Release 5 Preview #3

Codesystem-eligibilityrequest-purpose.json

Financial Management Work GroupMaturity Level: N/AStandards Status: Informative

Raw JSON (canonical form + also see JSON Format Specification)

Definition for Code System EligibilityRequestPurpose

{
  "resourceType" : "CodeSystem",
  "id" : "eligibilityrequest-purpose",
  "meta" : {
    "lastUpdated" : "2020-09-22T18:47:55.896+00:00"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div>!-- Snipped for Brevity --></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/eligibilityrequest-purpose",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.1.1183"
  }],
  "version" : "4.5.0",
  "name" : "EligibilityRequestPurpose",
  "title" : "EligibilityRequestPurpose",
  "status" : "draft",
  "experimental" : false,
  "date" : "2020-09-22T18:47:55+00:00",
  "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.",
  "caseSensitive" : true,
  "valueSet" : "http://hl7.org/fhir/ValueSet/eligibilityrequest-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.