11. 2. Health insurance information
(Japanese version) module Version 1.1
Namespace declaration
Namespace declaration of this module
is as follows.
xmlns:mmlHi="http://www.medxml.net/MML/ContentModule/HealthInsurance/1.1"
Element list
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Element
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Attribute
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Data type
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Occurrence
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Table
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1
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mmlHi:HealthInsuranceModule
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mmlHi:countryType
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string
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#IMPLIED
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1.1.
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mmlHi:insuranceClass
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string
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?
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mmlHi:ClassCode
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string
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#REQUIRED
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mmlHi:tableId
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string
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#REQUIRED
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MML0031
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1.2.
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mmlHi:insuranceNumber
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string
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1.3.
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mmlHi:clientId
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1.3.1.
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mmlHi:group
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string
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1.3.2.
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mmlHi:number
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string
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1.4.
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mmlHi:familyClass
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boolean
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1.5.
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mmlHi:clientInfo
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?
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1.5.1.
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mmlHi:personName
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?
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1.5.1.1.
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mmlNm:Name
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*
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1.5.2.
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mmlHi:addresses
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?
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1.5.2.1.
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mmlAd:Address
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*
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1.5.3.
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mmlHi:phones
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?
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1.5.3.1.
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mmlPh:Phone
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*
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1.6.
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mmlHi:continuedDiseases
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?
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1.6.1.
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mmlHi:diseases
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string
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+
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1.7.
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mmlHi:startDate
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date
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1.8.
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mmlHi:expiredDate
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date
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1.9.
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mmlHi:paymentInRatio
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decimal
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?
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1.10.
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mmlHi:paymentOutRatio
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decimal
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?
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1.11.
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mmlHi:insuredInfo
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?
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1.11.1.
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mmlHi:facility
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?
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1.11.1.1.
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mmlFc:Facility
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?
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1.11.2.
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mmlHi:addresses
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?
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1.11.2.1.
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mmlAd:Address
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*
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1.11.3.
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mmlHi:phones
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?
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1.11.3.1.
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mmlPh:Phone
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*
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1.12.
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mmlHi:workInfo
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?
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1.12.1.
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mmlHi:facility
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?
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1.12.1.1.
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mmlFc:Facility
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?
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1.12.2.
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mmlHi:addresses
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?
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1.12.2.1.
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mmlAd:Address
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*
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1.12.3.
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mmlHi:phones
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?
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1.12.3.1.
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mmlPh:Phone
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*
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1.13.
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mmlHi:publicInsurance
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?
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1.13.1.
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mmlHi:publicInsuranceItem
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+
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mmlHi:priority
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string
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#REQUIRED
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1.13.1.1.
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mmlHi:providerName
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string
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?
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1.13.1.2.
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mmlHi:provider
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string
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1.13.1.3.
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mmlHi:recipient
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string
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1.13.1.4.
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mmlHi:startDate
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date
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1.13.1.5.
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mmlHi:expiredDate
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date
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1.13.1.6.
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mmlHi:paymentRatio
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decimal
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?
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mmlHi:RatioType
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string
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#REQUIRED
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MML0032
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Occurrence; blank: 1 appearance without fail, ?: 0 or 1 appearance, +: 1 or more appearances, *: 0 or more appearances
#REQUIRED: Required attribute, #IMPLIED: Omissible attribute
1.mmlHi:HealthInsuranceModule
Description: combination of available
health insurance and public insurance.
Omission: not allowed
Repetition: allowed. If multiple
combinations are available, <paragraph> should be repeated.
For example, if the following 3
insurance types are used;
1. National health insurance only
2. National health insurance and
public insurance (tuberculosis)
3. Continued social insurance
3 items of information should be
described separately by repeating the <paragraph> 3 times.
Attribute: the following attribute
is provided to indicate that this module is unique to Japan.
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Attribute name
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Data type
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Omission
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Remarks
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MmlHi:countryType
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string
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#IMPLIED
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Country type. Enter JPN
for Japan.
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Example:
<mmlHi:HealthInsuranceModule mmlHi:countryType = "JPN">
1.1.mmlHi:insuranceClass
Description: health insurance class.
In principle, table MML0031 is used, but in case there is a need of expanding
the table specifically to users due to local public insurance, etc. use another
table and enter the name of the new table.
