| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| TU | DomainResource | CoverageEligibilityResponse resource Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | ||
| 0..* | Identifier | Business Identifier for coverage eligiblity request | ||
| ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: Financial Resource Status Codes (Required) | |
| Σ | 1..* | code | auth-requirements | benefits | discovery | validation Binding: Eligibility Response Purpose (Required) | |
| Σ | 1..1 | Reference(Patient) | Intended recipient of products and services | |
| 0..* | BackboneElement | Event information | ||
| 1..1 | CodeableConcept | Specific event Binding: Dates Type Codes (Example) | ||
| 1..1 | Occurance date or period | |||
| dateTime | ||||
| Period | ||||
| 0..1 | Estimated date or dates of service | |||
| date | ||||
| Period | ||||
| Σ | 1..1 | dateTime | Response creation date | |
| 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Party responsible for the request | ||
| Σ | 1..1 | Reference(CoverageEligibilityRequest) | Eligibility request reference | |
| Σ | 1..1 | code | queued | complete | error | partial Binding: Eligibility Outcome (Required) | |
| 0..1 | string | Disposition Message | ||
| Σ | 1..1 | Reference(Organization) | Coverage issuer | |
| 0..* | BackboneElement | Patient insurance information | ||
| Σ | 1..1 | Reference(Coverage) | Insurance information | |
| 0..1 | boolean | Coverage inforce indicator | ||
| 0..1 | Period | When the benefits are applicable | ||
| C | 0..* | BackboneElement | Benefits and authorization details + Rule: SHALL contain a category or a billcode but not both. | |
| C | 0..1 | CodeableConcept | Benefit classification Binding: Benefit Category Codes (Example) | |
| C | 0..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLS Codes (Example) | |
| 0..* | CodeableConcept | Product or service billing modifiers Binding: Modifier type Codes (Example) | ||
| 0..1 | Reference(Practitioner | PractitionerRole) | Performing practitioner | ||
| 0..1 | boolean | Excluded from the plan | ||
| 0..1 | string | Short name for the benefit | ||
| 0..1 | string | Description of the benefit or services covered | ||
| 0..1 | CodeableConcept | In or out of network Binding: Network Type Codes (Example) | ||
| 0..1 | CodeableConcept | Individual or family Binding: Unit Type Codes (Example) | ||
| 0..1 | CodeableConcept | Annual or lifetime Binding: Benefit Term Codes (Example) | ||
| 0..* | BackboneElement | Benefit Summary | ||
| 1..1 | CodeableConcept | Benefit classification Binding: Benefit Type Codes (Example) | ||
| 0..1 | Benefits allowed | |||
| unsignedInt | ||||
| string | ||||
| Money | ||||
| 0..1 | Benefits used | |||
| unsignedInt | ||||
| string | ||||
| Money | ||||
| 0..1 | boolean | Authorization required flag | ||
| 0..* | CodeableConcept | Type of required supporting materials Binding: CoverageEligibilityResponse Auth Support Codes (Example) | ||
| 0..1 | uri | Preauthorization requirements endpoint | ||
| 0..1 | string | Preauthorization reference | ||
| 0..1 | CodeableConcept | Printed form identifier Binding: Form Codes (Example) | ||
| 0..* | BackboneElement | Processing errors | ||
| Σ | 1..1 | CodeableConcept | Error code detailing processing issues Binding: Adjudication Error Codes (Example) | |
| Σ | 0..* | string | FHIRPath of element(s) related to issue | |