{
"description": null,
"_filename": "Questionnaire-qgen-CoverageEligibilityResponse1.json",
"package_name": "hl7.fhir.r6.examples",
"date": "2025-04-01T12:16:37+11:00",
"publisher": "HL7 International / Financial Management",
"name": null,
"item": [ {
"item": [ {
"text": "This resource provides eligibility and plan details from the processing of an CoverageEligibilityRequest resource.",
"type": "display",
"linkId": "CoverageEligibilityResponse-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"item": [ {
"text": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.",
"type": "display",
"linkId": "CoverageEligibilityResponse.id-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Logical id of this artifact",
"type": "string",
"linkId": "CoverageEligibilityResponse.id.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.id",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
}, {
"item": [ {
"text": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"type": "display",
"linkId": "CoverageEligibilityResponse.meta-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Metadata about the resource",
"type": "group",
"linkId": "CoverageEligibilityResponse.meta",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
} ]
}, {
"item": [ {
"text": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.",
"type": "display",
"linkId": "CoverageEligibilityResponse.implicitRules-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "A set of rules under which this content was created",
"type": "string",
"linkId": "CoverageEligibilityResponse.implicitRules.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.implicitRules",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "uri"
} ]
}, {
"item": [ {
"text": "The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"type": "display",
"linkId": "CoverageEligibilityResponse.language-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "language",
"type": "coding",
"linkId": "CoverageEligibilityResponse.language.value",
"repeats": false,
"required": false,
"answerConstraint": "optionsOrType"
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.language",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "code"
} ]
}, {
"item": [ {
"text": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"type": "display",
"linkId": "CoverageEligibilityResponse.text-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Text summary of the resource, for human interpretation",
"type": "group",
"linkId": "CoverageEligibilityResponse.text",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
} ]
}, {
"item": [ {
"text": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels. Contained resources may be a resource type defined in the FHIR specification, or an [additional resource](resource.html#additional).",
"type": "display",
"linkId": "CoverageEligibilityResponse.contained-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Contained, inline Resources",
"type": "group",
"linkId": "CoverageEligibilityResponse.contained",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"type": "display",
"linkId": "CoverageEligibilityResponse.extension-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Additional content defined by implementations",
"type": "group",
"linkId": "CoverageEligibilityResponse.extension",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"type": "display",
"linkId": "CoverageEligibilityResponse.modifierExtension-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Extensions that cannot be ignored",
"type": "group",
"linkId": "CoverageEligibilityResponse.modifierExtension",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "A unique identifier assigned to this coverage eligiblity request.",
"type": "display",
"linkId": "CoverageEligibilityResponse.identifier-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "label:",
"type": "string",
"linkId": "CoverageEligibilityResponse.identifier.label",
"repeats": false,
"required": false
}, {
"text": "system:",
"type": "string",
"linkId": "CoverageEligibilityResponse.identifier.system",
"repeats": false,
"required": false
}, {
"text": "value:",
"type": "string",
"linkId": "CoverageEligibilityResponse.identifier.value",
"repeats": false,
"required": false
} ],
"text": "Business Identifier for coverage eligiblity request",
"type": "group",
"linkId": "CoverageEligibilityResponse.identifier",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "Identifier"
} ]
}, {
"item": [ {
"text": "The status of the resource instance. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"type": "display",
"linkId": "CoverageEligibilityResponse.status-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "status",
"type": "coding",
"linkId": "CoverageEligibilityResponse.status.value",
"repeats": false,
"required": false,
"answerConstraint": "optionsOrType"
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.status",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "code"
} ]
}, {
"item": [ {
"text": "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.",
"type": "display",
"linkId": "CoverageEligibilityResponse.purpose-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "purpose",
"type": "coding",
"linkId": "CoverageEligibilityResponse.purpose.value",
"repeats": false,
"required": false,
"answerConstraint": "optionsOrType"
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.purpose",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "code"
} ]
}, {
"item": [ {
"text": "The party who is the beneficiary of the supplied coverage and for whom eligibility is sought.",
"type": "display",
"linkId": "CoverageEligibilityResponse.patient-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Intended recipient of products and services",
"type": "reference",
"linkId": "CoverageEligibilityResponse.patient.value",
"repeats": false,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource",
"valueCode": "Patient"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
"valueString": "subject=$subj&patient=$subj&encounter=$encounter"
} ]
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.patient",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "Reference"
} ]
}, {
"item": [ {
"text": "Information code for an event with a corresponding date or period.",
"type": "display",
"linkId": "CoverageEligibilityResponse.event-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"item": [ {
"text": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"type": "display",
"linkId": "CoverageEligibilityResponse.event.id-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Unique id for inter-element referencing",
