source: ccr2ccd-xslt/trunk/make/PayersSectionMedicareTemplate.xml.save@ 1071

Last change on this file since 1071 was 991, checked in by George Lilly, 14 years ago

latest qrda work

File size: 3.9 KB
Line 
1<component>
2<section>
3<!--We are including only a coverage activity for Medicare here. There is also policy activity and and authorization activity that I don't think we need to report for QRDA, at least not for most reports-->
4<templateId root="2.16.840.1.113883.10.20.1.9"/>
5<!-- 48768-6 is payment sources and is fixed CQ-188,189,190-->
6<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment Sources"/>
7<!--CQ-191,192-->
8<title>Payers</title>
9<!--medicare-->
10<entry typeCode="DRIV">
11<!--WVP moodCode is DEF is definition to describe the characteristics of who must be involved in an act CQ-194,195-->
12<act classCode="ACT" moodCode="DEF">
13<!--WVP coverage activity template is the 10.20.1.20 CQ-193-->
14<templateId root="2.16.840.1.113883.10.20.1.20"/>
15<!--Coverage Shall Include and Act ID CQ-196-->
16<!--looks like a UUID to me-->
17<id root="1751b180-8a54-11df-a4ee-0800200c9c66"/><!--FIX!!!???-->
18<!--CQ-197-198-->
19<!--CQ199,200-->
20<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" displayName="Payment sources"/>
21<statusCode code="completed"/>
22<!--A coverage activity shall contain on or more act/entryRelationship. The value for act/entryRelationship/@typeCode shall be COMP which SHALL be the CMS QRDA Policy Activity CQ-201, 203-->
23<!--It MAY contain an entryRelationship/sequenceNumber CQ-202-->
24<entryRelationship typeCode="COMP">
25<!-- for the act is event with moodCode EVN CQ-205,206,207-->
26<act classCode="ACT" moodCode="EVN">
27<!--Policy activity is the 10.20.1.26 template CQ-205-->
28<templateId root="2.16.840.1.113883.10.20.1.26"/>
29
30<!-- act/id which is the group or contract number related to the insurance policy or program CQ-208-->
31<id root="dbbb6311-8a4d-11df-a4ee-0800200c9c66"/><!--!!!FIX-->
32<!--Act statusCode must be completed CQ-210-->
33<statusCode code="completed"/>
34<!--This SHOULD be present and comes from the downloadable resource S display name is in quotes AUTOPOL - "automobile" policy;EHCPOL additional insurance in addition to Medicare in this case
35HSAPOL "Health Spending Account";PUBLICPOL "public healthcare" which is NOT Medicare - maybe a state program for example
36WBCPOL is "workers compensation" CQ-211,212-->
37<!--<code code="PUBLICPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Public Healthcare"/>-->
38<code code="PUBLICPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Public Healthcare"/>
39<!--WVP performer type codes are numerous but PRF is performer representing the Payer CQ-213-->
40<performer typeCode="PRF">
41
42<!--performer/assignedEntity id is the payer identification and the extension comes from the downloadable resource section I insurance plan TYPE CQ-214-->
43<assignedEntity>
44<id root="2.16.840.1.113883.12.86" extension="MC"/>
45<!--<representedOrganization>
46<name>CMS</name>
47</representedOrganization>-->
48</assignedEntity>
49</performer>
50<!-- Act/participant @typeCode this represents the covered party CQ-215-->
51<participant typeCode="COV">
52<participantRole>
53<!--A covered party in a policy activity SHOULD contain one or more participant/participantRole/id to represent the patien's member of subscriber identifier with respect to the payer
54For participant/paricipantRole/id either the Social Security Number or HIC Number SHALL be submitted for Medicare patients. for SSN the ID @root SHALL be 2.16.840.1.113883.4.1 where
55the HIC id/@root shall be 2.16.840.1.113883.3.249.13 CQ-216"RoleCode" in the downloadable resource-->
56<!-- in this case theextension is the patients SSN for a medicare patient so it is the same each time for one patient-->
57<id root="2.16.840.1.113883.4.1" extension="@@SSN@@"/>
58<!--The covered party in tha policy activity SHOULD contain exactly one particpant/participantRole/code for self, family etc from the valuse set PolicyOrPrograCoverageRoleType 2.16.840.1.113883.1.11.19809 CQ-217,218-->
59<code code="SELF" codeSystem="2.16.840.1.113883.5.111" displayName="Self"/>
60</participantRole>
61</participant>
62</act>
63</entryRelationship>
64</act>
65</entry>
66</section>
67</component>
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