HL7 Vietnam VN Core FHIR Implementation Guide

Hướng dẫn triển khai FHIR cốt lõi Việt Nam — VN Core FHIR Implementation Guide
0.10.0 - Draft for Community Review Viet Nam cờ

Hướng dẫn triển khai FHIR cốt lõi Việt Nam — VN Core FHIR Implementation Guide - Draft for Community Review (v0.10.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Hồ sơ tài nguyên: Kiến nghị xem xét lại chi phí BHYT — VN Core BHYT Cost Appeal Task

URL chính thức: http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim-appeal-task Phiên bản: 0.10.0
Computable Name: VNCoreClaimAppealTask
Định danh khác: OID:2.25.161089673617632664299011809196868855799.42.34

Theo dõi một kiến nghị của cơ sở khám bệnh, chữa bệnh đề nghị xem xét lại việc TỪ CHỐI THANH TOÁN hoặc việc THU HỒI chi phí khám bệnh, chữa bệnh bảo hiểm y tế.

Căn cứ pháp lý. NĐ 188/2025/NĐ-CP Điều 51 khoản 3: cơ sở khám bệnh, chữa bệnh "có quyền kiến nghị cơ quan bảo hiểm xã hội xem xét lại việc từ chối thanh toán … hoặc kiến nghị cơ quan có thẩm quyền xem xét, giải quyết theo quy định của pháp luật". Điều 52 khoản 4 lặp lại quyền đó cho việc thu hồi. Điều 53 quy định trách nhiệm các bên và nói tới kết quả giải quyết cuối cùng.

Vì sao profile riêng chứ không mở rộng VNCoreTask. VNCoreTask đã khoá focus vào VNCoreServiceRequest hoặc VNCoreMedicationRequest — hai luồng chuyển người bệnh và cấp phát thuốc. Kiến nghị chi phí nhắm vào ClaimResponse hoặc PaymentReconciliation, không nằm trong tập đó; kế thừa sẽ buộc phải nới focus của profile cha và làm loãng chính ràng buộc khiến nó hữu ích.

Vì sao dùng Task mà không phải resource khác. Đây là quyết định ánh xạ CỤC BỘ của VN Core: nghị định quy định quyền và trách nhiệm, không chỉ định resource FHIR nào. Task được chọn vì quy trình này là một công việc có vòng đời, có bên yêu cầu, bên thực hiện và kết quả — đúng ngữ nghĩa Task. Không nên hiểu là nghị định yêu cầu dùng Task.

Ranh giới. Profile theo dõi TIẾN TRÌNH kiến nghị; nó không phán xét kiến nghị đúng hay sai, và không thay thế biên bản giám định hay văn bản thu hồi — hai chứng từ đó nằm ở DocumentReference được focus hoặc input trỏ tới.

Usages:

You can also check for usages in the FHIR IG Statistics

Các dạng xem hình thức của nội dung hồ sơ

Mô tả profile, differential, snapshot và các biểu diễn liên quan.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Task C 0..* Task A task to be performed
Constraints: inv-1, vn-claim-appeal-outcome-required, vn-claim-appeal-state-coherent, vn-claim-appeal-decision-chronology
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:appealStage SO 1..1 Coding Giai đoạn kiến nghị — phân biệt đang ở cơ quan BHXH hay đã chuyển cơ quan có thẩm quyền
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage
Binding: Giai đoạn kiến nghị chi phí BHYT — BHYT Cost Appeal Stage ValueSet (required)
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... intent SOΣ 1..1 code unknown | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: TaskIntent (required): Distinguishes whether the task is a proposal, plan or full order.
Fixed Value: order
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... code SOΣ 1..1 CodeableConcept Loại công việc — kiến nghị xem xét lại
Binding: TaskCode (example): Codes to identify what the task involves. These will typically be specific to a particular workflow.
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... text SΣ 1..1 string Plain text representation of the concept
... focus SOΣ 1..1 Reference(Kết quả giải quyết BHYT VN Core — VN Core ClaimResponse Profile | Đối soát và phân bổ khoản thanh toán BHYT — VN Core BHYT Payment Reconciliation | DocumentReference) Quyết định bị kiến nghị: kết quả giám định hoặc đối soát thanh toán/thu hồi
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... for SOΣ 0..1 Reference(Resource) Người bệnh liên quan nếu kiến nghị gắn với một hồ sơ cụ thể
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... executionPeriod SOΣ 0..1 Period Khoảng thời gian xem xét kiến nghị — `end` là thời điểm ra quyết định
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... authoredOn SOC 1..1 dateTime Thời điểm nêu kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... requester SOΣ 1..1 Reference(Cơ sở khám bệnh, chữa bệnh VN Core — VN Core KCB Organization Profile | Cơ sở y tế VN Core — VN Core Organization Profile) Cơ sở khám bệnh, chữa bệnh nêu kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... owner SOΣ 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan giải quyết: cơ quan bảo hiểm xã hội hoặc cơ quan có thẩm quyền
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... reasonCode SO 0..1 CodeableConcept Lý do kiến nghị
Binding Description: (example): Indicates why the task is needed. E.g. Suspended because patient admitted to hospital.
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... input SO 0..* BackboneElement Tài liệu kèm theo: biên bản giám định, văn bản thu hồi, chứng từ bổ sung
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Label for the input
Binding Description: (example): Codes to identify types of input parameters. These will typically be specific to a particular workflow. E.g. "Comparison source", "Applicable consent", "Concomitent Medications", etc.
.... value[x] 1..1 Content to use in performing the task
..... valueBase64Binary base64Binary
..... valueBoolean boolean
..... valueCanonical canonical(Any)
..... valueCode code
..... valueDate date
..... valueDateTime dateTime
..... valueDecimal decimal
..... valueId id
..... valueInstant instant
..... valueInteger integer
..... valueMarkdown markdown
..... valueOid oid
..... valuePositiveInt positiveInt
..... valueString string
..... valueTime time
..... valueUnsignedInt unsignedInt
..... valueUri uri
..... valueUrl url
..... valueUuid uuid
..... valueAddress Address
..... valueAge Age
..... valueAnnotation Annotation
..... valueAttachment Attachment
..... valueCodeableConcept CodeableConcept
..... valueCoding Coding
..... valueContactPoint ContactPoint
..... valueCount Count
..... valueDistance Distance
..... valueDuration Duration
..... valueHumanName HumanName
..... valueIdentifier Identifier
..... valueMoney Money
..... valuePeriod Period
..... valueQuantity Quantity
..... valueRange Range
..... valueRatio Ratio
..... valueReference Reference(Any)
..... valueSampledData SampledData
..... valueSignature Signature
..... valueTiming Timing
..... valueContactDetail ContactDetail
..... valueContributor Contributor
..... valueDataRequirement DataRequirement
..... valueExpression Expression
..... valueParameterDefinition ParameterDefinition
..... valueRelatedArtifact RelatedArtifact
..... valueTriggerDefinition TriggerDefinition
..... valueUsageContext UsageContext
..... valueDosage Dosage
..... valueMeta Meta
... output SO 0..* BackboneElement Kết quả giải quyết — bắt buộc khi kiến nghị đã kết thúc
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Label for output
Binding Description: (example): Codes to identify types of input parameters. These will typically be specific to a particular workflow. E.g. "Identified issues", "Preliminary results", "Filler order", "Final results", etc.
.... value[x] 1..1 Result of output
..... valueBase64Binary base64Binary
..... valueBoolean boolean
..... valueCanonical canonical(Any)
..... valueCode code
..... valueDate date
..... valueDateTime dateTime
..... valueDecimal decimal
..... valueId id
..... valueInstant instant
..... valueInteger integer
..... valueMarkdown markdown
..... valueOid oid
..... valuePositiveInt positiveInt
..... valueString string
..... valueTime time
..... valueUnsignedInt unsignedInt
..... valueUri uri
..... valueUrl url
..... valueUuid uuid
..... valueAddress Address
..... valueAge Age
..... valueAnnotation Annotation
..... valueAttachment Attachment
..... valueCodeableConcept CodeableConcept
..... valueCoding Coding
..... valueContactPoint ContactPoint
..... valueCount Count
..... valueDistance Distance
..... valueDuration Duration
..... valueHumanName HumanName
..... valueIdentifier Identifier
..... valueMoney Money
..... valuePeriod Period
..... valueQuantity Quantity
..... valueRange Range
..... valueRatio Ratio
..... valueReference Reference(Any)
..... valueSampledData SampledData
..... valueSignature Signature
..... valueTiming Timing
..... valueContactDetail ContactDetail
..... valueContributor Contributor
..... valueDataRequirement DataRequirement
..... valueExpression Expression
..... valueParameterDefinition ParameterDefinition
..... valueRelatedArtifact RelatedArtifact
..... valueTriggerDefinition TriggerDefinition
..... valueUsageContext UsageContext
..... valueDosage Dosage
..... valueMeta Meta

