FHIR IG analytics| Package | hl7.fhir.uv.xver-r5.r3 |
| Resource Type | StructureDefinition |
| Id | StructureDefinition-profile-CoverageEligibilityRequest-for-EligibilityRequest.json |
| FHIR Version | R3 |
| Source | http://hl7.org/fhir/uv/xver-r5.r3/0.1.0/StructureDefinition-profile-CoverageEligibilityRequest-for-EligibilityRequest.html |
| URL | http://hl7.org/fhir/5.0/StructureDefinition/profile-CoverageEligibilityRequest-for-EligibilityRequest |
| Version | 0.1.0 |
| Status | active |
| Date | 2026-03-17T16:05:12.9299949-05:00 |
| Name | Profile_R5_CoverageEligibilityRequest_R3_EligibilityRequest |
| Title | Cross-version Profile for R5.CoverageEligibilityRequest for use in FHIR STU3 |
| Realm | uv |
| Authority | hl7 |
| Description | This cross-version profile allows R5 CoverageEligibilityRequest content to be represented via FHIR STU3 EligibilityRequest resources. |
| Type | EligibilityRequest |
| Kind | resource |
No resources found
| StructureDefinition | ||
| hl7.fhir.uv.xver-r5.r4.r4#0.0.1-snapshot-2 | extension-CoverageEligibilityRequest.event | Cross-version Extension for R5.CoverageEligibilityRequest.event for use in FHIR R4 |
| hl7.fhir.uv.xver-r5.r3#0.1.0 | extension-CoverageEligibilityRequest.insurance | R5: Patient insurance information (new) |
| hl7.fhir.uv.xver-r5.r3#0.1.0 | extension-CoverageEligibilityRequest.item | R5: Item to be evaluated for eligibiity (new) |
| hl7.fhir.uv.xver-r5.r3#0.1.0 | extension-CoverageEligibilityRequest.purpose | R5: auth-requirements | benefits | discovery | validation (new) |
| hl7.fhir.uv.xver-r5.r3#0.1.0 | extension-CoverageEligibilityRequest.supportingInfo | R5: Supporting information (new) |
Note: links and images are rebased to the (stated) source
Generated Narrative: StructureDefinition profile-CoverageEligibilityRequest-for-EligibilityRequest
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  EligibilityRequest | 0..* | EligibilityRequest | Determine insurance validity and scope of coverage | |
  Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |
   extension:purpose | 1..* | code | R5: auth-requirements | benefits | discovery | validation (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.purpose Binding: R5EligibilityrequestPurposeForR3 (0.1.0) (required): A code specifying the types of information being requested. | |
| extension:event | 0..* | (Complex) | R5: Event information (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.event | |
| extension:provider | 0..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] | R5: Party responsible for the request URL: http://hl7.org/fhir/StructureDefinition/alternate-reference | |
| extension:supportingInfo | 0..* | (Complex) | R5: Supporting information (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.supportingInfo | |
| extension:insurance | 0..* | (Complex) | R5: Patient insurance information (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.insurance | |
 extension:item | 0..* | (Complex) | R5: Item to be evaluated for eligibiity (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.item | |
 patient | ||||
 Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |
 extension:patient | 1..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] | R5: Intended recipient of products and services additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference | |
| enterer | ||||
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:enterer | 0..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] | R5: enterer additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference | |
| insurer | ||||
| Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:insurer | 1..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] | R5: Coverage issuer additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference | |
| facility | ||||
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:facility | 0..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] | R5: Servicing facility additional types URL: http://hl7.org/fhir/StructureDefinition/alternate-reference | |
| Documentation for this format | ||||
FHIR
FHIRsmith{
"resourceType": "StructureDefinition",
"id": "profile-CoverageEligibilityRequest-for-EligibilityRequest",
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "fhir"
},
{
"extension": [
{
"url": "packageId",
"valueId": "hl7.fhir.uv.xver-r5.r3"
},
{
"url": "version",
"valueString": "0.1.0"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/package-source"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 0,
"_valueInteger": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueUri": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r3"
}
]
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "trial-use",
"_valueCode": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueUri": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r3"
