description: This profile provides eligibility and plan details from the processing of an CoverageEligibilityRequest resource.
package_name: ndhm.in
derivation: constraint
name: CoverageEligibilityResponse
type: CoverageEligibilityResponse
elements:
  patient:
    type: Reference
    refers: ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient']
    index: 1
  requestor:
    type: Reference
    refers: ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization', 'https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner', 'https://nrces.in/ndhm/fhir/r4/StructureDefinition/PractitionerRole']
    index: 2
  insurance:
    mustSupport: true
    index: 7
    elements:
      coverage:
        type: Reference
        mustSupport: true
        refers: ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Coverage']
        index: 8
      inforce: {mustSupport: true, index: 9}
      item:
        mustSupport: true
        index: 10
        elements:
          category:
            binding: {strength: example, valueSet: 'https://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-benefitcategory'}
            index: 11
            elements:
              coding:
                elements:
                  system: {index: 12}
                  code: {index: 13}
                  display: {index: 14}
                required: [display, system, code]
          productOrService:
            binding: {strength: example, valueSet: 'https://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-productorservice'}
            mustSupport: true
            index: 15
            elements:
              coding:
                elements:
                  system: {index: 16}
                  code: {index: 17}
                  display: {index: 18}
                required: [display, system, code]
          provider:
            type: Reference
            refers: ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner', 'https://nrces.in/ndhm/fhir/r4/StructureDefinition/PractitionerRole']
            index: 19
          benefit: {mustSupport: true, index: 20}
        required: [productOrService]
  request:
    type: Reference
    refers: ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest']
    index: 3
  purpose: {mustSupport: true, index: 0}
  outcome: {mustSupport: true, index: 4}
  disposition: {mustSupport: true, index: 5}
  insurer:
    type: Reference
    mustSupport: true
    refers: ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization']
    index: 6
  error: {mustSupport: true, index: 21}
package_version: 5.0.0
class: profile
kind: resource
url: https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse
base: http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse
version: 5.0.0
required: [requestor]