Qi-Core Implementation Guide (Release 2.1 Trial-Use Ballot)
This page is part of the Quality Improvement Core Framework (v2.1.0: STU 3 Ballot 1) based on FHIR R3. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions 
Organization 1 (Provider)
id: provider
identifier: 3456
Organization 2 (Insurer)
id: payor
identifier: 123456
Organization 3 (Practitioner)
id: requester
identifier: 6789
identifier: ABC123
basedOn: EligibilityRequest
replaces: prior CommunicationRequest
groupIdentifier: 12345
status: active
category: SolicitedAttachmentRequest
priority: routine
medium: written
recipient: Organization/Example
context: Encounter/example
payload: Please provide the accident report and any associated pictures to support your Claim #DEF5647.
occurrenceDateTime: 06/10/2016
authoredOn: 06/10/2016
sender: Patient/Example
requester: Practitioner/Example
© HL7.org 2011+. QICore STU 3 Ballot (v2.1.0, based on FHIR v3.0.1-11917) generated on Wed, Dec 20, 2017 12:42+1100. QA Page
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