HSAAP Special Authority FHIR Implementation Guide
0.1.1 - draft New Zealand flag

HSAAP Special Authority FHIR Implementation Guide - Local Development build (v0.1.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Example Submission Bundle (direct FHIR) - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="sa-example-submission-bundle"/>
  <meta>
    <profile
             value="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/sa-submission-bundle"/>
  </meta>
  <type value="collection"/>
  <timestamp value="2026-10-14T10:35:05+13:00"/>
  <entry>
    <fullUrl
             value="https://api.example.health.nz/fhir/Claim/sa-example-claim"/>
    <resource>
      <Claim>
        <id value="sa-example-claim"/>
        <meta>
          <profile
                   value="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/sa-claim"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Claim_sa-example-claim"> </a><p class="res-header-id"><b>Generated Narrative: Claim sa-example-claim</b></p><a name="sa-example-claim"> </a><a name="hcsa-example-claim"> </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-sa-claim.html">SA Claim</a></p></div><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claim-type pharmacy}">Pharmacy</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href="Patient-sa-example-patient.html">Aroha Parata (official) (no stated gender), DoB: 1968-03-14 ( https://standards.digital.health.nz/ns/nhi-id#NHI#ZZZ0016 (use: official))</a></p><p><b>created</b>: 2026-10-14 10:35:00+1300</p><p><b>provider</b>: <a href="Practitioner-sa-example-applicant.html">Jane Smith (official) (https://standards.digital.health.nz/ns/hpi-person-id#HPIProvider#99ZZZZ (use: official))</a></p><p><b>priority</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}">Normal</span></p><h3>SupportingInfos</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td>1</td><td><span title="Codes:{https://fhir-ig.digital.health.nz/special-authority/CodeSystem/sa-supporting-info-category questionnaire-response}">Questionnaire response</span></td><td><a href="QuestionnaireResponse-sa-example-qr.html">Response to Questionnaire '-&gt;Example Special Authority form SA9999 - Initial application' about '-&gt;Aroha Parata (official) (no stated gender), DoB: 1968-03-14 ( https://standards.digital.health.nz/ns/nhi-id#NHI#ZZZ0016 (use: official))'</a></td></tr></table><h3>Insurances</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style="display: none">*</td><td>1</td><td>true</td><td>Pharmaceutical Schedule</td></tr></table></div>
        </text>
        <status value="active"/>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
            <code value="pharmacy"/>
          </coding>
        </type>
        <use value="preauthorization"/>
        <patient>🔗 
          <reference value="Patient/sa-example-patient"/>
        </patient>
        <created value="2026-10-14T10:35:00+13:00"/>
        <provider>🔗 
          <reference value="Practitioner/sa-example-applicant"/>
        </provider>
        <priority>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/processpriority"/>
            <code value="normal"/>
          </coding>
        </priority>
        <supportingInfo>
          <sequence value="1"/>
          <category>
            <coding>
              <system
                      value="https://fhir-ig.digital.health.nz/special-authority/CodeSystem/sa-supporting-info-category"/>
              <code value="questionnaire-response"/>
            </coding>
          </category>
          <valueReference>🔗 
            <reference value="QuestionnaireResponse/sa-example-qr"/>
          </valueReference>
        </supportingInfo>
        <insurance>
          <sequence value="1"/>
          <focal value="true"/>
          <coverage>
            <display value="Pharmaceutical Schedule"/>
          </coverage>
        </insurance>
      </Claim>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="https://api.example.health.nz/fhir/QuestionnaireResponse/sa-example-qr"/>
    <resource>
      <QuestionnaireResponse>
        <id value="sa-example-qr"/>
        <meta>
          <profile
                   value="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/sa-questionnaire-response"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="QuestionnaireResponse_sa-example-qr"> </a><p class="res-header-id"><b>Generated Narrative: QuestionnaireResponse sa-example-qr</b></p><a name="sa-example-qr"> </a><a name="hcsa-example-qr"> </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-sa-questionnaire-response.html">SA QuestionnaireResponse</a></p></div><table border="1" cellpadding="0" cellspacing="0" class="xhtTableBorder1"><tr class="xhtRowBorder2"><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Definition</a></th><th scope="col" style="" class="hierarchy xhtCellBorder1"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Answer</a><span style="float: right"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck1.