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5.1.0 - 5.1.0 (April 2024) International flag

This page is part of the FHIR Core Extensions Registry (v5.1.0: Release 5.1) based on FHIR (HL7® FHIR® Standard) v5.0.0. This is the current published version. For a full list of available versions, see the Directory of published versions

: FML Conversion for CoverageEligibilityResponse: R5 to R4B - XML Representation

Page standards status: Trial-use Maturity Level: 1

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<StructureMap xmlns="http://hl7.org/fhir">
  <id value="CoverageEligibilityResponse5to4B"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><pre class="fml">
<span style="color: #cc00cc">/// <b>url</b> = </span><span style="color: blue">'http://hl7.org/fhir/StructureMap/CoverageEligibilityResponse5to4B'</span>
<span style="color: #cc00cc">/// <b>name</b> = </span><span style="color: blue">'CoverageEligibilityResponse5to4B'</span>
<span style="color: #cc00cc">/// <b>title</b> = </span><span style="color: blue">'FML Conversion for CoverageEligibilityResponse: R5 to R4B'</span>
<span style="color: #cc00cc">/// <b>status</b> = </span><span style="color: blue">'active'</span>

<b>conceptmap</b><span style="color: navy"> &quot;</span>EligibilityOutcome<span style="color: navy">&quot; {
</span><b>  prefix </b>s<span style="color: navy"> = &quot;</span><a href="http://hl7.org/fhir/R5/codesystem-eligibility-outcome.html" title="Claim Processing Codes">http://hl7.org/fhir/eligibility-outcome</a><span style="color: navy">&quot;
</span><b>  prefix </b>t<span style="color: navy"> = &quot;</span><a href="http://hl7.org/fhir/R4B/codesystem-remittance-outcome.html" title="RemittanceOutcome">http://hl7.org/fhir/4.3/remittance-outcome</a><span style="color: navy">&quot;
</span>
  s<span style="color: navy">:</span>queued <b>-</b> t<span style="color: navy">:</span>queued
  s<span style="color: navy">:</span>complete <b>-</b> t<span style="color: navy">:</span>complete
  s<span style="color: navy">:</span>error <b>-</b> t<span style="color: navy">:</span>error
  s<span style="color: navy">:</span>partial <b>-</b> t<span style="color: navy">:</span>partial
<span style="color: navy">}

</span><b>conceptmap</b><span style="color: navy"> &quot;</span>EligibilityResponsePurpose<span style="color: navy">&quot; {
</span><b>  prefix </b>s<span style="color: navy"> = &quot;</span><a href="http://hl7.org/fhir/R5/codesystem-eligibilityresponse-purpose.html" title="Eligibility Response Purpose">http://hl7.org/fhir/eligibilityresponse-purpose</a><span style="color: navy">&quot;
</span><b>  prefix </b>t<span style="color: navy"> = &quot;</span><a href="http://hl7.org/fhir/R4B/codesystem-eligibilityresponse-purpose.html" title="EligibilityResponsePurpose">http://hl7.org/fhir/4.3/eligibilityresponse-purpose</a><span style="color: navy">&quot;
</span>
  s<span style="color: navy">:</span>&quot;auth-requirements&quot; <b>-</b> t<span style="color: navy">:</span><span style="color: navy">&quot;</span>auth-requirements<span style="color: navy">&quot;</span>
  s<span style="color: navy">:</span>benefits <b>-</b> t<span style="color: navy">:</span>benefits
  s<span style="color: navy">:</span>discovery <b>-</b> t<span style="color: navy">:</span>discovery
  s<span style="color: navy">:</span>validation <b>-</b> t<span style="color: navy">:</span>validation
<span style="color: navy">}

</span><b>conceptmap</b><span style="color: navy"> &quot;</span>EligibilityResponseStatus<span style="color: navy">&quot; {
</span><b>  prefix </b>s<span style="color: navy"> = &quot;</span><a href="http://hl7.org/fhir/R5/codesystem-fm-status.html" title="Financial Resource Status Codes">http://hl7.org/fhir/fm-status</a><span style="color: navy">&quot;
</span><b>  prefix </b>t<span style="color: navy"> = &quot;</span><a href="http://hl7.org/fhir/R4B/codesystem-fm-status.html" title="Financial Resource Status Codes">http://hl7.org/fhir/4.3/fm-status</a><span style="color: navy">&quot;
</span>
  s<span style="color: navy">:</span>active <b>-</b> t<span style="color: navy">:</span>active
  s<span style="color: navy">:</span>cancelled <b>-</b> t<span style="color: navy">:</span>cancelled
  s<span style="color: navy">:</span>draft <b>-</b> t<span style="color: navy">:</span>draft
  s<span style="color: navy">:</span>&quot;entered-in-error&quot; <b>-</b> t<span style="color: navy">:</span><span style="color: navy">&quot;</span>entered-in-error<span style="color: navy">&quot;</span>
<span style="color: navy">}

