German Practice Management FHIR Profiles (R4)
0.90.0 - STU1 Germany

German Practice Management FHIR Profiles (R4) - Local Development build (v0.90.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Function training rejection - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/ClaimResponse/ExampleFunctionTrainingRejection> a fhir:ClaimResponse ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "ExampleFunctionTrainingRejection"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "https://fhir.cognovis.de/praxis/StructureDefinition/rehabilitation-participation-pas-claim-response-de" ;
       fhir:index 0 ;
       fhir:link <https://fhir.cognovis.de/praxis/StructureDefinition/rehabilitation-participation-pas-claim-response-de>
     ]
  ] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse ExampleFunctionTrainingRejection</b></p><a name=\"ExampleFunctionTrainingRejection\"> </a><a name=\"hcExampleFunctionTrainingRejection\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rehabilitation-participation-pas-claim-response-de.html\">Rehabilitation Participation PAS ClaimResponse DE</a></p></div><p><b>identifier</b>: <code>https://fhir.cognovis.de/praxis/NamingSystem/authorization-response-id</code>/E56-DECISION-2026-0002</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}\">Professional</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"Patient-ExampleRehabPatient.html\">Alex Becker (official) Unknown, DoB: 1978-04-17</a></p><p><b>created</b>: 2026-07-19 09:30:00+0200</p><p><b>insurer</b>: <a href=\"Organization-ExampleRehabPayer.html\">Organization Example statutory payer</a></p><p><b>request</b>: <a href=\"Claim-ExampleFunctionTrainingClaim.html\">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</a></p><p><b>outcome</b>: Processing Complete</p><p><b>disposition</b>: The requested service requires additional clinical evidence.</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 1</p><h3>Adjudications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Category</b></td><td><b>Reason</b></td><td><b>Value</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}\">Eligible Amount</span></td><td><span title=\"Codes:{https://fhir.cognovis.de/praxis/CodeSystem/rehabilitation-authorization-decision-reason insufficient-clinical-evidence}\">Insufficient Clinical Evidence</span></td><td>0</td></tr></table></blockquote></div>"
  ] ;
  fhir:ClaimResponse.identifier [
     fhir:index 0 ;
     fhir:Identifier.system [ fhir:value "https://fhir.cognovis.de/praxis/NamingSystem/authorization-response-id" ] ;
     fhir:Identifier.value [ fhir:value "E56-DECISION-2026-0002" ]
  ] ;
  fhir:ClaimResponse.status [ fhir:value "active"] ;
  fhir:ClaimResponse.type [
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ] ;
       fhir:Coding.code [ fhir:value "professional" ]
     ]
  ] ;
  fhir:ClaimResponse.use [ fhir:value "preauthorization"] ;
  fhir:ClaimResponse.patient [
     fhir:link <http://hl7.org/fhir/Patient/ExampleRehabPatient> ;
     fhir:Reference.reference [ fhir:value "Patient/ExampleRehabPatient" ]
  ] ;
  fhir:ClaimResponse.created [ fhir:value "2026-07-19T09:30:00+02:00"^^xsd:dateTime] ;
  fhir:ClaimResponse.insurer [
     fhir:link <http://hl7.org/fhir/Organization/ExampleRehabPayer> ;
     fhir:Reference.reference [ fhir:value "Organization/ExampleRehabPayer" ]
  ] ;
  fhir:ClaimResponse.request [
     fhir:link <http://hl7.org/fhir/Claim/ExampleFunctionTrainingClaim> ;
     fhir:Reference.reference [ fhir:value "Claim/ExampleFunctionTrainingClaim" ]
  ] ;
  fhir:ClaimResponse.outcome [ fhir:value "complete"] ;
  fhir:ClaimResponse.disposition [ fhir:value "The requested service requires additional clinical evidence."] ;
  fhir:ClaimResponse.item [
     fhir:index 0 ;
     fhir:ClaimResponse.item.itemSequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:ClaimResponse.item.adjudication [
       fhir:index 0 ;
       fhir:ClaimResponse.item.adjudication.category [
         fhir:CodeableConcept.coding [
           fhir:index 0 ;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ;
           fhir:Coding.code [ fhir:value "eligible" ]
         ]
       ] ;
       fhir:ClaimResponse.item.adjudication.reason [
         fhir:CodeableConcept.coding [
           fhir:index 0 ;
           fhir:Coding.system [ fhir:value "https://fhir.cognovis.de/praxis/CodeSystem/rehabilitation-authorization-decision-reason" ] ;
           fhir:Coding.code [ fhir:value "insufficient-clinical-evidence" ]
         ]
       ] ;
       fhir:ClaimResponse.item.adjudication.value [ fhir:value "0"^^xsd:decimal ]
     ]
  ] .

<http://hl7.org/fhir/Patient/ExampleRehabPatient> a fhir:Patient .

<http://hl7.org/fhir/Organization/ExampleRehabPayer> a fhir:Organization .

<http://hl7.org/fhir/Claim/ExampleFunctionTrainingClaim> a fhir:Claim .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/ClaimResponse/ExampleFunctionTrainingRejection.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/ClaimResponse/ExampleFunctionTrainingRejection.ttl> .