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Example CodeSystem/eligibilityresponse-purpose (JSON)

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

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

Definition for Code SystemEligibilityResponsePurpose

{
  "resourceType" : "CodeSystem",
  "id" : "eligibilityresponse-purpose",
  "meta" : {
    "lastUpdated" : "2024-12-12T18:56:29.677+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><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.