Bộ Hướng dẫn Triển khai Core FHIR cho Việt Nam
0.8.0 - Draft for Community Review
Bộ Hướng dẫn Triển khai Core FHIR cho Việt Nam - Draft for Community Review (v0.8.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Draft tại thời điểm 2026-07-17 |
Các định nghĩa cho vn-ext-insurance-cost-info phần mở rộng
Guidance on how to interpret the contents of this table can be foundhere
| 0. Extension | |
| Definition | Extension tái sử dụng cho thông tin chi phí BHYT trên từng item (thuốc/DVKT/VTYT). Bao gồm: phạm vi BHYT (PHAM_VI), tỷ lệ thanh toán BHYT (TYLE_TT/TYLE_TT_BH), mức hưởng (MUC_HUONG), mức trần thanh toán BHYT (T_TRANTT), tỷ lệ thanh toán dịch vụ (TYLE_TT_DV), đơn giá BHYT (DON_GIA_BH) và thành tiền BHYT (THANH_TIEN_BH). Dùng trên: MedicationRequest, Procedure, Claim.item, ServiceRequest và MedicationDispense khi các resource đó đang đóng vai trò nguồn dữ liệu cho dòng chi phí. Với thiết bị/vật tư, ưu tiên đặt trên Claim.item; không dùng trên DeviceUseStatement vì DeviceUseStatement là ghi nhận sử dụng lâm sàng. Mapping XML 3176: PHAM_VI, TYLE_TT, MUC_HUONG; DON_GIA_BH (Bảng 3 STT 15), TYLE_TT_DV (Bảng 3 STT 17), THANH_TIEN_BH (Bảng 2 STT 21, Bảng 3 STT 20), T_TRANTT (Bảng 3 STT 21). Nguồn thiết kế: OHP Data Processor (medication-pham-vi, medication-payment-ratio, medication-benefit-level). Căn cứ: QĐ 3176/QĐ-BYT (29/10/2024); NĐ 188/2025/NĐ-CP (trần thanh toán BHYT 45 tháng lương cơ sở). Optional Extension Element - found in all resources. |
| Short | Thông tin chi phí BHYT — Insurance Cost Info ExtensionOptional Extensions Element |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Is Modifier | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists())ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 2. Extension.extension:scope | |
| Slice Name | scope |
| Definition | An Extension |
| Short | Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CPAdditional content defined by implementations |
| Control | 0..1* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 4. Extension.extension:scope.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | ExtensionAdditional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..0* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 6. Extension.extension:scope.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | scope |
| 8. Extension.extension:scope.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Value of extension |
| Control | 10..1 |
| Binding | Unless not suitable, these codes SHALL be taken from For codes, see Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible to http://fhir.hl7.org.vn/core/ValueSet/vn-insurance-scope-vs) |
| Type | CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 10. Extension.extension:paymentRatio | |
| Slice Name | paymentRatio |
| Definition | An Extension |
| Short | Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50Additional content defined by implementations |
| Control | 0..1* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 12. Extension.extension:paymentRatio.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | ExtensionAdditional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..0* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 14. Extension.extension:paymentRatio.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | paymentRatio |
| 16. Extension.extension:paymentRatio.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Value of extension |
| Control | 10..1 |
| Type | decimal, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 18. Extension.extension:benefitLevel | |
| Slice Name | benefitLevel |
| Definition | An Extension |
| Short | Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40Additional content defined by implementations |
