DHIN 2025Connectathon FHIR IG
0.2.0 - ci-build Nigeria flag

DHIN 2025Connectathon FHIR IG, published by DHIN. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Nigeria-FHIR-Community/2025Connectathon/ and changes regularly. See the Directory of published versions

: Eligibility Response - Approved - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/CoverageEligibilityResponse/CER-Response-001> a fhir:CoverageEligibilityResponse ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "CER-Response-001"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-coverage-eligibility-response" ;
       fhir:index 0 ;
       fhir:link <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-coverage-eligibility-response>
     ]
  ] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CoverageEligibilityResponse CER-Response-001</b></p><a name=\"CER-Response-001\"> </a><a name=\"hcCER-Response-001\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-coverage-eligibility-response.html\">NG Claim Coverage Eligibility Response</a></p></div><p><b>status</b>: Active</p><p><b>purpose</b>: Coverage benefits</p><p><b>patient</b>: <a href=\"Bundle-NgEligibilityCheck-Request.html#urn-uuid-aaabbbcc-e5f6-4789-a123-456789abcdef\">Chika Okafor  Male, DoB: 1990-04-21 ( mobile: 08031112233)</a></p><p><b>created</b>: 2025-10-15 09:06:30+0100</p><p><b>request</b>: <a href=\"Bundle-NgEligibilityCheck-Request.html#urn-uuid-dddeeeff-e5f6-4789-a123-456789abcdef\">CoverageEligibilityRequest: status = active; purpose = benefits; created = 2025-10-15 09:05:00+0100</a></p><p><b>outcome</b>: Processing Complete</p><p><b>disposition</b>: Eligible for covered services per active policy.</p><p><b>insurer</b>: <a href=\"Bundle-NgEligibilityCheck-Request.html#urn-uuid-cccddde1-e5f6-4789-a123-456789abcdef\">Organization XYZ HMO</a></p><blockquote><p><b>insurance</b></p><p><b>coverage</b>: <a href=\"Bundle-NgEligibilityCheck-Response.html#urn-uuid-fffaaabb-e5f6-4789-a123-456789abcdef\">Coverage: status = active; type = extended healthcare; period = 2025-01-01 --&gt; 2025-12-31</a></p><p><b>inforce</b>: true</p><blockquote><p><b>item</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-benefitcategory 1}\">Outpatient</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Allowed[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/benefit-type copay}\">vision-exam</span></td><td>1</td></tr></table></blockquote></blockquote></div>"
  ] ;
  fhir:CoverageEligibilityResponse.status [ fhir:value "active"] ;
  fhir:CoverageEligibilityResponse.purpose [
     fhir:value "benefits" ;
     fhir:index 0
  ] ;
  fhir:CoverageEligibilityResponse.patient [
     fhir:Reference.reference [ fhir:value "urn:uuid:aaabbbcc-e5f6-4789-a123-456789abcdef" ]
  ] ;
  fhir:CoverageEligibilityResponse.created [ fhir:value "2025-10-15T09:06:30+01:00"^^xsd:dateTime] ;
  fhir:CoverageEligibilityResponse.request [
     fhir:Reference.reference [ fhir:value "urn:uuid:dddeeeff-e5f6-4789-a123-456789abcdef" ]
  ] ;
  fhir:CoverageEligibilityResponse.outcome [ fhir:value "complete"] ;
  fhir:CoverageEligibilityResponse.disposition [ fhir:value "Eligible for covered services per active policy."] ;
  fhir:CoverageEligibilityResponse.insurer [
     fhir:Reference.reference [ fhir:value "urn:uuid:cccddde1-e5f6-4789-a123-456789abcdef" ]
  ] ;
  fhir:CoverageEligibilityResponse.insurance [
     fhir:index 0 ;
     fhir:CoverageEligibilityResponse.insurance.coverage [
       fhir:Reference.reference [ fhir:value "urn:uuid:fffaaabb-e5f6-4789-a123-456789abcdef" ]
     ] ;
     fhir:CoverageEligibilityResponse.insurance.inforce [ fhir:value "true"^^xsd:boolean ] ;
     fhir:CoverageEligibilityResponse.insurance.item [
       fhir:index 0 ;
       fhir:CoverageEligibilityResponse.insurance.item.category [
         fhir:CodeableConcept.coding [
           fhir:index 0 ;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-benefitcategory" ] ;
           fhir:Coding.code [ fhir:value "1" ]
         ] ;
         fhir:CodeableConcept.text [ fhir:value "Outpatient" ]
       ] ;
       fhir:CoverageEligibilityResponse.insurance.item.benefit [
         fhir:index 0 ;
         fhir:CoverageEligibilityResponse.insurance.item.benefit.type [
           fhir:CodeableConcept.coding [
             fhir:index 0 ;
             fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/benefit-type" ] ;
             fhir:Coding.code [ fhir:value "copay" ]
           ] ;
           fhir:CodeableConcept.text [ fhir:value "vision-exam" ]
         ] ;
         fhir:CoverageEligibilityResponse.insurance.item.benefit.allowedUnsignedInt [ fhir:value "1"^^xsd:nonNegativeInteger ]
       ]
     ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/CoverageEligibilityResponse/CER-Response-001.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/CoverageEligibilityResponse/CER-Response-001.ttl> .