doco Documentation for this format
NameBên giám định BHYT (Adjudicator)Bên gửi hồ sơ BHYT (Submitter)doco
.. Task
... Slices for extension
.... extension:appealStage
... status
... intent
... focus
... for
... executionPeriod
... authoredOn
... requester
... owner
... reasonCode
... input
... output

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Task.status Base required TaskStatus 📍4.0.1 FHIR Std.
Task.intent Base required TaskIntent 📍4.0.1 FHIR Std.
Task.code Base example Task Codes 📍4.0.1 FHIR Std.
Task.reasonCode Base example Not State Unknown
Task.input.type Base example Not State Unknown
Task.output.type Base example Not State Unknown

Constraints

Id Grade Path(s) Description Expression
dom-2 error Task If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Task If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Task If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Task If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Task A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
inv-1 error Task Last modified date must be greater than or equal to authored-on date. lastModified.exists().not() or authoredOn.exists().not() or lastModified >= authoredOn
vn-claim-appeal-decision-chronology error Task Kiến nghị đã kết thúc phải ghi thời điểm ra quyết định, và thời điểm ấy không được sớm hơn ngày nêu kiến nghị. A concluded appeal SHALL carry executionPeriod.end, which SHALL NOT precede authoredOn. extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed' or code = 'withdrawn')).exists() implies (executionPeriod.end.exists() and executionPeriod.end >= authoredOn)
vn-claim-appeal-outcome-required error Task Kiến nghị ở giai đoạn giữ nguyên hoặc chấp nhận phải mang kết quả giải quyết, và NGƯỢC LẠI: output chỉ được xuất hiện khi kiến nghị đã có kết quả cuối (siết P1 #7 — output trước khi kết thúc là kết quả tiền chế). An appeal that is upheld or reversed SHALL carry its resolution output, and output SHALL only be present at a terminal result stage. (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).empty() or output.exists()) and (output.empty() or extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).exists())
vn-claim-appeal-state-coherent error Task Ma trận trạng thái Task ↔ giai đoạn kiến nghị: upheld/reversed chỉ đi với completed; withdrawn chỉ đi với cancelled; completed đòi giai đoạn là kết quả cuối. Task.status and appealStage SHALL follow the full coherence matrix (upheld/reversed ⇔ completed; withdrawn ⇒ cancelled). (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).empty() or status = 'completed') and (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and code = 'withdrawn').empty() or status = 'cancelled') and (status != 'completed' or extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).exists())

