This is the set of resources that conform to both CoverageEligibilityResponse (https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse) and CoverageEligibilityResponse (https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse).
Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||
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![]() ![]() | 0..* | CoverageEligibilityResponse resource | ||||||
![]() ![]() ![]() | Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]() ![]() | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() ![]() | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
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![]() ![]() ![]() | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
![]() ![]() ![]() | 0..* | Resource | Contained, inline Resources | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]() ![]() | 0..* | Identifier | Business Identifier for coverage eligiblity request | |||||
![]() ![]() ![]() | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | ||||
![]() ![]() ![]() | SΣ | 1..* | code | auth-requirements | benefits | discovery | validation Binding: ?? (required): A code specifying the types of information being requested. | ||||
![]() ![]() ![]() | Σ | 1..1 | Reference(Patient | #sd-Patient-Patient) | Intended recipient of products and services | ||||
![]() ![]() ![]() | 0..1 | Estimated date or dates of service | ||||||
![]() ![]() ![]() ![]() | date | |||||||
![]() ![]() ![]() ![]() | Period | |||||||
![]() ![]() ![]() | Σ | 1..1 | dateTime | Response creation date | ||||
![]() ![]() ![]() | 1..1 | Reference(Practitioner | PractitionerRole | Organization | #sd-Practitioner-Practitioner) | Party responsible for the request | |||||
![]() ![]() ![]() | Σ | 1..1 | Reference(CoverageEligibilityRequest | #sd-CoverageEligibilityRequest-CoverageEligibilityRequest) | Eligibility request reference | ||||
![]() ![]() ![]() | SΣ | 1..1 | code | queued | complete | error | partial Binding: ?? (required): The outcome of the processing. | ||||
![]() ![]() ![]() | S | 0..1 | string | Disposition Message | ||||
![]() ![]() ![]() | SΣ | 1..1 | Reference(Organization | #sd-Organization-Organization) | Coverage issuer | ||||
![]() ![]() ![]() | S | 0..* | BackboneElement | Patient insurance information | ||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() | SΣ | 1..1 | Reference(Coverage | #sd-Coverage-Coverage) | Insurance information | ||||
![]() ![]() ![]() ![]() | S | 0..1 | boolean | Coverage inforce indicator | ||||
![]() ![]() ![]() ![]() | 0..1 | Period | When the benefits are applicable | |||||
![]() ![]() ![]() ![]() | SC | 0..* | BackboneElement | Benefits and authorization details Constraints: ces-1 | ||||
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example) | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 1..1 | uri | Identity of the terminology system | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 1..1 | string | Representation defined by the system | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept | ||||
![]() ![]() ![]() ![]() ![]() | S | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes . | ||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..* | Coding | Code defined by a terminology system | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 1..1 | uri | Identity of the terminology system | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Version of the system - if relevant | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 1..1 | string | Representation defined by the system | ||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
![]() ![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | string | Plain text representation of the concept | ||||
![]() ![]() ![]() ![]() ![]() | 0..* | CodeableConcept | Product or service billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | Reference(Practitioner | PractitionerRole | #sd-Practitioner-Practitioner) | Performing practitioner | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | boolean | Excluded from the plan | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | string | Short name for the benefit | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | string | Description of the benefit or services covered | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | In or out of network Binding: ?? (example): Code to classify in or out of network services. | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Individual or family Binding: ?? (example): Unit covered/serviced - individual or family. | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Annual or lifetime Binding: ?? (example): Coverage unit - annual, lifetime. | |||||
![]() ![]() ![]() ![]() ![]() | S | 0..* | BackboneElement | Benefit Summary | ||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Benefit classification Binding: ?? (example): Deductable, visits, co-pay, etc. | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | Benefits allowed | ||||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | unsignedInt | |||||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | string | |||||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Money | |||||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | Benefits used | ||||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | unsignedInt | |||||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | string | |||||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Money | |||||||
![]() ![]() ![]() ![]() ![]() | 0..1 | boolean | Authorization required flag | |||||
![]() ![]() ![]() ![]() ![]() | 0..* | CodeableConcept | Type of required supporting materials Binding: ?? (example): Type of supporting information to provide with a preauthorization. | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | uri | Preauthorization requirements endpoint | |||||
![]() ![]() ![]() | 0..1 | string | Preauthorization reference | |||||
![]() ![]() ![]() | 0..1 | CodeableConcept | Printed form identifier Binding: ?? (example): The forms codes. | |||||
![]() ![]() ![]() | S | 0..* | BackboneElement | Processing errors | ||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Error code detailing processing issues Binding: ?? (example): The error codes for adjudication processing. | |||||
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