Documentmanifest-fm-attachment.xml

Financial Supporting Documentation Example of FM attachment (id = "654789")

<?xml version="1.0" encoding="UTF-8"?>
<DocumentManifest xmlns="http://hl7.org/fhir">
  <id value="654789"/> 
 

  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">A Financial Management Attachment example</div> 
  </text> 
  <contained> 
    <Organization> 
     
     
       
       
     

      <id value="org-1"/> 
      <identifier> 
        <system value="http://nationalidentifiers.org/insurers"/> 
        <value value="52345"/> 
      </identifier> 
    </Organization> 
  </contained> 
  <contained> 
    
    <DocumentReference>       <id value="a1"/>       <status value="current"/>       <content>         <attachment>           <contentType value="application/pdf"/>           <data value="SGVsbG8="/>           <title value="accident notes 20100201.pdf"/>           <creation value="2010-02-01T11:50:23-05:00"/>         </attachment>       </content>     </DocumentReference>   </contained>   <contained>     <DocumentReference>       <id value="a2"/>       <status value="current"/>       <content>         <attachment>           <contentType value="application/pdf"/>           <url value="http://happyvalley.com/docs/AB12345"/>           <size value="104274"/>           <hash value="SGVsbG8gdGhlcmU="/>           <creation value="2010-02-01T10:57:34+01:00"/>         </attachment>       </content>     </DocumentReference>   </contained> 
  <identifier> 
     
     

    <system value="http://happyvalley.com/supportingdocumentation"/> 
    <value value="52345"/> 
  </identifier> 
 

  <status value="current"/> 
  <created value="2014-09-21T11:50:23-05:00"/> 
  <recipient> 
    

    <reference value="#org-1"/> 
  </recipient> 
   

  <content> 
   
    
    
    
    
   

    <reference value="#a1"/> 
  </content> 
 

  <content> 
   
    
    
    
    
    
   

    <reference value="#a2"/> 
  </content> 
 
  

  <content> 
    <reference value="DocumentReference/example"/> 
  </content> 
  <content> 
    <reference value="DiagnosticReport/f001"/> 
  </content> 
  <related> 
    <!--   Claim these docs are supporting   -->
    <identifier> 
     
     

      <system value="http://happyvalley.com/claim"/> 
      <value value="12345"/> 
    </identifier> 
  </related> 
  
  

  <related> 
    <!--   Insurers response to the Claim these docs are supporting   -->
    <identifier> 
      <system value="http://www.BenefitsInc.com/fhir/remittance"/> 
      <value value="R3500"/> 
    </identifier> 
  </related> 
  



</

DocumentManifest

>