NameFlagsCard.TypeDescription & Constraintsdoco
.. EligibilityResponse DomainResourceEligibilityResponse resource
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... identifier 0..*IdentifierBusiness Identifier
... status ?!Σ0..1codeactive | cancelled | draft | entered-in-error
Financial Resource Status Codes (Required)
... created 0..1dateTimeCreation date
... requestProvider 0..1Reference(Practitioner)Responsible practitioner
... requestOrganization 0..1Reference(Organization)Responsible organization
... request 0..1Reference(EligibilityRequest)Eligibility reference
... outcome 0..1CodeableConceptcomplete | error | partial
RemittanceOutcome (Required)
... disposition 0..1stringDisposition Message
... insurer 0..1Reference(Organization)Insurer issuing the coverage
... inforce 0..1booleanCoverage inforce indicator
... insurance 0..*BackboneElementDetails by insurance coverage
.... coverage 0..1Reference(Coverage)Updated Coverage details
.... contract 0..1Reference(Contract)Contract details
.... benefitBalance 0..*BackboneElementBenefits by Category
..... category 1..1CodeableConceptType of services covered
Benefit Category Codes (Example)
..... subCategory 0..1CodeableConceptDetailed services covered within the type
Benefit SubCategory Codes (Example)
..... excluded 0..1booleanExcluded from the plan
..... name 0..1stringShort name for the benefit
..... description 0..1stringDescription of the benefit or services covered
..... network 0..1CodeableConceptIn or out of network
Network Type Codes (Example)
..... unit 0..1CodeableConceptIndividual or family
Unit Type Codes (Example)
..... term 0..1CodeableConceptAnnual or lifetime
Benefit Term Codes (Example)
..... financial 0..*BackboneElementBenefit Summary
...... type 1..1CodeableConceptDeductable, visits, benefit amount
Benefit Type Codes (Example)
...... allowed[x] 0..1Benefits allowed
....... allowedUnsignedIntunsignedInt
....... allowedStringstring
....... allowedMoneyMoney
...... used[x] 0..1Benefits used
....... usedUnsignedIntunsignedInt
....... usedMoneyMoney
... form 0..1CodeableConceptPrinted Form Identifier
Form Codes (Example)
... error 0..*BackboneElementProcessing errors
.... code 1..1CodeableConceptError code detailing processing issues
Adjudication Error Codes (Example)

doco Documentation for this format