</span><b>uses</b><span style="color: navy"> &quot;</span><a href="http://hl7.org/fhir/R5/coverageeligibilityresponse.html" title="CoverageEligibilityResponse">http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse</a><span style="color: navy">&quot; </span><b>alias </b>CoverageEligibilityResponseR5 <b>as </b><b>source</b>
<b>uses</b><span style="color: navy"> &quot;</span><a href="http://hl7.org/fhir/R4B/coverageeligibilityresponse.html" title="CoverageEligibilityResponse">http://hl7.org/fhir/4.3/StructureDefinition/CoverageEligibilityResponse</a><span style="color: navy">&quot; </span><b>alias </b>CoverageEligibilityResponseR4B <b>as </b><b>target</b>

<b>imports</b><span style="color: navy"> &quot;</span>http://hl7.org/fhir/StructureMap/*5to4B<span style="color: navy">&quot;
</span>
<b>group </b>CoverageEligibilityResponse<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span><span style="color: navy"> : </span>CoverageEligibilityResponseR5, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy"> : </span>CoverageEligibilityResponseR4B<span style="color: navy">)</span><b> extends </b>DomainResource<b> &lt;&lt;type+&gt;&gt;</b><span style="color: navy"> {
</span>  src.identifier<span style="color: navy"><b> -&gt; </b></span>tgt.identifier<span style="color: navy">;</span>
  src.status<b> as </b><span style="color: maroon">v</span><span style="color: navy"><b> -&gt; </b></span>tgt.status = <b>translate</b><span style="color: navy">(</span><span style="color: maroon">v</span><span style="color: navy">, </span><span style="color: blue">'#EligibilityResponseStatus'</span><span style="color: navy">, </span><span style="color: blue">'code'</span><span style="color: navy">)</span><span style="color: navy">;</span>
  src.purpose<b> as </b><span style="color: maroon">v</span><span style="color: navy"><b> -&gt; </b></span>tgt.purpose = <b>translate</b><span style="color: navy">(</span><span style="color: maroon">v</span><span style="color: navy">, </span><span style="color: blue">'#EligibilityResponsePurpose'</span><span style="color: navy">, </span><span style="color: blue">'code'</span><span style="color: navy">)</span><span style="color: navy">;</span>
  src.patient<span style="color: navy"><b> -&gt; </b></span>tgt.patient<span style="color: navy">;</span>
  src.serviced<span style="color: navy"> : </span>date<span style="color: navy"><b> -&gt; </b></span>tgt.serviced<span style="color: navy">;</span> <span style="color: navy">// </span><span style="color: green">src.event as s -&gt; tgt.event as t then CoverageEligibilityResponseEvent(s,t);</span>
  src.serviced<span style="color: navy"> : </span>Period<span style="color: navy"><b> -&gt; </b></span>tgt.serviced<span style="color: navy">;</span>
  src.created<span style="color: navy"><b> -&gt; </b></span>tgt.created<span style="color: navy">;</span>
  src.requestor<span style="color: navy"><b> -&gt; </b></span>tgt.requestor<span style="color: navy">;</span>
  src.request<span style="color: navy"><b> -&gt; </b></span>tgt.request<span style="color: navy">;</span>
  src.outcome<b> as </b><span style="color: maroon">v</span><span style="color: navy"><b> -&gt; </b></span>tgt.outcome = <b>translate</b><span style="color: navy">(</span><span style="color: maroon">v</span><span style="color: navy">, </span><span style="color: blue">'#EligibilityOutcome'</span><span style="color: navy">, </span><span style="color: blue">'code'</span><span style="color: navy">)</span><span style="color: navy">;</span>
  src.disposition<span style="color: navy"><b> -&gt; </b></span>tgt.disposition<span style="color: navy">;</span>
  src.insurer<span style="color: navy"><b> -&gt; </b></span>tgt.insurer<span style="color: navy">;</span>
  src.insurance<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -&gt; </b></span>tgt.insurance<b> as </b><span style="color: maroon">t</span><b> then </b>CoverageEligibilityResponseInsurance<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
  src.preAuthRef<span style="color: navy"><b> -&gt; </b></span>tgt.preAuthRef<span style="color: navy">;</span>
  src.form<span style="color: navy"><b> -&gt; </b></span>tgt.form<span style="color: navy">;</span>
  src.error<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -&gt; </b></span>tgt.error<b> as </b><span style="color: maroon">t</span><b> then </b>CoverageEligibilityResponseError<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
<span style="color: navy">}