"type": "string",
"linkId": "CoverageEligibilityResponse.event.id.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.event.id",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
}, {
"item": [ {
"text": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"type": "display",
"linkId": "CoverageEligibilityResponse.event.extension-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Additional content defined by implementations",
"type": "group",
"linkId": "CoverageEligibilityResponse.event.extension",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"type": "display",
"linkId": "CoverageEligibilityResponse.event.modifierExtension-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Extensions that cannot be ignored even if unrecognized",
"type": "group",
"linkId": "CoverageEligibilityResponse.event.modifierExtension",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "A coded event such as when a service is expected or a card printed.",
"type": "display",
"linkId": "CoverageEligibilityResponse.event.type-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "code:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.event.type.coding",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "text:",
"type": "string",
"linkId": "CoverageEligibilityResponse.event.type.text",
"repeats": false,
"required": false
} ],
"text": "Specific event",
"type": "group",
"linkId": "CoverageEligibilityResponse.event.type",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "CodeableConcept"
} ]
}, {
"item": [ {
"text": "A date or period in the past or future indicating when the event occurred or is expectd to occur.",
"type": "display",
"linkId": "CoverageEligibilityResponse.event.when[x]-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"item": [ {
"item": [ {
"type": "dateTime",
"linkId": "CoverageEligibilityResponse.event.when[x]._null.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.event.when[x]._null",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "datetime"
} ]
}, {
"item": [ {
"text": "start:",
"type": "dateTime",
"linkId": "CoverageEligibilityResponse.event.when[x]._null.low",
"repeats": false,
"required": false
}, {
"text": "end:",
"type": "dateTime",
"linkId": "CoverageEligibilityResponse.event.when[x]._null.end",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.event.when[x]._null",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "Period"
} ]
} ],
"text": "type",
"type": "coding",
"linkId": "CoverageEligibilityResponse.event.when[x]._type",
"repeats": false,
"required": false,
"answerValueSet": "#vs2",
"answerConstraint": "optionsOnly"
} ],
"text": "Occurance date or period",
"type": "group",
"linkId": "CoverageEligibilityResponse.event.when[x]",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
} ]
} ],
"text": "Event information",
"type": "group",
"linkId": "CoverageEligibilityResponse.event",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "The date or dates when the enclosed suite of services were performed or completed.",
"type": "display",
"linkId": "CoverageEligibilityResponse.serviced[x]-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"item": [ {
"item": [ {
"type": "dateTime",
"linkId": "CoverageEligibilityResponse.serviced[x]._null.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.serviced[x]._null",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "datetime"
} ]
}, {
"item": [ {
"text": "start:",
"type": "dateTime",
"linkId": "CoverageEligibilityResponse.serviced[x]._null.low",
"repeats": false,
"required": false
}, {
"text": "end:",
"type": "dateTime",
"linkId": "CoverageEligibilityResponse.serviced[x]._null.end",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.serviced[x]._null",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "Period"
} ]
} ],
"text": "type",
"type": "coding",
"linkId": "CoverageEligibilityResponse.serviced[x]._type",
"repeats": false,
"required": false,
"answerValueSet": "#vs3",
"answerConstraint": "optionsOnly"
} ],
"text": "Estimated date or dates of service",
"type": "group",
"linkId": "CoverageEligibilityResponse.serviced[x]",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
} ]
}, {
"item": [ {
"text": "The date this resource was created.",
"type": "display",
"linkId": "CoverageEligibilityResponse.created-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Response creation date",
"type": "dateTime",
"linkId": "CoverageEligibilityResponse.created.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.created",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "datetime"
} ]
}, {
"item": [ {
"text": "The provider which is responsible for the request. This party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below. This field is the Billing Provider, for example, a facility, provider group, lab or practitioner.",
"type": "display",
"linkId": "CoverageEligibilityResponse.requestor-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Party responsible for the request",
"type": "reference",
"linkId": "CoverageEligibilityResponse.requestor.value",
"repeats": false,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource",
"valueCode": "Practitioner, PractitionerRole, Organization"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
"valueString": "subject=$subj&patient=$subj&encounter=$encounter"
} ]
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.requestor",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "Reference"
} ]
}, {
"item": [ {
"text": "Reference to the original request resource.",
"type": "display",
"linkId": "CoverageEligibilityResponse.request-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Eligibility request reference",
"type": "reference",
"linkId": "CoverageEligibilityResponse.request.value",
"repeats": false,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource",
"valueCode": "CoverageEligibilityRequest"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
"valueString": "subject=$subj&patient=$subj&encounter=$encounter"
} ]
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.request",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "Reference"
} ]
}, {
"item": [ {
"text": "The outcome of the request processing. The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete).",
"type": "display",
"linkId": "CoverageEligibilityResponse.outcome-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "outcome",
"type": "coding",
"linkId": "CoverageEligibilityResponse.outcome.value",
"repeats": false,
