FHIR Implementation Guide for ABDM
6.0.0 - active India flag

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This page is part of the FHIR Implementation Guide for ABDM (v6.0.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Example CoverageEligibilityResponse: CoverageEligibilityResponse/benefits-example-01

Generated Narrative: CoverageEligibilityResponse

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

Profile: CoverageEligibilityResponse

status: active

purpose: benefits

patient: Patient/example-01 ""

created: 2023-09-07

requestor: Practitioner/example-01 ""

request: CoverageEligibilityRequest/benefits-example-01

outcome: complete

disposition: Policy is currently in-force.

insurer: Organization/example-02 "XYZ Insurance Co. Ltd."

insurance

coverage: Coverage/example-01

inforce: true

benefitPeriod: 2023-09-07 --> 2026-08-07

item

productOrService: Consultant (SNOMED CT#768839008)

Benefits

-TypeAllowed[x]Used[x]
*Benefit (Benefit Type Codes#benefit)₹50,000.00 (INR)₹0.00 (INR)

item

productOrService: Metformin hydrochloride 500 mg prolonged-release oral tablet (SNOMED CT#765507008)

Benefits

-TypeAllowed[x]Used[x]
*Benefit (Benefit Type Codes#benefit)₹50,000.00 (INR)₹0.00 (INR)