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="" style="background-color: white; background-color: inherit" title="QuestionnaireResponseRoot" class="hierarchy"/> sa-example-qr</td><td style="" class="hierarchy xhtCellBorder1"></td><td style="" class="hierarchy xhtCellBorder1"></td><td style="" class="hierarchy xhtCellBorder1">Questionnaire:<a href="Questionnaire-SA9999.html">Example Special Authority form SA9999 - Initial application</a></td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck01.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Group" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">sa-example-qr / </span>initial</td><td style="" class="hierarchy xhtCellBorder1"></td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1"/></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck010.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">sa-example-qr / initial / </span>00001</td><td style="" class="hierarchy xhtCellBorder1">Patient has a confirmed diagnosis of the relevant condition</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">true</td></tr>
<tr class="xhtRowBorder1 xhtRowOdd"><td style="background-image: url(tbl_bck010.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: #F7F7F7; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">sa-example-qr / initial / </span>00002</td><td style="" class="hierarchy xhtCellBorder1">Patient has had an inadequate response to at least 3 months of first-line treatment</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">true</td></tr>
<tr class="xhtRowBorder1 xhtRowEven"><td style="background-image: url(tbl_bck000.png)" class="hierarchy xhtCellBorder1 xhtCellNoWrap"><img src="tbl_spacer.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="" style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="" style="background-color: white; background-color: inherit" title="Item" class="hierarchy"/> <span style="position: absolute; width: 1px; height: 1px; padding: 0; margin: -1px; overflow: hidden; clip: rect(0, 0, 0, 0); white-space: nowrap; border: 0" class="sr-only">sa-example-qr / initial / </span>00003</td><td style="" class="hierarchy xhtCellBorder1">First-line treatment trialled</td><td style="" class="hierarchy xhtCellBorder1"/><td style="" class="hierarchy xhtCellBorder1">Example first-line medicine, 6 months</td></tr>
<tr><td colspan="4" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
        </text>
        <extension
                   url="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/request-for-waiver">
          <valueBoolean value="false"/>
        </extension>
        <extension
                   url="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/referring-practitioner">
          <valueReference>🔗 
            <reference value="Practitioner/sa-example-referrer"/>
          </valueReference>
        </extension>
        <identifier>
          <system value="https://pms.example.co.nz/sa-reference"/>
          <value value="PMS-REF-000981"/>
        </identifier>
        <questionnaire
                       value="https://fhir-ig.digital.health.nz/special-authority/Questionnaire/SA9999|a3f2b8c91d4e7062"/>
        <status value="completed"/>
        <subject>🔗 
          <reference value="Patient/sa-example-patient"/>
        </subject>
        <authored value="2026-10-14T10:32:00+13:00"/>
        <author>🔗 
          <reference value="Practitioner/sa-example-applicant"/>
        </author>
        <item>
          <linkId value="initial"/>
          <item>
            <linkId value="00001"/>
            <text
                  value="Patient has a confirmed diagnosis of the relevant condition"/>
            <answer>
              <valueBoolean value="true"/>
            </answer>
          </item>
          <item>
            <linkId value="00002"/>
            <text
                  value="Patient has had an inadequate response to at least 3 months of first-line treatment"/>
            <answer>
              <valueBoolean value="true"/>
            </answer>
          </item>
          <item>
            <linkId value="00003"/>
            <text value="First-line treatment trialled"/>
            <answer>
              <valueString value="Example first-line medicine, 6 months"/>
            </answer>
          </item>
        </item>
      </QuestionnaireResponse>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="https://api.example.health.nz/fhir/Patient/sa-example-patient"/>
    <resource>
      <Patient>
        <id value="sa-example-patient"/>
        <meta>
          <profile
                   value="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/sa-patient"/>
        </meta>
        <text>
