Release 5 Ballot

This page is part of the FHIR Specification (v5.0.0-ballot: R5 Ballot - see ballot notes). 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

4.4.1.772 ValueSet http://hl7.org/fhir/ValueSet/eligibilityresponse-purpose

Financial Management icon Work Group Maturity Level: 2Trial Use Use Context: Any

This is a value set defined by the FHIR project.

Summary

Defining URL:http://hl7.org/fhir/ValueSet/eligibilityresponse-purpose
Version:5.0.0-ballot
Name:EligibilityResponsePurpose
Title:EligibilityResponsePurpose
Status:draft
Definition:

A code specifying the types of information being requested.

Committee:Financial Management icon Work Group
OID:2.16.840.1.113883.4.642.3.1184 (for OID based terminology systems)
Flags:Immutable

This value set is used in the following places:

4.4.1.772.1 Content Logical Definition

 

4.4.1.772.2 Expansion

This expansion generated 10 Sep 2022

This value set contains 4 concepts

Expansion based on EligibilityResponsePurpose v5.0.0-ballot (CodeSystem)

CodeSystemDisplayDefinition
  auth-requirementshttp://hl7.org/fhir/eligibilityresponse-purposeCoverage auth-requirements

The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested.

  benefitshttp://hl7.org/fhir/eligibilityresponse-purposeCoverage benefits

The plan benefits and optionally benefits consumed for the listed, or discovered if specified, converages are requested.

  discoveryhttp://hl7.org/fhir/eligibilityresponse-purposeCoverage Discovery

The insurer is requested to report on any coverages which they are aware of in addition to any specifed.

  validationhttp://hl7.org/fhir/eligibilityresponse-purposeCoverage Validation

A check that the specified coverages are in-force is requested.

 

See the full registry of value sets defined as part of FHIR.

Explanation of the columns that may appear on this page:

LvlA few code lists that FHIR defines are hierarchical - each code is assigned a level. For value sets, levels are mostly used to organize codes for user convenience, but may follow code system hierarchy - see Code System for further information
SourceThe source of the definition of the code (when the value set draws in codes defined elsewhere)
CodeThe code (used as the code in the resource instance). If the code is in italics, this indicates that the code is not selectable ('Abstract')
DisplayThe display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
DefinitionAn explanation of the meaning of the concept
CommentsAdditional notes about how to use the code