Release 4 5

This page is part of the FHIR Specification (v4.0.1: R4 (v5.0.0: R5 - Mixed Normative and STU ) ). This is the current published version in it's permanent home (it will always be available at this URL). 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: R5 R4B R4

Coverageeligibilityresponse-example-error.json

Example CoverageEligibilityResponse/E2503 (JSON)

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

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

General Person Primary Coverage with error 

{
  "resourceType": "CoverageEligibilityResponse",
  "id": "E2503",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the CoverageEligibilityResponse.</div>"

  "resourceType" : "CoverageEligibilityResponse",
  "id" : "E2503",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the CoverageEligibilityResponse.</div>"

  },
  "identifier": [
    {
      "system": "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse",
      "value": "8812343"
    }
  ],
  "status": "active",
  "purpose": [
    "validation"
  ],
  "patient": {
    "reference": "Patient/f201"

  "identifier" : [{
    "system" : "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse",
    "value" : "8812343"
  }],
  "status" : "active",
  "purpose" : ["validation"],
  "patient" : {
    "reference" : "Patient/f201"

  },
  "created": "2014-09-16",
  "requestor": {
    "identifier": {
      "system": "http://national.org/clinic",
      "value": "OR1234"

  "created" : "2014-09-16",
  "requestor" : {
    "identifier" : {
      "system" : "http://national.org/clinic",
      "value" : "OR1234"

    }
  },
  "request": {
    "reference": "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332406"

  "request" : {
    "reference" : "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332406"

  },
  "outcome": "error",
  "disposition": "Eligibiliy request could not be processed, please address errors before submitting.",
  "insurer": {
    "reference": "Organization/2"

  "outcome" : "error",
  "disposition" : "Eligibiliy request could not be processed, please address errors before submitting.",
  "insurer" : {
    "reference" : "Organization/2"

  },
  "form": {
    "coding": [
      {
        "system": "http://national.org/form",
        "code": "ELRSP/2017/01"
      }
    ]

  "form" : {
    "coding" : [{
      "system" : "http://national.org/form",
      "code" : "ELRSP/2017/01"
    }]

  },
  "error": [
    {
      "code": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/adjudication-error",
            "code": "a001"
          }
        ]
      }

  "error" : [{
    "code" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/adjudication-error",
        "code" : "a001"
      }]

    }
  ]

  }]

}

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.