| Control | 0..1* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 20. Extension.extension:benefitLevel.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | ExtensionAdditional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..0* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 22. Extension.extension:benefitLevel.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | benefitLevel |
| 24. Extension.extension:benefitLevel.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Value of extension |
| Control | 10..1 |
| Type | decimal, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 26. Extension.extension:paymentCeiling | |
| Slice Name | paymentCeiling |
| Definition | An Extension |
| Short | Mức trần thanh toán BHYT của dòng chi phí (T_TRANTT)Additional content defined by implementations |
| Control | 0..1* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 28. Extension.extension:paymentCeiling.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | ExtensionAdditional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..0* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 30. Extension.extension:paymentCeiling.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | paymentCeiling |
| 32. Extension.extension:paymentCeiling.value[x] | |
| Definition | Mức thanh toán tối đa của quỹ BHYT đối với dòng chi phí DVKT/VTYT trong một lần thực hiện (T_TRANTT), tương ứng trần 45 tháng lương cơ sở theo NĐ 188/2025/NĐ-CP. Chỉ ghi khi VTYT/DVKT có quy định mức thanh toán BHYT; khi DON_GIA_BV vượt trần thì DON_GIA_BH = T_TRANTT. Ánh xạ trường T_TRANTT (Bảng 3 STT 21) theo QĐ 3176/QĐ-BYT. Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Trần thanh toán BHYT (VND)Value of extension |
| Control | 10..1 |
| Type | Money, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 34. Extension.extension:servicePaymentRatio | |
| Slice Name | servicePaymentRatio |
| Definition | Tỷ lệ thanh toán của dịch vụ kỹ thuật, ngày giường hoặc tiền công khám (TYLE_TT_DV, Bảng 3 STT 17) theo QĐ 3176/QĐ-BYT. Khác với paymentRatio (TYLE_TT_BH, Bảng 3 STT 18 — tỷ lệ thanh toán BHYT của thuốc/DVKT/VTYT): TYLE_TT_DV phản ánh mức tính giá dịch vụ, ví dụ nằm ghép 02 người ghi 50, nằm ghép từ 03 người ghi 33, giường 01 người ghi 100. Vắng mặt được hiểu là 100. Tham gia công thức THANH_TIEN_BV = SO_LUONG × DON_GIA_BV × TYLE_TT_DV/100 (Bảng 3 STT 19) và THANH_TIEN_BH (Bảng 3 STT 20). |
| Short | Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33Additional content defined by implementations |
| Control | 0..1* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 36. Extension.extension:servicePaymentRatio.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | ExtensionAdditional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..0* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 38. Extension.extension:servicePaymentRatio.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | servicePaymentRatio |
| 40. Extension.extension:servicePaymentRatio.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Value of extension |
| Control | 10..1 |
| Type | decimal, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 42. Extension.extension:insuranceUnitPrice | |
| Slice Name | insuranceUnitPrice |
| Definition | Đơn giá dịch vụ kỹ thuật, VTYT, tiền giường bệnh, tiền công khám do quỹ BHYT thanh toán (DON_GIA_BH, Bảng 3 STT 15) theo QĐ 3176/QĐ-BYT. Có thể khác đơn giá bệnh viện (DON_GIA_BV — Claim.item.unitPrice): khi VTYT có quy định mức thanh toán BHYT và DON_GIA_BV cao hơn mức thanh toán thì DON_GIA_BH = T_TRANTT (sub-extension paymentCeiling); không cao hơn thì DON_GIA_BH = DON_GIA_BV. Trường hợp VTYT tái sử dụng: DON_GIA_BH là giá thanh toán của 1 lần tái sử dụng. |