}
]
}
}
],
"url": "http://hl7.org/fhir/5.0/StructureDefinition/profile-CoverageEligibilityRequest-for-EligibilityRequest",
"version": "0.1.0",
"name": "Profile_R5_CoverageEligibilityRequest_R3_EligibilityRequest",
"title": "Cross-version Profile for R5.CoverageEligibilityRequest for use in FHIR STU3",
"status": "active",
"experimental": false,
"date": "2026-03-17T16:05:12.9299949-05:00",
"publisher": "FHIR Infrastructure",
"contact": [
{
"name": "FHIR Infrastructure",
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/fiwg"
}
]
}
],
"description": "This cross-version profile allows R5 CoverageEligibilityRequest content to be represented via FHIR STU3 EligibilityRequest resources.",
"jurisdiction": [
{
"coding": [
{
"system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code": "001",
"display": "World"
}
]
}
],
"fhirVersion": "3.0.2",
"mapping": [
{
"identity": "workflow",
"uri": "http://hl7.org/fhir/workflow",
"name": "Workflow Mapping"
},
{
"identity": "w5",
"uri": "http://hl7.org/fhir/w5",
"name": "W5 Mapping"
},
{
"identity": "cdanetv4",
"uri": "http://www.cda-adc.ca/en/services/cdanet/",
"name": "Canadian Dental Association eclaims standard"
},
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
}
],
"kind": "resource",
"abstract": false,
"type": "EligibilityRequest",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/EligibilityRequest",
"derivation": "constraint",
"snapshot": {
"element": [
{
"id": "EligibilityRequest",
"path": "EligibilityRequest",
"short": "Determine insurance validity and scope of coverage",
"definition": "The EligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an EligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.",
"min": 0,
"max": "*",
"base": {
"path": "EligibilityRequest",
"min": 0,
"max": "*"
},
"constraint": [
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-1",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain any narrative",
"expression": "contained.text.empty()",
"xpath": "not(parent::f:contained and f:text)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource",
"expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()",
"xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "workflow",
"map": "Request"
},
{
"identity": "w5",
"map": "financial.support"
}
]
},
{
"id": "EligibilityRequest.id",
"path": "EligibilityRequest.id",
"short": "Logical id of this artifact",
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "id"
}
],
"isSummary": true
},
{
"id": "EligibilityRequest.meta",
"path": "EligibilityRequest.meta",
"short": "Metadata about the resource",
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"isSummary": true
},
{
"id": "EligibilityRequest.implicitRules",
"path": "EligibilityRequest.implicitRules",
"short": "A set of rules under which this content was created",
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"isModifier": true,
"isSummary": true
},
{
"id": "EligibilityRequest.language",
"path": "EligibilityRequest.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueReference": {
"reference": "http://hl7.org/fhir/ValueSet/all-languages|3.0.2"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
}
],
"strength": "extensible",
"description": "A human language.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/languages|3.0.2"
}
}
},
{
"id": "EligibilityRequest.text",
"path": "EligibilityRequest.text",
"short": "Text summary of the resource, for human interpretation",
"definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"dom-1"
],
"mapping": [
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "EligibilityRequest.contained",
"path": "EligibilityRequest.contained",
"short": "Contained, inline Resources",
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "EligibilityRequest.extension",
"path": "EligibilityRequest.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"short": "Extension",
"definition": "An Extension",
"min": 1,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "EligibilityRequest.extension:purpose",
"path": "EligibilityRequest.extension",
"sliceName": "purpose",
"short": "R5: auth-requirements | benefits | discovery | validation (new)",
"definition": "R5: `CoverageEligibilityRequest.purpose` (new:code)",
"comment": "Element `CoverageEligibilityRequest.purpose` has a context of EligibilityRequest based on following the parent source element upwards and mapping to `EligibilityRequest`.\nElement `CoverageEligibilityRequest.purpose` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 1,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.purpose|0.1.0"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false
},
{
"id": "EligibilityRequest.extension:event",
"path": "EligibilityRequest.extension",
"sliceName": "event",
"short": "R5: Event information (new)",
