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Packagehl7.fhir.uv.xver-r5.r4b
Resource TypeCodeSystem
IdCodeSystem-eligibilityresponse-purpose.json
FHIR VersionR4B

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Narrative

Note: links and images are rebased to the (stated) source

This code system http://hl7.org/fhir/eligibilityresponse-purpose defines the following codes:

Code Display Definition
auth-requirements Coverage auth-requirements The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested.
benefits Coverage benefits The plan benefits and optionally benefits consumed for the listed, or discovered if specified, converages are requested.
discovery Coverage Discovery The insurer is requested to report on any coverages which they are aware of in addition to any specifed.
validation Coverage Validation A check that the specified coverages are in-force is requested.

Source1

{
  "resourceType": "CodeSystem",
  "id": "eligibilityresponse-purpose",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "trial-use"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 2
    },
    {
      "extension": [
        {
          "url": "packageId",
          "valueId": "hl7.fhir.uv.xver-r5.r4b"
        },
        {
          "url": "version",
          "valueString": "0.0.1-snapshot-2"
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/package-source"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fm"
    }
  ],
  "url": "http://hl7.org/fhir/eligibilityresponse-purpose",
  "version": "5.0.0",
  "name": "EligibilityResponsePurpose",
  "title": "Eligibility Response Purpose",
  "status": "active",
  "experimental": false,
  "date": "2021-01-05T09:01:24+10:00",
  "publisher": "Financial Management",
  "contact": [
    {
      "name": "Financial Management",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description": "A code specifying the types of information being requested.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "caseSensitive": true,
  "valueSet": "http://hl7.org/fhir/ValueSet/eligibilityresponse-purpose|4.3.0",
  "content": "complete",
  "concept": [
    {
      "code": "auth-requirements",
      "display": "Coverage auth-requirements",
      "definition": "The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested."
    },
    {
      "code": "benefits",
      "display": "Coverage benefits",
      "definition": "The plan benefits and optionally benefits consumed  for the listed, or discovered if specified, converages are requested."
    },
    {
      "code": "discovery",
      "display": "Coverage Discovery",
      "definition": "The insurer is requested to report on any coverages which they are aware of in addition to any specifed."
    },
    {
      "code": "validation",
      "display": "Coverage Validation",
      "definition": "A check that the specified coverages are in-force is requested."
    }
  ]
}