ExampleRehabRejectionBundle
type: Bundle
node role: treeRoot
resource.id:
  value: ExampleRehabRejectionBundle
bundle.type:
  value: collection
bundle.entry:
  index: 0
  bundle.entry.full url:
    value: https://fhir.cognovis.de/praxis/Patient/ExampleRehabPatient
  bundle.entry.resource: ExampleRehabPatient
bundle.entry:
  index: 1
  bundle.entry.full url:
    value: https://fhir.cognovis.de/praxis/Practitioner/ExampleRehabRequester
  bundle.entry.resource: ExampleRehabRequester
bundle.entry:
  index: 2
  bundle.entry.full url:
    value: https://fhir.cognovis.de/praxis/Organization/ExampleRehabPayer
  bundle.entry.resource: ExampleRehabPayer
bundle.entry:
  index: 3
  bundle.entry.full url:
    value: https://fhir.cognovis.de/praxis/Coverage/ExampleRehabCoverage
  bundle.entry.resource: ExampleRehabCoverage
bundle.entry:
  index: 4
  bundle.entry.full url:
    value: https://fhir.cognovis.de/praxis/Condition/ExampleRehabCondition
  bundle.entry.resource: ExampleRehabCondition
bundle.entry:
  index: 5
  bundle.entry.full url:
    value: https://fhir.cognovis.de/praxis/ServiceRequest/ExampleFunctionTrainingRequest
  bundle.entry.resource: ExampleFunctionTrainingRequest
bundle.entry:
  index: 6
  bundle.entry.full url:
    value: https://fhir.cognovis.de/praxis/Claim/ExampleFunctionTrainingClaim
  bundle.entry.resource: ExampleFunctionTrainingClaim
bundle.entry:
  index: 7
  bundle.entry.full url:
    value: https://fhir.cognovis.de/praxis/ClaimResponse/ExampleFunctionTrainingRejection
  bundle.entry.resource: ExampleFunctionTrainingRejection
bundle.entry:
  index: 8
  bundle.entry.full url:
    value: https://fhir.cognovis.de/praxis/Task/ExampleFunctionTrainingTask
  bundle.entry.resource: ExampleFunctionTrainingTask

ExampleRehabPatient
type: Patient
resource.id:
  value: ExampleRehabPatient
resource.meta:
  meta.profile:
    value: https://fhir.kbv.de/StructureDefinition/KBV_PR_Base_Patient
    index: 0
    link: https://fhir.kbv.de/StructureDefinition/KBV_PR_Base_Patient
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Patient ExampleRehabPatient Profile: KBV_PR_Base_Patient Alex Becker (official) Unknown, DoB: 1978-04-17 Active: true
patient.active:
  value: true
patient.name:
  index: 0
  human name.use:
    value: official
  human name.family:
    value: Becker
  human name.given:
    value: Alex
    index: 0
patient.gender:
  value: unknown
patient.birth date:
  value: 1978-04-17

ExampleRehabRequester
type: Practitioner
resource.id:
  value: ExampleRehabRequester
resource.meta:
  meta.profile:
    value: https://fhir.kbv.de/StructureDefinition/KBV_PR_Base_Practitioner
    index: 0
    link: https://fhir.kbv.de/StructureDefinition/KBV_PR_Base_Practitioner
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Practitioner ExampleRehabRequester Profile: KBV_PR_Base_Practitioner active: true name: Klara Neumann
practitioner.active:
  value: true
practitioner.name:
  index: 0
  human name.family:
    value: Neumann
  human name.given:
    value: Klara
    index: 0

ExampleRehabPayer
type: Organization
resource.id:
  value: ExampleRehabPayer
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Organization ExampleRehabPayer identifier: ArgeIkIknr/109500969 active: true name: Example statutory payer
organization.identifier:
  index: 0
  identifier.system:
    value: http://fhir.de/sid/arge-ik/iknr
  identifier.value:
    value: 109500969
organization.active:
  value: true
organization.name:
  value: Example statutory payer

