This resource provides eligibility and plan details from the processing of an Eligibility resource.

The Response business identifier.

The status of the resource instance.

Original request resource reference.

Transaction status: error, complete.

A description of the status of the adjudication.

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 the enclosed suite of services were performed or completed.

The Insurer who produced this adjudicated response.

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

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

Flag indicating if the coverage provided is inforce currently if no service date(s) specified or for the whole duration of the service dates.

The contract resource which may provide more detailed information.

The form to be used for printing the content.

Benefits and optionally current balances by Category.

Dental, Vision, Medical, Pharmacy, Rehab etc.

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

A short name or tag for the benefit, for example MED01, or DENT2.

A richer description of the benefit, for example 'DENT2 covers 100% of basic, 50% of major but exclused Ortho, Implants and Costmetic services'.

Network designation.

Unit designation: individual or family.

The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual vistis'.

Benefits Used to date.

Deductable, visits, benefit amount.

Benefits allowed.

Benefits used.

Mutually exclusive with Services Provided (Item).

An error code,from a specified code system, which details why the eligibility check could not be performed.