{
  "resourceType" : "ClaimResponse",
  "id" : "sa-example-cr-declined",
  "meta" : {
    "profile" : ["https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/sa-application-claimresponse"]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse sa-example-cr-declined</b></p><a name=\"sa-example-cr-declined\"> </a><a name=\"hcsa-example-cr-declined\"> </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-application-claimresponse.html\">SA Application ClaimResponse</a></p></div><blockquote><p><b>Application Status</b></p><ul><li>status: DONE</li><li>outcome: DECLINED</li><li>outcomeCode: <a href=\"CodeSystem-sa-outcome-code.html#sa-outcome-code-URNSA011\">SA Outcome Code: URNSA011</a> (URNSA011)</li><li>outcomeReason: An approval already exists for this patient and form.</li></ul></blockquote><blockquote><p><b>Existing Approval</b></p><ul><li>approvalType: CHEM</li><li>approvalNumber: <a href=\"NamingSystem-sa-approval-number.html\" title=\"Special Authority Approval Number. Carried on ClaimResponse.identifier and ClaimResponse.preAuthRef (D23).\">SAApprovalNumber</a>/25SA0001234</li><li>effectiveDate: 2026-02-01</li><li>expiryDate: 2027-02-01</li></ul></blockquote><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\u00a0(use:\u00a0official))</a></p><p><b>created</b>: 2026-10-14 10:35:07+1300</p><p><b>insurer</b>: Health New Zealand | Te Whatu Ora</p><p><b>requestor</b>: <a href=\"Practitioner-sa-example-applicant.html\">Jane Smith (official) (https://standards.digital.health.nz/ns/hpi-person-id#HPIProvider#99ZZZZ\u00a0(use:\u00a0official))</a></p><p><b>request</b>: Identifier: <a href=\"NamingSystem-sa-application-number.html\" title=\"Special Authority Application Number allocated by the special-authority-application-service. The only identifier carried on Claim.identifier (D23).\">SAApplicationNumber</a>/000123457</p><p><b>outcome</b>: Processing Complete</p><p><b>disposition</b>: An approval already exists for this patient and form.</p><h3>Errors</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://fhir-ig.digital.health.nz/special-authority/CodeSystem/sa-outcome-code URNSA011}\">URNSA011</span></td></tr></table></div>"
  },
  "extension" : [{
    "extension" : [{
      "url" : "status",
      "valueCode" : "DONE"
    },
    {
      "url" : "outcome",
      "valueCode" : "DECLINED"
    },
    {
      "url" : "outcomeCode",
      "valueCoding" : {
        "system" : "https://fhir-ig.digital.health.nz/special-authority/CodeSystem/sa-outcome-code",
        "code" : "URNSA011"
      }
    },
    {
      "url" : "outcomeReason",
      "valueString" : "An approval already exists for this patient and form."
    }],
    "url" : "https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/application-status"
  },
  {
    "extension" : [{
      "url" : "approvalType",
      "valueCode" : "CHEM"
    },
    {
      "url" : "approvalNumber",
      "valueIdentifier" : {
        "system" : "https://fhir-ig.digital.health.nz/special-authority/ns/approval-number",
        "value" : "25SA0001234"
      }
    },
    {
      "url" : "effectiveDate",
      "valueDate" : "2026-02-01"
    },
    {
      "url" : "expiryDate",
      "valueDate" : "2027-02-01"
    }],
    "url" : "https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/existing-approval"
  }],
  "status" : "active",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
      "code" : "pharmacy"
    }]
  },
  "use" : "preauthorization",
  "patient" : {
    "reference" : "Patient/sa-example-patient"
  },
  "created" : "2026-10-14T10:35:07+13:00",
  "insurer" : {
    "display" : "Health New Zealand | Te Whatu Ora"
  },
  "requestor" : {
    "reference" : "Practitioner/sa-example-applicant"
  },
  "request" : {
    "identifier" : {
      "system" : "https://fhir-ig.digital.health.nz/special-authority/ns/application-number",
      "value" : "000123457"
    }
  },
  "outcome" : "complete",
  "disposition" : "An approval already exists for this patient and form.",
  "error" : [{
    "code" : {
      "coding" : [{
        "system" : "https://fhir-ig.digital.health.nz/special-authority/CodeSystem/sa-outcome-code",
        "code" : "URNSA011"
      }]
    }
  }]
}