VN Core FHIR Implementation Guide — Bộ Hướng dẫn Triển khai FHIR Cốt lõi cho Việt Nam - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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: Vi du: Giai trinh quyen loi BHYT noi tru - XML Representation

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<ExplanationOfBenefit xmlns="http://hl7.org/fhir">
  <id value="ExampleExplanationOfBenefitBHYT"/>
  <meta>
    <profile
             value="http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-explanation-of-benefit"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ExplanationOfBenefit ExampleExplanationOfBenefitBHYT</b></p><a name="ExampleExplanationOfBenefitBHYT"> </a><a name="hcExampleExplanationOfBenefitBHYT"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-vn-core-explanation-of-benefit.html">Giải trình quyền lợi BHYT VN Core — VN Core ExplanationOfBenefit Profile</a></p></div><blockquote><p><b>Tổng chi phí theo nhóm — Claim Cost Summary Extension</b></p><ul><li>totalMedication: <span title="Vietnamese Dong">₫73,500</span> (VND)</li><li>totalInsurance: <span title="Vietnamese Dong">₫10,080,000</span> (VND)</li><li>totalPatientCopay: <span title="Vietnamese Dong">₫2,520,000</span> (VND)</li><li>totalPatientSelfPay: <span title="Vietnamese Dong">₫1,770,000</span> (VND)</li></ul></blockquote><blockquote><p><b>Kỳ thanh toán — Claim Payment Period Extension</b></p><ul><li>year: 2026</li><li>month: 3</li></ul></blockquote><p><b>Phương thức thanh toán — Payment Method Extension</b>: <span title="Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-payment-method-cs 1}">Phí dịch vụ (FFS)</span></p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}">Institutional</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href="Patient-ExamplePatientNguyenVanAn.html">Nguyen Van An</a></p><p><b>created</b>: 2026-03-19</p><p><b>insurer</b>: <a href="Organization-ExampleOrganizationBHXH.html">Bao hiem xa hoi Viet Nam</a></p><p><b>provider</b>: <a href="Organization-ExampleOrganizationChoRay.html">Benh vien Cho Ray</a></p><p><b>outcome</b>: Processing Complete</p><h3>Diagnoses</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>Type</b></td></tr><tr><td style="display: none">*</td><td>1</td><td><span title="Codes:{http://hl7.org/fhir/sid/icd-10 K35.8}">Acute appendicitis, other and unspecified</span></td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/ex-diagnosistype principal}">Principal Diagnosis</span></td></tr></table><h3>Insurances</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style="display: none">*</td><td>true</td><td><a href="Coverage-ExampleCoverageBHYTNew.html">Coverage: extension = Người lao động trong doanh nghiệp,-&gt;Bệnh viện Chợ Rẫy; identifier = http://fhir.hl7.org.vn/core/sid/bhyt#VNBHYT#001085012345; status = active; type = ; period = 2025-08-01 --&gt; 2026-07-31</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: <span title="Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs 1}">Khám bệnh</span></p><p><b>productOrService</b>: <span title="Codes:">Kham chuyen khoa</span></p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}">Submitted Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>150000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}">Eligible Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>150000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}">Benefit Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>120000</td><td>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: <span title="Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs 8}">Thuốc, dịch truyền</span></p><p><b>productOrService</b>: <span title="Codes:">Amoxicillin 500mg</span></p><p><b>quantity</b>: 21</p><h3>UnitPrices</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>3500</td><td>Vietnamese đồng</td></tr></table><h3>Nets</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>73500</td><td>Vietnamese đồng</td></tr></table><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}">Submitted Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>73500</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}">Benefit Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>58800</td><td>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}">Submitted Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>14370000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}">Benefit Amount</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>10080000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>payment</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/ex-paymenttype complete}">Complete</span></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>10080000</td><td>Vietnamese đồng</td></tr></table></blockquote><p><b>benefitPeriod</b>: 2026-01-01 --&gt; 2026-12-31</p></div>
  </text>
  <extension
             url="http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary">
    <extension url="totalMedication">
      <valueMoney>
        <value value="73500"/>
        <currency value="VND"/>
      </valueMoney>
    </extension>
    <extension url="totalInsurance">
      <valueMoney>
        <value value="10080000"/>
        <currency value="VND"/>
      </valueMoney>
    </extension>
    <extension url="totalPatientCopay">
      <valueMoney>
        <value value="2520000"/>
        <currency value="VND"/>
      </valueMoney>
    </extension>
    <extension url="totalPatientSelfPay">
      <valueMoney>
