CoverageEligibilityResponse Example: coverageeligibilityresponse-example-error

Narrative

A human-readable rendering of the CoverageEligibilityResponse.

Example XML

<CoverageEligibilityResponse 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="E2503"/>

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

    <identifier>
        <system value="http://www.BenefitsInc.com/fhir/coverageeligibilityresponse"/>
        <value value="8812343"/>
    </identifier>

    <status value="active"/>

    <purpose value="validation"/>

    <patient>
        <reference value="Patient/f201"/>
    </patient>

    <created value="2014-09-16"/>

    <requestor>
        <identifier>
            <system value="http://national.org/clinic"/>
            <value value="OR1234"/>
        </identifier>   
    </requestor>

    <request>
        <reference value="http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332406"/>
    </request>

    <outcome value="error" />

    <disposition value="Eligibiliy request could not be processed, please address errors before submitting."/>

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

    <form>
        <coding>
            <system value="http://national.org/form"/>
            <code value="ELRSP/2017/01"/>
        </coding>
    </form>

    <error>
        <code>
            <coding>
                <system value="http://terminology.hl7.org/CodeSystem/adjudication-error"/>
                <code value="a001"/>
            </coding>
        </code>
    </error>

</CoverageEligibilityResponse>