FHIR Implementation Guide for HCX
0.0.1 - CI Build
FHIR Implementation Guide for HCX - Local Development build (v0.0.1). See the Directory of published versions
Defining URL: | http://hl7.org/fhir/StructureDefinition/HCXCoverageEligibilityResponse |
Version: | 0.0.1 |
Name: | CoverageEligibilityResponse |
Status: | Draft as of 2021-08-16T09:29:23+11:00 (Standards Status: Trial Use) |
Definition: | This resource provides eligibility and plan details from the processing of an CoverageEligibilityRequest resource. |
Publisher: | HL7 International - HCX |
Committee: | Financial Management |
Maturity: | 2 |
Source Resource: | XML / JSON / Turtle |
The official URL for this profile is:
http://hl7.org/fhir/StructureDefinition/HCXCoverageEligibilityResponse
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from CoverageEligibilityResponse
This structure is derived from CoverageEligibilityResponse
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
CoverageEligibilityResponse | 0..* | CoverageEligibilityResponse | CoverageEligibilityResponse resource | |
identifier | 1..1 | Identifier | Business Identifier for coverage eligiblity request | |
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
purpose | Σ | 1..* | code | auth-requirements | benefits | discovery | validation Binding: EligibilityResponsePurpose (required): A code specifying the types of information being requested. |
patient | Σ | 1..1 | Reference(Patient) | Intended recipient of products and services |
serviced[x] | 0..1 | Estimated date or dates of service | ||
servicedDate | date | |||
servicedPeriod | Period | |||
created | Σ | 1..1 | dateTime | Response creation date |
requestor | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Party responsible for the request | |
request | Σ | 1..1 | Reference(CoverageEligibilityRequest) | Eligibility request reference |
outcome | Σ | 1..1 | code | queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing. |
disposition | 0..1 | string | Disposition Message | |
insurer | Σ | 1..1 | Reference(Organization) | Coverage issuer |
insurance | 0..* | BackboneElement | Patient insurance information | |
coverage | Σ | 1..1 | Reference(Coverage) | Insurance information |
inforce | 0..1 | boolean | Coverage inforce indicator | |
benefitPeriod | 0..1 | Period | When the benefits are applicable | |
item | I | 0..* | BackboneElement | Benefits and authorization details ces-1: SHALL contain a category or a billcode but not both. |
category | 0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision etc. | |
productOrService | 0..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |
modifier | 0..* | CodeableConcept | Product or service billing modifiers Binding: ModifierTypeCodes (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) | Performing practitioner | |
excluded | 0..1 | boolean | Excluded from the plan | |
name | 0..1 | string | Short name for the benefit | |
description | 0..1 | string | Description of the benefit or services covered | |
network | 0..1 | CodeableConcept | In or out of network Binding: NetworkTypeCodes (example): Code to classify in or out of network services. | |
unit | 0..1 | CodeableConcept | Individual or family Binding: UnitTypeCodes (example): Unit covered/serviced - individual or family. | |
term | 0..1 | CodeableConcept | Annual or lifetime Binding: BenefitTermCodes (example): Coverage unit - annual, lifetime. | |
benefit | 0..* | BackboneElement | Benefit Summary | |
type | 1..1 | CodeableConcept | Benefit classification Binding: BenefitTypeCodes (example): Deductable, visits, co-pay, etc. | |
allowed[x] | 0..1 | Benefits allowed | ||
allowedUnsignedInt | unsignedInt | |||
allowedString | string | |||
allowedMoney | Money | |||
used[x] | 0..1 | Benefits used | ||
usedUnsignedInt | unsignedInt | |||
usedString | string | |||
usedMoney | Money | |||
authorizationRequired | 0..1 | boolean | Authorization required flag | |
authorizationSupporting | 0..* | CodeableConcept | Type of required supporting materials Binding: CoverageEligibilityResponseAuthSupportCodes (example): Type of supporting information to provide with a preauthorization. | |
authorizationUrl | 0..1 | uri | Preauthorization requirements endpoint | |
preAuthRef | 0..1 | string | Preauthorization reference | |
form | 0..1 | CodeableConcept | Printed form identifier Binding: Form Codes (example): The forms codes. | |
error | 0..* | BackboneElement | Processing errors | |
code | 1..1 | CodeableConcept | Error code detailing processing issues Binding: Adjudication Error Codes (example): The error codes for adjudication processing. | |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
CoverageEligibilityResponse | 0..* | CoverageEligibilityResponse | CoverageEligibilityResponse resource | |
meta | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
contained | 0..* | Resource | Contained, inline Resources | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier | 1..1 | Identifier | Business Identifier for coverage eligiblity request | |
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
purpose | Σ | 1..* | code | auth-requirements | benefits | discovery | validation Binding: EligibilityResponsePurpose (required): A code specifying the types of information being requested. |
patient | Σ | 1..1 | Reference(Patient) | Intended recipient of products and services |
serviced[x] | 0..1 | Estimated date or dates of service | ||
servicedDate | date | |||
servicedPeriod | Period | |||
created | Σ | 1..1 | dateTime | Response creation date |
requestor | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Party responsible for the request | |
request | Σ | 1..1 | Reference(CoverageEligibilityRequest) | Eligibility request reference |