</span><span style="color: navy">// </span><span style="color: green">group CoverageEligibilityResponseEvent(source src, target tgt) extends BackboneElement {</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.type -&gt; tgt.type;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.when : dateTime -&gt; tgt.when;</span>
<span style="color: #b36b00" title="This element was not defined prior to R5">// src.when : Period -&gt; tgt.when;</span>
<span style="color: navy">// </span><span style="color: green">}</span>
<b>group </b>CoverageEligibilityResponseInsurance<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span>  src.coverage<span style="color: navy"><b> -&gt; </b></span>tgt.coverage<span style="color: navy">;</span>
  src.inforce<span style="color: navy"><b> -&gt; </b></span>tgt.inforce<span style="color: navy">;</span>
  src.benefitPeriod<span style="color: navy"><b> -&gt; </b></span>tgt.benefitPeriod<span style="color: navy">;</span>
  src.item<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -&gt; </b></span>tgt.item<b> as </b><span style="color: maroon">t</span><b> then </b>CoverageEligibilityResponseInsuranceItem<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
<span style="color: navy">}

</span><b>group </b>CoverageEligibilityResponseInsuranceItem<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span>  src.category<span style="color: navy"><b> -&gt; </b></span>tgt.category<span style="color: navy">;</span>
  src.productOrService<span style="color: navy"><b> -&gt; </b></span>tgt.productOrService<span style="color: navy">;</span>
  src.modifier<span style="color: navy"><b> -&gt; </b></span>tgt.modifier<span style="color: navy">;</span>
  src.provider<span style="color: navy"><b> -&gt; </b></span>tgt.provider<span style="color: navy">;</span>
  src.excluded<span style="color: navy"><b> -&gt; </b></span>tgt.excluded<span style="color: navy">;</span>
  src.name<span style="color: navy"><b> -&gt; </b></span>tgt.name<span style="color: navy">;</span>
  src.description<span style="color: navy"><b> -&gt; </b></span>tgt.description<span style="color: navy">;</span>
  src.network<span style="color: navy"><b> -&gt; </b></span>tgt.network<span style="color: navy">;</span>
  src.unit<span style="color: navy"><b> -&gt; </b></span>tgt.unit<span style="color: navy">;</span>
  src.term<span style="color: navy"><b> -&gt; </b></span>tgt.term<span style="color: navy">;</span>
  src.benefit<b> as </b><span style="color: maroon">s</span><span style="color: navy"><b> -&gt; </b></span>tgt.benefit<b> as </b><span style="color: maroon">t</span><b> then </b>CoverageEligibilityResponseInsuranceItemBenefit<span style="color: navy">(</span><span style="color: maroon">s</span><span style="color: navy">, </span><span style="color: maroon">t</span><span style="color: navy">)</span><span style="color: navy">;</span>
  src.authorizationRequired<span style="color: navy"><b> -&gt; </b></span>tgt.authorizationRequired<span style="color: navy">;</span>
  src.authorizationSupporting<span style="color: navy"><b> -&gt; </b></span>tgt.authorizationSupporting<span style="color: navy">;</span>
  src.authorizationUrl<span style="color: navy"><b> -&gt; </b></span>tgt.authorizationUrl<span style="color: navy">;</span>
<span style="color: navy">}

</span><b>group </b>CoverageEligibilityResponseInsuranceItemBenefit<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span>  src.type<span style="color: navy"><b> -&gt; </b></span>tgt.type<span style="color: navy">;</span>
  src.allowed<span style="color: navy"> : </span>unsignedInt<span style="color: navy"><b> -&gt; </b></span>tgt.allowed<span style="color: navy">;</span>
  src.allowed<span style="color: navy"> : </span>string<span style="color: navy"><b> -&gt; </b></span>tgt.allowed<span style="color: navy">;</span>
  src.allowed<span style="color: navy"> : </span>Money<span style="color: navy"><b> -&gt; </b></span>tgt.allowed<span style="color: navy">;</span>
  src.used<span style="color: navy"> : </span>unsignedInt<span style="color: navy"><b> -&gt; </b></span>tgt.used<span style="color: navy">;</span>
  src.used<span style="color: navy"> : </span>string<span style="color: navy"><b> -&gt; </b></span>tgt.used<span style="color: navy">;</span>
  src.used<span style="color: navy"> : </span>Money<span style="color: navy"><b> -&gt; </b></span>tgt.used<span style="color: navy">;</span>
<span style="color: navy">}

