FHIR Implementation Guide for ABDM
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This page is part of the FHIR Implementation Guide for ABDM (v6.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: TaskBundleForPaymentNoticeRequest-example-01 - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="TaskBundleForPaymentNoticeRequest-example-01"/>
  <meta>
    <profile
             value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/TaskBundle"/>
    <security>
      <system
              value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/>
      <code value="V"/>
      <display value="very restricted"/>
    </security>
  </meta>
  <identifier>
    <value value="bc3c6c57-2053-4d0e-ac40-139ccccff645"/>
  </identifier>
  <type value="collection"/>
  <entry>
    <fullUrl value="urn:uuid:c147ae4a-f6c1-4375-a5bb-cedf69235521"/>
    <resource>
      <Task>
        <id value="c147ae4a-f6c1-4375-a5bb-cedf69235521"/>
        <meta>
          <profile
                   value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Task"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Task_c147ae4a-f6c1-4375-a5bb-cedf69235521"> </a><p class="res-header-id"><b>Generated Narrative: Task c147ae4a-f6c1-4375-a5bb-cedf69235521</b></p><a name="c147ae4a-f6c1-4375-a5bb-cedf69235521"> </a><a name="hcc147ae4a-f6c1-4375-a5bb-cedf69235521"> </a><a name="c147ae4a-f6c1-4375-a5bb-cedf69235521-hi-IN"> </a><p><b>status</b>: Requested</p><p><b>intent</b>: order</p><p><b>code</b>: <span title="Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-task-codes deliver}">deliver</span></p><p><b>description</b>: payment status Check</p><p><b>authoredOn</b>: 2025-03-07</p><p><b>requester</b>: <a href="Bundle-TaskBundleForPaymentNoticeRequest-example-01.html#urn-uuid-a5b973a0-7274-4158-9f47-398be057b8e1">Organization-insurance-company</a></p><p><b>owner</b>: <a href="Bundle-TaskBundleForPaymentNoticeRequest-example-01.html#urn-uuid-5adfff18-d900-4016-bfa1-987af186bf8f">Organization-hospital</a></p><h3>Inputs</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/financialtaskinputtype status}">Status code</span></td><td><a href="Bundle-TaskBundleForPaymentNoticeRequest-example-01.html#urn-uuid-dd6916d4-485d-45d3-bcc9-f067cab42a70">PaymentNotice</a></td></tr></table></div>
        </text>
        <status value="requested"/>
        <intent value="order"/>
        <code>
          <coding>
            <system
                    value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-task-codes"/>
            <code value="deliver"/>
          </coding>
        </code>
        <description value="payment status Check"/>
        <authoredOn value="2025-03-07"/>
        <requester>
          <reference value="urn:uuid:a5b973a0-7274-4158-9f47-398be057b8e1"/>
          <display value="Organization-insurance-company"/>
        </requester>
        <owner>
          <reference value="urn:uuid:5adfff18-d900-4016-bfa1-987af186bf8f"/>
          <display value="Organization-hospital"/>
        </owner>
        <input>
          <type>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/financialtaskinputtype"/>
              <code value="status"/>
            </coding>
          </type>
          <valueReference>
            <reference value="urn:uuid:dd6916d4-485d-45d3-bcc9-f067cab42a70"/>
            <display value="PaymentNotice"/>
          </valueReference>
        </input>
      </Task>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:dd6916d4-485d-45d3-bcc9-f067cab42a70"/>
    <resource>
      <PaymentNotice>
        <id value="dd6916d4-485d-45d3-bcc9-f067cab42a70"/>
        <meta>
          <profile
                   value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/PaymentNotice"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="PaymentNotice_dd6916d4-485d-45d3-bcc9-f067cab42a70"> </a><p class="res-header-id"><b>Generated Narrative: PaymentNotice dd6916d4-485d-45d3-bcc9-f067cab42a70</b></p><a name="dd6916d4-485d-45d3-bcc9-f067cab42a70"> </a><a name="hcdd6916d4-485d-45d3-bcc9-f067cab42a70"> </a><a name="dd6916d4-485d-45d3-bcc9-f067cab42a70-hi-IN"> </a><p><b>identifier</b>: <code>http://benefitsinc.com/paymentnotice</code>/776543</p><p><b>status</b>: Active</p><p><b>created</b>: 2025-03-07 14:58:58+0530</p><p><b>payment</b>: <a href="Bundle-TaskBundleForPaymentNoticeRequest-example-01.html#urn-uuid-498c0785-7cb6-4e18-9848-e61f515ca257">PaymentReconciliation</a></p><p><b>paymentDate</b>: 2025-03-07</p><p><b>recipient</b>: <a href="Bundle-TaskBundleForPaymentNoticeRequest-example-01.html#urn-uuid-5adfff18-d900-4016-bfa1-987af186bf8f">Organization-hospital</a></p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>180000</td><td>Indian rupee</td></tr></table><p><b>paymentStatus</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/paymentstatus paid}">Paid</span></p></div>
        </text>
        <identifier>
          <system value="http://benefitsinc.com/paymentnotice"/>
          <value value="776543"/>
        </identifier>
        <status value="active"/>
        <created value="2025-03-07T14:58:58.181+05:30"/>
        <payment>
          <reference value="urn:uuid:498c0785-7cb6-4e18-9848-e61f515ca257"/>
          <display value="PaymentReconciliation"/>
        </payment>
