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
<Bundle xmlns="http://hl7.org/fhir">
<id value="atrius-in-insuranceplan-bundle-example"/>
<meta>
<profile
value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-insuranceplan-bundle"/>
</meta>
<language value="en"/>
<type value="collection"/>
<timestamp value="2026-04-01T00:00:00+05:30"/>
<entry>
<fullUrl
value="https://atrius.in/fhir/r4/atrius-in/InsurancePlan/atrius-in-insuranceplan-example"/>
<resource>
<InsurancePlan>
<id value="atrius-in-insuranceplan-example"/>
<meta>
<profile
value="https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-insuranceplan"/>
</meta>
<language value="en"/>
<text>
<status value="extensions"/>
<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>
</text>
<extension
url="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Exclusion">
<extension url="category">
<valueCodeableConcept>
<text value="Cosmetic procedures"/>
</valueCodeableConcept>
</extension>
<extension url="statement">
<valueString
value="Cosmetic and aesthetic procedures are excluded unless reconstructive after trauma."/>
</extension>
<extension url="item">
<valueCodeableConcept>
<text value="Rhinoplasty (aesthetic)"/>
</valueCodeableConcept>
</extension>
</extension>
<extension
url="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement">
<extension url="category">
<valueCodeableConcept>
<coding>
<system
value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category"/>
<code value="FCF"/>
<display value="Filled claim form"/>
</coding>
</valueCodeableConcept>
</extension>
<extension url="code">
<valueCodeableConcept>
<text value="Discharge summary"/>
</valueCodeableConcept>
</extension>
</extension>
<identifier>
<system value="https://irdai.gov.in/product-uin"/>
<value value="PMJAY-HOSP-2026"/>
</identifier>
<status value="active"/>
<type>
<coding>
<system
value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-insuranceplan-type"/>
<code value="01"/>
<display value="Hospitalisation Indemnity Policy"/>
</coding>
<text value="Hospitalization"/>
</type>
<name value="PM-JAY Hospitalization Cover"/>
<period>
<start value="2026-04-01"/>
<end value="2027-03-31"/>
</period>
<ownedBy>🔗
<reference value="Organization/atrius-in-organization-example"/>
</ownedBy>
<administeredBy>🔗
<reference value="Organization/atrius-in-organization-example"/>
</administeredBy>
<coverage>
<extension
url="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Condition">
<extension url="claim-condition">
<valueString
value="Covered: dengue, malaria, and enteric fever requiring admission."/>
</extension>
</extension>
<extension
url="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement">
<extension url="category">
<valueCodeableConcept>
<coding>
<system
value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category"/>
<code value="CER"/>
<display value="Medical Certficate"/>
</coding>
</valueCodeableConcept>
</extension>
<extension url="code">
<valueCodeableConcept>
<text value="Discharge summary"/>
</valueCodeableConcept>
</extension>
</extension>
<type>
<coding>
<system
value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-coverage-type"/>
<code value="00"/>
<display value="In Patient Hospitalization"/>
</coding>
<text value="Medical"/>
</type>
<benefit>
<type>
<coding>
<system
value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-benefit-type"/>
<code value="00"/>
<display value="ICU"/>
</coding>
<text value="Inpatient hospitalization"/>
</type>
</benefit>
</coverage>
<plan>
<extension
url="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-Condition">
<extension url="claim-condition">
<valueString
value="Pre-existing diabetes covered after 24 months."/>
</extension>
</extension>
<type>
<coding>
<system
value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-plan-type"/>
<code value="03"/>
<display value="Group"/>
</coding>
<text value="Standard"/>
</type>
</plan>
</InsurancePlan>
</resource>
</entry>
</Bundle>