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Financial Management Work Group | Maturity Level: N/A | Standards Status: Informative |
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Definition for Code SystemEligibilityRequestPurpose
@prefix fhir: <http://hl7.org/fhir/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- [a fhir:CodeSystem ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "eligibilityrequest-purpose"] ; # fhir:meta [ fhir:lastUpdated [ fhir:v "2025-02-16T15:32:40.206+00:00"^^xsd:dateTime ] ; fhir:profile ( [ fhir:v "http://hl7.org/fhir/StructureDefinition/shareablecodesystem"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/StructureDefinition/shareablecodesystem> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem eligibilityrequest-purpose</b></p><a name=\"eligibilityrequest-purpose\"> </a><a name=\"hceligibilityrequest-purpose\"> </a><a name=\"eligibilityrequest-purpose-en-US\"> </a><p>This case-sensitive code system <code>http://hl7.org/fhir/eligibilityrequest-purpose</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">auth-requirements<a name=\"eligibilityrequest-purpose-auth-requirements\"> </a></td><td>Coverage auth-requirements</td><td>The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested.</td></tr><tr><td style=\"white-space:nowrap\">benefits<a name=\"eligibilityrequest-purpose-benefits\"> </a></td><td>Coverage benefits</td><td>The plan benefits and optionally benefits consumed for the listed, or discovered if specified, converages are requested.</td></tr><tr><td style=\"white-space:nowrap\">discovery<a name=\"eligibilityrequest-purpose-discovery\"> </a></td><td>Coverage Discovery</td><td>The insurer is requested to report on any coverages which they are aware of in addition to any specifed.</td></tr><tr><td style=\"white-space:nowrap\">validation<a name=\"eligibilityrequest-purpose-validation\"> </a></td><td>Coverage Validation</td><td>A check that the specified coverages are in-force is requested.</td></tr></table></div>" ] ; # fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ] ; fhir:value [ fhir:v "fm" ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ] ; fhir:value [ fhir:v "trial-use" ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"^^xsd:anyURI ] ; fhir:value [ fhir:v "2"^^xsd:integer ] ] ) ; # fhir:url [ fhir:v "http://hl7.org/fhir/eligibilityrequest-purpose"^^xsd:anyURI] ; # fhir:identifier ( [ fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ; fhir:value [ fhir:v "urn:oid:2.16.840.1.113883.4.642.4.1183" ] ] ) ; # fhir:version [ fhir:v "6.0.0-ballot2"] ; # fhir:name [ fhir:v "EligibilityRequestPurpose"] ; # fhir:title [ fhir:v "Eligibility Request Purpose"] ; # fhir:status [ fhir:v "active"] ; # fhir:experimental [ fhir:v "false"^^xsd:boolean] ; # fhir:date [ fhir:v "2021-01-05T10:01:24+11:00"^^xsd:dateTime] ; # fhir:publisher [ fhir:v "HL7 (FHIR Project)"] ; # fhir:contact ( [ fhir:telecom ( [ fhir:system [ fhir:v "url" ] ; fhir:value [ fhir:v "http://hl7.org/fhir" ] ] [ fhir:system [ fhir:v "email" ] ; fhir:value [ fhir:v "fhir@lists.hl7.org" ] ] ) ] ) ; # fhir:description [ fhir:v "A code specifying the types of information being requested."] ; # fhir:jurisdiction ( [ fhir:coding ( [ fhir:system [ fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm"^^xsd:anyURI ] ; fhir:code [ fhir:v "001" ] ; fhir:display [ fhir:v "World" ] ] ) ] ) ; # fhir:caseSensitive [ fhir:v "true"^^xsd:boolean] ; # fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/eligibilityrequest-purpose"^^xsd:anyURI ; fhir:link <http://hl7.org/fhir/ValueSet/eligibilityrequest-purpose> ] ; # fhir:hierarchyMeaning [] ; # fhir:content [ fhir:v "complete"] ; # fhir:concept ( [ fhir:code [ fhir:v "auth-requirements" ] ; fhir:display [ fhir:v "Coverage auth-requirements" ] ; fhir:definition [ fhir:v "The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested." ] ] [ fhir:code [ fhir:v "benefits" ] ; fhir:display [ fhir:v "Coverage benefits" ] ; fhir:definition [ fhir:v "The plan benefits and optionally benefits consumed for the listed, or discovered if specified, converages are requested." ] ] [ fhir:code [ fhir:v "discovery" ] ; fhir:display [ fhir:v "Coverage Discovery" ] ; fhir:definition [ fhir:v "The insurer is requested to report on any coverages which they are aware of in addition to any specifed." ] ] [ fhir:code [ fhir:v "validation" ] ; fhir:display [ fhir:v "Coverage Validation" ] ; fhir:definition [ fhir:v "A check that the specified coverages are in-force is requested." ] ] )] . # # -------------------------------------------------------------------------------------
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.
FHIR ®© HL7.org 2011+. FHIR R6 hl7.fhir.core#6.0.0-ballot2 generated on Sun, Feb 16, 2025 16:10+0000.
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