        <value value="1770000"/>
        <currency value="VND"/>
      </valueMoney>
    </extension>
  </extension>
  <extension
             url="http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period">
    <extension url="year">
      <valueInteger value="2026"/>
    </extension>
    <extension url="month">
      <valueInteger value="3"/>
    </extension>
  </extension>
  <extension
             url="http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method">
    <valueCodeableConcept>
      <coding>
        <system
                value="http://fhir.hl7.org.vn/core/CodeSystem/vn-payment-method-cs"/>
        <code value="1"/>
        <display value="Phí dịch vụ (FFS)"/>
      </coding>
    </valueCodeableConcept>
  </extension>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
      <code value="institutional"/>
      <display value="Institutional"/>
    </coding>
  </type>
  <use value="claim"/>
  <patient>🔗 
    <reference value="Patient/ExamplePatientNguyenVanAn"/>
    <display value="Nguyen Van An"/>
  </patient>
  <created value="2026-03-19"/>
  <insurer>🔗 
    <reference value="Organization/ExampleOrganizationBHXH"/>
    <display value="Bao hiem xa hoi Viet Nam"/>
  </insurer>
  <provider>🔗 
    <reference value="Organization/ExampleOrganizationChoRay"/>
    <display value="Benh vien Cho Ray"/>
  </provider>
  <outcome value="complete"/>
  <diagnosis>
    <sequence value="1"/>
    <diagnosisCodeableConcept>
      <coding>
        <system value="http://hl7.org/fhir/sid/icd-10"/>
        <code value="K35.8"/>
        <display value="Acute appendicitis, other and unspecified"/>
      </coding>
    </diagnosisCodeableConcept>
    <type>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/ex-diagnosistype"/>
        <code value="principal"/>
        <display value="Principal Diagnosis"/>
      </coding>
    </type>
  </diagnosis>
  <insurance>
    <focal value="true"/>
    <coverage>🔗 
      <reference value="Coverage/ExampleCoverageBHYTNew"/>
    </coverage>
  </insurance>
  <item>
    <sequence value="1"/>
    <category>
      <coding>
        <system
                value="http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs"/>
        <code value="1"/>
        <display value="Khám bệnh"/>
      </coding>
    </category>
    <productOrService>
      <text value="Kham chuyen khoa"/>
    </productOrService>
    <adjudication>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
          <code value="submitted"/>
          <display value="Submitted Amount"/>
        </coding>
      </category>
      <amount>
        <value value="150000"/>
        <currency value="VND"/>
      </amount>
    </adjudication>
    <adjudication>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
          <code value="eligible"/>
          <display value="Eligible Amount"/>
        </coding>
      </category>
      <amount>
        <value value="150000"/>
        <currency value="VND"/>
      </amount>
    </adjudication>
    <adjudication>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
          <code value="benefit"/>
          <display value="Benefit Amount"/>
        </coding>
      </category>
      <amount>
        <value value="120000"/>
        <currency value="VND"/>
      </amount>
    </adjudication>
  </item>
  <item>
    <sequence value="2"/>
    <category>
      <coding>
        <system
                value="http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs"/>
        <code value="8"/>
        <display value="Thuốc, dịch truyền"/>
      </coding>
    </category>
    <productOrService>
      <text value="Amoxicillin 500mg"/>
    </productOrService>
    <quantity>
      <value value="21"/>
    </quantity>
    <unitPrice>
      <value value="3500"/>
      <currency value="VND"/>
    </unitPrice>
    <net>
      <value value="73500"/>
      <currency value="VND"/>
    </net>
    <adjudication>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
          <code value="submitted"/>
          <display value="Submitted Amount"/>
        </coding>
      </category>
      <amount>
        <value value="73500"/>
        <currency value="VND"/>
      </amount>
    </adjudication>
    <adjudication>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
          <code value="benefit"/>
          <display value="Benefit Amount"/>
        </coding>
      </category>
      <amount>
        <value value="58800"/>
        <currency value="VND"/>
      </amount>
    </adjudication>
  </item>
  <total>
    <category>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
        <code value="submitted"/>
        <display value="Submitted Amount"/>
      </coding>
    </category>
    <amount>
      <value value="14370000"/>
      <currency value="VND"/>
    </amount>
  </total>
  <total>
    <category>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
        <code value="benefit"/>
        <display value="Benefit Amount"/>
      </coding>
    </category>
    <amount>
      <value value="10080000"/>
      <currency value="VND"/>
    </amount>
  </total>
  <payment>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/ex-paymenttype"/>
        <code value="complete"/>
        <display value="Complete"/>
      </coding>
    </type>
    <amount>
      <value value="10080000"/>
      <currency value="VND"/>
    </amount>
  </payment>
  <benefitPeriod>
    <start value="2026-01-01"/>
    <end value="2026-12-31"/>
  </benefitPeriod>
</ExplanationOfBenefit>