outcome | Σ | 1..1 | code | queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing. |
disposition | 0..1 | string | Disposition Message | |
insurer | Σ | 1..1 | Reference(Organization) | Coverage issuer |
insurance | 0..* | BackboneElement | Patient insurance information | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
coverage | Σ | 1..1 | Reference(Coverage) | Insurance information |
inforce | 0..1 | boolean | Coverage inforce indicator | |
benefitPeriod | 0..1 | Period | When the benefits are applicable | |
item | I | 0..* | BackboneElement | Benefits and authorization details |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
category | 0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision etc. | |
productOrService | 0..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |
modifier | 0..* | CodeableConcept | Product or service billing modifiers Binding: ModifierTypeCodes (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) | Performing practitioner | |
excluded | 0..1 | boolean | Excluded from the plan | |
name | 0..1 | string | Short name for the benefit | |
description | 0..1 | string | Description of the benefit or services covered | |
network | 0..1 | CodeableConcept | In or out of network Binding: NetworkTypeCodes (example): Code to classify in or out of network services. | |
unit | 0..1 | CodeableConcept | Individual or family Binding: UnitTypeCodes (example): Unit covered/serviced - individual or family. | |
term | 0..1 | CodeableConcept | Annual or lifetime Binding: BenefitTermCodes (example): Coverage unit - annual, lifetime. | |
benefit | 0..* | BackboneElement | Benefit Summary | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | 1..1 | CodeableConcept | Benefit classification Binding: BenefitTypeCodes (example): Deductable, visits, co-pay, etc. | |
allowed[x] | 0..1 | Benefits allowed | ||
allowedUnsignedInt | unsignedInt | |||
allowedString | string | |||
allowedMoney | Money | |||
used[x] | 0..1 | Benefits used | ||
usedUnsignedInt | unsignedInt | |||
usedString | string | |||
usedMoney | Money | |||
authorizationRequired | 0..1 | boolean | Authorization required flag | |
authorizationSupporting | 0..* | CodeableConcept | Type of required supporting materials Binding: CoverageEligibilityResponseAuthSupportCodes (example): Type of supporting information to provide with a preauthorization. | |
authorizationUrl | 0..1 | uri | Preauthorization requirements endpoint | |
preAuthRef | 0..1 | string | Preauthorization reference | |
form | 0..1 | CodeableConcept | Printed form identifier Binding: Form Codes (example): The forms codes. | |
error | 0..* | BackboneElement | Processing errors | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | 1..1 | CodeableConcept | Error code detailing processing issues Binding: Adjudication Error Codes (example): The error codes for adjudication processing. | |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
CoverageEligibilityResponse | 0..* | CoverageEligibilityResponse | CoverageEligibilityResponse resource | |
Documentation for this format |
This structure is derived from CoverageEligibilityResponse
Differential View
This structure is derived from CoverageEligibilityResponse
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
CoverageEligibilityResponse | 0..* | CoverageEligibilityResponse | CoverageEligibilityResponse resource | |
identifier | 1..1 | Identifier | Business Identifier for coverage eligiblity request | |
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
purpose | Σ | 1..* | code | auth-requirements | benefits | discovery | validation Binding: EligibilityResponsePurpose (required): A code specifying the types of information being requested. |
patient | Σ | 1..1 | Reference(Patient) | Intended recipient of products and services |
serviced[x] | 0..1 | Estimated date or dates of service | ||
servicedDate | date | |||
servicedPeriod | Period | |||
created | Σ | 1..1 | dateTime | Response creation date |
requestor | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Party responsible for the request | |
request | Σ | 1..1 | Reference(CoverageEligibilityRequest) | Eligibility request reference |
outcome | Σ | 1..1 | code | queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing. |
disposition | 0..1 | string | Disposition Message | |
insurer | Σ | 1..1 | Reference(Organization) | Coverage issuer |
insurance | 0..* | BackboneElement | Patient insurance information | |
coverage | Σ | 1..1 | Reference(Coverage) | Insurance information |
inforce | 0..1 | boolean | Coverage inforce indicator | |
benefitPeriod | 0..1 | Period | When the benefits are applicable | |
item | I | 0..* | BackboneElement | Benefits and authorization details ces-1: SHALL contain a category or a billcode but not both. |
category | 0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision etc. | |
productOrService | 0..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |
modifier | 0..* | CodeableConcept | Product or service billing modifiers Binding: ModifierTypeCodes (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) | Performing practitioner | |
excluded | 0..1 | boolean | Excluded from the plan | |
name | 0..1 | string | Short name for the benefit | |
description | 0..1 | string | Description of the benefit or services covered | |
network | 0..1 | CodeableConcept | In or out of network Binding: NetworkTypeCodes (example): Code to classify in or out of network services. | |
unit | 0..1 | CodeableConcept | Individual or family Binding: UnitTypeCodes (example): Unit covered/serviced - individual or family. | |
term | 0..1 | CodeableConcept | Annual or lifetime Binding: BenefitTermCodes (example): Coverage unit - annual, lifetime. | |