| Short | Đơn giá do quỹ BHYT thanh toán (DON_GIA_BH)Additional content defined by implementations |
| Control | 0..1* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 44. Extension.extension:insuranceUnitPrice.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | ExtensionAdditional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..0* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 46. Extension.extension:insuranceUnitPrice.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | insuranceUnitPrice |
| 48. Extension.extension:insuranceUnitPrice.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Đơn giá BHYT thanh toán (VND)Value of extension |
| Control | 10..1 |
| Type | Money, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 50. Extension.extension:insuranceLineAmount | |
| Slice Name | insuranceLineAmount |
| Definition | Thành tiền do quỹ BHYT thanh toán của dòng chi phí (THANH_TIEN_BH) theo QĐ 3176/QĐ-BYT. Với thuốc: THANH_TIEN_BH = SO_LUONG × DON_GIA × TYLE_TT_BH/100 (Bảng 2 STT 21). Với DVKT/VTYT: THANH_TIEN_BH = SO_LUONG × DON_GIA_BH × TYLE_TT_DV/100 × TYLE_TT_BH/100 (Bảng 3 STT 20), làm tròn 2 chữ số thập phân. Khi vắng mặt, hệ thống tiếp nhận có thể suy ra từ THANH_TIEN_BV × TYLE_TT_BH/100 (đúng khi DON_GIA_BH = DON_GIA_BV và TYLE_TT_DV = 100); ghi giá trị tường minh khi DON_GIA_BH khác DON_GIA_BV hoặc có tỷ lệ đặc thù. |
| Short | Thành tiền do quỹ BHYT thanh toán của dòng chi phí (THANH_TIEN_BH)Additional content defined by implementations |
| Control | 0..1* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 52. Extension.extension:insuranceLineAmount.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | ExtensionAdditional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..0* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 54. Extension.extension:insuranceLineAmount.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | insuranceLineAmount |
| 56. Extension.extension:insuranceLineAmount.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Thành tiền BHYT thanh toán (VND)Value of extension |
| Control | 10..1 |
| Type | Money, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 58. Extension.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info |
| 60. Extension.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Value of extension |
| Control | 0..01 |
| Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be foundhere
| 0. Extension | |
| Definition | Extension tái sử dụng cho thông tin chi phí BHYT trên từng item (thuốc/DVKT/VTYT). Bao gồm: phạm vi BHYT (PHAM_VI), tỷ lệ thanh toán BHYT (TYLE_TT/TYLE_TT_BH), mức hưởng (MUC_HUONG), mức trần thanh toán BHYT (T_TRANTT), tỷ lệ thanh toán dịch vụ (TYLE_TT_DV), đơn giá BHYT (DON_GIA_BH) và thành tiền BHYT (THANH_TIEN_BH). Dùng trên: MedicationRequest, Procedure, Claim.item, ServiceRequest và MedicationDispense khi các resource đó đang đóng vai trò nguồn dữ liệu cho dòng chi phí. Với thiết bị/vật tư, ưu tiên đặt trên Claim.item; không dùng trên DeviceUseStatement vì DeviceUseStatement là ghi nhận sử dụng lâm sàng. Mapping XML 3176: PHAM_VI, TYLE_TT, MUC_HUONG; DON_GIA_BH (Bảng 3 STT 15), TYLE_TT_DV (Bảng 3 STT 17), THANH_TIEN_BH (Bảng 2 STT 21, Bảng 3 STT 20), T_TRANTT (Bảng 3 STT 21). Nguồn thiết kế: OHP Data Processor (medication-pham-vi, medication-payment-ratio, medication-benefit-level). Căn cứ: QĐ 3176/QĐ-BYT (29/10/2024); NĐ 188/2025/NĐ-CP (trần thanh toán BHYT 45 tháng lương cơ sở). |
| Short | Thông tin chi phí BHYT — Insurance Cost Info Extension |
| 2. Extension.extension:scope | |
| Slice Name | scope |
| Short | Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP |
| Control | 0..1 |
| 4. Extension.extension:scope.extension | |
| Control | 0..0 |
| 6. Extension.extension:scope.url | |
