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 Application ClaimResponse - Declined (existing Approval) - XML Representation

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<ClaimResponse xmlns="http://hl7.org/fhir">
  <id value="sa-example-cr-declined"/>
  <meta>
    <profile
             value="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/sa-application-claimresponse"/>
  </meta>
  <text>
    <status value="extensions"/>
    <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 (use: official))</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 (use: official))</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>
  </text>
  <extension
             url="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/application-status">
    <extension url="status">
      <valueCode value="DONE"/>
    </extension>
    <extension url="outcome">
      <valueCode value="DECLINED"/>
    </extension>
    <extension url="outcomeCode">
      <valueCoding>
        <system
                value="https://fhir-ig.digital.health.nz/special-authority/CodeSystem/sa-outcome-code"/>
        <code value="URNSA011"/>
      </valueCoding>
    </extension>
    <extension url="outcomeReason">
      <valueString
                   value="An approval already exists for this patient and form."/>
    </extension>
  </extension>
  <extension
             url="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/existing-approval">
    <extension url="approvalType">
      <valueCode value="CHEM"/>
    </extension>
    <extension url="approvalNumber">
      <valueIdentifier>
        <system
                value="https://fhir-ig.digital.health.nz/special-authority/ns/approval-number"/>
        <value value="25SA0001234"/>
      </valueIdentifier>
    </extension>
    <extension url="effectiveDate">
      <valueDate value="2026-02-01"/>
    </extension>
    <extension url="expiryDate">
      <valueDate value="2027-02-01"/>
    </extension>
  </extension>
  <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="2026-10-14T10:35:07+13:00"/>
  <insurer>
    <display value="Health New Zealand | Te Whatu Ora"/>
  </insurer>
  <requestor>🔗 
    <reference value="Practitioner/sa-example-applicant"/>
  </requestor>
  <request>
    <identifier>
      <system
              value="https://fhir-ig.digital.health.nz/special-authority/ns/application-number"/>
      <value value="000123457"/>
    </identifier>
  </request>
  <outcome value="complete"/>
  <disposition value="An approval already exists for this patient and form."/>
  <error>
    <code>
      <coding>
        <system
                value="https://fhir-ig.digital.health.nz/special-authority/CodeSystem/sa-outcome-code"/>
        <code value="URNSA011"/>
      </coding>
    </code>
  </error>
</ClaimResponse>