identifier | No | Identifier[] | Business Identifier for coverage eligiblity request |
status | Yes | code | active / cancelled / draft / entered-in-error |
priority | No | CodeableConcept | Desired processing priority |
purpose | Yes | code[] | auth-requirements / benefits / discovery / validation |
patient | Yes | Reference<Patient> | Intended recipient of products and services |
serviced[x] | No | date, Period | Estimated date or dates of service |
created | Yes | dateTime | Creation date |
enterer | No | Reference<Practitioner / PractitionerRole> | Author |
provider | No | Reference<Practitioner / PractitionerRole / Organization> | Party responsible for the request |
insurer | Yes | Reference<Organization> | Coverage issuer |
facility | No | Reference<Location> | Servicing facility |
supportingInfo | No | CoverageEligibilityRequestSupportingInfo | Supporting information |
- id | No | string | Unique id for inter-element referencing |
- extension | No | Extension[] | Additional content defined by implementations |
- modifierExtension | No | Extension[] | Extensions that cannot be ignored even if unrecognized |
- sequence | Yes | positiveInt | Information instance identifier |
- information | Yes | Reference<Resource> | Data to be provided |
- appliesToAll | No | boolean | Applies to all items |
insurance | No | CoverageEligibilityRequestInsurance | Patient insurance information |
- id | No | string | Unique id for inter-element referencing |
- extension | No | Extension[] | Additional content defined by implementations |
- modifierExtension | No | Extension[] | Extensions that cannot be ignored even if unrecognized |
- focal | No | boolean | Applicable coverage |
- coverage | Yes | Reference<Coverage> | Insurance information |
- businessArrangement | No | string | Additional provider contract number |
item | No | CoverageEligibilityRequestItem | Item to be evaluated for eligibiity |
- id | No | string | Unique id for inter-element referencing |
- extension | No | Extension[] | Additional content defined by implementations |
- modifierExtension | No | Extension[] | Extensions that cannot be ignored even if unrecognized |
- supportingInfoSequence | No | positiveInt[] | Applicable exception or supporting information |
- category | No | CodeableConcept | Benefit classification |
- productOrService | No | CodeableConcept | Billing, service, product, or drug code |
- modifier | No | CodeableConcept[] | Product or service billing modifiers |
- provider | No | Reference<Practitioner / PractitionerRole> | Perfoming practitioner |
- quantity | No | Quantity | Count of products or services |
- unitPrice | No | Money | Fee, charge or cost per item |
- facility | No | Reference<Location / Organization> | Servicing facility |
- diagnosis | No | CoverageEligibilityRequestItemDiagnosis | Applicable diagnosis |
- id | No | string | Unique id for inter-element referencing |
- extension | No | Extension[] | Additional content defined by implementations |
- modifierExtension | No | Extension[] | Extensions that cannot be ignored even if unrecognized |
- diagnosis[x] | No | CodeableConcept, Reference<Condition> | Nature of illness or problem |
- detail | No | Reference<Resource>[] | Product or service details |