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 CoverageEligibilityResponse/E2503 (JSON)

Financial Management Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient, Practitioner

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

General Person Primary Coverage with error

{
  "resourceType": "CoverageEligibilityResponse",
  "id": "E2503",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the CoverageEligibilityResponse.</div>"
  },
  "identifier": [
    {
      "system": "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse",
      "value": "8812343"
    }
  ],
  "status": "active",
  "purpose": [
    "validation"
  ],
  "patient": {
    "reference": "Patient/f201"
  },
  "created": "2014-09-16",
  "requestor": {
    "identifier": {
      "system": "http://national.org/clinic",
      "value": "OR1234"
    }
  },
  "request": {
    "reference": "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332406"
  },
  "outcome": "error",
  "disposition": "Eligibiliy request could not be processed, please address errors before submitting.",
  "insurer": {
    "reference": "Organization/2"
  },
  "form": {
    "coding": [
      {
        "system": "http://national.org/form",
        "code": "ELRSP/2017/01"
      }
    ]
  },
  "error": [
    {
      "code": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/adjudication-error",
            "code": "a001"
          }
        ]
      }
    }
  ]
}

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.