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Task C 0..* Task A task to be performed
Constraints: vn-claim-appeal-outcome-required, vn-claim-appeal-state-coherent, vn-claim-appeal-decision-chronology
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:appealStage SO 1..1 Coding Giai đoạn kiến nghị — phân biệt đang ở cơ quan BHXH hay đã chuyển cơ quan có thẩm quyền
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage
Binding: Giai đoạn kiến nghị chi phí BHYT — BHYT Cost Appeal Stage ValueSet (required)
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... status SO 1..1 code Vòng đời kỹ thuật: requested | in-progress | completed | cancelled
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... intent SO 1..1 code unknown | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Fixed Value: order
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... text S 1..1 string Plain text representation of the concept
... focus SO 1..1 Reference(Kết quả giải quyết BHYT VN Core — VN Core ClaimResponse Profile | Đối soát và phân bổ khoản thanh toán BHYT — VN Core BHYT Payment Reconciliation | DocumentReference) Quyết định bị kiến nghị: kết quả giám định hoặc đối soát thanh toán/thu hồi
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... for SO 0..1 Reference(Resource) Người bệnh liên quan nếu kiến nghị gắn với một hồ sơ cụ thể
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... executionPeriod SO 0..1 Period Khoảng thời gian xem xét kiến nghị — `end` là thời điểm ra quyết định
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... authoredOn SO 1..1 dateTime Thời điểm nêu kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... requester SO 1..1 Reference(Cơ sở khám bệnh, chữa bệnh VN Core — VN Core KCB Organization Profile | Cơ sở y tế VN Core — VN Core Organization Profile) Cơ sở khám bệnh, chữa bệnh nêu kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... owner SO 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan giải quyết: cơ quan bảo hiểm xã hội hoặc cơ quan có thẩm quyền
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... reasonCode SO 0..1 CodeableConcept Lý do kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... input SO 0..* BackboneElement Tài liệu kèm theo: biên bản giám định, văn bản thu hồi, chứng từ bổ sung
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... output SO 0..* BackboneElement Kết quả giải quyết — bắt buộc khi kiến nghị đã kết thúc
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)

doco Documentation for this format
NameBên giám định BHYT (Adjudicator)Bên gửi hồ sơ BHYT (Submitter)doco
.. Task
... Slices for extension
.... extension:appealStage
... status
... intent
... focus
... for
... executionPeriod
... authoredOn
... requester
... owner
... reasonCode
... input
... output

