מדריך למטמיע - טופס 17
1.0.0 - ci-build

This page is part of the T17 IG (v1.0.0: draft-1 Draft) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: T17 Request

Official URL: http://ig.fhir-il-community.org/T17/StructureDefinition/t17-request Version: 1.0.0
Draft as of 2024-09-01 Computable Name: T17Request

בדיקת קיום התחייבות, עם או בלי בקשה ליצירת התחייבות

T17-Request

הפרופיל מייצג בדיקת קיום התחייבות, עם או בלי בקשה ליצירת התחייבות. ה- Resource עליו הוא מוגדר: CoverageEligibilityRequest. הפרופיל עליו הוא מתבסס: il-core-coverage-eligibility-request

בנוסף להגדרות קארדינליות וקשרים לפרופילים הרלוונטיים כפי שהוגדרו בפרופיל ה- ILCORE, הפרופיל בפרויקט הנוכחי מתייחס גם למידע הבא:

  • מטרת הבקשה (purpose)
    • אלמנט validation – עבור שליחת בקשה חדשה להתחייבות.
    • אלמנט discovery – עבור בדיקה האם קיימת התחייבות באותה נקודת זמן, ללא פתיחת בקשה.
  • חובת הזנה של לפחות קוד שירות אחד שיהיה מסוג קוד שירות מב"ר
  • מידע נוסף (supportingInfo) אשר מוגבל ל- 3 סוגי ישויות:

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from ILCoreCoverageEligibilityRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. CoverageEligibilityRequest ILCoreCoverageEligibilityRequest
... identifier 1..* Identifier Business Identifier for coverage eligiblity request
.... system 1..1 uri The namespace for the identifier value
.... value 1..1 string The value that is unique
... purpose 1..1 code auth-requirements | benefits | discovery | validation
Binding: T17 EligibilityRequest Purpose codes (required)
... patient
.... identifier
..... system 1..1 uri The namespace for the identifier value
..... value 1..1 string The value that is unique
.... identifier
..... system 1..1 uri The namespace for the identifier value
..... value 1..1 string The value that is unique
... insurer
.... identifier
..... system 1..1 uri The namespace for the identifier value
..... value 1..1 string The value that is unique
... facility 0..1 Reference(T17 Requested Location) Servicing facility
.... reference 1..1 string Literal reference, Relative, internal or absolute URL
... Slices for supportingInfo 0..* BackboneElement Supporting information
Slice: Unordered, Closed by type:$this.resolve()
.... supportingInfo:doc-ref-recommendation 0..* BackboneElement Supporting information
..... information 1..1 Reference(T17 Visit Summary) Data to be provided
...... reference 1..1 string Literal reference, Relative, internal or absolute URL
...... type 1..1 uri Type the reference refers to (e.g. "Patient")
Required Pattern: DocumentReference
.... supportingInfo:appointment 0..1 BackboneElement Supporting information
..... information 1..1 Reference(T17 Booked Appointment) Data to be provided
...... reference 1..1 string Literal reference, Relative, internal or absolute URL
...... type 1..1 uri Type the reference refers to (e.g. "Patient")
Required Pattern: Appointment
.... supportingInfo:cov-elig-req-previous 0..1 BackboneElement Supporting information
..... information 1..1 Reference(T17 Request) Data to be provided
...... type 1..1 uri Type the reference refers to (e.g. "Patient")
Required Pattern: CoverageEligibilityRequest
...... identifier 1..1 Identifier Logical reference, when literal reference is not known
....... system 1..1 uri The namespace for the identifier value
....... value 1..1 string The value that is unique
... item 1..* BackboneElement Item to be evaluated for eligibiity
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
..... Slices for coding 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:moh 1..1 Coding Code defined by a terminology system
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://fhir.health.gov.il/cs/medical-service-moh
....... code 1..1 code Symbol in syntax defined by the system

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
CoverageEligibilityRequest.purposerequiredT17EligibilityrequestPurpose
http://ig.fhir-il-community.org/T17/ValueSet/t17-eligibilityrequest-purpose
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. CoverageEligibilityRequest 0..* ILCoreCoverageEligibilityRequest ILCore CoverageEligibilityRequest Profile
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 1..* Identifier Business Identifier for coverage eligiblity request
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 1..1 string The value that is unique
Example General: 123456
... purpose Σ 1..1 code auth-requirements | benefits | discovery | validation
Binding: T17 EligibilityRequest Purpose codes (required)
... patient Σ 1..1 Reference(ILCore Patient Profile) Intended recipient of products and services
... created Σ 1..1 dateTime Creation date
... insurer Σ 1..1 Reference(ILCore Organization Profile) Coverage issuer
... facility 0..1 Reference(T17 Requested Location) Servicing facility
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
... Slices for supportingInfo 0..* BackboneElement Supporting information
Slice: Unordered, Closed by type:$this.resolve()
.... supportingInfo:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(Resource) Data to be provided
.... supportingInfo:doc-ref-recommendation 0..* BackboneElement Supporting information
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(T17 Visit Summary) Data to be provided
...... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
...... type Σ 1..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).


