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Financial Management Work Group | Maturity Level: N/A | Standards Status: Informative |
Raw XML (canonical form + also see XML Format Specification)
Definition for Code SystemEligibilityResponsePurpose
<?xml version="1.0" encoding="UTF-8"?> <CodeSystem xmlns="http://hl7.org/fhir"> <id value="eligibilityresponse-purpose"/> <meta> <lastUpdated value="2024-10-02T17:31:51.554+00:00"/> <profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> </meta> <text> <status value="generated"/> <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> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="fm"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="trial-use"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="2"/> </extension> <url value="http://hl7.org/fhir/eligibilityresponse-purpose"/> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:oid:2.16.840.1.113883.4.642.4.1185"/> </identifier> <version value="6.0.0-ballot2"/> <name value="EligibilityResponsePurpose"/> <title value="Eligibility Response Purpose"/> <status value="active"/> <experimental value="false"/> <date value="2021-01-05T10:01:24+11:00"/> <publisher value="HL7 (FHIR Project)"/> <contact> <telecom> <system value="url"/> <value value="http://hl7.org/fhir"/> </telecom> <telecom> <system value="email"/> <value value="fhir@lists.hl7.org"/> </telecom> </contact> <description value="A code specifying the types of information being requested."/> <jurisdiction> <coding> <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/> <code value="001"/> <display value="World"/> </coding> </jurisdiction> <caseSensitive value="true"/> <valueSet value="http://hl7.org/fhir/ValueSet/eligibilityresponse-purpose"/> <content value="complete"/> <concept> <code value="auth-requirements"/> <display value="Coverage auth-requirements"/> <definition value="The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested."/> </concept> <concept> <code value="benefits"/> <display value="Coverage benefits"/> <definition value="The plan benefits and optionally benefits consumed for the listed, or discovered if specified, converages are requested."/> </concept> <concept> <code value="discovery"/> <display value="Coverage Discovery"/> <definition value="The insurer is requested to report on any coverages which they are aware of in addition to any specifed."/> </concept> <concept> <code value="validation"/> <display value="Coverage Validation"/> <definition value="A check that the specified coverages are in-force is requested."/> </concept> </CodeSystem>
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 Wed, Oct 2, 2024 17:55+0000.
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