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
vn-claim-appeal-decision-chronology error Task Kiến nghị đã kết thúc phải ghi thời điểm ra quyết định, và thời điểm ấy không được sớm hơn ngày nêu kiến nghị. A concluded appeal SHALL carry executionPeriod.end, which SHALL NOT precede authoredOn. extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed' or code = 'withdrawn')).exists() implies (executionPeriod.end.exists() and executionPeriod.end >= authoredOn)
vn-claim-appeal-outcome-required error Task Kiến nghị ở giai đoạn giữ nguyên hoặc chấp nhận phải mang kết quả giải quyết, và NGƯỢC LẠI: output chỉ được xuất hiện khi kiến nghị đã có kết quả cuối (siết P1 #7 — output trước khi kết thúc là kết quả tiền chế). An appeal that is upheld or reversed SHALL carry its resolution output, and output SHALL only be present at a terminal result stage. (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).empty() or output.exists()) and (output.empty() or extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).exists())
vn-claim-appeal-state-coherent error Task Ma trận trạng thái Task ↔ giai đoạn kiến nghị: upheld/reversed chỉ đi với completed; withdrawn chỉ đi với cancelled; completed đòi giai đoạn là kết quả cuối. Task.status and appealStage SHALL follow the full coherence matrix (upheld/reversed ⇔ completed; withdrawn ⇒ cancelled). (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).empty() or status = 'completed') and (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and code = 'withdrawn').empty() or status = 'cancelled') and (status != 'completed' or extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).exists())
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Task C 0..* Task A task to be performed
Constraints: inv-1, vn-claim-appeal-outcome-required, vn-claim-appeal-state-coherent, vn-claim-appeal-decision-chronology
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:appealStage SO 1..1 Coding Giai đoạn kiến nghị — phân biệt đang ở cơ quan BHXH hay đã chuyển cơ quan có thẩm quyền
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage
Binding: Giai đoạn kiến nghị chi phí BHYT — BHYT Cost Appeal Stage ValueSet (required)
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Task Instance Identifier
... instantiatesCanonical Σ 0..1 canonical(ActivityDefinition) Formal definition of task
... instantiatesUri Σ 0..1 uri Formal definition of task
... basedOn Σ 0..* Reference(Resource) Request fulfilled by this task
... groupIdentifier Σ 0..1 Identifier Requisition or grouper id
... partOf Σ 0..* Reference(Task) Composite task
... status ?!SOΣ 1..1 code Vòng đời kỹ thuật: requested | in-progress | completed | cancelled
Binding: TaskStatus (required): The current status of the task.
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... statusReason Σ 0..1 CodeableConcept Reason for current status
Binding Description: (example): Codes to identify the reason for current status. These will typically be specific to a particular workflow.
... businessStatus Σ 0..1 CodeableConcept E.g. "Specimen collected", "IV prepped"
Binding Description: (example): The domain-specific business-contextual sub-state of the task. For example: "Blood drawn", "IV inserted", "Awaiting physician signature", etc.
... intent SOΣ 1..1 code unknown | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: TaskIntent (required): Distinguishes whether the task is a proposal, plan or full order.
Fixed Value: order
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... priority 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): The task's priority.
... code SOΣ 1..1 CodeableConcept Loại công việc — kiến nghị xem xét lại
Binding: TaskCode (example): Codes to identify what the task involves. These will typically be specific to a particular workflow.
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
.... text SΣ 1..1 string Plain text representation of the concept
... description Σ 0..1 string Human-readable explanation of task
... focus SOΣ 1..1 Reference(Kết quả giải quyết BHYT VN Core — VN Core ClaimResponse Profile | Đối soát và phân bổ khoản thanh toán BHYT — VN Core BHYT Payment Reconciliation | DocumentReference) Quyết định bị kiến nghị: kết quả giám định hoặc đối soát thanh toán/thu hồi
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... for SOΣ 0..1 Reference(Resource) Người bệnh liên quan nếu kiến nghị gắn với một hồ sơ cụ thể
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this task originated
... executionPeriod SOΣ 0..1 Period Khoảng thời gian xem xét kiến nghị — `end` là thời điểm ra quyết định
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... authoredOn SOC 1..1 dateTime Thời điểm nêu kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... lastModified ΣC 0..1 dateTime Task Last Modified Date
... requester SOΣ 1..1 Reference(Cơ sở khám bệnh, chữa bệnh VN Core — VN Core KCB Organization Profile | Cơ sở y tế VN Core — VN Core Organization Profile) Cơ sở khám bệnh, chữa bệnh nêu kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... performerType 0..* CodeableConcept Requested performer
Binding: ProcedurePerformerRoleCodes (preferred): The type(s) of task performers allowed.
... owner SOΣ 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan giải quyết: cơ quan bảo hiểm xã hội hoặc cơ quan có thẩm quyền
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... location Σ 0..1 Reference(Location) Where task occurs
... reasonCode SO 0..1 CodeableConcept Lý do kiến nghị
Binding Description: (example): Indicates why the task is needed. E.g. Suspended because patient admitted to hospital.
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... reasonReference 0..1 Reference(Resource) Why task is needed
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... note 0..* Annotation Comments made about the task
... relevantHistory 0..* Reference(Provenance) Key events in history of the Task
... restriction 0..1 BackboneElement Constraints on fulfillment tasks
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... repetitions 0..1 positiveInt How many times to repeat
.... period 0..1 Period When fulfillment sought
.... recipient 0..* Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Group | Organization) For whom is fulfillment sought?
... input SO 0..* BackboneElement Tài liệu kèm theo: biên bản giám định, văn bản thu hồi, chứng từ bổ sung
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Label for the input
Binding Description: (example): Codes to identify types of input parameters. These will typically be specific to a particular workflow. E.g. "Comparison source", "Applicable consent", "Concomitent Medications", etc.
.... value[x] 1..1 Content to use in performing the task
..... valueBase64Binary base64Binary
..... valueBoolean boolean
..... valueCanonical canonical(Any)
..... valueCode code
..... valueDate date
..... valueDateTime dateTime
..... valueDecimal decimal
..... valueId id
..... valueInstant instant
..... valueInteger integer
..... valueMarkdown markdown
..... valueOid oid
..... valuePositiveInt positiveInt
..... valueString string
..... valueTime time
..... valueUnsignedInt unsignedInt
..... valueUri uri
..... valueUrl url
..... valueUuid uuid
..... valueAddress Address
..... valueAge Age
..... valueAnnotation Annotation
..... valueAttachment Attachment
..... valueCodeableConcept CodeableConcept
..... valueCoding Coding
..... valueContactPoint ContactPoint
..... valueCount Count
..... valueDistance Distance
..... valueDuration Duration
..... valueHumanName HumanName
..... valueIdentifier Identifier
..... valueMoney Money
..... valuePeriod Period
..... valueQuantity Quantity
..... valueRange Range
..... valueRatio Ratio
..... valueReference Reference(Any)
..... valueSampledData SampledData
..... valueSignature Signature
..... valueTiming Timing
..... valueContactDetail ContactDetail
..... valueContributor Contributor
..... valueDataRequirement DataRequirement
..... valueExpression Expression
..... valueParameterDefinition ParameterDefinition
..... valueRelatedArtifact RelatedArtifact
..... valueTriggerDefinition TriggerDefinition
..... valueUsageContext UsageContext
..... valueDosage Dosage
..... valueMeta Meta
... output SO 0..* BackboneElement Kết quả giải quyết — bắt buộc khi kiến nghị đã kết thúc
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Label for output
Binding Description: (example): Codes to identify types of input parameters. These will typically be specific to a particular workflow. E.g. "Identified issues", "Preliminary results", "Filler order", "Final results", etc.
.... value[x] 1..1 Result of output
..... valueBase64Binary base64Binary
..... valueBoolean boolean
..... valueCanonical canonical(Any)
..... valueCode code
..... valueDate date
..... valueDateTime dateTime
..... valueDecimal decimal
..... valueId id
..... valueInstant instant
..... valueInteger integer
..... valueMarkdown markdown
..... valueOid oid
..... valuePositiveInt positiveInt
..... valueString string
..... valueTime time
..... valueUnsignedInt unsignedInt
..... valueUri uri
..... valueUrl url
..... valueUuid uuid
..... valueAddress Address
..... valueAge Age
..... valueAnnotation Annotation
..... valueAttachment Attachment
..... valueCodeableConcept CodeableConcept
..... valueCoding Coding
..... valueContactPoint ContactPoint
..... valueCount Count
..... valueDistance Distance
..... valueDuration Duration
..... valueHumanName HumanName
..... valueIdentifier Identifier
..... valueMoney Money
..... valuePeriod Period
..... valueQuantity Quantity
..... valueRange Range
..... valueRatio Ratio
..... valueReference Reference(Any)
..... valueSampledData SampledData
..... valueSignature Signature
..... valueTiming Timing
..... valueContactDetail ContactDetail
..... valueContributor Contributor
..... valueDataRequirement DataRequirement
..... valueExpression Expression
..... valueParameterDefinition ParameterDefinition
..... valueRelatedArtifact RelatedArtifact
..... valueTriggerDefinition TriggerDefinition
..... valueUsageContext UsageContext
..... valueDosage Dosage
..... valueMeta Meta

doco Documentation for this format
NameBên giám định BHYT (Adjudicator)Bên gửi hồ sơ BHYT (Submitter)doco
.. Task
... Slices for extension
.... extension:appealStage
... status
... intent
... focus
... for
... executionPeriod
... authoredOn
... requester
... owner
... reasonCode
... input
... output

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Task.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Task.status Base required TaskStatus 📍4.0.1 FHIR Std.
Task.statusReason Base example Not State Unknown
Task.businessStatus Base example Not State Unknown
Task.intent Base required TaskIntent 📍4.0.1 FHIR Std.
Task.priority Base required Request priority 📍4.0.1 FHIR Std.
Task.code Base example Task Codes 📍4.0.1 FHIR Std.
Task.performerType Base preferred Procedure Performer Role Codes 📍4.0.1 FHIR Std.
Task.reasonCode Base example Not State Unknown
Task.input.type Base example Not State Unknown
Task.output.type Base example Not State Unknown

