R6 Ballot (2nd Draft)

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Example CoverageEligibilityResponse/E2500 (XML)

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

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

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General Person Primary Coverage Example (id = "E2500")

<?xml version="1.0" encoding="UTF-8"?>

<CoverageEligibilityResponse xmlns="http://hl7.org/fhir">
  <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"/> 
  <patient> 
    <reference value="Patient/pat1"/> 
  </patient> 
  <created value="2014-08-16"/> 
  <request> 
    <reference value="http://www.BenefitsInc.com/fhir/coverageeligibilityrequest/225476332402"/> 
  </request> 
  <outcome value="complete"/> 
  <disposition value="Policy is currently in-force."/> 
  <insurer> 
    <reference value="Organization/2"/> 
  </insurer> 
  <insurance> 
    <coverage> 
      <reference value="Coverage/9876B1"/> 
    </coverage> 
    <inforce value="true"/> 
  </insurance> 
</CoverageEligibilityResponse> 

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.