<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><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>