Release 5 FHIR CI-Build

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Example CoverageEligibilityResponse/E2502 (Turtle)

Maturity Level : N/A
Responsible Owner: Financial Management Work Group Standards Status : Informative Compartments : Patient , Practitioner

Raw Turtle (+ also see Turtle/RDF Format Specification )

General Person Primary Coverage with Benefit Details and new insurance 

@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .

@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

[a fhir:CoverageEligibilityResponse ;

<http://hl7.org/fhir/CoverageEligibilityResponse/E2502> a fhir:CoverageEligibilityResponse ;

  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "E2502"] ; # 
  fhir:text [
     fhir:status [ fhir:v "generated" ] ;
     fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the CoverageEligibilityResponse.</div>"

     fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the CoverageEligibilityResponse.</div>"^^rdf:XMLLiteral ]

  ] ; # 
  fhir:contained ( [
     a fhir:Coverage ;
     fhir:id [ fhir:v "coverage-1" ] ;
     fhir:identifier ( [
       fhir:system [ fhir:v "http://benefitsinc.com/certificate"^^xsd:anyURI ] ;

       fhir:system [
         fhir:v "http://benefitsinc.com/certificate"^^xsd:anyURI ;
         fhir:l <http://benefitsinc.com/certificate>
       ] ;

       fhir:value [ fhir:v "12345" ]
     ] ) ;
     fhir:status [ fhir:v "active" ] ;
     fhir:kind [ fhir:v "insurance" ] ;
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;

         fhir:system [
           fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
           fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>
         ] ;

         fhir:code [ fhir:v "EHCPOL" ]
       ] )
     ] ;
     fhir:subscriber [
       fhir:l <http://hl7.org/fhir/Patient/f201> ;

       fhir:reference [ fhir:v "Patient/f201" ]
     ] ;
     fhir:beneficiary [
       fhir:l <http://hl7.org/fhir/Patient/f201> ;

       fhir:reference [ fhir:v "Patient/f201" ]
     ] ;
     fhir:dependent [ fhir:v "1" ] ;
     fhir:relationship [
       fhir:coding ( [
         fhir:code [ fhir:v "self" ]
       ] )
     ] ;
     fhir:insurer [
       fhir:identifier [
         fhir:system [ fhir:v "http://www.bindb.com/bin"^^xsd:anyURI ] ;

         fhir:system [
           fhir:v "http://www.bindb.com/bin"^^xsd:anyURI ;
           fhir:l <http://www.bindb.com/bin>
         ] ;

         fhir:value [ fhir:v "123456" ]
       ]
     ] ;
     fhir:class ( [
       fhir:type [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>
           ] ;

           fhir:code [ fhir:v "EHCPOL" ]
         ] )
       ] ;
       fhir:value [
         fhir:value [ fhir:v "CBI35" ]
       ] ;
       fhir:name [ fhir:v "Corporate Baker's Inc. Plan#35" ]
     ] [
       fhir:type [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/coverage-class>
           ] ;

           fhir:code [ fhir:v "subplan" ]
         ] )
       ] ;
       fhir:value [
         fhir:value [ fhir:v "123" ]
       ] ;
       fhir:name [ fhir:v "Trainee Part-time Benefits" ]
     ] [
       fhir:type [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/coverage-class>
           ] ;

           fhir:code [ fhir:v "sequence" ]
         ] )
       ] ;
       fhir:value [
         fhir:value [ fhir:v "1" ]
       ]
     ] )
  ] ) ; # 
  fhir:identifier ( [
     fhir:system [ fhir:v "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse"^^xsd:anyURI ] ;

     fhir:system [
       fhir:v "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse"^^xsd:anyURI ;
       fhir:l <http://www.BenefitsInc.com/fhir/coverageeligibilityresponse>
     ] ;

     fhir:value [ fhir:v "8812342" ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:purpose ( [ fhir:v "validation"] [ fhir:v "benefits"] ) ; # 
  fhir:patient [
     fhir:l <http://hl7.org/fhir/Patient/f201> ;

     fhir:reference [ fhir:v "Patient/f201" ]
  ] ; # 
  fhir:created [ fhir:v "2014-09-16"^^xsd:date] ; # 
  fhir:requestor [
     fhir:identifier [
       fhir:system [ fhir:v "http://national.org/clinic"^^xsd:anyURI ] ;

       fhir:system [
         fhir:v "http://national.org/clinic"^^xsd:anyURI ;
         fhir:l <http://national.org/clinic>
       ] ;

       fhir:value [ fhir:v "OR1234" ]
     ]
  ] ; # 
  fhir:request [
     fhir:link <http://www.BenefitsInc.com/fhir/coverageeligibilityrequest/225476332405> ;

     fhir:l <http://www.BenefitsInc.com/fhir/coverageeligibilityrequest/225476332405> ;

     fhir:reference [ fhir:v "http://www.BenefitsInc.com/fhir/coverageeligibilityrequest/225476332405" ]
  ] ; # 
  fhir:outcome [ fhir:v "complete"] ; # 
  fhir:disposition [ fhir:v "Policy is currently in-force."] ; # 
  fhir:insurer [
     fhir:l <http://hl7.org/fhir/Organization/2> ;

     fhir:reference [ fhir:v "Organization/2" ]
  ] ; # 
  fhir:insurance ( [
     fhir:coverage [
       fhir:l <#coverage-1> ;

       fhir:reference [ fhir:v "#coverage-1" ]
     ] ;
     fhir:inforce [ fhir:v "true"^^xsd:boolean ] ;

     fhir:inforce [ fhir:v true ] ;

     fhir:item ( [
       fhir:category [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/ex-benefitcategory>
           ] ;

           fhir:code [ fhir:v "30" ] ;
           fhir:display [ fhir:v "Health Benefit Plan Coverage" ]
         ] )
       ] ;
       fhir:network [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-network>
           ] ;

           fhir:code [ fhir:v "in" ]
         ] )
       ] ;
       fhir:unit [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-unit>
           ] ;

           fhir:code [ fhir:v "individual" ]
         ] )
       ] ;
       fhir:term [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-term>
           ] ;

           fhir:code [ fhir:v "annual" ]
         ] )
       ] ;
       fhir:benefit ( [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "benefit" ]
           ] )
         ] ;
         fhir:allowed [
           a fhir:Money ;
           fhir:value [ fhir:v "500000"^^xsd:decimal ] ;
           fhir:currency [ fhir:v "USD" ]
         ] ;
         fhir:used [
           a fhir:Money ;
           fhir:value [ fhir:v "3748.00"^^xsd:decimal ] ;

           fhir:value [ fhir:v 3748.00 ] ;

           fhir:currency [ fhir:v "USD" ]
         ]
       ] [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "copay-maximum" ]
           ] )
         ] ;
         fhir:allowed [
           a fhir:Money ;
           fhir:value [ fhir:v "100"^^xsd:decimal ] ;
           fhir:currency [ fhir:v "USD" ]
         ]
       ] [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "copay-percent" ]
           ] )
         ] ;
         fhir:allowed [ fhir:v "20"^^xsd:nonNegativeInteger ]

         fhir:allowed [
           a fhir:UnsignedInt ;
           fhir:v "20"^^xsd:nonNegativeInteger
         ]

       ] )
     ] [
       fhir:category [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/ex-benefitcategory>
           ] ;

           fhir:code [ fhir:v "69" ] ;
           fhir:display [ fhir:v "Maternity" ]
         ] )
       ] ;
       fhir:network [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-network>
           ] ;

           fhir:code [ fhir:v "in" ]
         ] )
       ] ;
       fhir:unit [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-unit>
           ] ;

           fhir:code [ fhir:v "individual" ]
         ] )
       ] ;
       fhir:term [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-term>
           ] ;

           fhir:code [ fhir:v "annual" ]
         ] )
       ] ;
       fhir:benefit ( [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "benefit" ]
           ] )
         ] ;
         fhir:allowed [
           a fhir:Money ;
           fhir:value [ fhir:v "15000"^^xsd:decimal ] ;
           fhir:currency [ fhir:v "USD" ]
         ]
       ] )
     ] [
       fhir:category [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/ex-benefitcategory>
           ] ;

           fhir:code [ fhir:v "F3" ] ;
           fhir:display [ fhir:v "Dental Coverage" ]
         ] )
       ] ;
       fhir:network [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-network"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-network>
           ] ;

           fhir:code [ fhir:v "in" ]
         ] )
       ] ;
       fhir:unit [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-unit"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-unit>
           ] ;

           fhir:code [ fhir:v "individual" ]
         ] )
       ] ;
       fhir:term [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/benefit-term"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/benefit-term>
           ] ;

           fhir:code [ fhir:v "annual" ]
         ] )
       ] ;
       fhir:benefit ( [
         fhir:type [
           fhir:coding ( [
             fhir:code [ fhir:v "benefit" ]
           ] )
         ] ;
         fhir:allowed [
           a fhir:Money ;
           fhir:value [ fhir:v "2000"^^xsd:decimal ] ;
           fhir:currency [ fhir:v "USD" ]
         ]
       ] )
     ] [
       fhir:category [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;

           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/ex-benefitcategory>
           ] ;

           fhir:code [ fhir:v "F6" ] ;
           fhir:display [ fhir:v "Vision Coverage" ]
         ] )
       ] ;
       fhir:excluded [ fhir:v "true"^^xsd:boolean ] ;

       fhir:excluded [ fhir:v true ] ;

       fhir:name [ fhir:v "Vision" ] ; #   this benefit category is not covered under the plan  
       fhir:description [ fhir:v "Vision products and services such as exams, glasses and contact lenses." ]
     ] )
  ] ) ; # 
  fhir:form [
     fhir:coding ( [
       fhir:system [ fhir:v "http://national.org/form"^^xsd:anyURI ] ;

       fhir:system [
         fhir:v "http://national.org/form"^^xsd:anyURI ;
         fhir:l <http://national.org/form>
       ] ;

       fhir:code [ fhir:v "ELRSP/2017/01" ]
     ] )
  ]] . # 

  ] . # 

<http://hl7.org/fhir/Patient/f201> a fhir:Patient .

<http://hl7.org/fhir/Organization/2> a fhir:Organization .


# -------------------------------------------------------------------------------------

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.