This resource provides eligibility and plan details from the processing of an Eligibility resource.

The Response business identifier.

The status of the resource instance.

This element is labeled as a modifier because the status contains codes that mark the response as not currently valid.

Original request resource reference. The date when the enclosed suite of services were performed or completed.

The practitioner who is responsible for the services rendered to the patient.

The organization which is responsible for the services rendered to the patient.

Original request resource reference.

Transaction status: error, complete.

A description of the status of the adjudication.

The Insurer who produced this adjudicated response.

The version of Flag indicating if the style coverage provided is inforce currently if no service date(s) specified or for the whole duration of resource contents. This should be mapped to the allowable profiles for this and supporting resources. service dates.

The static and dynamic model to which contents conform, which insurer may be business version provide both the details for the requested coverage as well as details for additional coverages known to the insurer.

A suite of updated or standard/version. additional Coverages from the Insurer.

The contract resource which may provide more detailed information.

Benefits and optionally current balances by Category.

The style (standard) and version of the original material which was converted into this resource. Dental, Vision, Medical, Pharmacy, Rehab etc.

Dental: basic, major, ortho; Vision exam, glasses, contacts; etc.

Knowledge True if the indicated class of service is excluded from the original version can inform plan, missing or False indicated the processing of this instance so that information which service is processable by included in the originating system may be generated. coverage.

The date when A short name or tag for the enclosed suite of services were performed benefit, for example MED01, or completed. DENT2.

A richer description of the benefit, for example 'DENT2 covers 100% of basic, 50% of major but exclused Ortho, Implants and Costmetic services'.

The Insurer who produced this adjudicated response. Network designation.

Unit designation: individual or family.

The practitioner who is responsible for the services rendered to term or period of the patient. values such as 'maximum lifetime benefit' or 'maximum annual vistis'.

Benefits Used to date.

Deductable, visits, benefit amount.

The organization which is responsible Benefits allowed.

Benefits used.

The form to be used for printing the patient. content.

Mutually exclusive with Services Provided (Item).

An error code,from a specified code system, which details why the eligibility check could not be performed.