| Fixed Value | scope |
| 8. Extension.extension:scope.value[x] | |
| Control | 1..? |
| Binding | Unless not suitable, these codes SHALL be taken from Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible to http://fhir.hl7.org.vn/core/ValueSet/vn-insurance-scope-vs) |
| Type | CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 10. Extension.extension:paymentRatio | |
| Slice Name | paymentRatio |
| Short | Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50 |
| Control | 0..1 |
| 12. Extension.extension:paymentRatio.extension | |
| Control | 0..0 |
| 14. Extension.extension:paymentRatio.url | |
| Fixed Value | paymentRatio |
| 16. Extension.extension:paymentRatio.value[x] | |
| Control | 1..? |
| Type | decimal |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 18. Extension.extension:benefitLevel | |
| Slice Name | benefitLevel |
| Short | Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40 |
| Control | 0..1 |
| 20. Extension.extension:benefitLevel.extension | |
| Control | 0..0 |
| 22. Extension.extension:benefitLevel.url | |
| Fixed Value | benefitLevel |
| 24. Extension.extension:benefitLevel.value[x] | |
| Control | 1..? |
| Type | decimal |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 26. Extension.extension:paymentCeiling | |
| Slice Name | paymentCeiling |
| Short | Mức trần thanh toán BHYT của dòng chi phí (T_TRANTT) |
| Control | 0..1 |
| 28. Extension.extension:paymentCeiling.extension | |
| Control | 0..0 |
| 30. Extension.extension:paymentCeiling.url | |
| Fixed Value | paymentCeiling |
| 32. Extension.extension:paymentCeiling.value[x] | |
| Definition | Mức thanh toán tối đa của quỹ BHYT đối với dòng chi phí DVKT/VTYT trong một lần thực hiện (T_TRANTT), tương ứng trần 45 tháng lương cơ sở theo NĐ 188/2025/NĐ-CP. Chỉ ghi khi VTYT/DVKT có quy định mức thanh toán BHYT; khi DON_GIA_BV vượt trần thì DON_GIA_BH = T_TRANTT. Ánh xạ trường T_TRANTT (Bảng 3 STT 21) theo QĐ 3176/QĐ-BYT. |
| Short | Trần thanh toán BHYT (VND) |
| Control | 1..? |
| Type | Money |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 34. Extension.extension:servicePaymentRatio | |
| Slice Name | servicePaymentRatio |
| Definition | Tỷ lệ thanh toán của dịch vụ kỹ thuật, ngày giường hoặc tiền công khám (TYLE_TT_DV, Bảng 3 STT 17) theo QĐ 3176/QĐ-BYT. Khác với paymentRatio (TYLE_TT_BH, Bảng 3 STT 18 — tỷ lệ thanh toán BHYT của thuốc/DVKT/VTYT): TYLE_TT_DV phản ánh mức tính giá dịch vụ, ví dụ nằm ghép 02 người ghi 50, nằm ghép từ 03 người ghi 33, giường 01 người ghi 100. Vắng mặt được hiểu là 100. Tham gia công thức THANH_TIEN_BV = SO_LUONG × DON_GIA_BV × TYLE_TT_DV/100 (Bảng 3 STT 19) và THANH_TIEN_BH (Bảng 3 STT 20). |
| Short | Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33 |
| Control | 0..1 |
| 36. Extension.extension:servicePaymentRatio.extension | |
| Control | 0..0 |
| 38. Extension.extension:servicePaymentRatio.url | |
| Fixed Value | servicePaymentRatio |
| 40. Extension.extension:servicePaymentRatio.value[x] | |
| Control | 1..? |
| Type | decimal |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 42. Extension.extension:insuranceUnitPrice | |
| Slice Name | insuranceUnitPrice |
| Definition | Đơn giá dịch vụ kỹ thuật, VTYT, tiền giường bệnh, tiền công khám do quỹ BHYT thanh toán (DON_GIA_BH, Bảng 3 STT 15) theo QĐ 3176/QĐ-BYT. Có thể khác đơn giá bệnh viện (DON_GIA_BV — Claim.item.unitPrice): khi VTYT có quy định mức thanh toán BHYT và DON_GIA_BV cao hơn mức thanh toán thì DON_GIA_BH = T_TRANTT (sub-extension paymentCeiling); không cao hơn thì DON_GIA_BH = DON_GIA_BV. Trường hợp VTYT tái sử dụng: DON_GIA_BH là giá thanh toán của 1 lần tái sử dụng. |
| Short | Đơn giá do quỹ BHYT thanh toán (DON_GIA_BH) |
| Control | 0..1 |