ExampleRehabCoverage
type: Coverage
resource.id:
  value: ExampleRehabCoverage
resource.meta:
  meta.profile:
    value: https://fhir.cognovis.de/praxis/StructureDefinition/fpde-coverage-gkv
    index: 0
    link: https://fhir.cognovis.de/praxis/StructureDefinition/fpde-coverage-gkv
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Coverage ExampleRehabCoverage Profile: FPDE Coverage GKV identifier: Gesetzliche Krankenversicherung/A123456789 status: Active type: gesetzliche Krankenversicherung beneficiary: Alex Becker (official) Unknown, DoB: 1978-04-17 payor: Example statutory payer
coverage.identifier:
  index: 0
  identifier.type:
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://fhir.de/CodeSystem/identifier-type-de-basis
      coding.code:
        value: GKV
    codeable concept.coding:
      index: 1
      coding.system:
        value: http://fhir.de/CodeSystem/identifier-type-de-basis
      coding.code:
        value: KVZ10
  identifier.system:
    value: http://fhir.de/sid/gkv/kvid-10
  identifier.value:
    value: A123456789
coverage.status:
  value: active
coverage.type:
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://fhir.de/CodeSystem/versicherungsart-de-basis
    coding.code:
      value: GKV
    coding.display:
      value: gesetzliche Krankenversicherung
coverage.beneficiary:
  link: https://fhir.cognovis.de/praxis/Patient/ExampleRehabPatient
  reference.reference:
    value: Patient/ExampleRehabPatient
coverage.payor:
  index: 0
  link: https://fhir.cognovis.de/praxis/Organization/ExampleRehabPayer
  reference.reference:
    value: Organization/ExampleRehabPayer
  reference.display:
    value: Example statutory payer

ExampleRehabCondition
type: Condition
resource.id:
  value: ExampleRehabCondition
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Condition ExampleRehabCondition clinicalStatus: Active verificationStatus: Confirmed code: Persistent functional limitation after orthopedic treatment subject: Alex Becker (official) Unknown, DoB: 1978-04-17
condition.clinical status:
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/condition-clinical
    coding.code:
      value: active
condition.verification status:
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/condition-ver-status
    coding.code:
      value: confirmed
condition.code:
  codeable concept.text:
    value: Persistent functional limitation after orthopedic treatment
condition.subject:
  link: https://fhir.cognovis.de/praxis/Patient/ExampleRehabPatient
  reference.reference:
    value: Patient/ExampleRehabPatient

ExampleFunctionTrainingRequest
type: ServiceRequest
resource.id:
  value: ExampleFunctionTrainingRequest
resource.meta:
  meta.profile:
    value: https://fhir.cognovis.de/praxis/StructureDefinition/rehabilitation-participation-request-de
    index: 0
    link: https://fhir.cognovis.de/praxis/StructureDefinition/rehabilitation-participation-request-de
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: ServiceRequest ExampleFunctionTrainingRequest Profile: Rehabilitation Participation Request DE identifier: https://fhir.cognovis.de/praxis/NamingSystem/authorization-request-id/E56-2026-0002 status: Active intent: Order category: e56 Rehabilitation Participation code: Function training subject: Alex Becker (official) Unknown, DoB: 1978-04-17 occurrence: 2026-08-01 --> 2027-01-31 authoredOn: 2026-07-16 requester: Practitioner Klara Neumann reasonReference: Condition insurance: Coverage: identifier = Gesetzliche Krankenversicherung; status = active; type = gesetzliche Krankenversicherung
service request.identifier:
  index: 0
  identifier.system:
    value: https://fhir.cognovis.de/praxis/NamingSystem/authorization-request-id
  identifier.value:
    value: E56-2026-0002
service request.status:
  value: active
service request.intent:
  value: order
service request.category:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: https://fhir.cognovis.de/praxis/CodeSystem/annex-2b-care-domain
    coding.code:
      value: e56-rehabilitation-participation
service request.code:
  codeable concept.text:
    value: Function training
service request.subject:
  link: https://fhir.cognovis.de/praxis/Patient/ExampleRehabPatient
  reference.reference:
    value: Patient/ExampleRehabPatient
service request.occurrence period:
  period.start:
    value: 2026-08-01
  period.end:
    value: 2027-01-31
service request.authored on:
  value: 2026-07-16
service request.requester:
  link: https://fhir.cognovis.de/praxis/Practitioner/ExampleRehabRequester
  reference.reference:
    value: Practitioner/ExampleRehabRequester
service request.reason reference:
  index: 0
  link: https://fhir.cognovis.de/praxis/Condition/ExampleRehabCondition
  reference.reference:
    value: Condition/ExampleRehabCondition
service request.insurance:
  index: 0
  link: https://fhir.cognovis.de/praxis/Coverage/ExampleRehabCoverage
  reference.reference:
    value: Coverage/ExampleRehabCoverage

