",
"paymentAmount" : {
"value" : 750,
"currency" : "BRL"
},
"detail" : [
{
"type" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-79",
"code" : "01"
}
]
},
"request" : {
"reference" : "urn:uuid:78f9c56e-547c-4cc4-811d-561329296fc8"
},
"submitter" : {
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
},
"response" : {
"reference" : "urn:uuid:c4607cf7-d1a4-4044-b2dd-f05abc138fb9"
},
"date" : "2018-08-07",
"payee" : {
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
},
"amount" : {
"value" : 100,
"currency" : "BRL"
}
},
{
"type" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-79",
"code" : "02"
}
]
},
"request" : {
"reference" : "urn:uuid:78f9c56e-547c-4cc4-811d-561329296fc8"
},
"submitter" : {
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
},
"response" : {
"reference" : "urn:uuid:c4607cf7-d1a4-4044-b2dd-f05abc138fb9"
},
"date" : "2018-08-07",
"payee" : {
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
},
"amount" : {
"value" : 200,
"currency" : "BRL"
}
},
{
"type" : {
"coding" : [
{
"system" : "https://fhir.ans.gov.br/CodeSystem/tuss-79",
"code" : "03"
}
]
},
"request" : {
"reference" : "urn:uuid:78f9c56e-547c-4cc4-811d-561329296fc8"
},
"submitter" : {
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
},
"response" : {
"reference" : "urn:uuid:c4607cf7-d1a4-4044-b2dd-f05abc138fb9"
},
"date" : "2018-08-07",
"payee" : {
"reference" : "urn:uuid:a0bdc6bc-bfd8-4126-bf79-3231b82786ea"
},
"amount" : {
"value" : 200,
"currency" : "BRL"
}
}
]
},
"request" : {
"method" : "POST",
"url" : "PaymentReconciliation",
"ifNoneExist" : "request.identifier=https://fhir.ans.gov.br/sid/numero-guia-operadora|TESTESPSADT_221111&request.identifier=https://fhir.ans.gov.br/sid/numero-guia-prestador|TESTESPSADT_221111&response.identifier=https://fhir.ans.gov.br/sid/numero-guia-operadora|TESTESPSADT_221111&response.identifier=https://fhir.ans.gov.br/sid/numero-guia-prestador|TESTESPSADT_221111&payment-issuer.identifier=https://fhir.ans.gov.br/sid/registro-ans|361011&requestor.identifier=http://rnds.saude.gov.br/fhir/r4/NamingSystem/cnes|6609732"
}
}
]
}
IG © 2019+ Agência Nacional de Saúde Suplementar (ANS). Package br.gov.ans.fhir#202309 based on FHIR 4.0.1. Generated 2023-11-24
Links: Table of Contents |
QA Report