FHIR IG analytics| Package | ndhm.in |
| Resource Type | CoverageEligibilityResponse |
| Id | CoverageEligibilityResponse-benefits-example-01.json |
| FHIR Version | R4 |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: CoverageEligibilityResponse benefits-example-01
Language: en
Profile: CoverageEligibilityResponse
status: Active
purpose: Coverage benefits
patient: ABC Male, DoB: 1981-01-12 ( Medical record number: 22-7225-4829-5255)
created: 2023-09-07
requestor: Practitioner Dr. DEF
outcome: Processing Complete
disposition: Policy is currently in-force.
insurer: Organization XYZ Insurance Co. Ltd.
insurance
inforce: true
benefitPeriod: 2023-09-07 --> 2026-08-07
item
productOrService: Consultant
Benefits
Type Allowed[x] Used[x] Benefit ₹50,000.00 (INR) ₹0.00 (INR) item
productOrService: Metformin hydrochloride 500 mg prolonged-release oral tablet
Benefits
Type Allowed[x] Used[x] Benefit ₹50,000.00 (INR) ₹0.00 (INR)
{
"resourceType": "CoverageEligibilityResponse",
"id": "benefits-example-01",
"meta": {
"profile": [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse"
]
},
"language": "en",
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"status": "active",
"purpose": [
"benefits"
],
"patient": {
"reference": "Patient/example-01"
},
"created": "2023-09-07",
"requestor": {
"reference": "Practitioner/example-01"
},
"request": {
"reference": "CoverageEligibilityRequest/benefits-example-01"
},
"outcome": "complete",
"disposition": "Policy is currently in-force.",
"insurer": {
"reference": "Organization/example-02"
},
"insurance": [
{
"coverage": {
"reference": "Coverage/example-01"
},
"inforce": true,
"benefitPeriod": {
"start": "2023-09-07",
"end": "2026-08-07"
},
"item": [
{
"productOrService": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "768839008",
"display": "Consultant"
}
]
},
"benefit": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/benefit-type",
"code": "benefit",
"display": "Benefit"
}
]
},
"allowedMoney": {
"value": 50000,
"currency": "INR"
},
"usedMoney": {
"value": 0,
"currency": "INR"
}
}
]
},
{
"productOrService": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "765507008",
"display": "Metformin hydrochloride 500 mg prolonged-release oral tablet"
}
]
},
"benefit": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/benefit-type",
"code": "benefit",
"display": "Benefit"
}
]
},
"allowedMoney": {
"value": 50000,
"currency": "INR"
},
"usedMoney": {
"value": 0,
"currency": "INR"
}
}
]
}
]
}
]
}