Data type: string
Omission: allowed
Attribute:
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Attribute name
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Data type
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Omission
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Table
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mmlHi:ClassCode
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string
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#REQUIRED
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mmlHi:tableId
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string
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#REQUIRED
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MML0031
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Example:
<mmlHi:insuranceClass
mmlHi:ClassCode="00" mmlHi:tableId="MML0031">national
health insurance</mmlHi:insuranceClass>
1.2.mmlHi:insuranceNumber
Description: health insurance number
Data type: string
Omission: not allowed
Example:
<mmlHi:insuranceNumber>8001</mmlHi:insuranceNumber>
1.3.mmlHi:clientId
Description: information of an insured
person
Omission: not allowed
1.3.1.mmlHi:group
Description: insured person symbol
Data type: string
Omission: not allowed
1.3.2.mmlHi:number
Description: insured person number
Data type: string
Omission: not allowed
Example:
<mmlHi:clientId>
<mmlHi:group>MSMHS</mmlHi:group>
<mmlHi:number>421</mmlHi:number>
</mmlHi:clientId>
1.4.mmlHi:familyClass
Description: indication of an insured
person or family member. true: insured person, false: family
Data type: boolean
Omission: not allowed
Example: a case of an insured person
<mmlHi:familyClass>true</mmlHi:familyClass>
Example: a case of a family member
<mmlHi:familyClass>false</mmlHi:familyClass>
1.5.mmlHi:clientInfo
Description: information of an insured
person
Omission: allowed
1.5.1.mmlHi:personName
Description: parent element for the
input of insured person's names described below.
Omission: allowed.
1.5.1.1.mmlNm:Name
Description: name. Refer to the MML
common format (Name expression format) for the structure.
Omission: allowed
Repetition: allowed. If multiple expression methods are available, the element should be repeated.
1.5.2. mmlHi:addresses
Description: parent element for the
input of insured peoson's addresses described below.
Omission: allowed
1.5.2.1.mmlAd:Address
Description: address. Refer to the
MML common format (Address expression format) for the structure.
Omission: allowed
Repetition: allowed. If multiple
addresses or multiple expression methods are available, the element should
be repeated.
1.5.3.mmlHi:phones
Description: parent element for the
input of insured person's telephone numbers described below.
Omission: allowed
1.5.3.1.mmlPh:Phone
Description: telephone number. Refer
to the MML common format (Telephone number format) for the structure.
Omission: allowed
Repetition: allowed. If multiple
telephone numbers are available, the element should be repeated.
1.6.mmlHi:continuedDiseases
Description: continued disease information
Omission: allowed
1.6.1.mmlHi:diseases
Description: name of an applicable
continued disease
Data type: string
Omission: not allowed
Repetition: allowed. If multiple
continued diseases are available, the element should be repeated.
Example: Diabetes mellitus and
hypertension
<mmlHi:continuedDiseases>
<mmlHi:diseases>diabetes mellitus</mmlHi:diseases>
<mmlHi:diseases>hypertension</mmlHi:diseases>
</mmlHi:continuedDiseases>
1.7.mmlHi:startDate
Description: start date (issue date)
Data type: date Format: CCYY-MM-DD
Omission: not allowed
Example:
<mmlHi:startDate>1995-04-01</mmlHi:startDate>
1.8.mmlHi:expiredDate
Description: expiration date
Data type: date Format: CCYY-MM-DD
Omission: not allowed
Example:
<mmlHi:expiredDate>1999-09-30</mmlHi:expiredDate>
1.9.mmlHi:paymentInRatio
Description: insured person's payment
ratio for an inpatient care. 0 [.0] [0] - 1 [.0] [0] (Example: “0.3” for 30
% payment)
Data type: decimal
Omission: allowed
Example: 20 % of payment ratio
<mmlHi:paymentInRatio>0.2</mmlHi:paymentInRatio>
1.10.mmlHi:paymentOutRatio
Description: insured person's payment
ratio for an outpatient care. 0 [.0] [0] - 1 [.0] [0] (Example: “0.3” for
30 % payment)
Data type: decimal
Omission: allowed
Example: 20 % of payment ratio
<mmlHi:paymentOutRatio>0.2</mmlHi:paymentOutRatio>
1.11.mmlHi:insuredInfo
Description: insurer's information
Omission: allowed
1.11.1.mmlHi:facility
Description: parent element for the
input of insurer's information described below.