"definition": "R5: `CoverageEligibilityRequest.event` (new:BackboneElement)",
"comment": "Element `CoverageEligibilityRequest.event` has a context of EligibilityRequest based on following the parent source element upwards and mapping to `EligibilityRequest`.\nElement `CoverageEligibilityRequest.event` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.event|0.1.0"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false
},
{
"id": "EligibilityRequest.extension:provider",
"path": "EligibilityRequest.extension",
"sliceName": "provider",
"short": "R5: Party responsible for the request",
"definition": "R5: `CoverageEligibilityRequest.provider`",
"comment": "Element `CoverageEligibilityRequest.provider` is mapped to FHIR STU3 element `EligibilityRequest.provider` as `SourceIsBroaderThanTarget`.\nElement `CoverageEligibilityRequest.provider` is mapped to FHIR STU3 element `EligibilityRequest.organization` as `SourceIsBroaderThanTarget`.\nThe standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `CoverageEligibilityRequest.provider` with unmapped reference targets: Organization, Practitioner, PractitionerRole.\nTypically this field would be 1..1 where this party is accountable for the data content within the claim but is not necessarily the facility, provider group or practitioner who provided the products and services listed within this claim resource. This field is the Billing Provider, for example, a facility, provider group, lab or practitioner.",
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/StructureDefinition/alternate-reference"
}
]
},
{
"id": "EligibilityRequest.extension:supportingInfo",
"path": "EligibilityRequest.extension",
"sliceName": "supportingInfo",
"short": "R5: Supporting information (new)",
"definition": "R5: `CoverageEligibilityRequest.supportingInfo` (new:BackboneElement)",
"comment": "Element `CoverageEligibilityRequest.supportingInfo` has a context of EligibilityRequest based on following the parent source element upwards and mapping to `EligibilityRequest`.\nElement `CoverageEligibilityRequest.supportingInfo` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).\nOften there are multiple jurisdiction specific valuesets which are required.",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.supportingInfo|0.1.0"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false
},
{
"id": "EligibilityRequest.extension:insurance",
"path": "EligibilityRequest.extension",
"sliceName": "insurance",
"short": "R5: Patient insurance information (new)",
"definition": "R5: `CoverageEligibilityRequest.insurance` (new:BackboneElement)",
"comment": "Element `CoverageEligibilityRequest.insurance` has a context of EligibilityRequest based on following the parent source element upwards and mapping to `EligibilityRequest`.\nElement `CoverageEligibilityRequest.insurance` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).\nAll insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.insurance|0.1.0"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false
},
{
"id": "EligibilityRequest.extension:item",
"path": "EligibilityRequest.extension",
"sliceName": "item",
"short": "R5: Item to be evaluated for eligibiity (new)",
"definition": "R5: `CoverageEligibilityRequest.item` (new:BackboneElement)",
"comment": "Element `CoverageEligibilityRequest.item` has a context of EligibilityRequest based on following the parent source element upwards and mapping to `EligibilityRequest`.\nElement `CoverageEligibilityRequest.item` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.item|0.1.0"
}
],
"condition": [
"ele-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": false
},
{
"id": "EligibilityRequest.modifierExtension",
"path": "EligibilityRequest.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "EligibilityRequest.identifier",
"path": "EligibilityRequest.identifier",
"short": "Business Identifier",
"definition": "The Response business identifier.",
"min": 0,
"max": "*",
"base": {
"path": "EligibilityRequest.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"mapping": [
{
"identity": "workflow",
"map": "Request.identifier"
},
{
"identity": "w5",
"map": "id"
}
]
},
{
"id": "EligibilityRequest.status",
"path": "EligibilityRequest.status",
"short": "active | cancelled | draft | entered-in-error",
"definition": "The status of the resource instance.",
"requirements": "This element is labeled as a modifier because the status contains codes that mark the request as not currently valid.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.status",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"isModifier": true,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "EligibilityRequestStatus"
}
],
"strength": "required",
"description": "A code specifying the state of the resource instance.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/fm-status|3.0.2"
