EnrollEligCOB
Class CoverageEligibilityResponse

"This resource provides eligibility and plan details from the processing of an CoverageEligibilityRequest resource." - HL7 FHIR, CoverageEligibilityResponse

Attributes
«TS» PointInTime dateCreated dateCreated

"The date this resource was created." - HL7 FHIR, CoverageEligibilityResponse.created

«IVL_TS» Period datesOfService datesOfService

"The date or dates when the enclosed suite of services were performed or completed." - HL7 FHIR, CoverageEligibilityResponse.serviced[x]
Note that in FHIR, the data type of this property can be either a DateTime or a Period. In the FHIM, this is modeled as a Period. If a only a date/time is needed, use Period.start and leave Period.end empty.

String disposition disposition

"A human readable description of the status of the adjudication." - HL7 FHIR, CoverageEligibilityResponse.disposition

Error error error

"Errors encountered during the processing of the request." - HL7 FHIR, CoverageEligibilityResponse.error

«CS» Code form form

"A code for the form to be used for printing the content." - HL7 FHIR, CoverageEligibilityResponse.form

«II» Id identifier identifier

"A unique identifier assigned to this coverage eligiblity request." - HL7 FHIR, CoverageEligibilityResponse.identifier

ResponseInsurance insurance insurance

"Financial instruments for reimbursement for the health care products and services." - HL7 FHIR, CoverageEligibilityResponse.insurance

Organization insurer insurer

"The Insurer who issued the coverage in question and is the author of the response." - HL7 FHIR, CoverageEligibilityResponse.insurer

«CS» Code outcome outcome

"The outcome of the request processing." Possible values are: Queued; Processing Complete; Error; Partial Processing. - HL7 FHIR, CoverageEligibilityResponse.outcome

CoveredPatient patient patient

"The party who is the beneficiary of the supplied coverage and for whom eligibility is sought." - HL7 FHIR, CoverageEligibilityResponse.patient

String preAuthRef preAuthRef

"A reference from the Insurer to which these services pertain to be used on further communication and as proof that the request occurred." - HL7 FHIR, CoverageEligibilityResponse.preAuthRef

«CS» Code purpose purpose

"Code to specify whether requesting: prior authorization requirements for some service categories or billing codes; benefits for coverages specified or discovered; discovery and return of coverages for the patient; and/or validation that the specified coverage is in-force at the date/period specified or 'now' if not specified." Possible values are: Coverage auth-requirements; Coverage benefits; Coverage Discovery; Coverage Validation. - HL7 FHIR, CoverageEligibilityResponse.purpose

CoverageEligibilityRequest request request

"Reference to the original request resource." - HL7 FHIR, CoverageEligibilityResponse.request

HealthcareProvider requestor requestor

"The provider which is responsible for the request." - HL7 FHIR, CoverageEligibilityResponse.requestor

«CS» Code status status

"The status of the resource instance." Possible values are: Active; Cancelled; Draft; Entered in Error. - HL7 FHIR, CoverageEligibilityResponse.status


Properties:

Alias
Classifier Behavior
Is Abstractfalse
Is Activefalse
Is Leaffalse
Keywords
NameCoverageEligibilityResponse
Name Expression
NamespaceEnrollEligCOB
Owned Template Signature
OwnerEnrollEligCOB
Owning Template Parameter
PackageEnrollEligCOB
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse
Representation
Stereotype
Template Parameter
VisibilityPublic

Attribute Details

 dateCreated
Public «TS» PointInTime dateCreated

"The date this resource was created." - HL7 FHIR, CoverageEligibilityResponse.created

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamedateCreated
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::dateCreated
Stereotype
Template Parameter
Type«TS» PointInTime
Upper1
Upper Value(1)
VisibilityPublic


 datesOfService
Public «IVL_TS» Period datesOfService

"The date or dates when the enclosed suite of services were performed or completed." - HL7 FHIR, CoverageEligibilityResponse.serviced[x]
Note that in FHIR, the data type of this property can be either a DateTime or a Period. In the FHIM, this is modeled as a Period. If a only a date/time is needed, use Period.start and leave Period.end empty.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamedatesOfService
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::datesOfService
Stereotype
Template Parameter
Type«IVL_TS» Period
Upper1
Upper Value(1)
VisibilityPublic


 disposition
Public String disposition

"A human readable description of the status of the adjudication." - HL7 FHIR, CoverageEligibilityResponse.disposition

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
Namedisposition
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::disposition
Stereotype
Template Parameter
TypeString
Upper1
Upper Value(1)
VisibilityPublic


 error
Public Error error

"Errors encountered during the processing of the request." - HL7 FHIR, CoverageEligibilityResponse.error

Constraints:
Properties:

