FHIR Implementation Guide for ABDM
3.0.1 - CI Build India flag


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FHIR Implementation Guide for ABDM - Local Development build (v3.0.1). See the Directory of published versions

Example CoverageEligibilityResponse: CoverageEligibilityResponse/benefit-example-01

Generated Narrative: CoverageEligibilityResponse

Resource CoverageEligibilityResponse "benefit-example-01" (Language "en")

Profile: CoverageEligibilityResponse

status: active

purpose: validation, benefits

patient: Patient/example-01 ""

serviced: 2023-08-07

created: 2022-08-07

requestor: Practitioner/example-01 ""

request: CoverageEligibilityRequest/benefit-example-01

outcome: queued

disposition: Policy is currently in-force.

insurer: Organization/example-01 "XYZ Lab Pvt.Ltd."

insurance

coverage: Coverage/example-01

inforce: true

benefitPeriod: 2022-05-07 --> 2025-08-07

item

productOrService: Removal of foreign body (SNOMED CT#10849003)

benefit

type: Benefit (Benefit Type Codes#benefit)

allowed: ₹150,000.00 (INR)

benefit

type: Copayment maximum per service (Benefit Type Codes#copay-maximum)

allowed: ₹200,000.00 (INR)

benefit

type: Copayment Percent per service (Benefit Type Codes#copay-percent)

allowed: 20