        <paymentDate value="2025-03-07"/>
        <recipient>
          <reference value="urn:uuid:5adfff18-d900-4016-bfa1-987af186bf8f"/>
          <display value="Organization-hospital"/>
        </recipient>
        <amount>
          <value value="180000"/>
          <currency value="INR"/>
        </amount>
        <paymentStatus>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/paymentstatus"/>
            <code value="paid"/>
          </coding>
        </paymentStatus>
      </PaymentNotice>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:a5b973a0-7274-4158-9f47-398be057b8e1"/>
    <resource>
      <Organization>
        <id value="a5b973a0-7274-4158-9f47-398be057b8e1"/>
        <meta>
          <profile
                   value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_a5b973a0-7274-4158-9f47-398be057b8e1"> </a><p class="res-header-id"><b>Generated Narrative: Organization a5b973a0-7274-4158-9f47-398be057b8e1</b></p><a name="a5b973a0-7274-4158-9f47-398be057b8e1"> </a><a name="hca5b973a0-7274-4158-9f47-398be057b8e1"> </a><a name="a5b973a0-7274-4158-9f47-398be057b8e1-hi-IN"> </a><p><b>identifier</b>: Registry of Hospitals in Network of Insurance (ROHINI) ID/4567878</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/organization-type ins}">Insurance Company</span></p><p><b>name</b>: XYZ Insurance Co. Ltd.</p><p><b>telecom</b>: <a href="tel:+9124326341234">+91 243 2634 1234</a>, <a href="mailto:contact@xyz.org">contact@xyz.org</a></p></div>
        </text>
        <identifier>
          <type>
            <coding>
              <system
                      value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code"/>
              <code value="ROHINI"/>
              <display
                       value="Registry of Hospitals in Network of Insurance (ROHINI) ID"/>
            </coding>
          </type>
          <system value="https://rohini.iib.gov.in/"/>
          <value value="4567878"/>
        </identifier>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/organization-type"/>
            <code value="ins"/>
            <display value="Insurance Company"/>
          </coding>
        </type>
        <name value="XYZ Insurance Co. Ltd."/>
        <telecom>
          <system value="phone"/>
          <value value="+91 243 2634 1234"/>
          <use value="work"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="contact@xyz.org"/>
          <use value="work"/>
        </telecom>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:5adfff18-d900-4016-bfa1-987af186bf8f"/>
    <resource>
      <Organization>
        <id value="5adfff18-d900-4016-bfa1-987af186bf8f"/>
        <meta>
          <profile
                   value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_5adfff18-d900-4016-bfa1-987af186bf8f"> </a><p class="res-header-id"><b>Generated Narrative: Organization 5adfff18-d900-4016-bfa1-987af186bf8f</b></p><a name="5adfff18-d900-4016-bfa1-987af186bf8f"> </a><a name="hc5adfff18-d900-4016-bfa1-987af186bf8f"> </a><a name="5adfff18-d900-4016-bfa1-987af186bf8f-hi-IN"> </a><p><b>identifier</b>: Provider number/45675454</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/organization-type prov}">Healthcare Provider</span></p><p><b>name</b>: XYZ Hospital Co. Ltd.</p><p><b>telecom</b>: <a href="tel:+9124326341278">+91 243 2634 1278</a>, <a href="mailto:contact@xyz.org">contact@xyz.org</a></p></div>
        </text>
        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="PRN"/>
              <display value="Provider number"/>
            </coding>
          </type>
          <system value="https://facility.ndhm.gov.in"/>
          <value value="45675454"/>
        </identifier>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/organization-type"/>
            <code value="prov"/>
            <display value="Healthcare Provider"/>
          </coding>
        </type>
        <name value="XYZ Hospital Co. Ltd."/>
        <telecom>
          <system value="phone"/>
          <value value="+91 243 2634 1278"/>
          <use value="work"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="contact@xyz.org"/>
          <use value="work"/>
        </telecom>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:498c0785-7cb6-4e18-9848-e61f515ca257"/>
    <resource>
      <PaymentReconciliation>
        <id value="498c0785-7cb6-4e18-9848-e61f515ca257"/>
        <meta>
          <profile
                   value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/PaymentReconciliation"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="PaymentReconciliation_498c0785-7cb6-4e18-9848-e61f515ca257"> </a><p class="res-header-id"><b>Generated Narrative: PaymentReconciliation 498c0785-7cb6-4e18-9848-e61f515ca257</b></p><a name="498c0785-7cb6-4e18-9848-e61f515ca257"> </a><a name="hc498c0785-7cb6-4e18-9848-e61f515ca257"> </a><a name="498c0785-7cb6-4e18-9848-e61f515ca257-hi-IN"> </a><p><b>identifier</b>: <code>http://www.BenefitsInc.com/fhir/enrollmentresponse</code>/781234</p><p><b>status</b>: Active</p><p><b>period</b>: 2025-03-01 11:01:00+0500 --&gt; 2025-03-07 11:01:00+0500</p><p><b>created</b>: 2025-03-07</p><p><b>paymentIssuer</b>: <a href="Bundle-TaskBundleForPaymentNoticeRequest-example-01.html#urn-uuid-a5b973a0-7274-4158-9f47-398be057b8e1">Organization-Insurance-Company</a></p><p><b>requestor</b>: <a href="Bundle-TaskBundleForPaymentNoticeRequest-example-01.html#urn-uuid-5adfff18-d900-4016-bfa1-987af186bf8f">Organization-hospital</a></p><p><b>outcome</b>: Processing Complete</p><p><b>disposition</b>: 2025 march month settlement.