Eligibility Response Purpose

• Official URL: http://hl7.org/fhir/eligibilityresponse-purpose
• Version: 6.0.0
• Status: active
• Name: EligibilityResponsePurpose
• Title: Eligibility Response Purpose
• Publisher: HL7 (FHIR Project)
• Description: A code specifying the types of information being requested.
• Case Sensitive: true
• Content: complete

Concepts

CodeSystem XML

<?xml version="1.0" encoding="UTF-8"?>

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="eligibilityresponse-purpose"/>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="normative"/>
  </extension>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="2"/>
  </extension>
  <url value="http://hl7.org/fhir/eligibilityresponse-purpose"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.4.1185"/>
  </identifier>
  <version value="6.0.0"/>
  <name value="EligibilityResponsePurpose"/>
  <title value="Eligibility Response Purpose"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2021-01-05T10:01:24+11:00"/>
  <publisher value="HL7 (FHIR Project)"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org/fhir"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="fhir@lists.hl7.org"/>
    </telecom>
  </contact>
  <description value="A code specifying the types of information being requested."/>
  <caseSensitive value="true"/>
  <valueSet value="http://hl7.org/fhir/ValueSet/eligibilityresponse-purpose"/>
  <content value="complete"/>
  <concept>
    <code value="auth-requirements"/>
    <display value="Coverage auth-requirements"/>
    <definition value="The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested."/>
  </concept>
  <concept>
    <code value="benefits"/>
    <display value="Coverage benefits"/>
    <definition value="The plan benefits and optionally benefits consumed  for the listed, or discovered if specified, converages are requested."/>
  </concept>
  <concept>
    <code value="discovery"/>
    <display value="Coverage Discovery"/>
    <definition value="The insurer is requested to report on any coverages which they are aware of in addition to any specifed."/>
  </concept>
  <concept>
    <code value="validation"/>
    <display value="Coverage Validation"/>
    <definition value="A check that the specified coverages are in-force is requested."/>
  </concept>
</CodeSystem>