<?xml version="1.0" encoding="UTF-8"?>

<CommunicationRequest xmlns="http://hl7.org/fhir">
  <id value="fm-solicit"/>
  <text>
    <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml">Request for Accident Report</div>
  </text>
  <contained>
    <Organization>
      <id value="provider"/>
      <identifier>
        <system value="http://www.jurisdiction.com/provideroffices"/>
        <value value="3456"/>
      </identifier>
    </Organization>
  </contained>
  <contained>
    <Organization>
      <id value="payor"/>
      <identifier>
        <system value="http://www.jurisdiction.com/insurer"/>
        <value value="123456"/>
      </identifier>
    </Organization>
  </contained>
  <contained>
    <Practitioner>
      <id value="requester"/>
      <identifier>
        <value value="6789"/>
      </identifier>
    </Practitioner>
  </contained>
  <!--  body of the resource  -->
  <!--  this is the value to which the response will refer  -->
  <identifier>
    <system value="http://www.jurisdiction.com/insurer/123456"/>
    <value value="ABC123"/>
  </identifier>
  <basedOn>
    <display value="EligibilityRequest"/>
  </basedOn>
  <replaces>
    <display value="prior CommunicationRequest"/>
  </replaces>
  <groupIdentifier>
    <value value="12345"/>
  </groupIdentifier>
  <status value="active"/>
  <intent value="proposal"/>
  <category>
    <coding>
      <system value="http://acme.org/messagetypes"/>
      <code value="SolicitedAttachmentRequest"/>
    </coding>
  </category>
  <priority value="routine"/>
  <medium>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ParticipationMode"/>
      <code value="WRITTEN"/>
      <display value="written"/>
    </coding>
    <text value="written"/>
  </medium>
  <encounter>
    <reference value="Encounter/example"/>
  </encounter>
  <payload>
    <contentCodeableConcept>
      <text value="Please provide the accident report and any associated pictures to support your Claim# DEF5647."/>
    </contentCodeableConcept>
  </payload>
  <occurrenceDateTime value="2016-06-10T11:01:10-08:00"/>
  <authoredOn value="2016-06-10T11:01:10-08:00"/>
  <requester>
    <reference value="#requester"/>
  </requester>
  <recipient>
    <reference value="#provider"/>
  </recipient>
  <informationProvider>
    <reference value="#payor"/>
  </informationProvider>
</CommunicationRequest>