| 44. Extension.extension:insuranceUnitPrice.extension | |
| Control | 0..0 |
| 46. Extension.extension:insuranceUnitPrice.url | |
| Fixed Value | insuranceUnitPrice |
| 48. Extension.extension:insuranceUnitPrice.value[x] | |
| Short | Đơn giá BHYT thanh toán (VND) |
| Control | 1..? |
| Type | Money |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 50. Extension.extension:insuranceLineAmount | |
| Slice Name | insuranceLineAmount |
| Definition | Thành tiền do quỹ BHYT thanh toán của dòng chi phí (THANH_TIEN_BH) theo QĐ 3176/QĐ-BYT. Với thuốc: THANH_TIEN_BH = SO_LUONG × DON_GIA × TYLE_TT_BH/100 (Bảng 2 STT 21). Với DVKT/VTYT: THANH_TIEN_BH = SO_LUONG × DON_GIA_BH × TYLE_TT_DV/100 × TYLE_TT_BH/100 (Bảng 3 STT 20), làm tròn 2 chữ số thập phân. Khi vắng mặt, hệ thống tiếp nhận có thể suy ra từ THANH_TIEN_BV × TYLE_TT_BH/100 (đúng khi DON_GIA_BH = DON_GIA_BV và TYLE_TT_DV = 100); ghi giá trị tường minh khi DON_GIA_BH khác DON_GIA_BV hoặc có tỷ lệ đặc thù. |
| Short | Thành tiền do quỹ BHYT thanh toán của dòng chi phí (THANH_TIEN_BH) |
| Control | 0..1 |
| 52. Extension.extension:insuranceLineAmount.extension | |
| Control | 0..0 |
| 54. Extension.extension:insuranceLineAmount.url | |
| Fixed Value | insuranceLineAmount |
| 56. Extension.extension:insuranceLineAmount.value[x] | |
| Short | Thành tiền BHYT thanh toán (VND) |
| Control | 1..? |
| Type | Money |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| 58. Extension.url | |
| Fixed Value | http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info |
| 60. Extension.value[x] | |
| Control | 0..0 |
Guidance on how to interpret the contents of this table can be foundhere
| 0. Extension | |
| Definition | Extension tái sử dụng cho thông tin chi phí BHYT trên từng item (thuốc/DVKT/VTYT). Bao gồm: phạm vi BHYT (PHAM_VI), tỷ lệ thanh toán BHYT (TYLE_TT/TYLE_TT_BH), mức hưởng (MUC_HUONG), mức trần thanh toán BHYT (T_TRANTT), tỷ lệ thanh toán dịch vụ (TYLE_TT_DV), đơn giá BHYT (DON_GIA_BH) và thành tiền BHYT (THANH_TIEN_BH). Dùng trên: MedicationRequest, Procedure, Claim.item, ServiceRequest và MedicationDispense khi các resource đó đang đóng vai trò nguồn dữ liệu cho dòng chi phí. Với thiết bị/vật tư, ưu tiên đặt trên Claim.item; không dùng trên DeviceUseStatement vì DeviceUseStatement là ghi nhận sử dụng lâm sàng. Mapping XML 3176: PHAM_VI, TYLE_TT, MUC_HUONG; DON_GIA_BH (Bảng 3 STT 15), TYLE_TT_DV (Bảng 3 STT 17), THANH_TIEN_BH (Bảng 2 STT 21, Bảng 3 STT 20), T_TRANTT (Bảng 3 STT 21). Nguồn thiết kế: OHP Data Processor (medication-pham-vi, medication-payment-ratio, medication-benefit-level). Căn cứ: QĐ 3176/QĐ-BYT (29/10/2024); NĐ 188/2025/NĐ-CP (trần thanh toán BHYT 45 tháng lương cơ sở). |
| Short | Thông tin chi phí BHYT — Insurance Cost Info Extension |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Is Modifier | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 2. Extension.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| 4. Extension.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 6. Extension.extension:scope | |
| Slice Name | scope |
| Definition | An Extension |
| Short | Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP |
| Control | 0..1 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 8. Extension.extension:scope.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| 10. Extension.extension:scope.extension | |
| Definition | An Extension |
| Short | Extension |
| Control | 0..0 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 12. Extension.extension:scope.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | scope |
| 14. Extension.extension:scope.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Value of extension |
| Control | 1..1 |
