FHIR Extensions Pack
5.3.0-ballot-tc1 - (September 2025 Ballot) International flag

FHIR Extensions Pack, published by HL7 International / FHIR Infrastructure. This guide is not an authorized publication; it is the continuous build for version 5.3.0-ballot-tc1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-extensions/ and changes regularly. See the Directory of published versions

Extension: Request Insurance

Official URL: http://hl7.org/fhir/StructureDefinition/request-insurance Version: 5.3.0-ballot-tc1
Standards status: Trial-use Maturity Level: 3 Computable Name: RequestInsurance
Other Identifiers: OID:2.16.840.1.113883.4.642.5.1725

The relevant insurance Coverage for this request to perform Eligibility checking, authorization, pre-determination or claiming for goods and/or services renderable or rendered, etc..\n\nResponses from insurers (ClaimResponse) containing responses to prior authorization or pre-determination requests to guide in the choosing of goods and services informed by reimbursement guidance, and to provide authorization numbers which may need to be quoted on future claims for reimbursement.

Context of Use

This extension may be used on the following element(s)

Usage info

Usages:

  • This Extension is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

Changes since version 5.2.0:

  • The resource metadata has changed (description)
  • The data elements list has changed
  • One or more text definitions, invariants or bindings have changed

    • Formal Views of Extension Content

    Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

    This structure is derived from Extension

    Summary

    Simple Extension with the type Reference: The relevant insurance Coverage for this request to perform Eligibility checking, authorization, pre-determination or claiming for goods and/or services renderable or rendered, etc..\n\nResponses from insurers (ClaimResponse) containing responses to prior authorization or pre-determination requests to guide in the choosing of goods and services informed by reimbursement guidance, and to provide authorization numbers which may need to be quoted on future claims for reimbursement.

    Maturity: 3

    This structure is derived from Extension

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Extension 0..* Extension Associated insurance coverage
    ... extension 0..0 Extension
    ... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/request-insurance"
    ... value[x] 1..1 Reference(Coverage | ClaimResponse) Value of extension

    doco Documentation for this format
    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Extension 0..* Extension Associated insurance coverage
    ... id 0..1 id Unique id for inter-element referencing
    ... extension 0..0 Extension
    Slice: Unordered, Open by value:url
    ... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/request-insurance"

    doco Documentation for this format

    This structure is derived from Extension

    Summary

    Simple Extension with the type Reference: The relevant insurance Coverage for this request to perform Eligibility checking, authorization, pre-determination or claiming for goods and/or services renderable or rendered, etc..\n\nResponses from insurers (ClaimResponse) containing responses to prior authorization or pre-determination requests to guide in the choosing of goods and services informed by reimbursement guidance, and to provide authorization numbers which may need to be quoted on future claims for reimbursement.

    Maturity: 3

    Differential View

    This structure is derived from Extension

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Extension 0..* Extension Associated insurance coverage
    ... extension 0..0 Extension
    ... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/request-insurance"
    ... value[x] 1..1 Reference(Coverage | ClaimResponse) Value of extension

    doco Documentation for this format

    Snapshot View

    NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
    .. Extension 0..* Extension Associated insurance coverage
    ... id 0..1 id Unique id for inter-element referencing
    ... extension 0..0 Extension
    Slice: Unordered, Open by value:url
    ... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/request-insurance"

    doco Documentation for this format

     

    Other representations of profile: CSV, Excel, Schematron

    Constraints

    Id Grade Path(s) Description Expression
    ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
    ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

    R4B

    The extension is unchanged in R4B

    R4

    The extension is unchanged in R4

    R3

    The extension is unchanged in R3

    Search Parameters for this Extension

    (none found)