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Packageorg.dhin-hie.sandbox
Resource TypeCoverageEligibilityResponse
IdCoverageEligibilityResponse-CER-Response-001.json
FHIR VersionR4

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Narrative

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

Generated Narrative: CoverageEligibilityResponse CER-Response-001

status: Active

purpose: Coverage benefits

patient: Chika Okafor Male, DoB: 1990-04-21 ( mobile: 08031112233)

created: 2025-10-15 09:06:30+0100

request: CoverageEligibilityRequest: status = active; purpose = benefits; created = 2025-10-15 09:05:00+0100

outcome: Processing Complete

disposition: Eligible for covered services per active policy.

insurer: Organization XYZ HMO

insurance

coverage: Coverage: status = active; type = extended healthcare; period = 2025-01-01 --> 2025-12-31

inforce: true

item

category: Outpatient

Benefits

-TypeAllowed[x]
*vision-exam1

Source1

{
  "resourceType": "CoverageEligibilityResponse",
  "id": "CER-Response-001",
  "meta": {
    "profile": [
      "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-coverage-eligibility-response"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "status": "active",
  "purpose": [
    "benefits"
  ],
  "patient": {
    "reference": "urn:uuid:aaabbbcc-e5f6-4789-a123-456789abcdef"
  },
  "created": "2025-10-15T09:06:30+01:00",
  "request": {
    "reference": "urn:uuid:dddeeeff-e5f6-4789-a123-456789abcdef"
  },
  "outcome": "complete",
  "disposition": "Eligible for covered services per active policy.",
  "insurer": {
    "reference": "urn:uuid:cccddde1-e5f6-4789-a123-456789abcdef"
  },
  "insurance": [
    {
      "coverage": {
        "reference": "urn:uuid:fffaaabb-e5f6-4789-a123-456789abcdef"
      },
      "inforce": true,
      "item": [
        {
          "category": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/ex-benefitcategory",
                "code": "1"
              }
            ],
            "text": "Outpatient"
          },
          "benefit": [
            {
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/benefit-type",
                    "code": "copay"
                  }
                ],
                "text": "vision-exam"
              },
              "allowedUnsignedInt": 1
            }
          ]
        }
      ]
    }
  ]
}