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

• Narrative Content
• XML
• JSON
• TTL

: CoverageEligibilityResponse/preauth-example-01 - JSON Representation

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{
  "resourceType" : "CoverageEligibilityResponse",
  "id" : "preauth-example-01",
  "meta" : {
    "profile" : [
      "https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: CoverageEligibilityResponse</b><a name=\"preauth-example-01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource CoverageEligibilityResponse \"preauth-example-01\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-CoverageEligibilityResponse.html\">CoverageEligibilityResponse</a></p></div><p><b>status</b>: active</p><p><b>purpose</b>: auth-requirements</p><p><b>patient</b>: <a href=\"Patient-example-01.html\">Patient/example-01</a> \"\"</p><p><b>serviced</b>: 2025-08-07</p><p><b>created</b>: 2022-07-08</p><p><b>requestor</b>: <a href=\"Practitioner-example-01.html\">Practitioner/example-01</a> \"\"</p><p><b>request</b>: <a href=\"CoverageEligibilityRequest-preauth-example-01.html\">CoverageEligibilityRequest/preauth-example-01</a></p><p><b>outcome</b>: complete</p><p><b>disposition</b>: Policy is currently in-force.</p><p><b>insurer</b>: <a href=\"Organization-example-01.html\">Organization/example-01</a> \"XYZ Lab Pvt.Ltd.\"</p><blockquote><p><b>insurance</b></p><p><b>coverage</b>: <a href=\"Coverage-example-01.html\">Coverage/example-01</a></p><p><b>inforce</b>: true</p><blockquote><p><b>item</b></p><p><b>productOrService</b>: Removal of foreign body <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#10849003)</span></p><p><b>authorizationRequired</b>: true</p><p><b>authorizationSupporting</b>: Lab Order <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-coverageeligibilityresponse-ex-auth-support.html\">CoverageEligibilityResponse Auth Support Codes</a>#laborder)</span></p></blockquote></blockquote></div>"
  },
  "status" : "active",
  "purpose" : [
    "auth-requirements"
  ],
  "patient" : {
    "reference" : "Patient/example-01"
  },
  "servicedDate" : "2025-08-07",
  "created" : "2022-07-08",
  "requestor" : {
    "reference" : "Practitioner/example-01"
  },
  "request" : {
    "reference" : "CoverageEligibilityRequest/preauth-example-01"
  },
  "outcome" : "complete",
  "disposition" : "Policy is currently in-force.",
  "insurer" : {
    "reference" : "Organization/example-01"
  },
  "insurance" : [
    {
      "id" : "2222",
      "coverage" : {
        "reference" : "Coverage/example-01"
      },
      "inforce" : true,
      "item" : [
        {
          "id" : "11111",
          "productOrService" : {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "10849003",
                "display" : "Removal of foreign body"
              }
            ]
          },
          "authorizationRequired" : true,
          "authorizationSupporting" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/coverageeligibilityresponse-ex-auth-support",
                  "code" : "laborder",
                  "display" : "Lab Order"
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}