EligibilityRequest - FHIR v1.1.0

GAO Ballot Package

This page is part of the FHIR Specification (v1.1.0: STU 3 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R3 R2

This is a frozen snapshot of the FHIR specification created for the purpose of balloting the GAO implementation Guide. It includes draft changes that may be part of the future DSTU 2.1 release but further change is expected. Readers should focus solely on the GAO implementation content, and FHIR DSTU 2 for other purposes.

7.4.5 Resource EligibilityRequest - Detailed Descriptions

Detailed Descriptions for the elements in the EligibilityRequest resource.

EligibilityRequest
Definition	This resource provides the insurance eligibility details from the insurer regarding a specified coverage and optionally some class of service.
Control	1..1
Summary	true
EligibilityRequest.identifier
Definition	The Response business identifier.
Note	This is a business identifer, not a resource identifier (see discussion)
Control	0..*
Type	Identifier
Summary	true
EligibilityRequest.ruleset
Definition	The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources.
Control	0..1
Binding	Ruleset Codes: The static and dynamic model to which contents conform, which may be business version or standard/version. (Example)
Type	Coding
Summary	true
EligibilityRequest.originalRuleset
Definition	The style (standard) and version of the original material which was converted into this resource.
Control	0..1
Binding	Ruleset Codes: The static and dynamic model to which contents conform, which may be business version or standard/version. (Example)
Type	Coding
Requirements	Knowledge of the original version can inform the processing of this instance so that information which is processable by the originating system may be generated.
Summary	true
EligibilityRequest.created
Definition	The date when this resource was created.
Control	0..1
Type	dateTime
Summary	true
EligibilityRequest.target
Definition	The Insurer who is target of the request.
Control	0..1
Type	Reference(Organization)
Summary	true
EligibilityRequest.provider
Definition	The practitioner who is responsible for the services rendered to the patient.
Control	0..1
Type	Reference(Practitioner)
Summary	true
EligibilityRequest.organization
Definition	The organization which is responsible for the services rendered to the patient.
Control	0..1
Type	Reference(Organization)
Summary	true