Constraints

Id Grade Path(s) Description Expression
dom-2 error Task If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Task If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Task If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Task If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Task A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
inv-1 error Task Last modified date must be greater than or equal to authored-on date. lastModified.exists().not() or authoredOn.exists().not() or lastModified >= authoredOn
vn-claim-appeal-decision-chronology error Task Kiến nghị đã kết thúc phải ghi thời điểm ra quyết định, và thời điểm ấy không được sớm hơn ngày nêu kiến nghị. A concluded appeal SHALL carry executionPeriod.end, which SHALL NOT precede authoredOn. extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed' or code = 'withdrawn')).exists() implies (executionPeriod.end.exists() and executionPeriod.end >= authoredOn)
vn-claim-appeal-outcome-required error Task Kiến nghị ở giai đoạn giữ nguyên hoặc chấp nhận phải mang kết quả giải quyết, và NGƯỢC LẠI: output chỉ được xuất hiện khi kiến nghị đã có kết quả cuối (siết P1 #7 — output trước khi kết thúc là kết quả tiền chế). An appeal that is upheld or reversed SHALL carry its resolution output, and output SHALL only be present at a terminal result stage. (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).empty() or output.exists()) and (output.empty() or extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).exists())
vn-claim-appeal-state-coherent error Task Ma trận trạng thái Task ↔ giai đoạn kiến nghị: upheld/reversed chỉ đi với completed; withdrawn chỉ đi với cancelled; completed đòi giai đoạn là kết quả cuối. Task.status and appealStage SHALL follow the full coherence matrix (upheld/reversed ⇔ completed; withdrawn ⇒ cancelled). (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).empty() or status = 'completed') and (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and code = 'withdrawn').empty() or status = 'cancelled') and (status != 'completed' or extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).exists())

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NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Task C 0..* Task A task to be performed
Constraints: inv-1, vn-claim-appeal-outcome-required, vn-claim-appeal-state-coherent, vn-claim-appeal-decision-chronology
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:appealStage SO 1..1 Coding Giai đoạn kiến nghị — phân biệt đang ở cơ quan BHXH hay đã chuyển cơ quan có thẩm quyền
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage
Binding: Giai đoạn kiến nghị chi phí BHYT — BHYT Cost Appeal Stage ValueSet (required)
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... intent SOΣ 1..1 code unknown | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: TaskIntent (required): Distinguishes whether the task is a proposal, plan or full order.
Fixed Value: order
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... code SOΣ 1..1 CodeableConcept Loại công việc — kiến nghị xem xét lại
Binding: TaskCode (example): Codes to identify what the task involves. These will typically be specific to a particular workflow.
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... text SΣ 1..1 string Plain text representation of the concept
... focus SOΣ 1..1 Reference(Kết quả giải quyết BHYT VN Core — VN Core ClaimResponse Profile | Đối soát và phân bổ khoản thanh toán BHYT — VN Core BHYT Payment Reconciliation | DocumentReference) Quyết định bị kiến nghị: kết quả giám định hoặc đối soát thanh toán/thu hồi
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... for SOΣ 0..1 Reference(Resource) Người bệnh liên quan nếu kiến nghị gắn với một hồ sơ cụ thể
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... executionPeriod SOΣ 0..1 Period Khoảng thời gian xem xét kiến nghị — `end` là thời điểm ra quyết định
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... authoredOn SOC 1..1 dateTime Thời điểm nêu kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... requester SOΣ 1..1 Reference(Cơ sở khám bệnh, chữa bệnh VN Core — VN Core KCB Organization Profile | Cơ sở y tế VN Core — VN Core Organization Profile) Cơ sở khám bệnh, chữa bệnh nêu kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... owner SOΣ 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan giải quyết: cơ quan bảo hiểm xã hội hoặc cơ quan có thẩm quyền
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... reasonCode SO 0..1 CodeableConcept Lý do kiến nghị
Binding Description: (example): Indicates why the task is needed. E.g. Suspended because patient admitted to hospital.
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... input SO 0..* BackboneElement Tài liệu kèm theo: biên bản giám định, văn bản thu hồi, chứng từ bổ sung
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Label for the input
Binding Description: (example): Codes to identify types of input parameters. These will typically be specific to a particular workflow. E.g. "Comparison source", "Applicable consent", "Concomitent Medications", etc.
.... value[x] 1..1 Content to use in performing the task
..... valueBase64Binary base64Binary
..... valueBoolean boolean
..... valueCanonical canonical(Any)
..... valueCode code
..... valueDate date
..... valueDateTime dateTime
..... valueDecimal decimal
..... valueId id
..... valueInstant instant
..... valueInteger integer
..... valueMarkdown markdown
..... valueOid oid
..... valuePositiveInt positiveInt
..... valueString string
..... valueTime time
..... valueUnsignedInt unsignedInt
..... valueUri uri
..... valueUrl url
..... valueUuid uuid
..... valueAddress Address
..... valueAge Age
..... valueAnnotation Annotation
..... valueAttachment Attachment
..... valueCodeableConcept CodeableConcept
..... valueCoding Coding
..... valueContactPoint ContactPoint
..... valueCount Count
..... valueDistance Distance
..... valueDuration Duration
..... valueHumanName HumanName
..... valueIdentifier Identifier
..... valueMoney Money
..... valuePeriod Period
..... valueQuantity Quantity
..... valueRange Range
..... valueRatio Ratio
..... valueReference Reference(Any)
..... valueSampledData SampledData
..... valueSignature Signature
..... valueTiming Timing
..... valueContactDetail ContactDetail
..... valueContributor Contributor
..... valueDataRequirement DataRequirement
..... valueExpression Expression
..... valueParameterDefinition ParameterDefinition
..... valueRelatedArtifact RelatedArtifact
..... valueTriggerDefinition TriggerDefinition
..... valueUsageContext UsageContext
..... valueDosage Dosage
..... valueMeta Meta
... output SO 0..* BackboneElement Kết quả giải quyết — bắt buộc khi kiến nghị đã kết thúc
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Label for output
Binding Description: (example): Codes to identify types of input parameters. These will typically be specific to a particular workflow. E.g. "Identified issues", "Preliminary results", "Filler order", "Final results", etc.
.... value[x] 1..1 Result of output
..... valueBase64Binary base64Binary
..... valueBoolean boolean
..... valueCanonical canonical(Any)
..... valueCode code
..... valueDate date
..... valueDateTime dateTime
..... valueDecimal decimal
..... valueId id
..... valueInstant instant
..... valueInteger integer
..... valueMarkdown markdown
..... valueOid oid
..... valuePositiveInt positiveInt
..... valueString string
..... valueTime time
..... valueUnsignedInt unsignedInt
..... valueUri uri
..... valueUrl url
..... valueUuid uuid
..... valueAddress Address
..... valueAge Age
..... valueAnnotation Annotation
..... valueAttachment Attachment
..... valueCodeableConcept CodeableConcept
..... valueCoding Coding
..... valueContactPoint ContactPoint
..... valueCount Count
..... valueDistance Distance
..... valueDuration Duration
..... valueHumanName HumanName
..... valueIdentifier Identifier
..... valueMoney Money
..... valuePeriod Period
..... valueQuantity Quantity
..... valueRange Range
..... valueRatio Ratio
..... valueReference Reference(Any)
..... valueSampledData SampledData
..... valueSignature Signature
..... valueTiming Timing
..... valueContactDetail ContactDetail
..... valueContributor Contributor
..... valueDataRequirement DataRequirement
..... valueExpression Expression
..... valueParameterDefinition ParameterDefinition
..... valueRelatedArtifact RelatedArtifact
..... valueTriggerDefinition TriggerDefinition
..... valueUsageContext UsageContext
..... valueDosage Dosage
..... valueMeta Meta