"required": false,
"answerConstraint": "optionsOrType"
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.outcome",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "code"
} ]
}, {
"item": [ {
"text": "A human readable description of the status of the adjudication.",
"type": "display",
"linkId": "CoverageEligibilityResponse.disposition-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Disposition Message",
"type": "string",
"linkId": "CoverageEligibilityResponse.disposition.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.disposition",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
}, {
"item": [ {
"text": "The Insurer who issued the coverage in question and is the author of the response.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurer-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Coverage issuer",
"type": "reference",
"linkId": "CoverageEligibilityResponse.insurer.value",
"repeats": false,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource",
"valueCode": "Organization"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
"valueString": "subject=$subj&patient=$subj&encounter=$encounter"
} ]
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurer",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "Reference"
} ]
}, {
"item": [ {
"text": "All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance-display"
}, {
"text": "Financial instruments for reimbursement for the health care products and services.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"item": [ {
"text": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.id-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Unique id for inter-element referencing",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.id.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.id",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
}, {
"item": [ {
"text": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.extension-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Additional content defined by implementations",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.extension",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.modifierExtension-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Extensions that cannot be ignored even if unrecognized",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.modifierExtension",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.coverage-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Insurance information",
"type": "reference",
"linkId": "CoverageEligibilityResponse.insurance.coverage.value",
"repeats": false,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource",
"valueCode": "Coverage"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
"valueString": "subject=$subj&patient=$subj&encounter=$encounter"
} ]
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.coverage",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "Reference"
} ]
}, {
"item": [ {
"text": "Flag indicating if the coverage provided is inforce currently if no service date(s) specified or for the whole duration of the service dates.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.inforce-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Coverage inforce indicator",
"type": "boolean",
"linkId": "CoverageEligibilityResponse.insurance.inforce.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.inforce",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "boolean"
} ]
}, {
"item": [ {
"text": "The term of the benefits documented in this response.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.benefitPeriod-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "start:",
"type": "dateTime",
"linkId": "CoverageEligibilityResponse.insurance.benefitPeriod.low",
"repeats": false,
"required": false
}, {
"text": "end:",
"type": "dateTime",
"linkId": "CoverageEligibilityResponse.insurance.benefitPeriod.end",
"repeats": false,
"required": false
} ],
"text": "When the benefits are applicable",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.benefitPeriod",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "Period"
} ]
}, {
"item": [ {
"text": "Benefits and optionally current balances, and authorization details by category or service.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"item": [ {
"text": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.id-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Unique id for inter-element referencing",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.id.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.id",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
}, {
"item": [ {
"text": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.extension-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Additional content defined by implementations",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.extension",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.modifierExtension-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Extensions that cannot be ignored even if unrecognized",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.modifierExtension",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "Code to identify the general type of benefits under which products and services are provided. Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.category-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "code:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.insurance.item.category.coding",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "text:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.category.text",
"repeats": false,
"required": false
} ],
"text": "Benefit classification",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.category",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "CodeableConcept"
} ]
}, {
"item": [ {
"text": "This contains the product, service, drug or other billing code for the item. Code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI).",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.productOrService-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "code:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.insurance.item.productOrService.coding",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "text:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.productOrService.text",
"repeats": false,
"required": false
} ],
"text": "Billing, service, product, or drug code",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.productOrService",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "CodeableConcept"