Required Pattern: DocumentReference
.... supportingInfo:appointment 0..1 BackboneElement Supporting information
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(T17 Booked Appointment) Data to be provided
...... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
...... type Σ 1..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).


Required Pattern: Appointment
.... supportingInfo:cov-elig-req-previous 0..1 BackboneElement Supporting information
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(T17 Request) Data to be provided
...... type Σ 1..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).


Required Pattern: CoverageEligibilityRequest
...... identifier Σ 1..1 Identifier Logical reference, when literal reference is not known
....... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

....... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
....... value Σ 1..1 string The value that is unique
Example General: 123456
... item 1..* BackboneElement Item to be evaluated for eligibiity
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.

..... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:moh Σ 1..1 Coding Code defined by a terminology system
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://fhir.health.gov.il/cs/medical-service-moh
....... code Σ 1..1 code Symbol in syntax defined by the system

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
CoverageEligibilityRequest.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.statusrequiredFinancialResourceStatusCodes
http://hl7.org/fhir/ValueSet/fm-status|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.purposerequiredT17EligibilityrequestPurpose
http://ig.fhir-il-community.org/T17/ValueSet/t17-eligibilityrequest-purpose
from this IG
CoverageEligibilityRequest.supportingInfo:doc-ref-recommendation.information.typeextensiblePattern: DocumentReference
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:appointment.information.typeextensiblePattern: Appointment
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:cov-elig-req-previous.information.typeextensiblePattern: CoverageEligibilityRequest
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:cov-elig-req-previous.information.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.item.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorCoverageEligibilityRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageEligibilityRequestIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCoverageEligibilityRequestIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCoverageEligibilityRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCoverageEligibilityRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. CoverageEligibilityRequest 0..* ILCoreCoverageEligibilityRequest ILCore CoverageEligibilityRequest Profile
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 1..* Identifier Business Identifier for coverage eligiblity request
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

.... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.

... priority 0..1 CodeableConcept Desired processing priority
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: STAT, normal, Deferred.

... purpose Σ 1..1 code auth-requirements | benefits | discovery | validation
Binding: T17 EligibilityRequest Purpose codes (required)
... patient Σ 1..1 Reference(ILCore Patient Profile) Intended recipient of products and services
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... display Σ 0..1 string Text alternative for the resource
... serviced[x] 0..1 Estimated date or dates of service
.... servicedDate date
.... servicedPeriod Period
... created Σ 1..1 dateTime Creation date
... enterer 0..1 Reference(ILCore Practitioner Profile | ILCore PractitionerRole Profile) Author
... provider 0..1 Reference(ILCore Practitioner Profile | ILCore PractitionerRole Profile | ILCore Organization Profile) Party responsible for the request
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... display Σ 0..1 string Text alternative for the resource
... insurer Σ 1..1 Reference(ILCore Organization Profile) Coverage issuer
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... display Σ 0..1 string Text alternative for the resource
... facility 0..1 Reference(T17 Requested Location) Servicing facility
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... Slices for supportingInfo 0..* BackboneElement Supporting information
Slice: Unordered, Closed by type:$this.resolve()
.... supportingInfo:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(Resource) Data to be provided
..... appliesToAll 0..1 boolean Applies to all items
.... supportingInfo:doc-ref-recommendation 0..* BackboneElement Supporting information
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(T17 Visit Summary) Data to be provided
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
...... type Σ 1..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).


Required Pattern: DocumentReference
...... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
...... display Σ 0..1 string Text alternative for the resource
..... appliesToAll 0..1 boolean Applies to all items
.... supportingInfo:appointment 0..1 BackboneElement Supporting information
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(T17 Booked Appointment) Data to be provided
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
...... type Σ 1..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).


Required Pattern: Appointment
...... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
...... display Σ 0..1 string Text alternative for the resource
..... appliesToAll 0..1 boolean Applies to all items
.... supportingInfo:cov-elig-req-previous 0..1 BackboneElement Supporting information
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(T17 Request) Data to be provided
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
...... type Σ 1..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).