doco Documentation for this format
NameBên giám định BHYT (Adjudicator)Bên gửi hồ sơ BHYT (Submitter)doco
.. Task
... Slices for extension
.... extension:appealStage
... status
... intent
... focus
... for
... executionPeriod
... authoredOn
... requester
... owner
... reasonCode
... input
... output

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Task.status Base required TaskStatus 📍4.0.1 FHIR Std.
Task.intent Base required TaskIntent 📍4.0.1 FHIR Std.
Task.code Base example Task Codes 📍4.0.1 FHIR Std.
Task.reasonCode Base example Not State Unknown
Task.input.type Base example Not State Unknown
Task.output.type Base example Not State Unknown

Constraints

Id Grade Path(s) Description Expression
dom-2 error Task If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Task If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Task If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Task If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Task A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
inv-1 error Task Last modified date must be greater than or equal to authored-on date. lastModified.exists().not() or authoredOn.exists().not() or lastModified >= authoredOn
vn-claim-appeal-decision-chronology error Task Kiến nghị đã kết thúc phải ghi thời điểm ra quyết định, và thời điểm ấy không được sớm hơn ngày nêu kiến nghị. A concluded appeal SHALL carry executionPeriod.end, which SHALL NOT precede authoredOn. extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed' or code = 'withdrawn')).exists() implies (executionPeriod.end.exists() and executionPeriod.end >= authoredOn)
vn-claim-appeal-outcome-required error Task Kiến nghị ở giai đoạn giữ nguyên hoặc chấp nhận phải mang kết quả giải quyết, và NGƯỢC LẠI: output chỉ được xuất hiện khi kiến nghị đã có kết quả cuối (siết P1 #7 — output trước khi kết thúc là kết quả tiền chế). An appeal that is upheld or reversed SHALL carry its resolution output, and output SHALL only be present at a terminal result stage. (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).empty() or output.exists()) and (output.empty() or extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).exists())
vn-claim-appeal-state-coherent error Task Ma trận trạng thái Task ↔ giai đoạn kiến nghị: upheld/reversed chỉ đi với completed; withdrawn chỉ đi với cancelled; completed đòi giai đoạn là kết quả cuối. Task.status and appealStage SHALL follow the full coherence matrix (upheld/reversed ⇔ completed; withdrawn ⇒ cancelled). (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).empty() or status = 'completed') and (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and code = 'withdrawn').empty() or status = 'cancelled') and (status != 'completed' or extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).exists())

Dạng xem Differential

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Task C 0..* Task A task to be performed
Constraints: vn-claim-appeal-outcome-required, vn-claim-appeal-state-coherent, vn-claim-appeal-decision-chronology
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:appealStage SO 1..1 Coding Giai đoạn kiến nghị — phân biệt đang ở cơ quan BHXH hay đã chuyển cơ quan có thẩm quyền
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage
Binding: Giai đoạn kiến nghị chi phí BHYT — BHYT Cost Appeal Stage ValueSet (required)
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... status SO 1..1 code Vòng đời kỹ thuật: requested | in-progress | completed | cancelled
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... intent SO 1..1 code unknown | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Fixed Value: order
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... text S 1..1 string Plain text representation of the concept
... focus SO 1..1 Reference(Kết quả giải quyết BHYT VN Core — VN Core ClaimResponse Profile | Đối soát và phân bổ khoản thanh toán BHYT — VN Core BHYT Payment Reconciliation | DocumentReference) Quyết định bị kiến nghị: kết quả giám định hoặc đối soát thanh toán/thu hồi
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... for SO 0..1 Reference(Resource) Người bệnh liên quan nếu kiến nghị gắn với một hồ sơ cụ thể
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... executionPeriod SO 0..1 Period Khoảng thời gian xem xét kiến nghị — `end` là thời điểm ra quyết định
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... authoredOn SO 1..1 dateTime Thời điểm nêu kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... requester SO 1..1 Reference(Cơ sở khám bệnh, chữa bệnh VN Core — VN Core KCB Organization Profile | Cơ sở y tế VN Core — VN Core Organization Profile) Cơ sở khám bệnh, chữa bệnh nêu kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... owner SO 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan giải quyết: cơ quan bảo hiểm xã hội hoặc cơ quan có thẩm quyền
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... reasonCode SO 0..1 CodeableConcept Lý do kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... input SO 0..* BackboneElement Tài liệu kèm theo: biên bản giám định, văn bản thu hồi, chứng từ bổ sung
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... output SO 0..* BackboneElement Kết quả giải quyết — bắt buộc khi kiến nghị đã kết thúc
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)

doco Documentation for this format
NameBên giám định BHYT (Adjudicator)Bên gửi hồ sơ BHYT (Submitter)doco
.. Task
... Slices for extension
.... extension:appealStage
... status
... intent
... focus
... for
... executionPeriod
... authoredOn
... requester
... owner
... reasonCode
... input
... output

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
vn-claim-appeal-decision-chronology error Task Kiến nghị đã kết thúc phải ghi thời điểm ra quyết định, và thời điểm ấy không được sớm hơn ngày nêu kiến nghị. A concluded appeal SHALL carry executionPeriod.end, which SHALL NOT precede authoredOn. extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed' or code = 'withdrawn')).exists() implies (executionPeriod.end.exists() and executionPeriod.end >= authoredOn)
vn-claim-appeal-outcome-required error Task Kiến nghị ở giai đoạn giữ nguyên hoặc chấp nhận phải mang kết quả giải quyết, và NGƯỢC LẠI: output chỉ được xuất hiện khi kiến nghị đã có kết quả cuối (siết P1 #7 — output trước khi kết thúc là kết quả tiền chế). An appeal that is upheld or reversed SHALL carry its resolution output, and output SHALL only be present at a terminal result stage. (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).empty() or output.exists()) and (output.empty() or extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).exists())
vn-claim-appeal-state-coherent error Task Ma trận trạng thái Task ↔ giai đoạn kiến nghị: upheld/reversed chỉ đi với completed; withdrawn chỉ đi với cancelled; completed đòi giai đoạn là kết quả cuối. Task.status and appealStage SHALL follow the full coherence matrix (upheld/reversed ⇔ completed; withdrawn ⇒ cancelled). (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).empty() or status = 'completed') and (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and code = 'withdrawn').empty() or status = 'cancelled') and (status != 'completed' or extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).exists())

Dạng xem SnapshotView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Task C 0..* Task A task to be performed
Constraints: inv-1, vn-claim-appeal-outcome-required, vn-claim-appeal-state-coherent, vn-claim-appeal-decision-chronology
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:appealStage SO 1..1 Coding Giai đoạn kiến nghị — phân biệt đang ở cơ quan BHXH hay đã chuyển cơ quan có thẩm quyền
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage
Binding: Giai đoạn kiến nghị chi phí BHYT — BHYT Cost Appeal Stage ValueSet (required)
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Task Instance Identifier
... instantiatesCanonical Σ 0..1 canonical(ActivityDefinition) Formal definition of task
... instantiatesUri Σ 0..1 uri Formal definition of task
... basedOn Σ 0..* Reference(Resource) Request fulfilled by this task
... groupIdentifier Σ 0..1 Identifier Requisition or grouper id
... partOf Σ 0..* Reference(Task) Composite task
... status ?!SOΣ 1..1 code Vòng đời kỹ thuật: requested | in-progress | completed | cancelled
Binding: TaskStatus (required): The current status of the task.
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... statusReason Σ 0..1 CodeableConcept Reason for current status
Binding Description: (example): Codes to identify the reason for current status. These will typically be specific to a particular workflow.
... businessStatus Σ 0..1 CodeableConcept E.g. "Specimen collected", "IV prepped"
Binding Description: (example): The domain-specific business-contextual sub-state of the task. For example: "Blood drawn", "IV inserted", "Awaiting physician signature", etc.
... intent SOΣ 1..1 code unknown | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option
Binding: TaskIntent (required): Distinguishes whether the task is a proposal, plan or full order.
Fixed Value: order
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... priority 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): The task's priority.
... code SOΣ 1..1 CodeableConcept Loại công việc — kiến nghị xem xét lại
Binding: TaskCode (example): Codes to identify what the task involves. These will typically be specific to a particular workflow.
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ 0..* Coding Code defined by a terminology system
.... text SΣ 1..1 string Plain text representation of the concept
... description Σ 0..1 string Human-readable explanation of task
... focus SOΣ 1..1 Reference(Kết quả giải quyết BHYT VN Core — VN Core ClaimResponse Profile | Đối soát và phân bổ khoản thanh toán BHYT — VN Core BHYT Payment Reconciliation | DocumentReference) Quyết định bị kiến nghị: kết quả giám định hoặc đối soát thanh toán/thu hồi
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... for SOΣ 0..1 Reference(Resource) Người bệnh liên quan nếu kiến nghị gắn với một hồ sơ cụ thể
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this task originated
... executionPeriod SOΣ 0..1 Period Khoảng thời gian xem xét kiến nghị — `end` là thời điểm ra quyết định
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... authoredOn SOC 1..1 dateTime Thời điểm nêu kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... lastModified ΣC 0..1 dateTime Task Last Modified Date
... requester SOΣ 1..1 Reference(Cơ sở khám bệnh, chữa bệnh VN Core — VN Core KCB Organization Profile | Cơ sở y tế VN Core — VN Core Organization Profile) Cơ sở khám bệnh, chữa bệnh nêu kiến nghị
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... performerType 0..* CodeableConcept Requested performer
Binding: ProcedurePerformerRoleCodes (preferred): The type(s) of task performers allowed.
... owner SOΣ 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan giải quyết: cơ quan bảo hiểm xã hội hoặc cơ quan có thẩm quyền
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... location Σ 0..1 Reference(Location) Where task occurs
... reasonCode SO 0..1 CodeableConcept Lý do kiến nghị
Binding Description: (example): Indicates why the task is needed. E.g. Suspended because patient admitted to hospital.
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
... reasonReference 0..1 Reference(Resource) Why task is needed
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... note 0..* Annotation Comments made about the task
... relevantHistory 0..* Reference(Provenance) Key events in history of the Task
... restriction 0..1 BackboneElement Constraints on fulfillment tasks
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... repetitions 0..1 positiveInt How many times to repeat
.... period 0..1 Period When fulfillment sought
.... recipient 0..* Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Group | Organization) For whom is fulfillment sought?
... input SO 0..* BackboneElement Tài liệu kèm theo: biên bản giám định, văn bản thu hồi, chứng từ bổ sung
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Label for the input
Binding Description: (example): Codes to identify types of input parameters. These will typically be specific to a particular workflow. E.g. "Comparison source", "Applicable consent", "Concomitent Medications", etc.
.... value[x] 1..1 Content to use in performing the task
..... valueBase64Binary base64Binary
..... valueBoolean boolean
..... valueCanonical canonical(Any)
..... valueCode code
..... valueDate date
..... valueDateTime dateTime
..... valueDecimal decimal
..... valueId id
..... valueInstant instant
..... valueInteger integer
..... valueMarkdown markdown
..... valueOid oid
..... valuePositiveInt positiveInt
..... valueString string
..... valueTime time
..... valueUnsignedInt unsignedInt
..... valueUri uri
..... valueUrl url
..... valueUuid uuid
..... valueAddress Address
..... valueAge Age
..... valueAnnotation Annotation
..... valueAttachment Attachment
..... valueCodeableConcept CodeableConcept
..... valueCoding Coding
..... valueContactPoint ContactPoint
..... valueCount Count
..... valueDistance Distance
..... valueDuration Duration
..... valueHumanName HumanName
..... valueIdentifier Identifier
..... valueMoney Money
..... valuePeriod Period
..... valueQuantity Quantity
..... valueRange Range
..... valueRatio Ratio
..... valueReference Reference(Any)
..... valueSampledData SampledData
..... valueSignature Signature
..... valueTiming Timing
..... valueContactDetail ContactDetail
..... valueContributor Contributor
..... valueDataRequirement DataRequirement
..... valueExpression Expression
..... valueParameterDefinition ParameterDefinition
..... valueRelatedArtifact RelatedArtifact
..... valueTriggerDefinition TriggerDefinition
..... valueUsageContext UsageContext
..... valueDosage Dosage
..... valueMeta Meta
... output SO 0..* BackboneElement Kết quả giải quyết — bắt buộc khi kiến nghị đã kết thúc
ObligationsActor
SHALL:populate-if-known Bên gửi hồ sơ BHYT (Submitter)
SHALL:no-error & SHALL:persist Bên giám định BHYT (Adjudicator)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Label for output
Binding Description: (example): Codes to identify types of input parameters. These will typically be specific to a particular workflow. E.g. "Identified issues", "Preliminary results", "Filler order", "Final results", etc.
.... value[x] 1..1 Result of output
..... valueBase64Binary base64Binary
..... valueBoolean boolean
..... valueCanonical canonical(Any)
..... valueCode code
..... valueDate date
..... valueDateTime dateTime
..... valueDecimal decimal
..... valueId id
..... valueInstant instant
..... valueInteger integer
..... valueMarkdown markdown
..... valueOid oid
..... valuePositiveInt positiveInt
..... valueString string
..... valueTime time
..... valueUnsignedInt unsignedInt
..... valueUri uri
..... valueUrl url
..... valueUuid uuid
..... valueAddress Address
..... valueAge Age
..... valueAnnotation Annotation
..... valueAttachment Attachment
..... valueCodeableConcept CodeableConcept
..... valueCoding Coding
..... valueContactPoint ContactPoint
..... valueCount Count
..... valueDistance Distance
..... valueDuration Duration
..... valueHumanName HumanName
..... valueIdentifier Identifier
..... valueMoney Money
..... valuePeriod Period
..... valueQuantity Quantity
..... valueRange Range
..... valueRatio Ratio
..... valueReference Reference(Any)
..... valueSampledData SampledData
..... valueSignature Signature
..... valueTiming Timing
..... valueContactDetail ContactDetail
..... valueContributor Contributor
..... valueDataRequirement DataRequirement
..... valueExpression Expression
..... valueParameterDefinition ParameterDefinition
..... valueRelatedArtifact RelatedArtifact
..... valueTriggerDefinition TriggerDefinition
..... valueUsageContext UsageContext
..... valueDosage Dosage
..... valueMeta Meta

