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Financial Management Work Group | Maturity Level: N/A | Standards Status: Informative |
Raw JSON (canonical form + also see JSON Format Specification)
Definition for Code SystemEligibilityResponsePurpose
{ "resourceType" : "CodeSystem", "id" : "eligibilityresponse-purpose", "meta" : { "lastUpdated" : "2025-03-13T13:26:38.591+00:00", "profile" : ["http://hl7.org/fhir/StructureDefinition/shareablecodesystem"] }, "text" : { "status" : "generated", "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem eligibilityresponse-purpose</b></p><a name=\"eligibilityresponse-purpose\"> </a><a name=\"hceligibilityresponse-purpose\"> </a><a name=\"eligibilityresponse-purpose-en-US\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"shareablecodesystem.html\">Shareable CodeSystem</a></p></div><p>This case-sensitive code system <code>http://hl7.org/fhir/eligibilityresponse-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=\"eligibilityresponse-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=\"eligibilityresponse-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=\"eligibilityresponse-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=\"eligibilityresponse-purpose-validation\"> </a></td><td>Coverage Validation</td><td>A check that the specified coverages are in-force is requested.</td></tr></table></div>" }, "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg", "valueCode" : "fm" }, { "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status", "valueCode" : "trial-use" }, { "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm", "valueInteger" : 2 }], "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-ballot2", "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." }] }
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 Thu, Mar 13, 2025 13:31+0000.
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