} ]
}, {
"item": [ {
"text": "Item typification or modifiers codes to convey additional context for the product or service. For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.modifier-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "code:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.insurance.item.modifier.coding",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "text:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.modifier.text",
"repeats": false,
"required": false
} ],
"text": "Product or service billing modifiers",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.modifier",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "CodeableConcept"
} ]
}, {
"item": [ {
"text": "The practitioner who is eligible for the provision of the product or service.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.provider-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Performing practitioner",
"type": "reference",
"linkId": "CoverageEligibilityResponse.insurance.item.provider.value",
"repeats": false,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceResource",
"valueCode": "Practitioner, PractitionerRole"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-referenceFilter",
"valueString": "subject=$subj&patient=$subj&encounter=$encounter"
} ]
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.provider",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "Reference"
} ]
}, {
"item": [ {
"text": "True if the indicated class of service is excluded from the plan, missing or False indicates the product or service is included in the coverage.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.excluded-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Excluded from the plan",
"type": "boolean",
"linkId": "CoverageEligibilityResponse.insurance.item.excluded.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.excluded",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "boolean"
} ]
}, {
"item": [ {
"text": "A short name or tag for the benefit. For example: MED01, or DENT2.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.name-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Short name for the benefit",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.name.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.name",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
}, {
"item": [ {
"text": "A richer description of the benefit or services covered. For example 'DENT2 covers 100% of basic, 50% of major but excludes Ortho, Implants and Cosmetic services'.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.description-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Description of the benefit or services covered",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.description.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.description",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
}, {
"item": [ {
"text": "Is a flag to indicate whether the benefits refer to in-network providers or out-of-network providers.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.network-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "code:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.insurance.item.network.coding",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "text:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.network.text",
"repeats": false,
"required": false
} ],
"text": "In or out of network",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.network",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "CodeableConcept"
} ]
}, {
"item": [ {
"text": "Indicates if the benefits apply to an individual or to the family.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.unit-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "code:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.insurance.item.unit.coding",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "text:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.unit.text",
"repeats": false,
"required": false
} ],
"text": "Individual or family",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.unit",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "CodeableConcept"
} ]
}, {
"item": [ {
"text": "The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.term-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "code:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.insurance.item.term.coding",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "text:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.term.text",
"repeats": false,
"required": false
} ],
"text": "Annual or lifetime",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.term",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "CodeableConcept"
} ]
}, {
"item": [ {
"text": "Benefits used to date.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"item": [ {
"text": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.id-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Unique id for inter-element referencing",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.id.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.id",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
}, {
"item": [ {
"text": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.extension-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Additional content defined by implementations",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.extension",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.modifierExtension-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Extensions that cannot be ignored even if unrecognized",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.modifierExtension",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "Classification of benefit being provided. For example: deductible, visits, benefit amount.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.type-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "code:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.type.coding",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "text:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.type.text",
"repeats": false,
"required": false
} ],
"text": "Benefit classification",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.type",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "CodeableConcept"
} ]
}, {
"item": [ {