doco Documentation for this format
NameBên giám định BHYT (Adjudicator)Bên gửi hồ sơ BHYT (Submitter)doco
.. Task
... Slices for extension
.... extension:appealStage
... status
... intent
... focus
... for
... executionPeriod
... authoredOn
... requester
... owner
... reasonCode
... input
... output

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Task.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Task.status Base required TaskStatus 📍4.0.1 FHIR Std.
Task.statusReason Base example Not State Unknown
Task.businessStatus Base example Not State Unknown
Task.intent Base required TaskIntent 📍4.0.1 FHIR Std.
Task.priority Base required Request priority 📍4.0.1 FHIR Std.
Task.code Base example Task Codes 📍4.0.1 FHIR Std.
Task.performerType Base preferred Procedure Performer Role Codes 📍4.0.1 FHIR Std.
Task.reasonCode Base example Not State Unknown
Task.input.type Base example Not State Unknown
Task.output.type Base example Not State Unknown

Constraints

Id Grade Path(s) Description Expression
dom-2 error Task If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Task If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Task If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Task If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Task A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
inv-1 error Task Last modified date must be greater than or equal to authored-on date. lastModified.exists().not() or authoredOn.exists().not() or lastModified >= authoredOn
vn-claim-appeal-decision-chronology error Task Kiến nghị đã kết thúc phải ghi thời điểm ra quyết định, và thời điểm ấy không được sớm hơn ngày nêu kiến nghị. A concluded appeal SHALL carry executionPeriod.end, which SHALL NOT precede authoredOn. extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed' or code = 'withdrawn')).exists() implies (executionPeriod.end.exists() and executionPeriod.end >= authoredOn)
vn-claim-appeal-outcome-required error Task Kiến nghị ở giai đoạn giữ nguyên hoặc chấp nhận phải mang kết quả giải quyết, và NGƯỢC LẠI: output chỉ được xuất hiện khi kiến nghị đã có kết quả cuối (siết P1 #7 — output trước khi kết thúc là kết quả tiền chế). An appeal that is upheld or reversed SHALL carry its resolution output, and output SHALL only be present at a terminal result stage. (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).empty() or output.exists()) and (output.empty() or extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).exists())
vn-claim-appeal-state-coherent error Task Ma trận trạng thái Task ↔ giai đoạn kiến nghị: upheld/reversed chỉ đi với completed; withdrawn chỉ đi với cancelled; completed đòi giai đoạn là kết quả cuối. Task.status and appealStage SHALL follow the full coherence matrix (upheld/reversed ⇔ completed; withdrawn ⇒ cancelled). (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).empty() or status = 'completed') and (extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and code = 'withdrawn').empty() or status = 'cancelled') and (status != 'completed' or extension.where(url = 'http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-appeal-stage').value.ofType(Coding).where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-claim-appeal-stage-cs' and (code = 'upheld' or code = 'reversed')).exists())

 

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