This page is part of the FHIR Implementation Guide for ABDM (v6.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

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Resource Profile: CoverageEligibilityResponse - Mappings

Draft as of 2025-03-18

Mappings for the CoverageEligibilityResponse resource profile.

Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

CoverageEligibilityResponse
CoverageEligibilityResponse	Event
identifier	Event.identifier
status	Event.status
patient	Event.subject
request	Event.basedOn
disposition	Event.note

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

CoverageEligibilityResponse
CoverageEligibilityResponse
identifier	FiveWs.identifier
status	FiveWs.status
purpose	FiveWs.class
patient	FiveWs.subject[x], FiveWs.subject
serviced[x]	FiveWs.done[x]
created	FiveWs.recorded
requestor	FiveWs.source
request	FiveWs.why[x]
insurance
item
provider	FiveWs.source

Mappings for Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/)

CoverageEligibilityResponse
CoverageEligibilityResponse
patient	C06,C07,C08, C05, C04
serviced[x]	F09
requestor	B01
request	A02|G01
insurance
item
provider	B01
preAuthRef	F03
form	G42

Mappings for RIM Mapping (http://hl7.org/v3)

CoverageEligibilityResponse
CoverageEligibilityResponse	Entity. Role, or Act
text	Act.text?
contained	N/A
extension	N/A
modifierExtension	N/A
insurance
id	n/a
extension	n/a
modifierExtension	N/A
item
id	n/a
extension	n/a
modifierExtension	N/A
category
id	n/a
extension	n/a
coding	union(., ./translation)
id	n/a
extension	n/a
system	./codeSystem
version	./codeSystemVersion
code	./code
display	CV.displayName
userSelected	CD.codingRationale
text	./originalText[mediaType/code="text/plain"]/data
productOrService
id	n/a
extension	n/a
coding	union(., ./translation)
id	n/a
extension	n/a
system	./codeSystem
version	./codeSystemVersion
code	./code
display	CV.displayName
userSelected	CD.codingRationale
text	./originalText[mediaType/code="text/plain"]/data
benefit
id	n/a
extension	n/a
modifierExtension	N/A
preAuthRef	23
error
id	n/a
extension	n/a
modifierExtension	N/A