| Binding | Unless not suitable, these codes SHALL be taken from Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible to http://fhir.hl7.org.vn/core/ValueSet/vn-insurance-scope-vs) |
| Type | CodeableConcept |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 16. Extension.extension:paymentRatio | |
| Slice Name | paymentRatio |
| Definition | An Extension |
| Short | Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50 |
| Control | 0..1 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 18. Extension.extension:paymentRatio.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| 20. Extension.extension:paymentRatio.extension | |
| Definition | An Extension |
| Short | Extension |
| Control | 0..0 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 22. Extension.extension:paymentRatio.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | paymentRatio |
| 24. Extension.extension:paymentRatio.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Value of extension |
| Control | 1..1 |
| Type | decimal |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 26. Extension.extension:benefitLevel | |
| Slice Name | benefitLevel |
| Definition | An Extension |
| Short | Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40 |
| Control | 0..1 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 28. Extension.extension:benefitLevel.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| 30. Extension.extension:benefitLevel.extension | |
| Definition | An Extension |
| Short | Extension |
| Control | 0..0 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 32. Extension.extension:benefitLevel.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | benefitLevel |
| 34. Extension.extension:benefitLevel.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Value of extension |
| Control | 1..1 |
| Type | decimal |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 36. Extension.extension:paymentCeiling | |
| Slice Name | paymentCeiling |
| Definition | An Extension |
| Short | Mức trần thanh toán BHYT của dòng chi phí (T_TRANTT) |
| Control | 0..1 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 38. Extension.extension:paymentCeiling.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| 40. Extension.extension:paymentCeiling.extension | |
| Definition | An Extension |
| Short | Extension |
| Control | 0..0 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 42. Extension.extension:paymentCeiling.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | paymentCeiling |
| 44. Extension.extension:paymentCeiling.value[x] | |
| Definition | Mức thanh toán tối đa của quỹ BHYT đối với dòng chi phí DVKT/VTYT trong một lần thực hiện (T_TRANTT), tương ứng trần 45 tháng lương cơ sở theo NĐ 188/2025/NĐ-CP. Chỉ ghi khi VTYT/DVKT có quy định mức thanh toán BHYT; khi DON_GIA_BV vượt trần thì DON_GIA_BH = T_TRANTT. Ánh xạ trường T_TRANTT (Bảng 3 STT 21) theo QĐ 3176/QĐ-BYT. |
| Short | Trần thanh toán BHYT (VND) |
| Control | 1..1 |
| Type | Money |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 46. Extension.extension:servicePaymentRatio | |
| Slice Name | servicePaymentRatio |
| Definition | Tỷ lệ thanh toán của dịch vụ kỹ thuật, ngày giường hoặc tiền công khám (TYLE_TT_DV, Bảng 3 STT 17) theo QĐ 3176/QĐ-BYT. Khác với paymentRatio (TYLE_TT_BH, Bảng 3 STT 18 — tỷ lệ thanh toán BHYT của thuốc/DVKT/VTYT): TYLE_TT_DV phản ánh mức tính giá dịch vụ, ví dụ nằm ghép 02 người ghi 50, nằm ghép từ 03 người ghi 33, giường 01 người ghi 100. Vắng mặt được hiểu là 100. Tham gia công thức THANH_TIEN_BV = SO_LUONG × DON_GIA_BV × TYLE_TT_DV/100 (Bảng 3 STT 19) và THANH_TIEN_BH (Bảng 3 STT 20). |
| Short | Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33 |
| Control | 0..1 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 48. Extension.extension:servicePaymentRatio.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| 50. Extension.extension:servicePaymentRatio.extension | |
| Definition | An Extension |
| Short | Extension |
| Control | 0..0 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 52. Extension.extension:servicePaymentRatio.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | servicePaymentRatio |
| 54. Extension.extension:servicePaymentRatio.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Value of extension |
| Control | 1..1 |
| Type | decimal |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 56. Extension.extension:insuranceUnitPrice | |
| Slice Name | insuranceUnitPrice |
| Definition | Đơn giá dịch vụ kỹ thuật, VTYT, tiền giường bệnh, tiền công khám do quỹ BHYT thanh toán (DON_GIA_BH, Bảng 3 STT 15) theo QĐ 3176/QĐ-BYT. Có thể khác đơn giá bệnh viện (DON_GIA_BV — Claim.item.unitPrice): khi VTYT có quy định mức thanh toán BHYT và DON_GIA_BV cao hơn mức thanh toán thì DON_GIA_BH = T_TRANTT (sub-extension paymentCeiling); không cao hơn thì DON_GIA_BH = DON_GIA_BV. Trường hợp VTYT tái sử dụng: DON_GIA_BH là giá thanh toán của 1 lần tái sử dụng. |
| Short | Đơn giá do quỹ BHYT thanh toán (DON_GIA_BH) |
| Control | 0..1 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 58. Extension.extension:insuranceUnitPrice.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| 60. Extension.extension:insuranceUnitPrice.extension | |
| Definition | An Extension |
| Short | Extension |
| Control | 0..0 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 62. Extension.extension:insuranceUnitPrice.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | insuranceUnitPrice |
| 64. Extension.extension:insuranceUnitPrice.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Đơn giá BHYT thanh toán (VND) |
| Control | 1..1 |
| Type | Money |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 66. Extension.extension:insuranceLineAmount | |
| Slice Name | insuranceLineAmount |
| Definition | Thành tiền do quỹ BHYT thanh toán của dòng chi phí (THANH_TIEN_BH) theo QĐ 3176/QĐ-BYT. Với thuốc: THANH_TIEN_BH = SO_LUONG × DON_GIA × TYLE_TT_BH/100 (Bảng 2 STT 21). Với DVKT/VTYT: THANH_TIEN_BH = SO_LUONG × DON_GIA_BH × TYLE_TT_DV/100 × TYLE_TT_BH/100 (Bảng 3 STT 20), làm tròn 2 chữ số thập phân. Khi vắng mặt, hệ thống tiếp nhận có thể suy ra từ THANH_TIEN_BV × TYLE_TT_BH/100 (đúng khi DON_GIA_BH = DON_GIA_BV và TYLE_TT_DV = 100); ghi giá trị tường minh khi DON_GIA_BH khác DON_GIA_BV hoặc có tỷ lệ đặc thù. |
| Short | Thành tiền do quỹ BHYT thanh toán của dòng chi phí (THANH_TIEN_BH) |
| Control | 0..1 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 68. Extension.extension:insuranceLineAmount.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| 70. Extension.extension:insuranceLineAmount.extension | |
| Definition | An Extension |
| Short | Extension |
| Control | 0..0 |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 72. Extension.extension:insuranceLineAmount.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | insuranceLineAmount |
| 74. Extension.extension:insuranceLineAmount.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Thành tiền BHYT thanh toán (VND) |
| Control | 1..1 |
| Type | Money |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 76. Extension.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Short | identifies the meaning of the extension |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info |
| 78. Extension.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | Value of extension |
| Control | 0..0 |
| Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | false |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
