DSTU2
This
page
is
part
of
the
FHIR
Specification
(v0.0.82:
(v1.0.2:
DSTU
1).
2).
The
current
version
which
supercedes
this
version
is
5.0.0
.
For
a
full
list
of
available
versions,
see
the
Directory
of
published
versions
.
Page
versions:
R3
R2
This
resource
maintained
by
the
is
marked
as
a
draft
.
|
Financial
Management
Work
Group
|
Maturity Level : 0 | Compartments : Not linked to any defined compartments |
This resource provides the insurance eligibility details from the insurer regarding a specified coverage and optionally some class of service.
This resource has not yet undergone proper review by FM. At this time, it is to be considered as a draft.
The EligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an Eligibility Response, with information regarding whether the stated coverage is valid and in-force, and potentially the amount of coverage which may be available to any services classes identified in this request. Todo
This
resource
is
referenced
by
[EligibilityResponse]
eligibilityresponse
Structure
| Name | Flags | Card. | Type |
Description
&
Constraints
|
|---|---|---|---|---|
EligibilityRequest
|
Σ | DomainResource | Eligibility request | |
identifier
|
Σ | 0..* | Identifier | Business Identifier |
|
ruleset
|
Σ | 0..1 | Coding |
Resource
version
Ruleset Codes ( Example ) |
|
originalRuleset
|
Σ | 0..1 | Coding |
Original
version
Ruleset Codes ( Example ) |
created
|
Σ | 0..1 | dateTime | Creation date |
target
|
Σ | 0..1 | Reference ( Organization ) | Insurer |
|
provider
|
Σ | 0..1 | Reference ( Practitioner ) | Responsible practitioner |
organization
|
Σ | 0..1 | Reference ( Organization ) | Responsible organization |
|
Documentation
for
this
format
| ||||
UML Diagram
XML Template
<EligibilityRequest xmlns="http://hl7.org/fhir"><!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension -->
<</identifier><identifier><!-- 0..* Identifier Business Identifier --></identifier> <ruleset><!-- 0..1 Coding Resource version --></ruleset> <originalRuleset><!-- 0..1 Coding Original version --></originalRuleset>< <</target> <</provider> <</organization><created value="[dateTime]"/><!-- 0..1 Creation date --> <target><!-- 0..1 Reference(Organization) Insurer --></target> <provider><!-- 0..1 Reference(Practitioner) Responsible practitioner --></provider> <organization><!-- 0..1 Reference(Organization) Responsible organization --></organization> </EligibilityRequest>
JSON Template
{
"resourceType" : "EligibilityRequest",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"
"identifier" : [{ Identifier }], // Business Identifier
"ruleset" : { Coding }, // Resource version
"originalRuleset" : { Coding }, // Original version
"
"
"
"
"created" : "<dateTime>", // Creation date
"target" : { Reference(Organization) }, // Insurer
"provider" : { Reference(Practitioner) }, // Responsible practitioner
"organization" : { Reference(Organization) } // Responsible organization
}
Structure
| Name | Flags | Card. | Type |
Description
&
Constraints
|
|---|---|---|---|---|
|
EligibilityRequest
|
Σ | DomainResource | Eligibility request | |
|
identifier
|
Σ | 0..* | Identifier | Business Identifier |
|
ruleset
|
Σ | 0..1 | Coding |
Resource
version
Ruleset Codes ( Example ) |
|
originalRuleset
|
Σ | 0..1 | Coding |
Original
version
Ruleset Codes ( Example ) |
|
created
|
Σ | 0..1 | dateTime | Creation date |
|
target
|
Σ | 0..1 | Reference ( Organization ) | Insurer |
|
provider
|
Σ | 0..1 | Reference ( Practitioner ) | Responsible practitioner |
|
organization
|
Σ | 0..1 | Reference ( Organization ) | Responsible organization |
|
Documentation
for
this
format
| ||||
XML Template
<EligibilityRequest xmlns="http://hl7.org/fhir"><</identifier><identifier><!-- 0..* Identifier Business Identifier --></identifier> <ruleset><!-- 0..1 Coding Resource version --></ruleset> <originalRuleset><!-- 0..1 Coding Original version --></originalRuleset>< <</target> <</provider> <</organization><created value="[dateTime]"/><!-- 0..1 Creation date --> <target><!-- 0..1 Reference(Organization) Insurer --></target> <provider><!-- 0..1 Reference(Practitioner) Responsible practitioner --></provider> <organization><!-- 0..1 Reference(Organization) Responsible organization --></organization> </EligibilityRequest>
JSON Template
{
"resourceType" : "EligibilityRequest",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"
"identifier" : [{ Identifier }], // Business Identifier
"ruleset" : { Coding }, // Resource version
"originalRuleset" : { Coding }, // Original version
"
"
"
"
"created" : "<dateTime>", // Creation date
"target" : { Reference(Organization) }, // Insurer
"provider" : { Reference(Practitioner) }, // Responsible practitioner
"organization" : { Reference(Organization) } // Responsible organization
}
Alternate definitions: Schema / Schematron , Resource Profile ( XML , JSON ), Questionnaire
| Path | Definition | Type | Reference |
|---|---|---|---|
|
EligibilityRequest.ruleset
EligibilityRequest.originalRuleset |
The
static
and
dynamic
model
to
which
contents
conform,
which
may
be
business
version
or
|
Example |
|
Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.
| Name | Type | Description | Paths |
| identifier | token | The business identifier of the Eligibility | EligibilityRequest.identifier |
©
HL7.org
2011+.
FHIR
DSTU
(v0.4.0-4902)
DSTU2
(v1.0.2-7202)
generated
on
Fri,
Mar
27,
Sat,
Oct
24,
2015
00:19+1100.
07:43+1100.
Links:
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