CoverageEligibilityRequest Example: coverageeligibilityrequest-example-2

Narrative

A human-readable rendering of the CoverageEligibilityRequest

Example XML

<CoverageEligibilityRequest xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../schema/remittance.xsd">
    <id value="52346"/>

    <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the CoverageEligibilityRequest</div>
    </text>

    <identifier>
        <system value="http://happyvalley.com/coverageelegibilityrequest"/>
        <value value="52346"/>
    </identifier>

    <status value="active"/>

    <priority>
        <coding>
            <code value="normal"/>
        </coding>
    </priority>

    <purpose value="validation"/>
    <purpose value="benefits"/>

    <patient>
        <reference value="Patient/pat1"/>
    </patient>

    <servicedDate value="2014-09-17"/> <!-- Anticipated service date -->

    <created value="2014-08-16"/>

    <enterer>
        <identifier>
            <system value="http://happyvalleyclinic.com/staff"/>
            <value value="14"/>
        </identifier>
    </enterer>

    <provider>
        <reference value="Organization/1"/>
    </provider>

    <insurer>
        <reference value="Organization/2"/>
    </insurer>

    <facility>
        <identifier>
            <system value="http://statecliniclicensor.com/clinicid"/>
            <value value="G35B9"/>
        </identifier>
    </facility>

    <insurance>
        <coverage>
            <reference value="Coverage/9876B1"/>
        </coverage>

        <businessArrangement value="NB8742"/>
    </insurance>

    <item>
        <category>
            <coding>
                <system value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
                <code value="69"/>
                <display value="Maternity"/>
            </coding>
        </category>
    </item>

</CoverageEligibilityRequest>