FHIR Implementation Guide for HCX
0.7.0 - CI Build

FHIR Implementation Guide for HCX - Local Development build (v0.7.0). See the Directory of published versions

: HCX Coverage Eligibility Request example - XML Representation

Raw xml | Download



<CoverageEligibilityRequest xmlns="http://hl7.org/fhir">
  <id value="example-01"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"> Admitted to Cardiac Unit,UVW Hospital between June 28 and July 9 2020</div>
  </text>
  <identifier>
    <system value="https://www.tmh.in/coverage-eligibility-request"/>
    <value value="dc82673b-8c71-48c2-8a17-16dcb3b035f6"/>
  </identifier>
  <status value="active"/>
  <priority>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/processpriority"/>
      <code value="normal"/>
    </coding>
  </priority>
  <purpose value="discovery"/>
  <patient id="RVH1003">
    <identifier>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <code value="SN"/>
          <display value="Subscriber Number"/>
        </coding>
      </type>
      <system value="http://gicofIndia.com/beneficiaries"/>
      <value value="BEN-101"/>
    </identifier>
  </patient>
  <servicedPeriod>
    <start value="2022-02-07T21:49:56+05:30"/>
    <end value="2022-02-09T21:49:56+05:30"/>
  </servicedPeriod>
  <created value="2022-02-08T21:49:56+05:30"/>
  <enterer id="NPR-6897">
    <identifier>
      <system value="https://ndhm.gov.in/npr"/>
      <value value="NPR-6897"/>
    </identifier>
  </enterer>
  <provider id="Tmh01">
    <identifier>
      <system value="http://abdm.gov.in/facilities"/>
      <value value="HFR-ID-FOR-TMH"/>
    </identifier>
  </provider>
  <insurer id="GICOFINDIA">
    <identifier>
      <system value="http://irdai.gov.in/insurers"/>
      <value value="112"/>
    </identifier>
  </insurer>
  <insurance>
    <focal value="true"/>
    <coverage id="dadde132-ad64-4d18-8c18-1d52d7e86abc">
      <identifier>
        <system value="https://www.gicofIndia.in/policies"/>
        <value value="policy-RVH1003"/>
      </identifier>
    </coverage>
  </insurance>
</CoverageEligibilityRequest>