STU3 Candidate
FinancialThis page is part of the FHIR Specification (v1.8.0: STU 3 Draft). 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
Detailed Descriptions for the elements in the EligibilityRequest resource.
| EligibilityRequest | |
| Definition | This resource provides the details from the insurer to identify a specified coverage and optionally some class of service. |
| Control | 1..1 |
| EligibilityRequest.identifier | |
| Definition | The Response business identifier. |
| Note | This is a business identifer, not a resource identifier (see discussion) |
| Control | 0..* |
| Type | Identifier |
| EligibilityRequest.status | |
| Definition | The status of the resource instance. |
| Control | 0..1 |
| Terminology Binding | Financial Resource Status Codes (Required) |
| Type | code |
| Is Modifier | true |
| Summary | true |
| EligibilityRequest.priority | |
| Definition | Immediate (STAT), best effort (NORMAL), deferred (DEFER). |
| Control | 0..1 |
| Terminology Binding | Priority Codes (Example) |
| Type | CodeableConcept |
| EligibilityRequest.patient | |
| Definition | Patient Resource. |
| Control | 0..1 |
| Type | Reference(Patient) |
| Comments | 1..1. |
| EligibilityRequest.serviced[x] | |
| Definition | The date or dates when the enclosed suite of services were performed or completed. |
| Control | 0..1 |
| Type | date|Period |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| EligibilityRequest.created | |
| Definition | The date when this resource was created. |
| Control | 0..1 |
| Type | dateTime |
| EligibilityRequest.enterer | |
| Definition | Person who created the invoice/claim/pre-determination or pre-authorization. |
| Control | 0..1 |
| Type | Reference(Practitioner) |
| EligibilityRequest.provider | |
| Definition | The practitioner who is responsible for the services rendered to the patient. |
| Control | 0..1 |
| Type | Reference(Practitioner) |
| EligibilityRequest.organization | |
| Definition | The organization which is responsible for the services rendered to the patient. |
| Control | 0..1 |
| Type | Reference(Organization) |
| EligibilityRequest.insurer | |
| Definition | The Insurer who is target of the request. |
| Control | 0..1 |
| Type | Reference(Organization) |
| EligibilityRequest.facility | |
| Definition | Facility where the services were provided. |
| Control | 0..1 |
| Type | Reference(Location) |
| EligibilityRequest.coverage | |
| Definition | Financial instrument by which payment information for health care. |
| Control | 0..1 |
| Type | Reference(Coverage) |
| Requirements | Need to identify the issuer to target for processing and for coordination of benefit processing. |
| Comments | 1..1. |
| EligibilityRequest.businessArrangement | |
| Definition | The contract number of a business agreement which describes the terms and conditions. |
| Control | 0..1 |
| Type | string |
| EligibilityRequest.benefitCategory | |
| Definition | Dental, Vision, Medical, Pharmacy, Rehab etc. |
| Control | 0..1 |
| Terminology Binding | Benefit Category Codes (Example) |
| Type | CodeableConcept |
| EligibilityRequest.benefitSubCategory | |
| Definition | Dental: basic, major, ortho; Vision exam, glasses, contacts; etc. |
| Control | 0..1 |
| Terminology Binding | Benefit SubCategory Codes (Example) |
| Type | CodeableConcept |
© HL7.org 2011+. FHIR STU3 Candidate (v1.8.0-10521) generated on Tue, Dec 6, 2016 12:26+1100. QA Page
Links: Search |
Version History |
Table of Contents |
Compare to DSTU2 |
|
Propose a change