"text": "The quantity of the benefit which is permitted under the coverage.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"item": [ {
"item": [ {
"type": "integer",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]._null.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]._null",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "integer"
} ]
}, {
"item": [ {
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]._null.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]._null",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
}, {
"item": [ {
"text": "comp:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]._null.comparator",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "value:",
"type": "decimal",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]._null.value",
"repeats": false,
"required": false
}, {
"text": "units:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]._null.units",
"repeats": false,
"required": false
}, {
"text": "coded units:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]._null.code",
"repeats": false,
"required": false
}, {
"text": "units system:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]._null.system",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]._null",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "Quantity"
} ]
} ],
"text": "type",
"type": "coding",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]._type",
"repeats": false,
"required": false,
"answerValueSet": "#vs4",
"answerConstraint": "optionsOnly"
} ],
"text": "Benefits allowed",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.allowed[x]",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
} ]
}, {
"item": [ {
"text": "The quantity of the benefit which have been consumed to date.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"item": [ {
"item": [ {
"type": "integer",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]._null.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]._null",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "integer"
} ]
}, {
"item": [ {
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]._null.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]._null",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
}, {
"item": [ {
"text": "comp:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]._null.comparator",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "value:",
"type": "decimal",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]._null.value",
"repeats": false,
"required": false
}, {
"text": "units:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]._null.units",
"repeats": false,
"required": false
}, {
"text": "coded units:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]._null.code",
"repeats": false,
"required": false
}, {
"text": "units system:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]._null.system",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]._null",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "Quantity"
} ]
} ],
"text": "type",
"type": "coding",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]._type",
"repeats": false,
"required": false,
"answerValueSet": "#vs5",
"answerConstraint": "optionsOnly"
} ],
"text": "Benefits used",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit.used[x]",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
} ]
} ],
"text": "Benefit Summary",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.benefit",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "A boolean flag indicating whether a preauthorization is required prior to actual service delivery.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.authorizationRequired-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Authorization required flag",
"type": "boolean",
"linkId": "CoverageEligibilityResponse.insurance.item.authorizationRequired.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.authorizationRequired",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "boolean"
} ]
}, {
"item": [ {
"text": "Codes or comments regarding information or actions associated with the preauthorization.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.authorizationSupporting-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "code:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.insurance.item.authorizationSupporting.coding",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "text:",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.authorizationSupporting.text",
"repeats": false,
"required": false
} ],
"text": "Type of required supporting materials",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.authorizationSupporting",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "CodeableConcept"
} ]
}, {
"item": [ {
"text": "A web location for obtaining requirements or descriptive information regarding the preauthorization.",
"type": "display",
"linkId": "CoverageEligibilityResponse.insurance.item.authorizationUrl-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Preauthorization requirements endpoint",
"type": "string",
"linkId": "CoverageEligibilityResponse.insurance.item.authorizationUrl.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item.authorizationUrl",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "uri"
} ]
} ],
"text": "Benefits and authorization details",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance.item",
"repeats": true,
"required": false
} ],
"text": "Patient insurance information",
"type": "group",
"linkId": "CoverageEligibilityResponse.insurance",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "A reference from the Insurer to which these services pertain to be used on further communication and as proof that the request occurred.",
"type": "display",
"linkId": "CoverageEligibilityResponse.preAuthRef-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Preauthorization reference",
"type": "string",
"linkId": "CoverageEligibilityResponse.preAuthRef.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.preAuthRef",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
}, {
"item": [ {
"text": "A code for the form to be used for printing the content. May be needed to identify specific jurisdictional forms.",
"type": "display",
"linkId": "CoverageEligibilityResponse.form-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "code:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.form.coding",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "text:",
"type": "string",
"linkId": "CoverageEligibilityResponse.form.text",
"repeats": false,
"required": false
