This
page
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part
of
the
FHIR
Specification
(v4.0.1:
R4
(v5.0.0:
R5
-
Mixed
Normative
and
STU
)
).
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Codesystem-eligibilityrequest-purpose.xml
Example
CodeSystem/eligibilityrequest-purpose
(XML)
Raw
XML
(
canonical
form
+
also
see
XML
Format
Specification
)
Definition
for
Code
System
EligibilityRequestPurpose
SystemEligibilityRequestPurpose
<?xml version="1.0" encoding="UTF-8"?>
This code system http://hl7.org/fhir/eligibilityrequest-purpose defines the following
codes:
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.
benefits
The plan benefits and optionally benefits consumed for the listed, or discovered if specified,
converages are requested.
discovery
The insurer is requested to report on any coverages which they are aware of in addition
to any specifed.
validation
The prior authorization requirements for the listed, or discovered if specified, converages
for the categories of service and/or specifed biling codes are requested.
The plan benefits and optionally benefits consumed for the listed, or discovered if specified,
converages are requested.
The insurer is requested to report on any coverages which they are aware of in addition
to any specifed.
<CodeSystem xmlns="http://hl7.org/fhir">
<id value="eligibilityrequest-purpose"/>
<meta>
<lastUpdated value="2023-03-26T15:21:02.749+11:00"/>
<profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<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>
<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> <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> <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"/> <name value="EligibilityRequestPurpose"/> <title value="Eligibility Request Purpose"/> <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"/> <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"/> <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"/> <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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