Required Pattern: CoverageEligibilityRequest
...... identifier Σ 1..1 Identifier Logical reference, when literal reference is not known
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

....... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

....... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
....... value Σ 1..1 string The value that is unique
Example General: 123456
....... period Σ 0..1 Period Time period when id is/was valid for use
....... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
...... display Σ 0..1 string Text alternative for the resource
..... appliesToAll 0..1 boolean Applies to all items
... insurance 0..* BackboneElement Patient insurance information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... focal 0..1 boolean Applicable coverage
.... coverage 1..1 Reference(Coverage) Insurance information
.... businessArrangement 0..1 string Additional provider contract number
... item 1..* BackboneElement Item to be evaluated for eligibiity
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... supportingInfoSequence 0..* positiveInt Applicable exception or supporting information
.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision etc.

.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.

..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:moh Σ 1..1 Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://fhir.health.gov.il/cs/medical-service-moh
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... modifier 0..* CodeableConcept Product or service billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


.... provider 0..1 Reference(ILCore Practitioner Profile | ILCore PractitionerRole Profile) Perfoming practitioner
.... quantity 0..1 SimpleQuantity Count of products or services
.... unitPrice 0..1 Money Fee, charge or cost per item
.... facility 0..1 Reference(Location | Organization) Servicing facility
.... diagnosis 0..* BackboneElement Applicable diagnosis
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... Slices for diagnosis[x] 0..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD-10Codes (example): ICD10 Diagnostic codes.

...... diagnosisCodeableConcept CodeableConcept
...... diagnosisReference Reference(Condition)
...... diagnosis[x]:diagnosisReference 0..1 Reference(ILCore Condition Profile) Nature of illness or problem
Binding: ICD-10Codes (example): ICD10 Diagnostic codes.

.... detail 0..* Reference(Resource) Product or service details

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
CoverageEligibilityRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
CoverageEligibilityRequest.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
CoverageEligibilityRequest.statusrequiredFinancialResourceStatusCodes
http://hl7.org/fhir/ValueSet/fm-status|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.priorityexampleProcessPriorityCodes
http://hl7.org/fhir/ValueSet/process-priority
from the FHIR Standard
CoverageEligibilityRequest.purposerequiredT17EligibilityrequestPurpose
http://ig.fhir-il-community.org/T17/ValueSet/t17-eligibilityrequest-purpose
from this IG
CoverageEligibilityRequest.patient.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.patient.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.patient.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
CoverageEligibilityRequest.provider.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.provider.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.provider.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
CoverageEligibilityRequest.insurer.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.insurer.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.insurer.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
CoverageEligibilityRequest.facility.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:doc-ref-recommendation.information.typeextensiblePattern: DocumentReference
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:appointment.information.typeextensiblePattern: Appointment
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:cov-elig-req-previous.information.typeextensiblePattern: CoverageEligibilityRequest
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:cov-elig-req-previous.information.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:cov-elig-req-previous.information.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
CoverageEligibilityRequest.item.categoryexampleBenefitCategoryCodes
http://hl7.org/fhir/ValueSet/ex-benefitcategory
from the FHIR Standard
CoverageEligibilityRequest.item.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard
CoverageEligibilityRequest.item.modifierexampleModifierTypeCodes
http://hl7.org/fhir/ValueSet/claim-modifiers
from the FHIR Standard
CoverageEligibilityRequest.item.diagnosis.diagnosis[x]exampleICD-10Codes
http://hl7.org/fhir/ValueSet/icd-10
from the FHIR Standard
CoverageEligibilityRequest.item.diagnosis.diagnosis[x]:diagnosisReferenceexampleICD-10Codes
http://hl7.org/fhir/ValueSet/icd-10
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorCoverageEligibilityRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageEligibilityRequestIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCoverageEligibilityRequestIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCoverageEligibilityRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCoverageEligibilityRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from ILCoreCoverageEligibilityRequest

Summary

Mandatory: 9 elements(15 nested mandatory elements)
Fixed: 1 element

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of CoverageEligibilityRequest.supportingInfo (Closed)
  • The element 1 is sliced based on the value of CoverageEligibilityRequest.item.productOrService.coding