}
},
"mapping": [
{
"identity": "workflow",
"map": "Request.status"
},
{
"identity": "w5",
"map": "status"
}
]
},
{
"id": "EligibilityRequest.priority",
"path": "EligibilityRequest.priority",
"short": "Desired processing priority",
"definition": "Immediate (STAT), best effort (NORMAL), deferred (DEFER).",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.priority",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProcessPriority"
}
],
"strength": "example",
"description": "The timeliness with which processing is required: STAT, normal, Deferred",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/process-priority|3.0.2"
}
},
"mapping": [
{
"identity": "workflow",
"map": "Request.priority"
},
{
"identity": "w5",
"map": "class"
}
]
},
{
"id": "EligibilityRequest.patient",
"path": "EligibilityRequest.patient",
"short": "The subject of the Products and Services",
"definition": "Patient Resource.",
"comment": "1..1.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.patient",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
}
],
"mapping": [
{
"identity": "workflow",
"map": "Request.subject"
},
{
"identity": "cdanetv4",
"map": "C06,C07,C08, C05, C04"
},
{
"identity": "w5",
"map": "who.focus"
}
]
},
{
"id": "EligibilityRequest.patient.id",
"path": "EligibilityRequest.patient.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "EligibilityRequest.patient.extension",
"path": "EligibilityRequest.patient.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"ordered": false,
"rules": "open"
},
"short": "Extension",
"definition": "An Extension",
"min": 1,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "EligibilityRequest.patient.extension:patient",
"path": "EligibilityRequest.patient.extension",
"sliceName": "patient",
"short": "R5: Intended recipient of products and services additional types",
"definition": "R5: `CoverageEligibilityRequest.patient` additional types from child elements (display, identifier, reference, type)",
"comment": "Element `CoverageEligibilityRequest.patient` is mapped to FHIR STU3 element `EligibilityRequest.patient` as `SourceIsBroaderThanTarget`.\nThe mappings for `CoverageEligibilityRequest.patient` do not cover the following types based on type expansion: display, identifier, reference, type.\nThe standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `CoverageEligibilityRequest.patient` with unmapped reference targets: Patient.\n1..1.",
"min": 1,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/StructureDefinition/alternate-reference"
}
]
},
{
"id": "EligibilityRequest.patient.reference",
"path": "EligibilityRequest.patient.reference",
"short": "Literal reference, Relative, internal or absolute URL",
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.reference",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ref-1"
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "EligibilityRequest.patient.identifier",
"path": "EligibilityRequest.patient.identifier",
"short": "Logical reference, when literal reference is not known",
"definition": "An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".identifier"
}
]
},
{
"id": "EligibilityRequest.patient.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "EligibilityRequest.patient.display",
"short": "Text alternative for the resource",
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "EligibilityRequest.serviced[x]",
"path": "EligibilityRequest.serviced[x]",
"short": "Estimated date or dates of Service",
"definition": "The date or dates when the enclosed suite of services were performed or completed.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.serviced[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "date"
},
{
"code": "Period"
}
],
"mapping": [
{
"identity": "cdanetv4",
"map": "F09"
},
{
"identity": "w5",
"map": "when.done"
}
]
},
{
"id": "EligibilityRequest.created",
"path": "EligibilityRequest.created",
"short": "Creation date",
"definition": "The date when this resource was created.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.created",
"min": 0,
"max": "1"
},
"type": [
{
"code": "dateTime"
}
],
"mapping": [
{
"identity": "workflow",
"map": "Request.authoredOn"
},
{
"identity": "w5",
"map": "when.recorded"
}
]
},
{
"id": "EligibilityRequest.enterer",
"path": "EligibilityRequest.enterer",
"short": "Author",
"definition": "Person who created the invoice/claim/pre-determination or pre-authorization.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.enterer",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
}
],
"mapping": [
{
"identity": "w5",
"map": "who.author"
}
]
},
{
"id": "EligibilityRequest.enterer.id",
"path": "EligibilityRequest.enterer.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "EligibilityRequest.enterer.extension",
"path": "EligibilityRequest.enterer.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"ordered": false,
