This is the set of resources that conform to both FAIS CoverageEligibilityResponse Profile (https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.CoverageEligibilityResponse) and FAIS CoverageEligibilityResponse Profile (https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.CoverageEligibilityResponse).
Name | Flags | Card. | Type | Description & Constraints![]() | ||||
---|---|---|---|---|---|---|---|---|
![]() ![]() | 0..* | CoverageEligibilityResponse resource dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management | ||||||
![]() ![]() ![]() | Σ | 0..1 | Meta | Metadata about the resource ele-1: All FHIR elements must have a @value or children | ||||
![]() ![]() ![]() | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() | 0..1 | Narrative | Text summary of the resource, for human interpretation ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() | 0..* | Resource | Contained, inline Resources | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
![]() ![]() ![]() | 0..* | Identifier | Business Identifier for coverage eligiblity request ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. ele-1: All FHIR elements must have a @value or children | ||||
![]() ![]() ![]() | Σ | 1..* | code | auth-requirements | benefits | discovery | validation Binding: ?? (required): A code specifying the types of information being requested. ele-1: All FHIR elements must have a @value or children | ||||
![]() ![]() ![]() | Σ | 1..1 | Reference(Patient) | Intended recipient of products and services ele-1: All FHIR elements must have a @value or children | ||||
![]() ![]() ![]() | 0..1 | Estimated date or dates of service ele-1: All FHIR elements must have a @value or children | ||||||
![]() ![]() ![]() ![]() | date | |||||||
![]() ![]() ![]() ![]() | Period | |||||||
![]() ![]() ![]() | Σ | 1..1 | dateTime | Response creation date ele-1: All FHIR elements must have a @value or children | ||||
![]() ![]() ![]() | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Party responsible for the request ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() | Σ | 1..1 | Reference(FAIS CoverageEligibilityRequest Profile | #sd-IHE.FAIS.CoverageEligibilityRequest-IHE.FAIS.CoverageEligibilityRequest) | Eligibility request reference ele-1: All FHIR elements must have a @value or children | ||||
![]() ![]() ![]() | Σ | 1..1 | code | queued | complete | error | partial Binding: ?? (required): The outcome of the processing. ele-1: All FHIR elements must have a @value or children | ||||
![]() ![]() ![]() | 0..1 | string | Disposition Message ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() | Σ | 1..1 | Reference(Organization) | Coverage issuer ele-1: All FHIR elements must have a @value or children | ||||
![]() ![]() ![]() | 0..* | BackboneElement | Patient insurance information ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
![]() ![]() ![]() ![]() | Σ | 1..1 | Reference(Coverage) | Insurance information ele-1: All FHIR elements must have a @value or children | ||||
![]() ![]() ![]() ![]() | 0..1 | boolean | Coverage inforce indicator ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() | 0..1 | Period | When the benefits are applicable ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() | C | 0..* | BackboneElement | Benefits and authorization details ces-1: SHALL contain a category or a billcode but not both. ele-1: All FHIR elements must have a @value or children | ||||
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example): Benefit categories such as: oral, medical, vision etc. ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example): Allowable service and product codes. ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() | 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. ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | Reference(Practitioner | PractitionerRole) | Performing practitioner ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | boolean | Excluded from the plan ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | string | Short name for the benefit ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | string | Description of the benefit or services covered ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | In or out of network Binding: ?? (example): Code to classify in or out of network services. ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Individual or family Binding: ?? (example): Unit covered/serviced - individual or family. ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Annual or lifetime Binding: ?? (example): Coverage unit - annual, lifetime. ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() | 0..* | BackboneElement | Benefit Summary ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
![]() ![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Benefit classification Binding: ?? (example): Deductable, visits, co-pay, etc. ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | Benefits allowed ele-1: All FHIR elements must have a @value or children | ||||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | unsignedInt | |||||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | string | |||||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Money | |||||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | Benefits used ele-1: All FHIR elements must have a @value or children | ||||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | unsignedInt | |||||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | string | |||||||
![]() ![]() ![]() ![]() ![]() ![]() ![]() | Money | |||||||
![]() ![]() ![]() ![]() ![]() | 0..1 | boolean | Authorization required flag ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() | 0..* | CodeableConcept | Type of required supporting materials Binding: ?? (example): Type of supporting information to provide with a preauthorization. ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | uri | Preauthorization requirements endpoint ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() | 0..1 | string | Preauthorization reference ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() | 0..1 | CodeableConcept | Printed form identifier Binding: ?? (example): The forms codes. ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() | 0..* | BackboneElement | Processing errors ele-1: All FHIR elements must have a @value or children | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Error code detailing processing issues Binding: ?? (example): The error codes for adjudication processing. ele-1: All FHIR elements must have a @value or children | |||||
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