ExampleFunctionTrainingClaim
type: Claim
resource.id:
  value: ExampleFunctionTrainingClaim
resource.meta:
  meta.profile:
    value: https://fhir.cognovis.de/praxis/StructureDefinition/rehabilitation-participation-pas-claim-de
    index: 0
    link: https://fhir.cognovis.de/praxis/StructureDefinition/rehabilitation-participation-pas-claim-de
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Claim ExampleFunctionTrainingClaim Profile: Rehabilitation Participation PAS Claim DE identifier: https://fhir.cognovis.de/praxis/NamingSystem/authorization-request-id/E56-PAS-2026-0002 status: Active type: Professional use: Preauthorization patient: Alex Becker (official) Unknown, DoB: 1978-04-17 created: 2026-07-16 11:00:00+0200 insurer: Organization Example statutory payer provider: Practitioner Klara Neumann priority: Normal referral: ServiceRequest Insurances - Sequence Focal Coverage * 1 true Coverage: identifier = Gesetzliche Krankenversicherung; status = active; type = gesetzliche Krankenversicherung Items - Sequence ProductOrService Quantity * 1 Function training 24 sessions (Details: UCUM code1 = '1*')
claim.identifier:
  index: 0
  identifier.system:
    value: https://fhir.cognovis.de/praxis/NamingSystem/authorization-request-id
  identifier.value:
    value: E56-PAS-2026-0002
claim.status:
  value: active
claim.type:
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/claim-type
    coding.code:
      value: professional
claim.use:
  value: preauthorization
claim.patient:
  link: https://fhir.cognovis.de/praxis/Patient/ExampleRehabPatient
  reference.reference:
    value: Patient/ExampleRehabPatient
claim.created:
  value: 2026-07-16T11:00:00+02:00
claim.insurer:
  link: https://fhir.cognovis.de/praxis/Organization/ExampleRehabPayer
  reference.reference:
    value: Organization/ExampleRehabPayer
claim.provider:
  link: https://fhir.cognovis.de/praxis/Practitioner/ExampleRehabRequester
  reference.reference:
    value: Practitioner/ExampleRehabRequester
claim.priority:
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/processpriority
    coding.code:
      value: normal
claim.referral:
  link: https://fhir.cognovis.de/praxis/ServiceRequest/ExampleFunctionTrainingRequest
  reference.reference:
    value: ServiceRequest/ExampleFunctionTrainingRequest
claim.insurance:
  index: 0
  claim.insurance.sequence:
    value: 1
  claim.insurance.focal:
    value: true
  claim.insurance.coverage:
    link: https://fhir.cognovis.de/praxis/Coverage/ExampleRehabCoverage
    reference.reference:
      value: Coverage/ExampleRehabCoverage
claim.item:
  index: 0
  claim.item.sequence:
    value: 1
  claim.item.product or service:
    codeable concept.text:
      value: Function training
  claim.item.quantity:
    quantity.value:
      value: 24
    quantity.unit:
      value: sessions
    quantity.system:
      value: http://unitsofmeasure.org
    quantity.code:
      value: 1

ExampleFunctionTrainingRejection
type: ClaimResponse
resource.id:
  value: ExampleFunctionTrainingRejection
resource.meta:
  meta.profile:
    value: https://fhir.cognovis.de/praxis/StructureDefinition/rehabilitation-participation-pas-claim-response-de
    index: 0
    link: https://fhir.cognovis.de/praxis/StructureDefinition/rehabilitation-participation-pas-claim-response-de
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: ClaimResponse ExampleFunctionTrainingRejection Profile: Rehabilitation Participation PAS ClaimResponse DE identifier: https://fhir.cognovis.de/praxis/NamingSystem/authorization-response-id/E56-DECISION-2026-0002 status: Active type: Professional use: Preauthorization patient: Alex Becker (official) Unknown, DoB: 1978-04-17 created: 2026-07-19 09:30:00+0200 insurer: Organization Example statutory payer request: Claim: identifier = https://fhir.cognovis.de/praxis/NamingSystem/authorization-request-id#E56-PAS-2026-0002; status = active; type = Professional; use = preauthorization; created = 2026-07-16 11:00:00+0200; priority = Normal outcome: Processing Complete disposition: The requested service requires additional clinical evidence. item itemSequence: 1 Adjudications - Category Reason Value * Eligible Amount Insufficient Clinical Evidence 0
claim response.identifier:
  index: 0
  identifier.system:
    value: https://fhir.cognovis.de/praxis/NamingSystem/authorization-response-id
  identifier.value:
    value: E56-DECISION-2026-0002
claim response.status:
  value: active
claim response.type:
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/claim-type
    coding.code:
      value: professional
claim response.use:
  value: preauthorization
claim response.patient:
  link: https://fhir.cognovis.de/praxis/Patient/ExampleRehabPatient
  reference.reference:
    value: Patient/ExampleRehabPatient
claim response.created:
  value: 2026-07-19T09:30:00+02:00
claim response.insurer:
  link: https://fhir.cognovis.de/praxis/Organization/ExampleRehabPayer
  reference.reference:
    value: Organization/ExampleRehabPayer
claim response.request:
  link: https://fhir.cognovis.de/praxis/Claim/ExampleFunctionTrainingClaim
  reference.reference:
    value: Claim/ExampleFunctionTrainingClaim
claim response.outcome:
  value: complete
claim response.disposition:
  value: The requested service requires additional clinical evidence.
claim response.item:
  index: 0
  claim response.item.item sequence:
    value: 1
  claim response.item.adjudication:
    index: 0
    claim response.item.adjudication.category:
      codeable concept.coding:
        index: 0
    claim response.item.adjudication.reason:
      codeable concept.coding:
        index: 0
    claim response.item.adjudication.value:
      value: 0

