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CoverageEligibilityRequestItem

The CoverageEligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.

type CoverageEligibilityRequestItem implements Element {
  supportingInfoSequence: [Int]
  category: CodeableConcept
  productOrService: CodeableConcept
  modifier: [CodeableConcept]
  provider: Reference
  quantity: Quantity
  unitPrice: Money
  facility: Reference
  diagnosis: [CoverageEligibilityRequestDiagnosis]
  detail: [Reference]
  modifierExtension: [Extension]
  extension: [Extension]
  id: String
}

Fields​

CoverageEligibilityRequestItem.supportingInfoSequence ● [Int] list scalar​

Exceptions, special conditions and supporting information applicable for this service or product line.

CoverageEligibilityRequestItem.category ● CodeableConcept object​

Code to identify the general type of benefits under which products and services are provided.

CoverageEligibilityRequestItem.productOrService ● CodeableConcept object​

This contains the product, service, drug or other billing code for the item.

CoverageEligibilityRequestItem.modifier ● [CodeableConcept] list object​

Item typification or modifiers codes to convey additional context for the product or service.

CoverageEligibilityRequestItem.provider ● Reference object​

The practitioner who is responsible for the product or service to be rendered to the patient.

CoverageEligibilityRequestItem.quantity ● Quantity object​

The number of repetitions of a service or product.

CoverageEligibilityRequestItem.unitPrice ● Money object​

The amount charged to the patient by the provider for a single unit.

CoverageEligibilityRequestItem.facility ● Reference object​

Facility where the services will be provided.

CoverageEligibilityRequestItem.diagnosis ● [CoverageEligibilityRequestDiagnosis] list object​

Patient diagnosis for which care is sought.

CoverageEligibilityRequestItem.detail ● [Reference] list object​

The plan/proposal/order describing the proposed service in detail.

CoverageEligibilityRequestItem.modifierExtension ● [Extension] list object​

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 manageable, 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

CoverageEligibilityRequestItem.extension ● [Extension] list object​

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 manageable, 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.

CoverageEligibilityRequestItem.id ● String scalar​

Interfaces​

Element interface​

Base definition for all elements in a resource. If the element is present, it must have a value for at least one of the defined elements, an @id referenced from the Narrative, or extensions

Member Of​

CoverageEligibilityRequest object