Properties

NameRequiredTypeDescription
identifierNoIdentifier[]Business Identifier for coverage eligiblity request
statusYescodeactive / cancelled / draft / entered-in-error
purposeYescode[]auth-requirements / benefits / discovery / validation
patientYesReference<Patient>Intended recipient of products and services
serviced[x]Nodate, PeriodEstimated date or dates of service
createdYesdateTimeResponse creation date
requestorNoReference<Practitioner / PractitionerRole / Organization>Party responsible for the request
requestYesReference<CoverageEligibilityRequest>Eligibility request reference
outcomeYescodequeued / complete / error / partial
dispositionNostringDisposition Message
insurerYesReference<Organization>Coverage issuer
insuranceNoCoverageEligibilityResponseInsurancePatient insurance information
- idNostringUnique id for inter-element referencing
- extensionNoExtension[]Additional content defined by implementations
- modifierExtensionNoExtension[]Extensions that cannot be ignored even if unrecognized
- coverageYesReference<Coverage>Insurance information
- inforceNobooleanCoverage inforce indicator
- benefitPeriodNoPeriodWhen the benefits are applicable
- itemNoCoverageEligibilityResponseInsuranceItemBenefits and authorization details
- idNostringUnique id for inter-element referencing
- extensionNoExtension[]Additional content defined by implementations
- modifierExtensionNoExtension[]Extensions that cannot be ignored even if unrecognized
- categoryNoCodeableConceptBenefit classification
- productOrServiceNoCodeableConceptBilling, service, product, or drug code
- modifierNoCodeableConcept[]Product or service billing modifiers
- providerNoReference<Practitioner / PractitionerRole>Performing practitioner
- excludedNobooleanExcluded from the plan
- nameNostringShort name for the benefit
- descriptionNostringDescription of the benefit or services covered
- networkNoCodeableConceptIn or out of network
- unitNoCodeableConceptIndividual or family
- termNoCodeableConceptAnnual or lifetime
- benefitNoCoverageEligibilityResponseInsuranceItemBenefitBenefit Summary
- idNostringUnique id for inter-element referencing
- extensionNoExtension[]Additional content defined by implementations
- modifierExtensionNoExtension[]Extensions that cannot be ignored even if unrecognized
- typeYesCodeableConceptBenefit classification
- allowed[x]NounsignedInt, string, MoneyBenefits allowed
- used[x]NounsignedInt, string, MoneyBenefits used
- authorizationRequiredNobooleanAuthorization required flag
- authorizationSupportingNoCodeableConcept[]Type of required supporting materials
- authorizationUrlNouriPreauthorization requirements endpoint
preAuthRefNostringPreauthorization reference
formNoCodeableConceptPrinted form identifier
errorNoCoverageEligibilityResponseErrorProcessing errors
- idNostringUnique id for inter-element referencing
- extensionNoExtension[]Additional content defined by implementations
- modifierExtensionNoExtension[]Extensions that cannot be ignored even if unrecognized
- codeYesCodeableConceptError code detailing processing issues

Search Parameters

NameTypeDescriptionExpression
createddateThe creation dateCoverageEligibilityResponse.created
dispositionstringThe contents of the disposition messageCoverageEligibilityResponse.disposition
identifiertokenThe business identifierCoverageEligibilityResponse.identifier
insurerreferenceThe organization which generated this resourceCoverageEligibilityResponse.insurer
outcometokenThe processing outcomeCoverageEligibilityResponse.outcome
patientreferenceThe reference to the patientCoverageEligibilityResponse.patient
requestreferenceThe EligibilityRequest referenceCoverageEligibilityResponse.request
requestorreferenceThe EligibilityRequest providerCoverageEligibilityResponse.requestor
statustokenThe EligibilityRequest statusCoverageEligibilityResponse.status

Inherited Properties

NameRequiredTypeDescription
idNostringLogical id of this artifact
metaNoMetaMetadata about the resource
implicitRulesNouriA set of rules under which this content was created
languageNocodeLanguage of the resource content
textNoNarrativeText summary of the resource, for human interpretation
containedNoResource[]Contained, inline Resources
extensionNoExtension[]Additional content defined by implementations
modifierExtensionNoExtension[]Extensions that cannot be ignored

To view the FHIR specification for this resource, see CoverageEligibilityResponse.