NameFlagsCard.TypeDescription & Constraintsdoco
.. EligibilityResponse DomainResourceEligibilityResponse resource
... identifier 0..*IdentifierBusiness Identifier
... status ?!Σ1..1codeactive | cancelled | draft | entered-in-error
EligibilityResponseStatus (Required)
... request[x] 0..1Claim reference
.... requestIdentifierIdentifier
.... requestReferenceReference(EligibilityRequest)
... outcome 0..1codecomplete | error | partial
RemittanceOutcome (Required)
... disposition 0..1stringDisposition Message
... ruleset 0..1CodingResource version
Ruleset Codes (Example)
... originalRuleset 0..1CodingOriginal version
Ruleset Codes (Example)
... created 0..1dateTimeCreation date
... organization[x] 0..1Insurer
.... organizationIdentifierIdentifier
.... organizationReferenceReference(Organization)
... requestProvider[x] 0..1Responsible practitioner
.... requestProviderIdentifierIdentifier
.... requestProviderReferenceReference(Practitioner)
... requestOrganization[x] 0..1Responsible organization
.... requestOrganizationIdentifierIdentifier
.... requestOrganizationReferenceReference(Organization)
... inforce 0..1booleanCoverage inforce
... contract 0..1Reference(Contract)Contract details
... form 0..1CodingPrinted Form Identifier
Form Codes (Required)
... benefitBalance 0..*BackboneElementBenefits by Category
.... category 1..1CodingBenefit Category
Benefit Category Codes (Example)
.... subCategory 0..1CodingBenefit SubCategory
Benefit SubCategory Codes (Example)
.... name 0..1stringShort name for the benefit
.... description 0..1stringDescription of the benefit
.... network 0..1CodingIn or out of network
Network Type Codes (Example)
.... unit 0..1CodingIndividual or family
Unit Type Codes (Example)
.... term 0..1CodingAnnual or lifetime
Benefit Term Codes (Example)
.... financial 0..*BackboneElementBenefit Summary
..... type 1..1CodingDeductable, visits, benefit amount
Benefit Type Codes (Example)
..... benefit[x] 0..1Benefits allowed
...... benefitUnsignedIntunsignedInt
...... benefitStringstring
...... benefitMoneyMoney
..... benefitUsed[x] 0..1Benefits used
...... benefitUsedUnsignedIntunsignedInt
...... benefitUsedMoneyMoney
... error 0..*BackboneElementProcessing errors
.... code 1..1CodingError code detailing processing issues
Adjudication Error Codes (Required)

doco Documentation for this format