benefit | 0..* | BackboneElement | Benefit Summary | |
type | 1..1 | CodeableConcept | Benefit classification Binding: BenefitTypeCodes (example): Deductable, visits, co-pay, etc. | |
allowed[x] | 0..1 | Benefits allowed | ||
allowedUnsignedInt | unsignedInt | |||
allowedString | string | |||
allowedMoney | Money | |||
used[x] | 0..1 | Benefits used | ||
usedUnsignedInt | unsignedInt | |||
usedString | string | |||
usedMoney | Money | |||
authorizationRequired | 0..1 | boolean | Authorization required flag | |
authorizationSupporting | 0..* | CodeableConcept | Type of required supporting materials Binding: CoverageEligibilityResponseAuthSupportCodes (example): Type of supporting information to provide with a preauthorization. | |
authorizationUrl | 0..1 | uri | Preauthorization requirements endpoint | |
preAuthRef | 0..1 | string | Preauthorization reference | |
form | 0..1 | CodeableConcept | Printed form identifier Binding: Form Codes (example): The forms codes. | |
error | 0..* | BackboneElement | Processing errors | |
code | 1..1 | CodeableConcept | Error code detailing processing issues Binding: Adjudication Error Codes (example): The error codes for adjudication processing. | |
Documentation for this format |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
CoverageEligibilityResponse | 0..* | CoverageEligibilityResponse | CoverageEligibilityResponse resource | |
meta | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. | |
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
contained | 0..* | Resource | Contained, inline Resources | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier | 1..1 | Identifier | Business Identifier for coverage eligiblity request | |
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
purpose | Σ | 1..* | code | auth-requirements | benefits | discovery | validation Binding: EligibilityResponsePurpose (required): A code specifying the types of information being requested. |
patient | Σ | 1..1 | Reference(Patient) | Intended recipient of products and services |
serviced[x] | 0..1 | Estimated date or dates of service | ||
servicedDate | date | |||
servicedPeriod | Period | |||
created | Σ | 1..1 | dateTime | Response creation date |
requestor | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Party responsible for the request | |
request | Σ | 1..1 | Reference(CoverageEligibilityRequest) | Eligibility request reference |
outcome | Σ | 1..1 | code | queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing. |
disposition | 0..1 | string | Disposition Message | |
insurer | Σ | 1..1 | Reference(Organization) | Coverage issuer |
insurance | 0..* | BackboneElement | Patient insurance information | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
coverage | Σ | 1..1 | Reference(Coverage) | Insurance information |
inforce | 0..1 | boolean | Coverage inforce indicator | |
benefitPeriod | 0..1 | Period | When the benefits are applicable | |
item | I | 0..* | BackboneElement | Benefits and authorization details |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
category | 0..1 | CodeableConcept | Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision etc. | |
productOrService | 0..1 | CodeableConcept | Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes. | |
modifier | 0..* | CodeableConcept | Product or service billing modifiers Binding: ModifierTypeCodes (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) | Performing practitioner | |
excluded | 0..1 | boolean | Excluded from the plan | |
name | 0..1 | string | Short name for the benefit | |
description | 0..1 | string | Description of the benefit or services covered | |
network | 0..1 | CodeableConcept | In or out of network Binding: NetworkTypeCodes (example): Code to classify in or out of network services. | |
unit | 0..1 | CodeableConcept | Individual or family Binding: UnitTypeCodes (example): Unit covered/serviced - individual or family. | |
term | 0..1 | CodeableConcept | Annual or lifetime Binding: BenefitTermCodes (example): Coverage unit - annual, lifetime. | |
benefit | 0..* | BackboneElement | Benefit Summary | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | 1..1 | CodeableConcept | Benefit classification Binding: BenefitTypeCodes (example): Deductable, visits, co-pay, etc. | |
allowed[x] | 0..1 | Benefits allowed | ||
allowedUnsignedInt | unsignedInt | |||
allowedString | string | |||
allowedMoney | Money | |||
used[x] | 0..1 | Benefits used | ||
usedUnsignedInt | unsignedInt | |||
usedString | string | |||
usedMoney | Money | |||
authorizationRequired | 0..1 | boolean | Authorization required flag | |
authorizationSupporting | 0..* | CodeableConcept | Type of required supporting materials Binding: CoverageEligibilityResponseAuthSupportCodes (example): Type of supporting information to provide with a preauthorization. | |
authorizationUrl | 0..1 | uri | Preauthorization requirements endpoint | |
preAuthRef | 0..1 | string | Preauthorization reference | |
form | 0..1 | CodeableConcept | Printed form identifier Binding: Form Codes (example): The forms codes. | |
error | 0..* | BackboneElement | Processing errors | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
code | 1..1 | CodeableConcept | Error code detailing processing issues Binding: Adjudication Error Codes (example): The error codes for adjudication processing. | |
Documentation for this format |
Other representations of profile: CSV, Excel, Schematron
Path | Conformance | ValueSet |
CoverageEligibilityResponse.language | preferred | CommonLanguages Max Binding: AllLanguages |
CoverageEligibilityResponse.status | required | FinancialResourceStatusCodes |
CoverageEligibilityResponse.purpose | required | EligibilityResponsePurpose |
