Atrius India Core FHIR Implementation Guide
0.1.0 - ci-build
Atrius India Core FHIR Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "atrius-in-insuranceplan-bundle-example",
"meta" : {
"profile" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-insuranceplan-bundle"
]
},
"language" : "en",
"type" : "collection",
"timestamp" : "2026-04-01T00:00:00+05:30",
"entry" : [
{
"fullUrl" : "https://atrius.in/fhir/r4/atrius-in/InsurancePlan/atrius-in-insuranceplan-example",
"resource" : {
"resourceType" : "InsurancePlan",
"id" : "atrius-in-insuranceplan-example",
"meta" : {
"profile" : [
🔗 "https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-insuranceplan"
]
},
"language" : "en",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"InsurancePlan_atrius-in-insuranceplan-example\"> </a><p class=\"res-header-id\"><b>Generated Narrative: InsurancePlan atrius-in-insuranceplan-example</b></p><a name=\"atrius-in-insuranceplan-example\"> </a><a name=\"hcatrius-in-insuranceplan-example\"> </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-atrius-in-insuranceplan.html\">Atrius India Core InsurancePlan</a></p></div><blockquote><p><b>ClaimExclusion</b></p><ul><li>category: <span title=\"Codes:\">Cosmetic procedures</span></li><li>statement: Cosmetic and aesthetic procedures are excluded unless reconstructive after trauma.</li><li>item: <span title=\"Codes:\">Rhinoplasty (aesthetic)</span></li></ul></blockquote><blockquote><p><b>ClaimSupportingInfoRequirement</b></p><ul><li>category: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category FCF}\">Filled claim form</span></li><li>code: <span title=\"Codes:\">Discharge summary</span></li></ul></blockquote><p><b>identifier</b>: <a href=\"NamingSystem-atrius-in-irdai-product-uin-ns.html\" title=\"IRDAI Unique Identification Number (UIN) for a regulated insurance product. Used as InsurancePlan.identifier.system: the payer-issued product id that covers the combinations offered under that plan (NDHM InsurancePlan.identifier). Value is the UIN string (e.g. IRDAI product UIN or a PM-JAY product code in the same namespace). Do not use the bare website https://irdai.gov.in — that is not an identifier namespace.\">IRDAIProductUin</a>/PMJAY-HOSP-2026</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-insuranceplan-type 01}\">Hospitalization</span></p><p><b>name</b>: PM-JAY Hospitalization Cover</p><p><b>period</b>: 2026-04-01 --> 2027-03-31</p><p><b>ownedBy</b>: <a href=\"Organization-atrius-in-organization-example.html\">Organization AtriusIn General Hospital</a></p><p><b>administeredBy</b>: <a href=\"Organization-atrius-in-organization-example.html\">Organization AtriusIn General Hospital</a></p><blockquote><p><b>coverage</b></p><blockquote><p><b>ClaimCondition</b></p><ul><li>claim-condition: Covered: dengue, malaria, and enteric fever requiring admission.</li></ul></blockquote><blockquote><p><b>ClaimSupportingInfoRequirement</b></p><ul><li>category: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category CER}\">Medical Certficate</span></li><li>code: <span title=\"Codes:\">Discharge summary</span></li></ul></blockquote><p><b>type</b>: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-coverage-type 00}\">Medical</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-benefit-type 00}\">Inpatient hospitalization</span></td></tr></table></blockquote><h3>Plans</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td/><td><span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-plan-type 03}\">Standard</span></td></tr></table></div>"
},
"extension" : [
{
"extension" : [
{
"url" : "category",
"valueCodeableConcept" : {
"text" : "Cosmetic procedures"
}
},
{
"url" : "statement",
"valueString" : "Cosmetic and aesthetic procedures are excluded unless reconstructive after trauma."
},
{
"url" : "item",
"valueCodeableConcept" : {
"text" : "Rhinoplasty (aesthetic)"
}
}
],
"url" : "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Exclusion"
},
{
"extension" : [
{
"url" : "category",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category",
"code" : "FCF",
"display" : "Filled claim form"
}
]
}
},
{
"url" : "code",
"valueCodeableConcept" : {
"text" : "Discharge summary"
}
}
],
"url" : "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement"
}
],
"identifier" : [
{
"system" : "https://irdai.gov.in/product-uin",
"value" : "PMJAY-HOSP-2026"
}
],
"status" : "active",
"type" : [
{
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-insuranceplan-type",
"code" : "01",
"display" : "Hospitalisation Indemnity Policy"
}
],
"text" : "Hospitalization"
}
],
"name" : "PM-JAY Hospitalization Cover",
"period" : {
"start" : "2026-04-01",
"end" : "2027-03-31"
},
"ownedBy" : {
🔗 "reference" : "Organization/atrius-in-organization-example"
},
"administeredBy" : {
🔗 "reference" : "Organization/atrius-in-organization-example"
},
"coverage" : [
{
"extension" : [
{
"extension" : [
{
"url" : "claim-condition",
"valueString" : "Covered: dengue, malaria, and enteric fever requiring admission."
}
],
"url" : "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Condition"
},
{
"extension" : [
{
"url" : "category",
"valueCodeableConcept" : {
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category",
"code" : "CER",
"display" : "Medical Certficate"
}
]
}
},
{
"url" : "code",
"valueCodeableConcept" : {
"text" : "Discharge summary"
}
}
],
"url" : "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement"
}
],
"type" : {
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-coverage-type",
"code" : "00",
"display" : "In Patient Hospitalization"
}
],
"text" : "Medical"
},
"benefit" : [
{
"type" : {
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-benefit-type",
"code" : "00",
"display" : "ICU"
}
],
"text" : "Inpatient hospitalization"
}
}
]
}
],
"plan" : [
{
"extension" : [
{
"extension" : [
{
"url" : "claim-condition",
"valueString" : "Pre-existing diabetes covered after 24 months."
}
],
"url" : "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Condition"
}
],
"type" : {
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-plan-type",
"code" : "03",
"display" : "Group"
}
],
"text" : "Standard"
}
}
]
}
}
]
}