CoverageEligibilityRequest

CoverageEligibilityRequest

draftResource52 elementsv4.0.1

The CoverageEligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/StructureDefinition/CoverageEligibilityRequest
ID
CoverageEligibilityRequest
Type
Base Definition
Derivation
specialization
Publisher
Health Level Seven International (Financial Management)
Version
4.0.1
PathCard.TypeDescription
CoverageEligibilityRequest
0..*
CoverageEligibilityRequest resource
id
0..1
string
Logical id of this artifact
meta
0..1
Metadata about the resource
implicitRules
0..1
uri
A set of rules under which this content was created
language
0..1
code
Language of the resource contentpreferred: languages
text
0..1
Text summary of the resource, for human interpretation
contained
0..*
Resource
Contained, inline Resources
extension
0..*
Additional content defined by implementations
modifierExtension
0..*
Extensions that cannot be ignored
identifier
0..*
Business Identifier for coverage eligiblity request
status
1..1
code
active | cancelled | draft | entered-in-errorrequired: fm-status
priority
0..1
Desired processing priorityexample: process-priority
purpose
1..*
code
auth-requirements | benefits | discovery | validationrequired: eligibilityrequest-purpose
patient
1..1
Intended recipient of products and services
serviced[x]
0..1
datePeriod
Estimated date or dates of service
created
1..1
dateTime
Creation date
enterer
0..1
Author
provider
0..1
Party responsible for the request
insurer
1..1
Coverage issuer
facility
0..1
Servicing facility
supportingInfo
0..*
BackboneElement
Supporting information
insurance
0..*
BackboneElement
Patient insurance information
item
0..*
BackboneElement
Item to be evaluated for eligibiity