Release 4

This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU) in it's permanent home (it will always be available at this URL). 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

Financial Management Work GroupMaturity Level: N/AStandards Status: InformativeSecurity Category: Patient Compartments: Patient, Practitioner

Mappings for the coverageeligibilityresponse resource (see Mappings to Other Standards for further information & status).

CoverageEligibilityResponse
    identifierFiveWs.identifier
    statusFiveWs.status
    purposeFiveWs.class
    patientFiveWs.subject[x]
    serviced[x]FiveWs.done[x]
    createdFiveWs.recorded
    requestorFiveWs.source
    requestFiveWs.why[x]
            providerFiveWs.source
CoverageEligibilityResponseEvent
    identifierEvent.identifier
    statusEvent.status
    patientEvent.subject
    requestEvent.basedOn
    dispositionEvent.note
CoverageEligibilityResponse
    preAuthRef23
CoverageEligibilityResponse
    identifier
    status
    purpose
    patientC06,C07,C08, C05, C04
    serviced[x]F09
    created
    requestorB01
    requestA02|G01
    outcome
    disposition
    insurer
    insurance
        coverage
        inforce
        benefitPeriod
        item
            category
            productOrService
            modifier
            providerB01
            excluded
            name
            description
            network
            unit
            term
            benefit
                type
                allowed[x]
                used[x]
            authorizationRequired
            authorizationSupporting
            authorizationUrl
    preAuthRefF03
    formG42
    error
        code