          <status value="extensions"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_sa-example-patient"> </a><p class="res-header-id"><b>Generated Narrative: Patient sa-example-patient</b></p><a name="sa-example-patient"> </a><a name="hcsa-example-patient"> </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-sa-patient.html">SA Patient</a></p></div><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Aroha Parata (official) (no stated gender), DoB: 1968-03-14 ( https://standards.digital.health.nz/ns/nhi-id#NHI#ZZZ0016 (use: official))</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td><td colspan="3">12 Kowhai Street Waikanae 5036 NZ (home) (NZ Suburb: Waikanae Beach)</td></tr></table></div>
        </text>
        <identifier>
          <use value="official"/>
          <system value="https://standards.digital.health.nz/ns/nhi-id"/>
          <value value="ZZZ0016"/>
        </identifier>
        <name>
          <use value="official"/>
          <family value="Parata"/>
          <given value="Aroha"/>
          <prefix value="Ms"/>
        </name>
        <birthDate value="1968-03-14"/>
        <address>
          <extension url="http://hl7.org.nz/fhir/StructureDefinition/suburb">
            <valueString value="Waikanae Beach"/>
          </extension>
          <use value="home"/>
          <line value="12 Kowhai Street"/>
          <city value="Waikanae"/>
          <postalCode value="5036"/>
          <country value="NZ"/>
        </address>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="https://api.example.health.nz/fhir/Practitioner/sa-example-applicant"/>
    <resource>
      <Practitioner>
        <id value="sa-example-applicant"/>
        <meta>
          <profile
                   value="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/sa-practitioner"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Practitioner_sa-example-applicant"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner sa-example-applicant</b></p><a name="sa-example-applicant"> </a><a name="hcsa-example-applicant"> </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-sa-practitioner.html">SA Practitioner</a></p></div><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Jane Smith (official) (https://standards.digital.health.nz/ns/hpi-person-id#HPIProvider#99ZZZZ (use: official))</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Other Id (see the one above)">Other Id:</td><td colspan="3"><a href="http://fhir.org.nz/ig/base/3.1.0/NamingSystem-medical-council-id.html" title="Medical Council of New Zealand Register Number">NZMC</a>/12345 (use: secondary)</td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Practitioner">Contact Detail</td><td colspan="3">1 Main Highway Otaki 5512 NZ (work)</td></tr></table></div>
        </text>
        <identifier>
          <use value="official"/>
          <system
                  value="https://standards.digital.health.nz/ns/hpi-person-id"/>
          <value value="99ZZZZ"/>
        </identifier>
        <identifier>
          <use value="secondary"/>
          <system
                  value="https://standards.digital.health.nz/ns/medical-council-id"/>
          <value value="12345"/>
        </identifier>
        <name>
          <use value="official"/>
          <family value="Smith"/>
          <given value="Jane"/>
          <prefix value="Dr"/>
        </name>
        <address>
          <use value="work"/>
          <line value="1 Main Highway"/>
          <city value="Otaki"/>
          <postalCode value="5512"/>
          <country value="NZ"/>
        </address>
      </Practitioner>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="https://api.example.health.nz/fhir/Practitioner/sa-example-referrer"/>
    <resource>
      <Practitioner>
        <id value="sa-example-referrer"/>
        <meta>
          <profile
                   value="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/sa-practitioner"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Practitioner_sa-example-referrer"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner sa-example-referrer</b></p><a name="sa-example-referrer"> </a><a name="hcsa-example-referrer"> </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-sa-practitioner.html">SA Practitioner</a></p></div><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Rawiri Ngata (official) (https://standards.digital.health.nz/ns/medical-council-id#NZMC#54321 (use: secondary))</p><hr/></div>
        </text>
        <identifier>
          <use value="secondary"/>
          <system
                  value="https://standards.digital.health.nz/ns/medical-council-id"/>
          <value value="54321"/>
        </identifier>
        <name>
          <use value="official"/>
          <family value="Ngata"/>
          <given value="Rawiri"/>
          <prefix value="Dr"/>
        </name>
      </Practitioner>
    </resource>
  </entry>
</Bundle>