Name Flags Card. Type Description & Constraints doco
. . EligibilityResponse DomainResource EligibilityResponse resource
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
. . . identifier 0..* Identifier Business Identifier
. . . status ?! Σ 0..1 code active | cancelled | draft | entered-in-error
Financial Resource Status Codes ( Required)
. . . created 0..1 dateTime Creation date
. . . requestProvider 0..1 Reference( Practitioner) Responsible practitioner
. . . requestOrganization 0..1 Reference( Organization) Responsible organization
. . . request 0..1 Reference( EligibilityRequest) Eligibility reference
. . . outcome 0..1 CodeableConcept complete | error | partial
RemittanceOutcome ( Required)
. . . disposition 0..1 string Disposition Message
. . . insurer 0..1 Reference( Organization) Insurer issuing the coverage
. . . inforce 0..1 boolean Coverage inforce indicator
. . . insurance 0..* BackboneElement Details by insurance coverage
. . . . coverage 0..1 Reference( Coverage) Updated Coverage details
. . . . contract 0..1 Reference( Contract) Contract details
. . . . benefitBalance 0..* BackboneElement Benefits by Category
. . . . . category 1..1 CodeableConcept Type of services covered
Benefit Category Codes ( Example)
. . . . . subCategory 0..1 CodeableConcept Detailed services covered within the type
Benefit SubCategory Codes ( Example)
. . . . . excluded 0..1 boolean Excluded from the plan
. . . . . name 0..1 string Short name for the benefit
. . . . . description 0..1 string Description of the benefit or services covered
. . . . . network 0..1 CodeableConcept In or out of network
Network Type Codes ( Example)
. . . . . unit 0..1 CodeableConcept Individual or family
Unit Type Codes ( Example)
. . . . . term 0..1 CodeableConcept Annual or lifetime
Benefit Term Codes ( Example)
. . . . . financial 0..* BackboneElement Benefit Summary
. . . . . . type 1..1 CodeableConcept Deductable, visits, benefit amount
Benefit Type Codes ( Example)
. . . . . . allowed[x] 0..1 Benefits allowed
. . . . . . . allowedUnsignedInt unsignedInt
. . . . . . . allowedString string
. . . . . . . allowedMoney Money
. . . . . . used[x] 0..1 Benefits used
. . . . . . . usedUnsignedInt unsignedInt
. . . . . . . usedMoney Money
. . . form 0..1 CodeableConcept Printed Form Identifier
Form Codes ( Example)
. . . error 0..* BackboneElement Processing errors
. . . . code 1..1 CodeableConcept Error code detailing processing issues
Adjudication Error Codes ( Example)

doco Documentation for this format