Omission: allowed.
1.11.1.1.mmlFc:Facility
Description: facility information.
Refer to the MML common format (Facility information format) for the structure.
Omission: allowed
1.11.2. mmlHi:addresses
Description: parent element for the
input of insurer’s addresses described below.
Omission: allowed
1.11.2.1.mmlAd:Address
Description: address. Refer to
the MML common format (Address expression format) for the structure.
Omission: allowed
Repetition: allowed. If multiple
addresses or multiple expression methods are available, the element should
be repeated.
1.11.3.mmlHi:phones
Description: parent element for the
input of insurer's telephone numbers described below.
Omission: allowed
1.11.3.1.mmlPh:Phone
Description: telephone number.
Refer to the MML common format (Telephone number format) for the structure.
Omission: allowed
Repetition: allowed. If multiple
telephone numbers are available, the element should be repeated.
1.12.mmlHi:workInfo
Description: place of business information
of an insured person.
Omission: allowed
1.12.1.mmlHi:facility
Description: parent element for the
input of place of business information described below.
Omission: allowed.
1.12.1.1.mmlFc:Facility
Description: facility information.
Refer to the MML common format (Facility information format) for the structure.
Omission: allowed
1.12.2.mmlHi:addresses
Description: parent element for the
input of addresses of place of business described below.
Omission: allowed
1.12.2.1.mmlAd:Address
Description: address. Refer to
the MML common format (Address expression format) for the structure.
Omission: allowed
Repetition: allowed. If multiple
addresses or multiple expression methods are available, the element should
be repeated.
1.12.3.mmlHi:phones
Description: parent element for the
input of telephone numbers of place of business described below.
Omission: allowed
1.12.3.1.mmlPh:Phone
Description: telephone number.
Refer to the MML common format (Telephone number format) for the structure.
Omission: allowed
Repetition: allowed. If multiple
telephone numbers are available, the element should be repeated.
1.13.mmlHi:publicInsurance
Description: medical information
covered by public insurance
Omission: allowed
1.13.1.mmlHi:publicInsuranceItem
Description: public insurance item
Omission: not allowed
Repetition: allowed. If multiple
types of public insurance are available, the element should be repeated.
Attribute:
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Attribute name
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Data type
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Omission
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Remarks
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mmlHi:priority
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string
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#REQUIRED
|
Priority of multiple
public insurances
Enter integers starting from
1
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Example:
<mmlHi:publicInsuranceItem mmlHi:priority = "1">
1.13.1.1.mmlHi:providerName
Description: public insurance name
Data type: string
Omission: allowed
1.13.1.2.mmlHi:provider
Description: provider number
Data type: string
Omission: not allowed
1.13.1.3.mmlHi:recipient
Description: recipient number
Data type: string
Omission: not allowed
1.13.1.4.mmlHi:startDate
Description: start date
Data type: date
Omission: not allowed
1.13.1.5.mmlHi:expireDate
Description: expiration date
Data type: date
Omission: not allowed
1.13.1.6.mmlHi:paymentRatio
Despription: payment ratio or amount
Data type: decimal
Omission: allowed
Attribute:
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Attribute name
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Data type
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Omission
|
Table
|
Remarks
|
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mmlHi:ratioType
|
String
|
#REQUIRED
|
MML0032
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Payment amount or ratio
is described.
|
Example:
In case payment type is “fixed”
and that the amount is 10,000 yen,
<mmlHi:paymentRatio mmlHi:ratioType="fix">10000</ mmlHi:paymentRatio>
In case payment type is
“ratio” and that the ratio is 5 %,
<mmlHi:paymentRatio mmlHi:ratioType="ratio">0.05</ mmlHi:paymentRatio>
Example:
<mmlHi:publicInsurance>
<mmlHi:publicInsuranceItem mmlHi:priority = "1">
<mmlHi:providerName>public
insurance</mmlHi:providerName>
<mmlHi:provider>15450034</mmlHi:provider>
<mmlHi:recipient>0009043</mmlHi:recipient>
<mmlHi:startDate>1997-09-30</mmlHi:startDate>
<mmlHi:expiredDate>1999-09-30</mmlHi:expiredDate>
<mmlHi:paymentRatio mmlHi:RatioType="fix">10000</mmlHi:paymentRatio>
</mmlHi:publicInsuranceItem>
</mmlHi:publicInsurance>
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