EnrollEligCOB
Class CoverageEligibilityRequest

"The CoverageEligibilityRequest provides 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." - HL7 FHIR, CoverageEligibilityRequest

Attributes
«TS» PointInTime dateCreated dateCreated

"The date when this resource was created." - HL7 FHIR, CoverageEligibilityRequest.created

«IVL_TS» Period datesOfService datesOfService

"The date or dates when the enclosed suite of services were performed or completed." - HL7 FHIR, CoverageEligibilityRequest.serviced[x]
Note that in FHIR, the data type of this property can be either a DateTime or a Period. In the FHIM, this is modeled as a Period. If a only a date/time is needed, use Period.start and leave Period.end empty.

Participation enterer enterer

"Person who created the request." - HL7 FHIR, CoverageEligibilityRequest.enterer

ServiceDeliveryLocation facility facility

"Facility where the services are intended to be provided." - HL7 FHIR, CoverageEligibilityRequest.facility

«II» Id identifier identifier

"A unique identifier assigned to this coverage eligiblity request." - HL7 FHIR, CoverageEligibilityRequest.identifier

Organization insurer insurer

"The Insurer who issued the coverage in question and is the recipient of the request." - HL7 FHIR, CoverageEligibilityRequest.insurer

RequestItem item item

"Service categories or billable services for which benefit details and/or an authorization prior to service delivery may be required by the payor." - HL7 FHIR, CoverageEligibilityRequest.item

CoveredPatient patient patient

"The party who is the beneficiary of the supplied coverage and for whom eligibility is sought." - HL7 FHIR, CoverageEligibilityRequest.patient

«CS» Code priority priority

"When the requestor expects the processor to complete processing." Possible values include: Immediate; Normal; Deferred. - HL7 FHIR, CoverageEligibilityRequest.priority

HealthcareProvider provider provider

"The provider which is responsible for the request." - HL7 FHIR, CoverageEligibilityRequest.provider

«CS» Code purpose purpose

"Code to specify whether requesting: prior authorization requirements for some service categories or billing codes; benefits for coverages specified or discovered; discovery and return of coverages for the patient; and/or validation that the specified coverage is in-force at the date/period specified or 'now' if not specified." Possible values are: Coverage auth-requirements; Coverage benefits; Coverage Discovery; Coverage Validation. - HL7 FHIR, CoverageEligibilityRequest.purpose

RequestedInsurance requestedInsurance requestedInsurance

"Financial instruments for reimbursement for the health care products and services." - HL7 FHIR, CoverageEligibilityRequest.insurance

«CS» Code status status

"The status of the resource instance." Possible values are: Active; Cancelled; Draft; Entered in Error. - HL7 FHIR, CoverageEligibilityRequest.status

SupportingInformation supportingInformation supportingInformation

"Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues." - HL7 FHIR, CoverageEligibilityRequest.supportingInfo


Properties:

Alias
Classifier Behavior
Is Abstractfalse
Is Activefalse
Is Leaffalse
Keywords
NameCoverageEligibilityRequest
Name Expression
NamespaceEnrollEligCOB
Owned Template Signature
OwnerEnrollEligCOB
Owning Template Parameter
PackageEnrollEligCOB
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest
Representation
Stereotype
Template Parameter
VisibilityPublic

Attribute Details

 dateCreated
Public «TS» PointInTime dateCreated

"The date when this resource was created." - HL7 FHIR, CoverageEligibilityRequest.created

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityRequest
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamedateCreated
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::dateCreated
Stereotype
Template Parameter
Type«TS» PointInTime
Upper1
Upper Value(1)
VisibilityPublic


 datesOfService
Public «IVL_TS» Period datesOfService

"The date or dates when the enclosed suite of services were performed or completed." - HL7 FHIR, CoverageEligibilityRequest.serviced[x]
Note that in FHIR, the data type of this property can be either a DateTime or a Period. In the FHIM, this is modeled as a Period. If a only a date/time is needed, use Period.start and leave Period.end empty.

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityRequest
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
NamedatesOfService
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::datesOfService
Stereotype
Template Parameter
Type«IVL_TS» Period
Upper1
Upper Value(1)
VisibilityPublic


 enterer
Public Participation enterer

"Person who created the request." - HL7 FHIR, CoverageEligibilityRequest.enterer

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityRequest
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
Nameenterer
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::enterer
Stereotype
Template Parameter
TypeParticipation
Upper1
Upper Value(1)
VisibilityPublic


 facility
Public ServiceDeliveryLocation facility

"Facility where the services are intended to be provided." - HL7 FHIR, CoverageEligibilityRequest.facility

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityRequest
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
Namefacility
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::facility
Stereotype
Template Parameter
TypeServiceDeliveryLocation
Upper1
Upper Value(1)
VisibilityPublic


 identifier
Public «II» Id identifier

"A unique identifier assigned to this coverage eligiblity request." - HL7 FHIR, CoverageEligibilityRequest.identifier