</p><p><b>paymentDate</b>: 2025-03-07</p><h3>PaymentAmounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>180000</td><td>Indian rupee</td></tr></table><p><b>paymentIdentifier</b>: UTRNUMBER2920287229</p><blockquote><p><b>detail</b></p><p><b>identifier</b>: CLAIMREFNUM7612345</p><p><b>type</b>: <span title="Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-payment-type approvedAmount}">Approved Amount</span></p><p><b>date</b>: 2024-03-31</p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>90000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>detail</b></p><p><b>identifier</b>: CLAIMREFNUM7612345</p><p><b>type</b>: <span title="Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-payment-type tds}">TDS Deduction</span></p><p><b>date</b>: 2024-03-31</p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>9000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>detail</b></p><p><b>identifier</b>: CLAIMREFNUM6789054</p><p><b>type</b>: <span title="Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-payment-type approvedAmount}">Approved Amount</span></p><p><b>date</b>: 2024-03-31</p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>110000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>detail</b></p><p><b>identifier</b>: CLAIMREFNUM6789054</p><p><b>type</b>: <span title="Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-payment-type tds}">TDS Deduction</span></p><p><b>date</b>: 2024-03-31</p><h3>Amounts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>11000</td><td>Indian rupee</td></tr></table></blockquote></div>
        </text>
        <identifier>
          <system value="http://www.BenefitsInc.com/fhir/enrollmentresponse"/>
          <value value="781234"/>
        </identifier>
        <status value="active"/>
        <period>
          <start value="2025-03-01T11:01:00+05:00"/>
          <end value="2025-03-07T11:01:00+05:00"/>
        </period>
        <created value="2025-03-07"/>
        <paymentIssuer>
          <reference value="urn:uuid:a5b973a0-7274-4158-9f47-398be057b8e1"/>
          <display value="Organization-Insurance-Company"/>
        </paymentIssuer>
        <requestor>
          <reference value="urn:uuid:5adfff18-d900-4016-bfa1-987af186bf8f"/>
          <display value="Organization-hospital"/>
        </requestor>
        <outcome value="complete"/>
        <disposition value="2025 march month settlement."/>
        <paymentDate value="2025-03-07"/>
        <paymentAmount>
          <value value="180000"/>
          <currency value="INR"/>
        </paymentAmount>
        <paymentIdentifier>
          <value value="UTRNUMBER2920287229"/>
        </paymentIdentifier>
        <detail>
          <identifier>
            <value value="CLAIMREFNUM7612345"/>
          </identifier>
          <type>
            <coding>
              <system
                      value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-payment-type"/>
              <code value="approvedAmount"/>
              <display value="Approved Amount"/>
            </coding>
          </type>
          <date value="2024-03-31"/>
          <amount>
            <value value="90000"/>
            <currency value="INR"/>
          </amount>
        </detail>
        <detail>
          <identifier>
            <value value="CLAIMREFNUM7612345"/>
          </identifier>
          <type>
            <coding>
              <system
                      value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-payment-type"/>
              <code value="tds"/>
              <display value="TDS Deduction"/>
            </coding>
          </type>
          <date value="2024-03-31"/>
          <amount>
            <value value="9000"/>
            <currency value="INR"/>
          </amount>
        </detail>
        <detail>
          <identifier>
            <value value="CLAIMREFNUM6789054"/>
          </identifier>
          <type>
            <coding>
              <system
                      value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-payment-type"/>
              <code value="approvedAmount"/>
              <display value="Approved Amount"/>
            </coding>
          </type>
          <date value="2024-03-31"/>
          <amount>
            <value value="110000"/>
            <currency value="INR"/>
          </amount>
        </detail>
        <detail>
          <identifier>
            <value value="CLAIMREFNUM6789054"/>
          </identifier>
          <type>
            <coding>
              <system
                      value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-payment-type"/>
              <code value="tds"/>
              <display value="TDS Deduction"/>
            </coding>
          </type>
          <date value="2024-03-31"/>
          <amount>
            <value value="11000"/>
            <currency value="INR"/>
          </amount>
        </detail>
      </PaymentReconciliation>
    </resource>
  </entry>
</Bundle>