</span><b>group </b>CoverageEligibilityResponseError<span style="color: navy">(</span><b>source</b> <span style="color: maroon">src</span>, <b>target</b> <span style="color: maroon">tgt</span><span style="color: navy">)</span><b> extends </b>BackboneElement<span style="color: navy"> {
</span>  src.code<span style="color: navy"><b> -&gt; </b></span>tgt.code<span style="color: navy">;</span>
<span style="color: navy">}

</span></pre></div>
  </text>
  <contained>
    <ConceptMap>
      <id value="EligibilityOutcome"/>
      <status value="active"/>
      <group>
        <source value="http://hl7.org/fhir/eligibility-outcome"/>
        <target value="http://hl7.org/fhir/4.3/remittance-outcome"/>
        <element>
          <code value="queued"/>
          <target>
            <code value="queued"/>
            <relationship value="related-to"/>
          </target>
        </element>
        <element>
          <code value="complete"/>
          <target>
            <code value="complete"/>
            <relationship value="related-to"/>
          </target>
        </element>
        <element>
          <code value="error"/>
          <target>
            <code value="error"/>
            <relationship value="related-to"/>
          </target>
        </element>
        <element>
          <code value="partial"/>
          <target>
            <code value="partial"/>
            <relationship value="related-to"/>
          </target>
        </element>
      </group>
    </ConceptMap>
  </contained>
  <contained>
    <ConceptMap>
      <id value="EligibilityResponsePurpose"/>
      <status value="active"/>
      <group>
        <source value="http://hl7.org/fhir/eligibilityresponse-purpose"/>
        <target value="http://hl7.org/fhir/4.3/eligibilityresponse-purpose"/>
        <element>
          <code value="auth-requirements"/>
          <target>
            <code value="auth-requirements"/>
            <relationship value="related-to"/>
          </target>
        </element>
        <element>
          <code value="benefits"/>
          <target>
            <code value="benefits"/>
            <relationship value="related-to"/>
          </target>
        </element>
        <element>
          <code value="discovery"/>
          <target>
            <code value="discovery"/>
            <relationship value="related-to"/>
          </target>
        </element>
        <element>
          <code value="validation"/>
          <target>
            <code value="validation"/>
            <relationship value="related-to"/>
          </target>
        </element>
      </group>
    </ConceptMap>
  </contained>
  <contained>
    <ConceptMap>
      <id value="EligibilityResponseStatus"/>
      <status value="active"/>
      <group>
        <source value="http://hl7.org/fhir/fm-status"/>
        <target value="http://hl7.org/fhir/4.3/fm-status"/>
        <element>
          <code value="active"/>
          <target>
            <code value="active"/>
            <relationship value="related-to"/>
          </target>
        </element>
        <element>
          <code value="cancelled"/>
          <target>
            <code value="cancelled"/>
            <relationship value="related-to"/>
          </target>
        </element>
        <element>
          <code value="draft"/>
          <target>
            <code value="draft"/>
            <relationship value="related-to"/>
          </target>
        </element>
        <element>
          <code value="entered-in-error"/>
          <target>
            <code value="entered-in-error"/>
            <relationship value="related-to"/>
          </target>
        </element>
      </group>
    </ConceptMap>
  </contained>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fhir"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/extensions/ImplementationGuide/hl7.fhir.uv.extensions"/>
      </extension>
    </valueInteger>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/extensions/ImplementationGuide/hl7.fhir.uv.extensions"/>
      </extension>
    </valueCode>
  </extension>
  <url
       value="http://hl7.org/fhir/StructureMap/CoverageEligibilityResponse5to4B"/>
  <version value="5.1.0"/>
  <name value="CoverageEligibilityResponse5to4B"/>
  <title value="FML Conversion for CoverageEligibilityResponse: R5 to R4B"/>
  <status value="active"/>
  <date value="2024-04-27T18:54:50+10:00"/>
  <publisher value="HL7 International / FHIR Infrastructure"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fiwg"/>
    </telecom>
  </contact>
  <description value="FMLConversionforCoverageEligibilityResponseR5toR4B"/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
    </coding>
  </jurisdiction>
  <structure>
    <url
         value="http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse"/>
    <mode value="source"/>
    <alias value="CoverageEligibilityResponseR5"/>
  </structure>
  <structure>
    <url
         value="http://hl7.org/fhir/4.3/StructureDefinition/CoverageEligibilityResponse"/>
    <mode value="target"/>
    <alias value="CoverageEligibilityResponseR4B"/>
  </structure>
