NameFlagsCard.TypeDescription & Constraintsdoco
.. CoverageEligibilityRequest TUDomainResourceCoverageEligibilityRequest resource
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier 0..*IdentifierBusiness Identifier for coverage eligiblity request
... status ?!Σ1..1codeactive | cancelled | draft | entered-in-error
Financial Resource Status Codes (Required)
... priority 0..1CodeableConceptDesired processing priority
Process Priority Codes (Example)
... purpose Σ1..*codeauth-requirements | benefits | discovery | validation
EligibilityRequestPurpose (Required)
... patient Σ1..1Reference(Patient)Intended recipient of products and services
... serviced[x] 0..1Estimated date or dates of service
.... servicedDatedate
.... servicedPeriodPeriod
... created Σ1..1dateTimeCreation date
... enterer 0..1Reference(Practitioner | PractitionerRole)Author
... provider 0..1Reference(Practitioner | PractitionerRole | Organization)Party responsible for the request
... insurer Σ1..1Reference(Organization)Coverage issuer
... facility 0..1Reference(Location)Servicing facility
... supportingInfo 0..*BackboneElementSupporting information
.... sequence 1..1positiveIntInformation instance identifier
.... information 1..1Reference(Any)Data to be provided
.... appliesToAll 0..1booleanApplies to all items
... insurance 0..*BackboneElementPatient insurance information
.... focal 0..1booleanApplicable coverage
.... coverage 1..1Reference(Coverage)Insurance information
.... businessArrangement 0..1stringAdditional provider contract number
... item 0..*BackboneElementItem to be evaluated for eligibiity
.... supportingInfoSequence 0..*positiveIntApplicable exception or supporting information
.... category 0..1CodeableConceptBenefit classification
Benefit Category Codes (Example)
.... productOrService 0..1CodeableConceptBilling, service, product, or drug code
USCLS Codes (Example)
.... modifier 0..*CodeableConceptProduct or service billing modifiers
Modifier type Codes (Example)
.... provider 0..1Reference(Practitioner | PractitionerRole)Perfoming practitioner
.... quantity 0..1SimpleQuantityCount of products or services
.... unitPrice 0..1MoneyFee, charge or cost per item
.... facility 0..1Reference(Location | Organization)Servicing facility
.... diagnosis 0..*BackboneElementApplicable diagnosis
..... diagnosis[x] 0..1Nature of illness or problem
ICD-10 Codes (Example)
...... diagnosisCodeableConceptCodeableConcept
...... diagnosisReferenceReference(Condition)
.... detail 0..*Reference(Any)Product or service details

doco Documentation for this format