"rules": "open"
},
"short": "Extension",
"definition": "An Extension",
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "EligibilityRequest.enterer.extension:enterer",
"path": "EligibilityRequest.enterer.extension",
"sliceName": "enterer",
"short": "R5: enterer additional types",
"definition": "R5: `CoverageEligibilityRequest.enterer` additional types from child elements (display, identifier, reference, type)",
"comment": "Element `CoverageEligibilityRequest.enterer` is mapped to FHIR STU3 element `EligibilityRequest.enterer` as `SourceIsBroaderThanTarget`.\nThe mappings for `CoverageEligibilityRequest.enterer` do not cover the following types based on type expansion: display, identifier, reference, type.\nThe standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `CoverageEligibilityRequest.enterer` with unmapped reference targets: Practitioner, PractitionerRole.",
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/StructureDefinition/alternate-reference"
}
]
},
{
"id": "EligibilityRequest.enterer.reference",
"path": "EligibilityRequest.enterer.reference",
"short": "Literal reference, Relative, internal or absolute URL",
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.reference",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ref-1"
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "EligibilityRequest.enterer.identifier",
"path": "EligibilityRequest.enterer.identifier",
"short": "Logical reference, when literal reference is not known",
"definition": "An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".identifier"
}
]
},
{
"id": "EligibilityRequest.enterer.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "EligibilityRequest.enterer.display",
"short": "Text alternative for the resource",
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "EligibilityRequest.provider",
"path": "EligibilityRequest.provider",
"short": "Responsible practitioner",
"definition": "The practitioner who is responsible for the services rendered to the patient.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.provider",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
}
],
"mapping": [
{
"identity": "workflow",
"map": "Request.requester.agent"
},
{
"identity": "cdanetv4",
"map": "B01"
},
{
"identity": "w5",
"map": "who.source"
}
]
},
{
"id": "EligibilityRequest.organization",
"path": "EligibilityRequest.organization",
"short": "Responsible organization",
"definition": "The organization which is responsible for the services rendered to the patient.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.organization",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
}
],
"mapping": [
{
"identity": "workflow",
"map": "Request.requester.onBehalfOf"
},
{
"identity": "w5",
"map": "who.source"
}
]
},
{
"id": "EligibilityRequest.insurer",
"path": "EligibilityRequest.insurer",
"short": "Target",
"definition": "The Insurer who is target of the request.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.insurer",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
}
],
"mapping": [
{
"identity": "workflow",
"map": "Request.performer"
},
{
"identity": "w5",
"map": "who"
}
]
},
{
"id": "EligibilityRequest.insurer.id",
"path": "EligibilityRequest.insurer.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "EligibilityRequest.insurer.extension",
"path": "EligibilityRequest.insurer.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"ordered": false,
"rules": "open"
},
"short": "Extension",
"definition": "An Extension",
"min": 1,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "EligibilityRequest.insurer.extension:insurer",
"path": "EligibilityRequest.insurer.extension",
"sliceName": "insurer",
"short": "R5: Coverage issuer additional types",
"definition": "R5: `CoverageEligibilityRequest.insurer` additional types from child elements (display, identifier, reference, type)",
"comment": "Element `CoverageEligibilityRequest.insurer` is mapped to FHIR STU3 element `EligibilityRequest.insurer` as `SourceIsBroaderThanTarget`.\nThe mappings for `CoverageEligibilityRequest.insurer` do not cover the following types based on type expansion: display, identifier, reference, type.\nThe standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `CoverageEligibilityRequest.insurer` with unmapped reference targets: Organization.",
"min": 1,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/StructureDefinition/alternate-reference"
}
]
},
{
"id": "EligibilityRequest.insurer.reference",
"path": "EligibilityRequest.insurer.reference",
"short": "Literal reference, Relative, internal or absolute URL",
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.reference",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ref-1"
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "EligibilityRequest.insurer.identifier",