  <import value="http://hl7.org/fhir/StructureMap/*5to4B"/>
  <group>
    <name value="CoverageEligibilityResponse"/>
    <extends value="DomainResource"/>
    <typeMode value="type-and-types"/>
    <input>
      <name value="src"/>
      <type value="CoverageEligibilityResponseR5"/>
      <mode value="source"/>
    </input>
    <input>
      <name value="tgt"/>
      <type value="CoverageEligibilityResponseR4B"/>
      <mode value="target"/>
    </input>
    <rule>
      <name value="identifier"/>
      <source>
        <context value="src"/>
        <element value="identifier"/>
        <variable value="vvv"/>
      </source>
      <target>
        <context value="tgt"/>
        <element value="identifier"/>
        <variable value="vvv"/>
        <transform value="create"/>
      </target>
      <dependent>
        <name value="DefaultMappingGroupAnonymousAlias"/>
        <parameter>
          <valueId value="vvv"/>
        </parameter>
        <parameter>
          <valueId value="vvv"/>
        </parameter>
      </dependent>
    </rule>
    <rule>
      <name value="status"/>
      <source>
        <context value="src"/>
        <element value="status"/>
        <variable value="v"/>
      </source>
      <target>
        <context value="tgt"/>
        <element value="status"/>
        <transform value="translate"/>
        <parameter>
          <valueId value="v"/>
        </parameter>
        <parameter>
          <valueString value="#EligibilityResponseStatus"/>
        </parameter>
        <parameter>
          <valueString value="code"/>
        </parameter>
      </target>
    </rule>
    <rule>
      <name value="purpose"/>
      <source>
        <context value="src"/>
        <element value="purpose"/>
        <variable value="v"/>
      </source>
      <target>
        <context value="tgt"/>
        <element value="purpose"/>
        <transform value="translate"/>
        <parameter>
          <valueId value="v"/>
        </parameter>
        <parameter>
          <valueString value="#EligibilityResponsePurpose"/>
        </parameter>
        <parameter>
          <valueString value="code"/>
        </parameter>
      </target>
    </rule>
    <rule>
      <name value="patient"/>
      <source>
        <context value="src"/>
        <element value="patient"/>
        <variable value="vvv"/>
      </source>
      <target>
        <context value="tgt"/>
        <element value="patient"/>
        <variable value="vvv"/>
        <transform value="create"/>
      </target>
      <dependent>
        <name value="DefaultMappingGroupAnonymousAlias"/>
        <parameter>
          <valueId value="vvv"/>
        </parameter>
        <parameter>
          <valueId value="vvv"/>
        </parameter>
      </dependent>
    </rule>
    <rule>
      <name value="servicedDate"/>
      <source>
        <context value="src"/>
        <type value="date"/>
        <element value="serviced"/>
        <variable value="vvv"/>
      </source>
      <target>
        <context value="tgt"/>
        <element value="serviced"/>
        <variable value="vvv"/>
        <transform value="create"/>
      </target>
      <dependent>
        <name value="DefaultMappingGroupAnonymousAlias"/>
        <parameter>
          <valueId value="vvv"/>
        </parameter>
        <parameter>
          <valueId value="vvv"/>
        </parameter>
      </dependent>
      <documentation
                     value="src.event as s -&gt; tgt.event as t then CoverageEligibilityResponseEvent(s,t);"/>
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        <context value="src"/>
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        <variable value="vvv"/>
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        <context value="tgt"/>
        <element value="serviced"/>
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        <transform value="create"/>
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          <valueId value="vvv"/>
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        <context value="src"/>
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        <context value="tgt"/>
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          <valueId value="v"/>
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        <parameter>
          <valueString value="#EligibilityOutcome"/>
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          <valueString value="code"/>
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        <context value="src"/>
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          <valueId value="vvv"/>
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        <context value="src"/>
        <element value="insurer"/>
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        <context value="src"/>
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src.type -&gt; tgt.type;
src.when : dateTime -&gt; tgt.when;
src.when : Period -&gt; tgt.when;
}"/>
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        <context value="src"/>
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</StructureMap>