AggregationNone
Alias
AssociationcoverageEligibilityResponse__error
Association End
ClassCoverageEligibilityResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
Nameerror
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::error
Stereotype
Template Parameter
TypeError
Upper*
Upper Value(*)
VisibilityPublic


 form
Public «CS» Code form

"A code for the form to be used for printing the content." - HL7 FHIR, CoverageEligibilityResponse.form

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityResponse
Terminologies[
HL7_FHIR_R4 Forms http://hl7.org/fhir/ValueSet/forms
]
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
Nameform
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::form
StereotypeValueSetConstraints
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 identifier
Public «II» Id identifier

"A unique identifier assigned to this coverage eligiblity request." - HL7 FHIR, CoverageEligibilityResponse.identifier

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
Nameidentifier
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::identifier
Stereotype
Template Parameter
Type«II» Id
Upper*
Upper Value(*)
VisibilityPublic


 insurance
Public ResponseInsurance insurance

"Financial instruments for reimbursement for the health care products and services." - HL7 FHIR, CoverageEligibilityResponse.insurance

Constraints:
Properties:

AggregationNone
Alias
AssociationcoverageEligibilityResponse_insurance
Association End
ClassCoverageEligibilityResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
Nameinsurance
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::insurance
Stereotype
Template Parameter
TypeResponseInsurance
Upper*
Upper Value(*)
VisibilityPublic


 insurer
Public Organization insurer

"The Insurer who issued the coverage in question and is the author of the response." - HL7 FHIR, CoverageEligibilityResponse.insurer

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1
Nameinsurer
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::insurer
Stereotype
Template Parameter
TypeOrganization
Upper1
Upper Value(1)
VisibilityPublic


 outcome
Public «CS» Code outcome

"The outcome of the request processing." Possible values are: Queued; Processing Complete; Error; Partial Processing. - HL7 FHIR, CoverageEligibilityResponse.outcome

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityResponse
Terminologies[
HL7_FHIR_R4 Claim Processing Codes http://hl7.org/fhir/ValueSet/remittance-outcome
]
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1
Nameoutcome
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::outcome
StereotypeValueSetConstraints
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 patient
Public CoveredPatient patient

"The party who is the beneficiary of the supplied coverage and for whom eligibility is sought." - HL7 FHIR, CoverageEligibilityResponse.patient

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1
Namepatient
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::patient
Stereotype
Template Parameter
TypeCoveredPatient
Upper1
Upper Value(1)
VisibilityPublic


 preAuthRef
Public String preAuthRef

"A reference from the Insurer to which these services pertain to be used on further communication and as proof that the request occurred." - HL7 FHIR, CoverageEligibilityResponse.preAuthRef

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamepreAuthRef
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::preAuthRef
Stereotype
Template Parameter
TypeString
Upper1
Upper Value(1)
VisibilityPublic


 purpose
Public «CS» Code purpose

"Code to specify whether requesting: prior authorization requirements for some service categories or billing codes; benefits for coverages specified or discovered; discovery and return of coverages for the patient; and/or validation that the specified coverage is in-force at the date/period specified or 'now' if not specified." Possible values are: Coverage auth-requirements; Coverage benefits; Coverage Discovery; Coverage Validation. - HL7 FHIR, CoverageEligibilityResponse.purpose

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1..*
Namepurpose
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::purpose
Stereotype
Template Parameter
Type«CS» Code
Upper*
Upper Value(*)
VisibilityPublic


 request
Public CoverageEligibilityRequest request

"Reference to the original request resource." - HL7 FHIR, CoverageEligibilityResponse.request

Constraints:
Properties:

AggregationNone
Alias
AssociationcoverageEligibilityResponse__request
Association End
ClassCoverageEligibilityResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1
Namerequest
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::request
Stereotype
Template Parameter
TypeCoverageEligibilityRequest
Upper1
Upper Value(1)
VisibilityPublic


 requestor
Public HealthcareProvider requestor

"The provider which is responsible for the request." - HL7 FHIR, CoverageEligibilityResponse.requestor

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityResponse
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
Namerequestor
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::requestor
Stereotype
Template Parameter
TypeHealthcareProvider
Upper1
Upper Value(1)
VisibilityPublic


 status
Public «CS» Code status

"The status of the resource instance." Possible values are: Active; Cancelled; Draft; Entered in Error. - HL7 FHIR, CoverageEligibilityResponse.status

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityResponse
Terminologies[
HL7_FHIR_R4 Financial Resource Status Codes http://hl7.org/fhir/ValueSet/fm-status
]
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
Namestatus
Name Expression
NamespaceCoverageEligibilityResponse
Opposite
OwnerCoverageEligibilityResponse
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityResponse::status
StereotypeValueSetConstraints
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic