DHIN 2025Connectathon FHIR IG
0.2.0 - ci-build
DHIN 2025Connectathon FHIR IG
0.2.0 - ci-build
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
{
"resourceType" : "CoverageEligibilityResponse",
"id" : "NgCoverageEligibilityResponse-ChikaXrayApproved",
"meta" : {
"profile" : [
🔗 "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-coverage-eligibility-response"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CoverageEligibilityResponse NgCoverageEligibilityResponse-ChikaXrayApproved</b></p><a name=\"NgCoverageEligibilityResponse-ChikaXrayApproved\"> </a><a name=\"hcNgCoverageEligibilityResponse-ChikaXrayApproved\"> </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>identifier</b>: <code>https://sandbox.dhin-hie.org/ig/CodeSystem/eligibility-request-id</code>/ELAPPROVE02</p><p><b>status</b>: Active</p><p><b>purpose</b>: Coverage Validation</p><p><b>patient</b>: <a href=\"Patient-Patient-Chika-Okafor.html\">Chika Okafor</a></p><p><b>created</b>: 2025-11-07 00:09:00+0100</p><p><b>requestor</b>: <a href=\"Organization-Organization-PortHarcourt-Hospital.html\">Port Harcourt Emergency Hospital</a></p><p><b>request</b>: <a href=\"CoverageEligibilityRequest-NgCoverageEligibilityRequest-ChikaEmergency.html\">CoverageEligibilityRequest: identifier = https://sandbox.dhin-hie.org/ig/CodeSystem/eligibility-request-id#ELAPPROVE01; status = active; purpose = validation; created = 2025-11-06 23:47:00+0100</a></p><p><b>outcome</b>: Processing Complete</p><p><b>disposition</b>: Pre-authorization APPROVED. Approved amount: ₦15,000. Patient copay: ₦1,500. Authorization code: PA-2025-8847. Valid until: 10-Nov-2025.</p><p><b>insurer</b>: <a href=\"Organization-Organization-Truth-HMO.html\">Truth HMO</a></p><blockquote><p><b>insurance</b></p><p><b>coverage</b>: <a href=\"Coverage-Coverage-Chika-TruthHMO.html\">Truth HMO Policy - Chika Okafor</a></p><p><b>inforce</b>: true</p><blockquote><p><b>item</b></p><p><b>productOrService</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 73610}\">Ankle X-ray - Right ankle sprain (ICD-10: S93.4)</span></p><p><b>description</b>: Pre-authorization approved for emergency ankle X-ray. Valid until 10-Nov-2025.</p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/benefit-type benefit}\">Benefit</span></p><p><b>allowed</b>: <span title=\"Nigerian Naira\">NGN15,000.00</span> (NGN)</p><p><b>used</b>: <span title=\"Nigerian Naira\">NGN0.00</span> (NGN)</p></blockquote><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/benefit-type copay}\">Copayment per service</span></p><p><b>allowed</b>: <span title=\"Nigerian Naira\">NGN1,500.00</span> (NGN)</p></blockquote><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/benefit-type room}\">HMO Coverage Amount</span></p><p><b>allowed</b>: <span title=\"Nigerian Naira\">NGN13,500.00</span> (NGN)</p></blockquote><p><b>authorizationRequired</b>: true</p><p><b>authorizationSupporting</b>: <span title=\"Codes:\">Emergency presentation with suspected fracture</span></p><p><b>authorizationUrl</b>: <a href=\"CodeSystem-eligibility-request-id.html\">Eligibility Request ID CodeSystem</a></p></blockquote></blockquote><p><b>preAuthRef</b>: PA-2025-8847</p></div>"
},
"identifier" : [
{
"system" : "https://sandbox.dhin-hie.org/ig/CodeSystem/eligibility-request-id",
"value" : "ELAPPROVE02"
}
],
"status" : "active",
"purpose" : [
"validation"
],
"patient" : {
🔗 "reference" : "Patient/Patient-Chika-Okafor",
"display" : "Chika Okafor"
},
"created" : "2025-11-07T00:09:00+01:00",
"requestor" : {
🔗 "reference" : "Organization/Organization-PortHarcourt-Hospital",
"display" : "Port Harcourt Emergency Hospital"
},
"request" : {
🔗 "reference" : "CoverageEligibilityRequest/NgCoverageEligibilityRequest-ChikaEmergency"
},
"outcome" : "complete",
"disposition" : "Pre-authorization APPROVED. Approved amount: ₦15,000. Patient copay: ₦1,500. Authorization code: PA-2025-8847. Valid until: 10-Nov-2025.",
"insurer" : {
🔗 "reference" : "Organization/Organization-Truth-HMO",
"display" : "Truth HMO"
},
"insurance" : [
{
"coverage" : {
🔗 "reference" : "Coverage/Coverage-Chika-TruthHMO",
"display" : "Truth HMO Policy - Chika Okafor"
},
"inforce" : true,
"item" : [
{
"productOrService" : {
"coding" : [
{
"system" : "http://www.ama-assn.org/go/cpt",
"code" : "73610",
"display" : "Radiologic examination, ankle; complete, minimum of 3 views"
}
],
"text" : "Ankle X-ray - Right ankle sprain (ICD-10: S93.4)"
},
"description" : "Pre-authorization approved for emergency ankle X-ray. Valid until 10-Nov-2025.",
"benefit" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/benefit-type",
"code" : "benefit",
"display" : "Benefit"
}
]
},
"allowedMoney" : {
"value" : 15000,
"currency" : "NGN"
},
"usedMoney" : {
"value" : 0,
"currency" : "NGN"
}
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/benefit-type",
"code" : "copay",
"display" : "Copayment per service"
}
]
},
"allowedMoney" : {
"value" : 1500,
"currency" : "NGN"
}
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/benefit-type",
"code" : "room",
"display" : "Room"
}
],
"text" : "HMO Coverage Amount"
},
"allowedMoney" : {
"value" : 13500,
"currency" : "NGN"
}
}
],
"authorizationRequired" : true,
"authorizationSupporting" : [
{
"text" : "Emergency presentation with suspected fracture"
}
],
"authorizationUrl" : "https://sandbox.dhin-hie.org/ig/CodeSystem/eligibility-request-id#PA-2025-8847"
}
]
}
],
"preAuthRef" : "PA-2025-8847"
}