CoverageEligibilityResponse.outcome | required | ClaimProcessingCodes |
CoverageEligibilityResponse.insurance.item.category | example | BenefitCategoryCodes |
CoverageEligibilityResponse.insurance.item.productOrService | example | USCLSCodes |
CoverageEligibilityResponse.insurance.item.modifier | example | ModifierTypeCodes |
CoverageEligibilityResponse.insurance.item.network | example | NetworkTypeCodes |
CoverageEligibilityResponse.insurance.item.unit | example | UnitTypeCodes |
CoverageEligibilityResponse.insurance.item.term | example | BenefitTermCodes |
CoverageEligibilityResponse.insurance.item.benefit.type | example | BenefitTypeCodes |
CoverageEligibilityResponse.insurance.item.authorizationSupporting | example | CoverageEligibilityResponseAuthSupportCodes |
CoverageEligibilityResponse.form | example | Form Codes |
CoverageEligibilityResponse.error.code | example | Adjudication Error Codes |
Id | Path | Details | Requirements |
dom-2 | CoverageEligibilityResponse | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | CoverageEligibilityResponse | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
dom-4 | CoverageEligibilityResponse | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
dom-5 | CoverageEligibilityResponse | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | CoverageEligibilityResponse | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | CoverageEligibilityResponse.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | CoverageEligibilityResponse.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | CoverageEligibilityResponse.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | CoverageEligibilityResponse.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | CoverageEligibilityResponse.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.status | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.purpose | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.patient | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.serviced[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.created | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.requestor | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.request | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.outcome | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.disposition | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurer | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | CoverageEligibilityResponse.insurance.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | CoverageEligibilityResponse.insurance.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | CoverageEligibilityResponse.insurance.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | CoverageEligibilityResponse.insurance.coverage | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.inforce | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.benefitPeriod | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ces-1 | CoverageEligibilityResponse.insurance.item | SHALL contain a category or a billcode but not both. : category.exists() xor productOrService.exists() | |
ele-1 | CoverageEligibilityResponse.insurance.item | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | CoverageEligibilityResponse.insurance.item.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | CoverageEligibilityResponse.insurance.item.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | CoverageEligibilityResponse.insurance.item.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | CoverageEligibilityResponse.insurance.item.category | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.productOrService | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.modifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.provider | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.excluded | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.name | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.description | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.network | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.unit | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.term | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.benefit | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.benefit.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | CoverageEligibilityResponse.insurance.item.benefit.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | CoverageEligibilityResponse.insurance.item.benefit.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | CoverageEligibilityResponse.insurance.item.benefit.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | CoverageEligibilityResponse.insurance.item.benefit.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.benefit.allowed[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.benefit.used[x] | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.authorizationRequired | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.authorizationSupporting | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.insurance.item.authorizationUrl | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.preAuthRef | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.form | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.error | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ele-1 | CoverageEligibilityResponse.error.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | CoverageEligibilityResponse.error.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | CoverageEligibilityResponse.error.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | CoverageEligibilityResponse.error.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
ele-1 | CoverageEligibilityResponse.error.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |