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
<CoverageEligibilityResponse xmlns="http://hl7.org/fhir">
<id value="NgCoverageEligibilityResponse-ChikaXrayApproved"/>
<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 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>
</text>
<identifier>
<system
value="https://sandbox.dhin-hie.org/ig/CodeSystem/eligibility-request-id"/>
<value value="ELAPPROVE02"/>
</identifier>
<status value="active"/>
<purpose value="validation"/>
<patient>🔗
<reference value="Patient/Patient-Chika-Okafor"/>
<display value="Chika Okafor"/>
</patient>
<created value="2025-11-07T00:09:00+01:00"/>
<requestor>🔗
<reference value="Organization/Organization-PortHarcourt-Hospital"/>
<display value="Port Harcourt Emergency Hospital"/>
</requestor>
<request>🔗
<reference
value="CoverageEligibilityRequest/NgCoverageEligibilityRequest-ChikaEmergency"/>
</request>
<outcome value="complete"/>
<disposition
value="Pre-authorization APPROVED. Approved amount: ₦15,000. Patient copay: ₦1,500. Authorization code: PA-2025-8847. Valid until: 10-Nov-2025."/>
<insurer>🔗
<reference value="Organization/Organization-Truth-HMO"/>
<display value="Truth HMO"/>
</insurer>
<insurance>
<coverage>🔗
<reference value="Coverage/Coverage-Chika-TruthHMO"/>
<display value="Truth HMO Policy - Chika Okafor"/>
</coverage>
<inforce value="true"/>
<item>
<productOrService>
<coding>
<system value="http://www.ama-assn.org/go/cpt"/>
<code value="73610"/>
<display
value="Radiologic examination, ankle; complete, minimum of 3 views"/>
</coding>
<text value="Ankle X-ray - Right ankle sprain (ICD-10: S93.4)"/>
</productOrService>
<description
value="Pre-authorization approved for emergency ankle X-ray. Valid until 10-Nov-2025."/>
<benefit>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-type"/>
<code value="benefit"/>
<display value="Benefit"/>
</coding>
</type>
<allowedMoney>
<value value="15000"/>
<currency value="NGN"/>
</allowedMoney>
<usedMoney>
<value value="0"/>
<currency value="NGN"/>
</usedMoney>
</benefit>
<benefit>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-type"/>
<code value="copay"/>
<display value="Copayment per service"/>
</coding>
</type>
<allowedMoney>
<value value="1500"/>
<currency value="NGN"/>
</allowedMoney>
</benefit>
<benefit>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/benefit-type"/>
<code value="room"/>
<display value="Room"/>
</coding>
<text value="HMO Coverage Amount"/>
</type>
<allowedMoney>
<value value="13500"/>
<currency value="NGN"/>
</allowedMoney>
</benefit>
<authorizationRequired value="true"/>
<authorizationSupporting>
<text value="Emergency presentation with suspected fracture"/>
</authorizationSupporting>
<authorizationUrl
value="https://sandbox.dhin-hie.org/ig/CodeSystem/eligibility-request-id#PA-2025-8847"/>
</item>
</insurance>
<preAuthRef value="PA-2025-8847"/>
</CoverageEligibilityResponse>