ExampleFunctionTrainingTask
type: Task
resource.id:
  value: ExampleFunctionTrainingTask
resource.meta:
  meta.profile:
    value: https://fhir.cognovis.de/praxis/StructureDefinition/rehabilitation-participation-pas-task-de
    index: 0
    link: https://fhir.cognovis.de/praxis/StructureDefinition/rehabilitation-participation-pas-task-de
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Task ExampleFunctionTrainingTask Profile: Rehabilitation Participation PAS Task DE identifier: https://fhir.cognovis.de/praxis/NamingSystem/authorization-task-id/E56-TASK-2026-0002 status: Completed intent: order code: Antrag einreichen for: Alex Becker (official) Unknown, DoB: 1978-04-17 authoredOn: 2026-07-16 11:00:00+0200 lastModified: 2026-07-19 09:30:00+0200 requester: Practitioner Klara Neumann owner: Organization Example statutory payer Inputs - Type Value[x] * Claim Reference Claim: identifier = https://fhir.cognovis.de/praxis/NamingSystem/authorization-request-id#E56-PAS-2026-0002; status = active; type = Professional; use = preauthorization; created = 2026-07-16 11:00:00+0200; priority = Normal Outputs - Type Value[x] * ClaimResponse Reference ClaimResponse: identifier = https://fhir.cognovis.de/praxis/NamingSystem/authorization-response-id#E56-DECISION-2026-0002; status = active; type = Professional; use = preauthorization; created = 2026-07-19 09:30:00+0200; outcome = complete; disposition = The requested service requires additional clinical evidence.
task.identifier:
  index: 0
  identifier.system:
    value: https://fhir.cognovis.de/praxis/NamingSystem/authorization-task-id
  identifier.value:
    value: E56-TASK-2026-0002
task.status:
  value: completed
task.intent:
  value: order
task.code:
  codeable concept.coding:
    index: 0
    coding.system:
      value: https://fhir.cognovis.de/praxis/CodeSystem/pas-task-code
    coding.code:
      value: submit
task.for:
  link: https://fhir.cognovis.de/praxis/Patient/ExampleRehabPatient
  reference.reference:
    value: Patient/ExampleRehabPatient
task.authored on:
  value: 2026-07-16T11:00:00+02:00
task.last modified:
  value: 2026-07-19T09:30:00+02:00
task.requester:
  link: https://fhir.cognovis.de/praxis/Practitioner/ExampleRehabRequester
  reference.reference:
    value: Practitioner/ExampleRehabRequester
task.owner:
  link: https://fhir.cognovis.de/praxis/Organization/ExampleRehabPayer
  reference.reference:
    value: Organization/ExampleRehabPayer
task.input:
  index: 0
  task.input.type:
    codeable concept.coding:
      index: 0
      coding.system:
        value: https://fhir.cognovis.de/praxis/CodeSystem/pas-task-input-type
      coding.code:
        value: claim-reference
  task.input.value reference:
    link: https://fhir.cognovis.de/praxis/Claim/ExampleFunctionTrainingClaim
    reference.reference:
      value: Claim/ExampleFunctionTrainingClaim
task.output:
  index: 0
  task.output.type:
    codeable concept.coding:
      index: 0
      coding.system:
        value: https://fhir.cognovis.de/praxis/CodeSystem/pas-task-input-type
      coding.code:
        value: response-reference
  task.output.value reference:
    link: https://fhir.cognovis.de/praxis/ClaimResponse/ExampleFunctionTrainingRejection
    reference.reference:
      value: ClaimResponse/ExampleFunctionTrainingRejection

value: eligible

value: insufficient-clinical-evidence