{
  "resourceType": "CodeSystem",
  "id": "eligibilityresponse-purpose",
  "meta": {
    "lastUpdated": "2026-05-20T15:02:53.575+00:00"
  },
  "text": {
    "status": "generated",
    "div": "\u003cdiv xmlns\u003d\"http://www.w3.org/1999/xhtml\"\u003e\u003cp class\u003d\"res-header-id\"\u003e\u003cb\u003eGenerated Narrative: CodeSystem eligibilityresponse-purpose\u003c/b\u003e\u003c/p\u003e\u003ca name\u003d\"eligibilityresponse-purpose\"\u003e \u003c/a\u003e\u003ca name\u003d\"hceligibilityresponse-purpose\"\u003e \u003c/a\u003e\u003cp\u003eThis case-sensitive code system \u003ccode\u003ehttp://hl7.org/fhir/eligibilityresponse-purpose\u003c/code\u003e defines the following codes:\u003c/p\u003e\u003ctable class\u003d\"codes\"\u003e\u003ctr\u003e\u003ctd style\u003d\"white-space:nowrap\"\u003e\u003cb\u003eCode\u003c/b\u003e\u003c/td\u003e\u003ctd\u003e\u003cb\u003eDisplay\u003c/b\u003e\u003c/td\u003e\u003ctd\u003e\u003cb\u003eDefinition\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd style\u003d\"white-space:nowrap\"\u003eauth-requirements\u003ca name\u003d\"eligibilityresponse-purpose-auth-requirements\"\u003e \u003c/a\u003e\u003c/td\u003e\u003ctd\u003eCoverage auth-requirements\u003c/td\u003e\u003ctd\u003eThe prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested.\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd style\u003d\"white-space:nowrap\"\u003ebenefits\u003ca name\u003d\"eligibilityresponse-purpose-benefits\"\u003e \u003c/a\u003e\u003c/td\u003e\u003ctd\u003eCoverage benefits\u003c/td\u003e\u003ctd\u003eThe plan benefits and optionally benefits consumed  for the listed, or discovered if specified, converages are requested.\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd style\u003d\"white-space:nowrap\"\u003ediscovery\u003ca name\u003d\"eligibilityresponse-purpose-discovery\"\u003e \u003c/a\u003e\u003c/td\u003e\u003ctd\u003eCoverage Discovery\u003c/td\u003e\u003ctd\u003eThe insurer is requested to report on any coverages which they are aware of in addition to any specifed.\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd style\u003d\"white-space:nowrap\"\u003evalidation\u003ca name\u003d\"eligibilityresponse-purpose-validation\"\u003e \u003c/a\u003e\u003c/td\u003e\u003ctd\u003eCoverage Validation\u003c/td\u003e\u003ctd\u003eA check that the specified coverages are in-force is requested.\u003c/td\u003e\u003c/tr\u003e\u003c/table\u003e\u003c/div\u003e"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fm"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "normative"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 4
    }
  ],
  "url": "http://hl7.org/fhir/eligibilityresponse-purpose",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.4.1185"
    }
  ],
  "version": "6.0.0-ballot4",
  "name": "EligibilityResponsePurpose",
  "title": "Eligibility Response Purpose",
  "status": "active",
  "experimental": false,
  "date": "2021-01-05T10:01:24+11:00",
  "publisher": "HL7 (FHIR Project)",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://hl7.org/fhir"
        },
        {
          "system": "email",
          "value": "fhir@lists.hl7.org"
        }
      ]
    }
  ],
  "description": "A code specifying the types of information being requested.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "caseSensitive": true,
  "valueSet": "http://hl7.org/fhir/ValueSet/eligibilityresponse-purpose",
  "content": "complete",
  "concept": [
    {
      "code": "auth-requirements",
      "display": "Coverage auth-requirements",
      "definition": "The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested."
    },
    {
      "code": "benefits",
      "display": "Coverage benefits",
      "definition": "The plan benefits and optionally benefits consumed  for the listed, or discovered if specified, converages are requested."
    },
    {
      "code": "discovery",
      "display": "Coverage Discovery",
      "definition": "The insurer is requested to report on any coverages which they are aware of in addition to any specifed."
    },
    {
      "code": "validation",
      "display": "Coverage Validation",
      "definition": "A check that the specified coverages are in-force is requested."
    }
  ]
}