2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). 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: R3 R2

7.4.4 Resource EligibilityResponse - Detailed Descriptions

Detailed Descriptions for the elements in the EligibilityResponse resource.

EligibilityResponse
Definition

This resource provides eligibility and plan details from the processing of an Eligibility resource.

Control1..1
EligibilityResponse.identifier
Definition

The Response Business Identifier.

Control0..*
TypeIdentifier
EligibilityResponse.request
Definition

Original request resource reference.

Control0..1
TypeReference(EligibilityRequest)
EligibilityResponse.outcome
Definition

Transaction status: error, complete.

Control0..1
BindingRemittanceOutcome: Required: http://hl7.org/fhir/RS-link (The outcome of the processing.)
Typecode
EligibilityResponse.disposition
Definition

A description of the status of the adjudication.

Control0..1
Typestring
EligibilityResponse.ruleset
Definition

The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources.

Control0..1
BindingRuleset: Example: See http://hl7.org/fhir/vs/ruleset (The static and dynamic model to which contents conform, may be business version or standard and version.)
TypeCoding
EligibilityResponse.originalRuleset
Definition

The style (standard) and version of the original material which was converted into this resource.

Control0..1
BindingRuleset: Example: See http://hl7.org/fhir/vs/ruleset (The static and dynamic model to which contents conform, may be business version or standard and version.)
TypeCoding
Requirements

Knowledge of the original version can inform the processing of this instance so that information which is processable by the originating system may be generated.

EligibilityResponse.created
Definition

The date when the enclosed suite of services were performed or completed.

Control0..1
TypedateTime
EligibilityResponse.organization
Definition

The Insurer who produced this adjudicated response.

Control0..1
TypeReference(Organization)
EligibilityResponse.requestProvider
Definition

The practitioner who is responsible for the services rendered to the patient.

Control0..1
TypeReference(Practitioner)
EligibilityResponse.requestOrganization
Definition

The organization which is responsible for the services rendered to the patient.

Control0..1
TypeReference(Organization)