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 - XML Representation

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<CoverageEligibilityResponse xmlns="http://hl7.org/fhir">
  <id value="CER-Response-001"/>
  <meta>
    <profile
             value="https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-coverage-eligibility-response"/>
  </meta>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <status value="active"/>
  <purpose value="benefits"/>
  <patient>
    <reference value="urn:uuid:aaabbbcc-e5f6-4789-a123-456789abcdef"/>
  </patient>
  <created value="2025-10-15T09:06:30+01:00"/>
  <request>
    <reference value="urn:uuid:dddeeeff-e5f6-4789-a123-456789abcdef"/>
  </request>
  <outcome value="complete"/>
  <disposition value="Eligible for covered services per active policy."/>
  <insurer>
    <reference value="urn:uuid:cccddde1-e5f6-4789-a123-456789abcdef"/>
  </insurer>
  <insurance>
    <coverage>
      <reference value="urn:uuid:fffaaabb-e5f6-4789-a123-456789abcdef"/>
    </coverage>
    <inforce value="true"/>
    <item>
      <category>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
          <code value="1"/>
        </coding>
        <text value="Outpatient"/>
      </category>
      <benefit>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/benefit-type"/>
            <code value="copay"/>
          </coding>
          <text value="vision-exam"/>
        </type>
        <allowedUnsignedInt value="1"/>
      </benefit>
    </item>
  </insurance>
</CoverageEligibilityResponse>