"path": "EligibilityRequest.insurer.identifier",
"short": "Logical reference, when literal reference is not known",
"definition": "An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".identifier"
}
]
},
{
"id": "EligibilityRequest.insurer.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "EligibilityRequest.insurer.display",
"short": "Text alternative for the resource",
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "EligibilityRequest.facility",
"path": "EligibilityRequest.facility",
"short": "Servicing Facility",
"definition": "Facility where the services were provided.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.facility",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Location"
}
],
"mapping": [
{
"identity": "w5",
"map": "where"
}
]
},
{
"id": "EligibilityRequest.facility.id",
"path": "EligibilityRequest.facility.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "EligibilityRequest.facility.extension",
"path": "EligibilityRequest.facility.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"ordered": false,
"rules": "open"
},
"short": "Extension",
"definition": "An Extension",
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
]
},
{
"id": "EligibilityRequest.facility.extension:facility",
"path": "EligibilityRequest.facility.extension",
"sliceName": "facility",
"short": "R5: Servicing facility additional types",
"definition": "R5: `CoverageEligibilityRequest.facility` additional types from child elements (display, identifier, reference, type)",
"comment": "Element `CoverageEligibilityRequest.facility` is mapped to FHIR STU3 element `EligibilityRequest.facility` as `SourceIsBroaderThanTarget`.\nThe mappings for `CoverageEligibilityRequest.facility` do not cover the following types based on type expansion: display, identifier, reference, type.\nThe standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `CoverageEligibilityRequest.facility` with unmapped reference targets: Location.",
"min": 0,
"max": "1",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/StructureDefinition/alternate-reference"
}
]
},
{
"id": "EligibilityRequest.facility.reference",
"path": "EligibilityRequest.facility.reference",
"short": "Literal reference, Relative, internal or absolute URL",
"definition": "A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.",
"comment": "Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure \"/[type]/[id]\" then it should be assumed that the reference is to a FHIR RESTful server.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.reference",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ref-1"
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "EligibilityRequest.facility.identifier",
"path": "EligibilityRequest.facility.identifier",
"short": "Logical reference, when literal reference is not known",
"definition": "An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.",
"comment": "When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. \n\nWhen both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference\n\nApplications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.identifier",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Identifier"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".identifier"
}
]
},
{
"id": "EligibilityRequest.facility.display",
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
"valueBoolean": true
}
],
"path": "EligibilityRequest.facility.display",
"short": "Text alternative for the resource",
"definition": "Plain text narrative that identifies the resource in addition to the resource reference.",
"comment": "This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.",
"min": 0,
"max": "1",
"base": {
"path": "Reference.display",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "EligibilityRequest.coverage",
"path": "EligibilityRequest.coverage",
"short": "Insurance or medical plan",
"definition": "Financial instrument by which payment information for health care.",
"comment": "1..1.",
"requirements": "Need to identify the issuer to target for processing and for coordination of benefit processing.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.coverage",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Coverage"
}
]
},
{
"id": "EligibilityRequest.businessArrangement",
"path": "EligibilityRequest.businessArrangement",
"short": "Business agreement",
"definition": "The contract number of a business agreement which describes the terms and conditions.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.businessArrangement",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
]
},
{
"id": "EligibilityRequest.benefitCategory",
"path": "EligibilityRequest.benefitCategory",
"short": "Type of services covered",
"definition": "Dental, Vision, Medical, Pharmacy, Rehab etc.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.benefitCategory",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BenefitCategory"
}
],
"strength": "example",
"description": "Benefit categories such as: oral, medical, vision etc.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/benefit-category|3.0.2"
}
}
},
{
"id": "EligibilityRequest.benefitSubCategory",
"path": "EligibilityRequest.benefitSubCategory",
"short": "Detailed services covered within the type",
"definition": "Dental: basic, major, ortho; Vision exam, glasses, contacts; etc.",
"min": 0,
"max": "1",
"base": {
"path": "EligibilityRequest.benefitSubCategory",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BenefitSubCategory"
}
],
"strength": "example",
"description": "Benefit subcategories such as: oral-basic, major, glasses",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/benefit-subcategory|3.0.2"
}
}
}
]
},
"differential": {
"element": [
{
"id": "EligibilityRequest",
"path": "EligibilityRequest"
},
{
"id": "EligibilityRequest.extension",
"path": "EligibilityRequest.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"min": 1,
"max": "*"
},
{
"id": "EligibilityRequest.extension:purpose",
"path": "EligibilityRequest.extension",
"sliceName": "purpose",
"short": "R5: auth-requirements | benefits | discovery | validation (new)",
"definition": "R5: `CoverageEligibilityRequest.purpose` (new:code)",
"comment": "Element `CoverageEligibilityRequest.purpose` has a context of EligibilityRequest based on following the parent source element upwards and mapping to `EligibilityRequest`.\nElement `CoverageEligibilityRequest.purpose` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 1,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.purpose|0.1.0"
}
]
},
{
"id": "EligibilityRequest.extension:event",
"path": "EligibilityRequest.extension",
"sliceName": "event",
"short": "R5: Event information (new)",
"definition": "R5: `CoverageEligibilityRequest.event` (new:BackboneElement)",
"comment": "Element `CoverageEligibilityRequest.event` has a context of EligibilityRequest based on following the parent source element upwards and mapping to `EligibilityRequest`.\nElement `CoverageEligibilityRequest.event` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.event|0.1.0"
}
]
},
{
"id": "EligibilityRequest.extension:provider",
"path": "EligibilityRequest.extension",
"sliceName": "provider",
"short": "R5: Party responsible for the request",
"definition": "R5: `CoverageEligibilityRequest.provider`",
"comment": "Element `CoverageEligibilityRequest.provider` is mapped to FHIR STU3 element `EligibilityRequest.provider` as `SourceIsBroaderThanTarget`.\nElement `CoverageEligibilityRequest.provider` is mapped to FHIR STU3 element `EligibilityRequest.organization` as `SourceIsBroaderThanTarget`.\nThe standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `CoverageEligibilityRequest.provider` with unmapped reference targets: Organization, Practitioner, PractitionerRole.\nTypically this field would be 1..1 where this party is accountable for the data content within the claim but is not necessarily the facility, provider group or practitioner who provided the products and services listed within this claim resource. This field is the Billing Provider, for example, a facility, provider group, lab or practitioner.",
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/StructureDefinition/alternate-reference"
}
]
},
{
"id": "EligibilityRequest.extension:supportingInfo",
"path": "EligibilityRequest.extension",
"sliceName": "supportingInfo",
"short": "R5: Supporting information (new)",
"definition": "R5: `CoverageEligibilityRequest.supportingInfo` (new:BackboneElement)",
"comment": "Element `CoverageEligibilityRequest.supportingInfo` has a context of EligibilityRequest based on following the parent source element upwards and mapping to `EligibilityRequest`.\nElement `CoverageEligibilityRequest.supportingInfo` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).\nOften there are multiple jurisdiction specific valuesets which are required.",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.supportingInfo|0.1.0"
}
]
},
{
"id": "EligibilityRequest.extension:insurance",
"path": "EligibilityRequest.extension",
"sliceName": "insurance",
"short": "R5: Patient insurance information (new)",
"definition": "R5: `CoverageEligibilityRequest.insurance` (new:BackboneElement)",
"comment": "Element `CoverageEligibilityRequest.insurance` has a context of EligibilityRequest based on following the parent source element upwards and mapping to `EligibilityRequest`.\nElement `CoverageEligibilityRequest.insurance` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).\nAll insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.insurance|0.1.0"
}
]
},
{
"id": "EligibilityRequest.extension:item",
"path": "EligibilityRequest.extension",
"sliceName": "item",
"short": "R5: Item to be evaluated for eligibiity (new)",
"definition": "R5: `CoverageEligibilityRequest.item` (new:BackboneElement)",
"comment": "Element `CoverageEligibilityRequest.item` has a context of EligibilityRequest based on following the parent source element upwards and mapping to `EligibilityRequest`.\nElement `CoverageEligibilityRequest.item` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).",
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/5.0/StructureDefinition/extension-CoverageEligibilityRequest.item|0.1.0"
}
]
},
{
"id": "EligibilityRequest.patient.extension",
"path": "EligibilityRequest.patient.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"min": 1,
"max": "*"
},
{
"id": "EligibilityRequest.patient.extension:patient",
"path": "EligibilityRequest.patient.extension",
"sliceName": "patient",
"short": "R5: Intended recipient of products and services additional types",
"definition": "R5: `CoverageEligibilityRequest.patient` additional types from child elements (display, identifier, reference, type)",
"comment": "Element `CoverageEligibilityRequest.patient` is mapped to FHIR STU3 element `EligibilityRequest.patient` as `SourceIsBroaderThanTarget`.\nThe mappings for `CoverageEligibilityRequest.patient` do not cover the following types based on type expansion: display, identifier, reference, type.\nThe standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `CoverageEligibilityRequest.patient` with unmapped reference targets: Patient.\n1..1.",
"min": 1,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/StructureDefinition/alternate-reference"
}
]
},
{
"id": "EligibilityRequest.enterer.extension",
"path": "EligibilityRequest.enterer.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"min": 0,
"max": "*"
},
{
"id": "EligibilityRequest.enterer.extension:enterer",
"path": "EligibilityRequest.enterer.extension",
"sliceName": "enterer",
"short": "R5: enterer additional types",
"definition": "R5: `CoverageEligibilityRequest.enterer` additional types from child elements (display, identifier, reference, type)",
"comment": "Element `CoverageEligibilityRequest.enterer` is mapped to FHIR STU3 element `EligibilityRequest.enterer` as `SourceIsBroaderThanTarget`.\nThe mappings for `CoverageEligibilityRequest.enterer` do not cover the following types based on type expansion: display, identifier, reference, type.\nThe standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `CoverageEligibilityRequest.enterer` with unmapped reference targets: Practitioner, PractitionerRole.",
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/StructureDefinition/alternate-reference"
}
]
},
{
"id": "EligibilityRequest.insurer.extension",
"path": "EligibilityRequest.insurer.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"min": 1,
"max": "*"
},
{
"id": "EligibilityRequest.insurer.extension:insurer",
"path": "EligibilityRequest.insurer.extension",
"sliceName": "insurer",
"short": "R5: Coverage issuer additional types",
"definition": "R5: `CoverageEligibilityRequest.insurer` additional types from child elements (display, identifier, reference, type)",
"comment": "Element `CoverageEligibilityRequest.insurer` is mapped to FHIR STU3 element `EligibilityRequest.insurer` as `SourceIsBroaderThanTarget`.\nThe mappings for `CoverageEligibilityRequest.insurer` do not cover the following types based on type expansion: display, identifier, reference, type.\nThe standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `CoverageEligibilityRequest.insurer` with unmapped reference targets: Organization.",
"min": 1,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/StructureDefinition/alternate-reference"
}
]
},
{
"id": "EligibilityRequest.facility.extension",
"path": "EligibilityRequest.facility.extension",
"slicing": {
"discriminator": [
{
"type": "value",
"path": "url"
}
],
"ordered": false,
"rules": "open"
},
"min": 0,
"max": "*"
},
{
"id": "EligibilityRequest.facility.extension:facility",
"path": "EligibilityRequest.facility.extension",
"sliceName": "facility",
"short": "R5: Servicing facility additional types",
"definition": "R5: `CoverageEligibilityRequest.facility` additional types from child elements (display, identifier, reference, type)",
"comment": "Element `CoverageEligibilityRequest.facility` is mapped to FHIR STU3 element `EligibilityRequest.facility` as `SourceIsBroaderThanTarget`.\nThe mappings for `CoverageEligibilityRequest.facility` do not cover the following types based on type expansion: display, identifier, reference, type.\nThe standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `CoverageEligibilityRequest.facility` with unmapped reference targets: Location.",
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": "http://hl7.org/fhir/StructureDefinition/alternate-reference"
}
]
}
]
}
}