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityRequest
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
Nameidentifier
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::identifier
Stereotype
Template Parameter
Type«II» Id
Upper*
Upper Value(*)
VisibilityPublic


 insurer
Public Organization insurer

"The Insurer who issued the coverage in question and is the recipient of the request." - HL7 FHIR, CoverageEligibilityRequest.insurer

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityRequest
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1
Nameinsurer
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::insurer
Stereotype
Template Parameter
TypeOrganization
Upper1
Upper Value(1)
VisibilityPublic


 item
Public RequestItem item

"Service categories or billable services for which benefit details and/or an authorization prior to service delivery may be required by the payor." - HL7 FHIR, CoverageEligibilityRequest.item

Constraints:
Properties:

AggregationNone
Alias
AssociationcoverageEligibilityRequest_item
Association End
ClassCoverageEligibilityRequest
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
Nameitem
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::item
Stereotype
Template Parameter
TypeRequestItem
Upper*
Upper Value(*)
VisibilityPublic


 patient
Public CoveredPatient patient

"The party who is the beneficiary of the supplied coverage and for whom eligibility is sought." - HL7 FHIR, CoverageEligibilityRequest.patient

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityRequest
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1
Namepatient
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::patient
Stereotype
Template Parameter
TypeCoveredPatient
Upper1
Upper Value(1)
VisibilityPublic


 priority
Public «CS» Code priority

"When the requestor expects the processor to complete processing." Possible values include: Immediate; Normal; Deferred. - HL7 FHIR, CoverageEligibilityRequest.priority

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityRequest
Terminologies[
HL7_FHIR_R4 Process Priority Codes http://hl7.org/fhir/ValueSet/process-priority
]
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
Namepriority
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::priority
StereotypeValueSetConstraints
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 provider
Public HealthcareProvider provider

"The provider which is responsible for the request." - HL7 FHIR, CoverageEligibilityRequest.provider

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityRequest
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity0..1
Nameprovider
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::provider
Stereotype
Template Parameter
TypeHealthcareProvider
Upper1
Upper Value(1)
VisibilityPublic


 purpose
Public «CS» Code purpose

"Code to specify whether requesting: prior authorization requirements for some service categories or billing codes; benefits for coverages specified or discovered; discovery and return of coverages for the patient; and/or validation that the specified coverage is in-force at the date/period specified or 'now' if not specified." Possible values are: Coverage auth-requirements; Coverage benefits; Coverage Discovery; Coverage Validation. - HL7 FHIR, CoverageEligibilityRequest.purpose

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityRequest
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1..*
Namepurpose
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::purpose
Stereotype
Template Parameter
Type«CS» Code
Upper*
Upper Value(*)
VisibilityPublic


 requestedInsurance
Public RequestedInsurance requestedInsurance

"Financial instruments for reimbursement for the health care products and services." - HL7 FHIR, CoverageEligibilityRequest.insurance

Constraints:
Properties:

AggregationNone
Alias
AssociationcoverageEligibilityRequest_requestedInsurance
Association End
ClassCoverageEligibilityRequest
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
NamerequestedInsurance
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::requestedInsurance
Stereotype
Template Parameter
TypeRequestedInsurance
Upper*
Upper Value(*)
VisibilityPublic


 status
Public «CS» Code status

"The status of the resource instance." Possible values are: Active; Cancelled; Draft; Entered in Error. - HL7 FHIR, CoverageEligibilityRequest.status

Constraints:
Properties:

AggregationNone
Alias
Association
Association End
ClassCoverageEligibilityRequest
Terminologies[
HL7_FHIR_R4 Financial Resource Status Codes http://hl7.org/fhir/ValueSet/fm-status
]
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower1
Lower Value(1)
Multiplicity1
Namestatus
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::status
StereotypeValueSetConstraints
Template Parameter
Type«CS» Code
Upper1
Upper Value(1)
VisibilityPublic


 supportingInformation
Public SupportingInformation supportingInformation

"Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues." - HL7 FHIR, CoverageEligibilityRequest.supportingInfo

Constraints:
Properties:

AggregationNone
Alias
AssociationcoverageEligibilityRequest_supportingInformation
Association End
ClassCoverageEligibilityRequest
Datatype
Default
Default Value
Is Compositefalse
Is Derivedfalse
Is Derived Unionfalse
Is Leaffalse
Is Orderedfalse
Is Read Onlyfalse
Is Staticfalse
Is Uniquetrue
Keywords
Lower0
Lower Value(0)
Multiplicity*
NamesupportingInformation
Name Expression
NamespaceCoverageEligibilityRequest
Opposite
OwnerCoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB::CoverageEligibilityRequest::supportingInformation
Stereotype
Template Parameter
TypeSupportingInformation
Upper*
Upper Value(*)
VisibilityPublic