This resource provides the insurance eligibility details from the insurer regarding a specified coverage and optionally some class of service.

The Response business identifier.

The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources.

The style (standard) and version of the original material which was converted into this resource.

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.

The date when this resource was created.

The Insurer who is target of the request.

The practitioner who is responsible for the services rendered to the patient.

The organization which is responsible for the services rendered to the patient.

Immediate (STAT), best effort (NORMAL), deferred (DEFER).

Person who created the invoice/claim/pre-determination or pre-authorization.

Facility where the services were provided.

Patient Resource.

1..1.

Financial instrument by which payment information for health care.

Need to identify the issuer to target for processing and for coordination of benefit processing.

1..1.

The contract number of a business agreement which describes the terms and conditions.

The relationship of the patient to the subscriber.

To determine relationship between the patient and the subscriber.

1..1.

The date or dates when the enclosed suite of services were performed or completed.

Dental, Vision, Medical, Pharmacy, Rehab etc.

Dental: basic, major, ortho; Vision exam, glasses, contacts; etc.