Terminology
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| Financial Management Work Group | Maturity Level : N/A | Standards Status : Informative |
Raw XML ( canonical form + also see XML Format Specification )
Definition for Code SystemEligibilityRequestPurpose
<?xml version="1.0" encoding="UTF-8"?> <CodeSystem xmlns="http://hl7.org/fhir"> <id value="eligibilityrequest-purpose"/> <meta><lastUpdated value="2022-12-14T07:12:54.019+11:00"/> <profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">This code system http://hl7.org/fhir/eligibilityrequest-purpose defines the following codes:<p> This code system <code> http://hl7.org/fhir/eligibilityrequest-purpose</code> defines the following codes: </p> <table class="codes"><tr><td style="white-space:nowrap"><b> Code</b></td><td><b> Display</b></td><td><b> Definition</b></td></tr><tr><td style="white-space:nowrap">auth-requirements<a name="eligibilityrequest-purpose-auth-requirements"> </a></td><td> Coverage auth-requirements</td>The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested.<td> The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested.</td> </tr><tr><td style="white-space:nowrap">benefits<a name="eligibilityrequest-purpose-benefits"> </a></td><td> Coverage benefits</td>The plan benefits and optionally benefits consumed for the listed, or discovered if specified, converages are requested.<td> The plan benefits and optionally benefits consumed for the listed, or discovered if specified, converages are requested.</td> </tr><tr><td style="white-space:nowrap">discovery<a name="eligibilityrequest-purpose-discovery"> </a></td><td> Coverage Discovery</td>The insurer is requested to report on any coverages which they are aware of in addition to any specifed.<td> The insurer is requested to report on any coverages which they are aware of in addition to any specifed.</td> </tr><tr><td style="white-space:nowrap">validation<a name="eligibilityrequest-purpose-validation"> </a></td><td> Coverage Validation</td><td> A check that the specified coverages are in-force is requested.</td></tr></table></div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="fm"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="trial-use"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="2"/> </extension> <url value="http://hl7.org/fhir/eligibilityrequest-purpose"/> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:oid:2.16.840.1.113883.4.642.4.1183"/> </identifier><version value="5.0.0-snapshot3"/> <name value="EligibilityRequestPurpose"/> <title value="EligibilityRequestPurpose"/><status value="active"/> <experimental value="false"/><date value="2021-01-05T10:01:24+11:00"/> <publisher value="HL7 (FHIR Project)"/> <contact> <telecom> <system value="url"/> <value value="http://hl7.org/fhir"/> </telecom> <telecom> <system value="email"/> <value value="fhir@lists.hl7.org"/> </telecom> </contact> <description value="A code specifying the types of information being requested."/> <jurisdiction> <coding> <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/> <code value="001"/> <display value="World"/> </coding> </jurisdiction> <caseSensitive value="true"/> <valueSet value="http://hl7.org/fhir/ValueSet/eligibilityrequest-purpose"/> <content value="complete"/> <concept> <code value="auth-requirements"/> <display value="Coverage auth-requirements"/>The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested.<definition value="The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested."/> </concept> <concept> <code value="benefits"/> <display value="Coverage benefits"/>The plan benefits and optionally benefits consumed for the listed, or discovered if specified, converages are requested.<definition value="The plan benefits and optionally benefits consumed for the listed, or discovered if specified, converages are requested."/> </concept> <concept> <code value="discovery"/> <display value="Coverage Discovery"/>The insurer is requested to report on any coverages which they are aware of in addition to any specifed.<definition value="The insurer is requested to report on any coverages which they are aware of in addition to any specifed."/> </concept> <concept> <code value="validation"/> <display value="Coverage Validation"/> <definition value="A check that the specified coverages are in-force is requested."/> </concept> </ CodeSystem >
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.
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hl7.fhir.r4b.core#4.3.0
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hl7.fhir.core#5.0.0-snapshot3
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14,
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