Coverageeligibilityrequest-example.json

Release 5 Ballot

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

Example CoverageEligibilityRequest/52345 (JSON)

Financial Management Work Group

Maturity Level: N/A

Standards Status: Informative

Compartments: Patient, Practitioner

Raw JSON (canonical form + also see JSON Format Specification)

General Person Primary Coverage Example

{
  "resourceType": "CoverageEligibilityRequest",
  "id": "52345",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the CoverageEligibilityRequest</div>"
  },
  "identifier": [
    {
      "system": "http://happyvalley.com/coverageelegibilityrequest",
      "value": "52345"
    }
  ],
  "status": "active",
  "priority": {
    "coding": [
      {
        "code": "normal"
      }
    ]
  },
  "purpose": [
    "validation"
  ],
  "patient": {
    "reference": "Patient/pat1"
  },
  "created": "2014-08-16",
  "provider": {
    "reference": "Organization/1"
  },
  "insurer": {
    "reference": "Organization/2"
  },
  "insurance": [
    {
      "focal": true,
      "coverage": {
        "reference": "Coverage/9876B1"
      }
    }
  ]
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.