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13.3.8 Resource CoverageEligibilityResponse - Mappings

Financial Management icon Work GroupMaturity Level: N/AStandards Status: InformativeSecurity Category: Patient Compartments: Patient, Practitioner

Mappings:

FiveWs Pattern Mapping

Workflow Pattern

RIM Mapping

Canadian Dental Association eclaims standard

Mappings for the CoverageEligibilityResponse resource (see Mappings to Other Standards for further information & status).

13.3.8.1 FiveWs Pattern Mapping (http://hl7.org/fhir/fivews icon)

CoverageEligibilityResponse financial.support
    identifier FiveWs.identifier
    status FiveWs.status
    purpose FiveWs.class
    patient FiveWs.subject[x]
    serviced[x] FiveWs.done[x]
    created FiveWs.recorded
    requestor FiveWs.source
    request FiveWs.why[x]
            provider FiveWs.source

13.3.8.2 Workflow Pattern (http://hl7.org/fhir/workflow icon)

CoverageEligibilityResponse Event
    identifier Event.identifier
    status Event.status
    patient Event.subject
    request Event.basedOn
    disposition Event.note

13.3.8.3 RIM Mapping (http://hl7.org/v3 icon)

CoverageEligibilityResponse
    preAuthRef 23

13.3.8.4 Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/ icon)

CoverageEligibilityResponse
    identifier
    status
    statusReason
    purpose
    patient C06,C07,C08, C05, C04
    event
        type
        when[x]
    serviced[x] F09
    created
    requestor B01
    request A02|G01
    outcome
    disposition
    insurer
    insurance
        coverage
        inforce
        benefitPeriod
        item
            category
            productOrService
            modifier
            provider B01
            excluded
            name
            description
            network
            unit
            term
            benefit
                type
                allowed[x]
                used[x]
            authorizationRequired
            authorizationSupporting
            authorizationUrl
    preAuthRef F03
    form G42
    error
        code
        expression