} ],
"text": "Printed form identifier",
"type": "group",
"linkId": "CoverageEligibilityResponse.form",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "CodeableConcept"
} ]
}, {
"item": [ {
"text": "Errors encountered during the processing of the request.",
"type": "display",
"linkId": "CoverageEligibilityResponse.error-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"item": [ {
"text": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"type": "display",
"linkId": "CoverageEligibilityResponse.error.id-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "Unique id for inter-element referencing",
"type": "string",
"linkId": "CoverageEligibilityResponse.error.id.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.error.id",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
}, {
"item": [ {
"text": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"type": "display",
"linkId": "CoverageEligibilityResponse.error.extension-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Additional content defined by implementations",
"type": "group",
"linkId": "CoverageEligibilityResponse.error.extension",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"type": "display",
"linkId": "CoverageEligibilityResponse.error.modifierExtension-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
} ],
"text": "Extensions that cannot be ignored even if unrecognized",
"type": "group",
"linkId": "CoverageEligibilityResponse.error.modifierExtension",
"repeats": true,
"required": false
}, {
"item": [ {
"text": "An error code,from a specified code system, which details why the eligibility check could not be performed.",
"type": "display",
"linkId": "CoverageEligibilityResponse.error.code-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "code:",
"type": "coding",
"linkId": "CoverageEligibilityResponse.error.code.coding",
"repeats": false,
"required": false,
"answerConstraint": "optionsOnly"
}, {
"text": "text:",
"type": "string",
"linkId": "CoverageEligibilityResponse.error.code.text",
"repeats": false,
"required": false
} ],
"text": "Error code detailing processing issues",
"type": "group",
"linkId": "CoverageEligibilityResponse.error.code",
"repeats": true,
"required": true,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-minOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-maxOccurs",
"valueInteger": 1
}, {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "CodeableConcept"
} ]
}, {
"item": [ {
"text": "A [simple subset of FHIRPath](fhirpath.html#simple) limited to element names, repetition indicators and the default child accessor that identifies one of the elements in the resource that caused this issue to be raised. The root of the FHIRPath is the resource or bundle that generated OperationOutcome. Each FHIRPath SHALL resolve to a single node.",
"type": "display",
"linkId": "CoverageEligibilityResponse.error.expression-flyover",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl",
"valueCodeableConcept": {
"coding": [ {
"code": "flyover",
"system": "http://hl7.org/fhir/questionnaire-item-control",
"display": "Fly-over"
} ]
}
} ]
}, {
"text": "FHIRPath of element(s) related to issue",
"type": "string",
"linkId": "CoverageEligibilityResponse.error.expression.value",
"repeats": false,
"required": false
} ],
"type": "group",
"linkId": "CoverageEligibilityResponse.error.expression",
"repeats": true,
"required": false,
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/questionnaire-fhirType",
"valueString": "string"
} ]
} ],
"text": "Processing errors",
"type": "group",
"linkId": "CoverageEligibilityResponse.error",
"repeats": true,
"required": false
} ],
"text": "CoverageEligibilityResponse resource",
"type": "group",
"linkId": "CoverageEligibilityResponse",
"repeats": true,
"required": false
} ],
"type": null,
"experimental": "false",
"resourceType": "Questionnaire",
"title": null,
"package_version": "6.0.0-ballot3",
"contained": [ {
"id": "vs2",
"name": "Type options for CoverageEligibilityResponse.event.when[x]",
"status": "active",
"expansion": {
"contains": [ {
"code": "dateTime",
"system": "http://hl7.org/fhir/fhir-types",
"display": "dateTime"
}, {
"code": "Period",
"system": "http://hl7.org/fhir/fhir-types",
"display": "Period"
} ],
"timestamp": "2025-04-01T12:24:48+11:00",
"identifier": "urn:uuid:d0b7b2b6-d91f-47bf-8e7c-bb78b8a25db9"
},
"description": "Type options for CoverageEligibilityResponse.event.when[x]",
"resourceType": "ValueSet"
}, {
"id": "vs3",
"name": "Type options for CoverageEligibilityResponse.serviced[x]",
"status": "active",
"expansion": {
"contains": [ {
"code": "date",
"system": "http://hl7.org/fhir/fhir-types",
"display": "date"
}, {
"code": "Period",
"system": "http://hl7.org/fhir/fhir-types",
"display": "Period"
} ],
"timestamp": "2025-04-01T12:24:48+11:00",
"identifier": "urn:uuid:7d00ebe0-3655-4da7-8a1a-d4a1316768f8"
},
"description": "Type options for CoverageEligibilityResponse.serviced[x]",
"resourceType": "ValueSet"
}, {
"id": "vs4",
"name": "Type options for CoverageEligibilityResponse.insurance.item.benefit.allowed[x]",
"status": "active",
"expansion": {
"contains": [ {
"code": "unsignedInt",
"system": "http://hl7.org/fhir/fhir-types",
"display": "unsignedInt"
}, {
"code": "string",
"system": "http://hl7.org/fhir/fhir-types",
"display": "string"
}, {
"code": "Money",
"system": "http://hl7.org/fhir/fhir-types",
"display": "Money"
} ],
"timestamp": "2025-04-01T12:24:48+11:00",
"identifier": "urn:uuid:31e0d92e-db3b-453c-997a-1cbdc49721f1"
},
"description": "Type options for CoverageEligibilityResponse.insurance.item.benefit.allowed[x]",
"resourceType": "ValueSet"
}, {
"id": "vs5",
"name": "Type options for CoverageEligibilityResponse.insurance.item.benefit.used[x]",
"status": "active",
"expansion": {
"contains": [ {
"code": "unsignedInt",
"system": "http://hl7.org/fhir/fhir-types",
"display": "unsignedInt"
}, {
"code": "string",
"system": "http://hl7.org/fhir/fhir-types",
"display": "string"
}, {
"code": "Money",
"system": "http://hl7.org/fhir/fhir-types",
"display": "Money"
} ],
"timestamp": "2025-04-01T12:24:48+11:00",
"identifier": "urn:uuid:211fffe2-ec9b-42b0-845c-9f37ef806957"
},
"description": "Type options for CoverageEligibilityResponse.insurance.item.benefit.used[x]",
"resourceType": "ValueSet"
} ],
"status": "draft",
"id": "e6a26d0a-218e-41f6-9bc2-7094b9deae29",
"kind": null,
"url": "http://hl7.org/fhir/Questionnaire/qgen-CoverageEligibilityResponse1",
"identifier": [ {
"system": "urn:ietf:rfc:3986"
} ],
"version": "6.0.0-ballot3"
}