Release 5 R6 Ballot (1st Draft)

This page is part of the FHIR Specification (v5.0.0: R5 - STU v6.0.0-ballot1: Release 6 Ballot (1st Draft) (see Ballot Notes ). This is the The current published version in it's permanent home (it will always be available at this URL). is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

Example CoverageEligibilityResponse/E2503 (XML)

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

Raw XML ( canonical form + also see XML Format Specification )

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General Person Primary Coverage with error (id = "E2503") 

<?xml version="1.0" encoding="UTF-8"?>

  
  
    
    
  
  
    
    
  
  
  
  
    
  
  
  
    
      
      
       
  
  
    
  
  
  
  
  
    
  
  
    
      
      
    
  
  
    
      
        
        
      
    
  

<CoverageEligibilityResponse xmlns="http://hl7.org/fhir">
  <id value="E2503"/> 

  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the CoverageEligibilityResponse.</div> 
  </text> 


  <identifier> 
    <system value="http://www.BenefitsInc.com/fhir/coverageeligibilityresponse"/> 
    <value value="8812343"/> 
  </identifier> 


  <status value="active"/> 


  <purpose value="validation"/> 


  <patient> 
    <reference value="Patient/f201"/> 
  </patient> 


  <created value="2014-09-16"/> 


  <requestor> 
    <identifier> 
      <system value="http://national.org/clinic"/> 
      <value value="OR1234"/> 
    </identifier>    
  </requestor> 


  <request> 
    <reference value="http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332406"/> 
  </request> 


  <outcome value="error"/> 

  
  <disposition value="Eligibiliy request could not be processed, please address errors before submitting."/> 


  <insurer> 
    <reference value="Organization/2"/> 
  </insurer> 


  <form> 
    <coding> 
      <system value="http://national.org/form"/> 
      <code value="ELRSP/2017/01"/> 
    </coding> 
  </form> 


  <error> 
    <code> 
      <coding> 
        <system value="http://terminology.hl7.org/CodeSystem/adjudication-error"/> 
        <code value="a001"/> 
      </coding> 
    </code> 
  </error> 





</

CoverageEligibilityResponse

>

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.