abstractbaseDefinitioncopyrightdate- Values Differ
descriptionexperimentalfhirVersionjurisdiction
jurisdiction[0]kindnamepublisherpurposestatustitletypeurlversion- Values Differ
| Left: | CoverageEligibilityRequest (https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest) |
| Right: | CoverageEligibilityRequest (https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest) |
| Error | StructureDefinition.version | Values for version differ: '6.0.0' vs '6.5.0' |
| Information | StructureDefinition.date | Values for date differ: '2024-01-24T14:28:59+05:30' vs '2025-03-18T17:41:18+05:30' |
| Information | StructureDefinition.comment | Values for comment differ: 'Every Object created by a TMS provider or TMS payer will have a unique identifier that will be genrated by the source system' vs 'Every Object created by a TMS provider or TMS payer will have a unique identifier that will be generated by the source system' |
| Name | Value | Comments | |
|---|---|---|---|
| abstract | false | ||
| baseDefinition | http://hl7.org/fhir/StructureDefinition/CoverageEligibilityRequest | ||
| copyright | |||
| date | 2024-01-24T14:28:59+05:30 | 2025-03-18T17:41:18+05:30 |
|
| description | This profile sets minimum expectations for CoverageEligibilityRequest to provide patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy. | ||
| experimental | |||
| fhirVersion | 4.0.1 | ||
| jurisdiction | |||
| jurisdiction[0] | urn:iso:std:iso:3166#IN | ||
| kind | resource | ||
| name | CoverageEligibilityRequest | ||
| publisher | National Resource Center for EHR Standards | ||
| purpose | |||
| status | draft | ||
| title | |||
| type | CoverageEligibilityRequest | ||
| url | https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest | ||
| version | 6.0.0 | 6.5.0 |
|
| Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
 CoverageEligibilityRequest | 0..* | CoverageEligibilityRequest | CoverageEligibilityRequest resource | 0..* | CoverageEligibilityRequest | CoverageEligibilityRequest resource | |||||||||||
 id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact | |||||||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |||||||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |||||||||
| language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| |||||||||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
| contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
 extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
| identifier | S | 1..1 | Identifier | Business Identifier for coverage eligiblity request | S | 1..1 | Identifier | Business Identifier for coverage eligiblity request | |||||||||
| status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | |||||||||
| priority | 1..1 | CodeableConcept | Desired processing priority Binding: ?? (example): The timeliness with which processing is required: STAT, normal, Deferred. | 1..1 | CodeableConcept | Desired processing priority Binding: ?? (example): The timeliness with which processing is required: STAT, normal, Deferred. | |||||||||||
| purpose | SΣ | 1..* | code | auth-requirements | benefits | discovery | validation Binding: ?? (required): A code specifying the types of information being requested. | SΣ | 1..* | code | auth-requirements | benefits | discovery | validation Binding: ?? (required): A code specifying the types of information being requested. | |||||||||
| patient | Σ | 1..1 | Reference(Patient) | Intended recipient of products and services | Σ | 1..1 | Reference(Patient) | Intended recipient of products and services | |||||||||
| serviced[x] | 0..1 | date, Period | Estimated date or dates of service | 0..1 | date, Period | Estimated date or dates of service | |||||||||||
| created | Σ | 1..1 | dateTime | Creation date | Σ | 1..1 | dateTime | Creation date | |||||||||
| enterer | 1..1 | Reference(Practitioner | PractitionerRole) | Author | 1..1 | Reference(Practitioner | PractitionerRole) | Author | |||||||||||
| provider | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Party responsible for the request | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Party responsible for the request | |||||||||||
| insurer | Σ | 1..1 | Reference(Organization) | Coverage issuer | Σ | 1..1 | Reference(Organization) | Coverage issuer | |||||||||
| facility | 1..1 | Reference(Location) | Servicing facility | 1..1 | Reference(Location) | Servicing facility | |||||||||||
 supportingInfo | S | 0..* | BackboneElement | Supporting information | S | 0..* | BackboneElement | Supporting information | |||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| sequence | 1..1 | positiveInt | Information instance identifier | 1..1 | positiveInt | Information instance identifier | |||||||||||
| information | 1..1 | Reference(Resource) | Data to be provided | 1..1 | Reference(Resource) | Data to be provided | |||||||||||
