Release 4B Ballot #1

This page is part of the FHIR Specification v4.1.0: R4B Ballot. About the R4B version of FHIR. 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: R5 R4B R4

13.2.10.1 Operation $submit on CoverageEligibilityRequest

Financial Management Work Group Maturity Level: 2Trial Use Compartments: N/A

This operation is used to submit an EligibilityRequest for assessment either as a single EligibilityRequest resource instance or as a Bundle containing the EligibilityRequest and other referenced resources, or Bundle containing a batch of EligibilityRequest resources, either as single EligibilityRequests resources or Bundle resources, for processing. The only input parameter is the single EligibilityRequest or Bundle resource and the only output is a single EligibilityResponse, Bundle of EligibilityResponses or an OperationOutcome resource.

The official URL for this operation definition is

 http://hl7.org/fhir/OperationDefinition/CoverageEligibilityRequest-submit

Formal Definition (as a OperationDefinition).

URL: [base]/CoverageEligibilityRequest/$submit

This is not an idempotent operation

In Parameters:
NameCardinalityTypeBindingProfileDocumentation
resource1..1Resource

An EligibilityRequest resource or Bundle of EligibilityRequests, either as individual EligibilityRequest resources or as Bundles each containing a single EligibilityRequest plus referenced resources.

Out Parameters:
NameCardinalityTypeBindingProfileDocumentation
return1..1Resource

An EligibilityResponse resource or Bundle of EligibilityResponse responses, either as individual EligibilityResponse resources or as Bundles each containing a single EligibilityResponse plus referenced resources.

Note: as this is the only out parameter, it is a resource, and it has the name 'return', the result of this operation is returned directly as a resource

13.2.10.1.1 Examples

Request:

POST [baseurl]/EligibilityRequest/$submit
[headers]

<?xml version="1.0" encoding="UTF-8"?>
<CoverageEligibilityRequest xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../schema/remittance.xsd">
	<id value="52345"/>

	<text>
		<status value="generated"/>
		<div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the CoverageEligibilityRequest</div>
	</text>

	<identifier>
		<system value="http://happyvalley.com/coverageelegibilityrequest"/>
		<value value="52345"/>
	</identifier>

	<status value="active"/>

	<priority>
		<coding>
			<code value="normal"/>
		</coding>
	</priority>
	
	<purpose value="validation"/>

	<patient>
		<reference value="Patient/pat1"/>
	</patient>

	<created value="2014-08-16"/>

	<organization>
		<reference value="Organization/1"/>
	</organization>

	<insurer>
		<reference value="Organization/2"/>
	</insurer>

	<coverage>
		<reference value="Coverage/9876B1"/>
	</coverage>

</CoverageEligibilityRequest>

Response:

HTTP/1.1 200 OK
[headers]

<?xml version="1.0" encoding="UTF-8"?>
<CoverageEligibilityResponse xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../schema/remittance.xsd">
	<id value="E2500"/>

	<text>
		<status value="generated"/>
		<div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the CoverageEligibilityResponse.</div>
	</text>

	<identifier>
		<system value="http://www.BenefitsInc.com/fhir/coverageeligibilityresponse"/>
		<value value="881234"/>
	</identifier>

	<status value="active"/>

	<purpose value="validation"/>

	<created value="2014-08-16"/>

	<request>
		<reference value="http://www.BenefitsInc.com/fhir/coverageeligibilityrequest/52345"/>
	</request>

	<outcome value="complete"/>

	<disposition value="Policy is currently in-force."/>

	<insurer>
		<reference value="Organization/2"/>
	</insurer>

	<inforce value="true"/>

</CoverageEligibilityResponse>

 

For more information about operations, including how they are invoked, see Operations.