Finance and Insurance Service (FAIS)
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Finance and Insurance Service (FAIS), published by IHE IT Infrastructure Technical Committee. This guide is not an authorized publication; it is the continuous build for version 1.0.1-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/ITI.Finance/ and changes regularly. See the Directory of published versions

: Use Case 2 - Example Coverage Eligibility Request - XML Representation

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<CoverageEligibilityRequest xmlns="http://hl7.org/fhir">
  <id value="ex-check-coverage-2"/>
  <meta>
    <profile
             value="https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.CoverageEligibilityRequest"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CoverageEligibilityRequest ex-check-coverage-2</b></p><a name="ex-check-coverage-2"> </a><a name="hcex-check-coverage-2"> </a><a name="ex-check-coverage-2-en-US"> </a><p><b>status</b>: Active</p><p><b>purpose</b>: Coverage benefits</p><p><b>patient</b>: <a href="Patient-ex-beneficiary-1.html">Purity Atieno  Female, DoB: 2000-05-04</a></p><p><b>serviced</b>: 2024-07-01 --&gt; 2024-12-31</p><p><b>created</b>: 2024-06-01 15:00:00+0000</p><p><b>enterer</b>: <a href="Practitioner-ex-doctor-2.html">Practitioner Kalu Kalu </a></p><p><b>provider</b>: <a href="Practitioner-ex-doctor-2.html">Practitioner Kalu Kalu </a></p><p><b>insurer</b>: <a href="Organization-ex-insurer-1.html">Organization National Health Insurance Scheme</a></p><p><b>facility</b>: <a href="Location-ex-hospital-2.html">Location Local Hospital</a></p><blockquote><p><b>item</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/ex-benefitcategory 1}">Medical Care</span></p><p><b>productOrService</b>: <span title="Codes:{http://loinc.org 21946-9}">Chemotherapy treatment Cancer</span></p><p><b>provider</b>: <a href="Practitioner-ex-doctor-2.html">Practitioner Kalu Kalu </a></p><p><b>facility</b>: <a href="Location-ex-hospital-2.html">Location Local Hospital</a></p><h3>Diagnoses</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Diagnosis[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://id.who.int/icd/release/11/mms XH1VB1}">Hybrid oncocytic chromophobe tumour</span></td></tr></table></blockquote></div>
  </text>
  <status value="active"/>
  <purpose value="benefits"/>
  <patient>🔗 
    <reference value="Patient/ex-beneficiary-1"/>
  </patient>
  <servicedPeriod>
    <start value="2024-07-01"/>
    <end value="2024-12-31"/>
  </servicedPeriod>
  <created value="2024-06-01T15:00:00Z"/>
  <enterer>🔗 
    <reference value="Practitioner/ex-doctor-2"/>
  </enterer>
  <provider>🔗 
    <reference value="Practitioner/ex-doctor-2"/>
  </provider>
  <insurer>🔗 
    <reference value="Organization/ex-insurer-1"/>
  </insurer>
  <facility>🔗 
    <reference value="Location/ex-hospital-2"/>
  </facility>
  <item>
    <category>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
        <code value="1"/>
      </coding>
    </category>
    <productOrService>
      <coding>
        <system value="http://loinc.org"/>
        <code value="21946-9"/>
        <display value="Chemotherapy treatment Cancer"/>
      </coding>
    </productOrService>
    <provider>🔗 
      <reference value="Practitioner/ex-doctor-2"/>
    </provider>
    <facility>🔗 
      <reference value="Location/ex-hospital-2"/>
    </facility>
    <diagnosis>
      <diagnosisCodeableConcept>
        <coding>
          <system value="http://id.who.int/icd/release/11/mms"/>
          <code value="XH1VB1"/>
          <display value="Hybrid oncocytic chromophobe tumour"/>
        </coding>
      </diagnosisCodeableConcept>
    </diagnosis>
  </item>
</CoverageEligibilityRequest>