| appliesToAll | 0..1 | boolean | Applies to all items | 0..1 | boolean | Applies to all items | |||||||||||
| insurance | S | 1..* | BackboneElement | Patient insurance information | S | 1..* | BackboneElement | Patient insurance information | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| focal | 0..1 | boolean | Applicable coverage | 0..1 | boolean | Applicable coverage | |||||||||||
| coverage | S | 1..1 | Reference(Coverage) | Insurance information | S | 1..1 | Reference(Coverage) | Insurance information | |||||||||
| businessArrangement | 0..1 | string | Additional provider contract number | 0..1 | string | Additional provider contract number | |||||||||||
 item | S | 0..* | BackboneElement | Item to be evaluated for eligibiity | S | 0..* | BackboneElement | Item to be evaluated for eligibiity | |||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| supportingInfoSequence | 0..* | positiveInt | Applicable exception or supporting information | 0..* | positiveInt | Applicable exception or supporting information | |||||||||||
| category | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example) | 0..1 | CodeableConcept | Benefit classification Binding: ?? (example) | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| coding | Σ | 0..* | Coding | Code defined by a terminology system | Σ | 0..* | Coding | Code defined by a terminology system | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| system | Σ | 1..1 | uri | Identity of the terminology system | Σ | 1..1 | uri | Identity of the terminology system | |||||||||
| version | Σ | 0..1 | string | Version of the system - if relevant | Σ | 0..1 | string | Version of the system - if relevant | |||||||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | Σ | 1..1 | code | Symbol in syntax defined by the system | |||||||||
| display | Σ | 1..1 | string | Representation defined by the system | Σ | 1..1 | string | Representation defined by the system | |||||||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | Σ | 0..1 | boolean | If this coding was chosen directly by the user | |||||||||
| text | Σ | 0..1 | string | Plain text representation of the concept | Σ | 0..1 | string | Plain text representation of the concept | |||||||||
| productOrService | S | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example) | S | 1..1 | CodeableConcept | Billing, service, product, or drug code Binding: ?? (example) | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| coding | Σ | 0..* | Coding | Code defined by a terminology system | Σ | 0..* | Coding | Code defined by a terminology system | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| system | Σ | 1..1 | uri | Identity of the terminology system | Σ | 1..1 | uri | Identity of the terminology system | |||||||||
| version | Σ | 0..1 | string | Version of the system - if relevant | Σ | 0..1 | string | Version of the system - if relevant | |||||||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | Σ | 1..1 | code | Symbol in syntax defined by the system | |||||||||
| display | Σ | 1..1 | string | Representation defined by the system | Σ | 1..1 | string | Representation defined by the system | |||||||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | Σ | 0..1 | boolean | If this coding was chosen directly by the user | |||||||||
| text | Σ | 0..1 | string | Plain text representation of the concept | Σ | 0..1 | string | Plain text representation of the concept | |||||||||
| modifier | 0..* | CodeableConcept | Product or service billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | 0..* | CodeableConcept | Product or service billing modifiers Binding: ?? (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen. | |||||||||||
| provider | 0..1 | Reference(Practitioner | PractitionerRole) | Perfoming practitioner | 0..1 | Reference(Practitioner | PractitionerRole) | Perfoming practitioner | |||||||||||
| quantity | 0..1 | ?? | Count of products or services | 0..1 | ?? | Count of products or services | |||||||||||
| unitPrice | 0..1 | Money | Fee, charge or cost per item | 0..1 | Money | Fee, charge or cost per item | |||||||||||
| facility | 0..1 | Reference(Location | Organization) | Servicing facility | 0..1 | Reference(Location | Organization) | Servicing facility | |||||||||||
| diagnosis | S | 0..* | BackboneElement | Applicable diagnosis | S | 0..* | BackboneElement | Applicable diagnosis | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| diagnosis[x] | 0..1 | CodeableConcept, Reference(Condition) | Nature of illness or problem Binding: ?? (example): ICD10 Diagnostic codes. | 0..1 | CodeableConcept, Reference(Condition) | Nature of illness or problem Binding: ?? (example) | |||||||||||
| detail | 0..* | Reference(Resource) | Product or service details | 0..* | Reference(Resource) | Product or service details | |||||||||||
| Documentation for this format | |||||||||||||||||