Differential View

This structure is derived from ILCoreCoverageEligibilityRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. CoverageEligibilityRequest ILCoreCoverageEligibilityRequest
... identifier 1..* Identifier Business Identifier for coverage eligiblity request
.... system 1..1 uri The namespace for the identifier value
.... value 1..1 string The value that is unique
... purpose 1..1 code auth-requirements | benefits | discovery | validation
Binding: T17 EligibilityRequest Purpose codes (required)
... patient
.... identifier
..... system 1..1 uri The namespace for the identifier value
..... value 1..1 string The value that is unique
.... identifier
..... system 1..1 uri The namespace for the identifier value
..... value 1..1 string The value that is unique
... insurer
.... identifier
..... system 1..1 uri The namespace for the identifier value
..... value 1..1 string The value that is unique
... facility 0..1 Reference(T17 Requested Location) Servicing facility
.... reference 1..1 string Literal reference, Relative, internal or absolute URL
... Slices for supportingInfo 0..* BackboneElement Supporting information
Slice: Unordered, Closed by type:$this.resolve()
.... supportingInfo:doc-ref-recommendation 0..* BackboneElement Supporting information
..... information 1..1 Reference(T17 Visit Summary) Data to be provided
...... reference 1..1 string Literal reference, Relative, internal or absolute URL
...... type 1..1 uri Type the reference refers to (e.g. "Patient")
Required Pattern: DocumentReference
.... supportingInfo:appointment 0..1 BackboneElement Supporting information
..... information 1..1 Reference(T17 Booked Appointment) Data to be provided
...... reference 1..1 string Literal reference, Relative, internal or absolute URL
...... type 1..1 uri Type the reference refers to (e.g. "Patient")
Required Pattern: Appointment
.... supportingInfo:cov-elig-req-previous 0..1 BackboneElement Supporting information
..... information 1..1 Reference(T17 Request) Data to be provided
...... type 1..1 uri Type the reference refers to (e.g. "Patient")
Required Pattern: CoverageEligibilityRequest
...... identifier 1..1 Identifier Logical reference, when literal reference is not known
....... system 1..1 uri The namespace for the identifier value
....... value 1..1 string The value that is unique
... item 1..* BackboneElement Item to be evaluated for eligibiity
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
..... Slices for coding 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:moh 1..1 Coding Code defined by a terminology system
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://fhir.health.gov.il/cs/medical-service-moh
....... code 1..1 code Symbol in syntax defined by the system

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
CoverageEligibilityRequest.purposerequiredT17EligibilityrequestPurpose
http://ig.fhir-il-community.org/T17/ValueSet/t17-eligibilityrequest-purpose
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. CoverageEligibilityRequest 0..* ILCoreCoverageEligibilityRequest ILCore CoverageEligibilityRequest Profile
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 1..* Identifier Business Identifier for coverage eligiblity request
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 1..1 string The value that is unique
Example General: 123456
... purpose Σ 1..1 code auth-requirements | benefits | discovery | validation
Binding: T17 EligibilityRequest Purpose codes (required)
... patient Σ 1..1 Reference(ILCore Patient Profile) Intended recipient of products and services
... created Σ 1..1 dateTime Creation date
... insurer Σ 1..1 Reference(ILCore Organization Profile) Coverage issuer
... facility 0..1 Reference(T17 Requested Location) Servicing facility
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
... Slices for supportingInfo 0..* BackboneElement Supporting information
Slice: Unordered, Closed by type:$this.resolve()
.... supportingInfo:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(Resource) Data to be provided
.... supportingInfo:doc-ref-recommendation 0..* BackboneElement Supporting information
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(T17 Visit Summary) Data to be provided
...... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
...... type Σ 1..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).


Required Pattern: DocumentReference
.... supportingInfo:appointment 0..1 BackboneElement Supporting information
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(T17 Booked Appointment) Data to be provided
...... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
...... type Σ 1..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).


Required Pattern: Appointment
.... supportingInfo:cov-elig-req-previous 0..1 BackboneElement Supporting information
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(T17 Request) Data to be provided
...... type Σ 1..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).


Required Pattern: CoverageEligibilityRequest
...... identifier Σ 1..1 Identifier Logical reference, when literal reference is not known
....... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

....... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
....... value Σ 1..1 string The value that is unique
Example General: 123456
... item 1..* BackboneElement Item to be evaluated for eligibiity
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.

..... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:moh Σ 1..1 Coding Code defined by a terminology system
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://fhir.health.gov.il/cs/medical-service-moh
....... code Σ 1..1 code Symbol in syntax defined by the system

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
CoverageEligibilityRequest.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.statusrequiredFinancialResourceStatusCodes
http://hl7.org/fhir/ValueSet/fm-status|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.purposerequiredT17EligibilityrequestPurpose
http://ig.fhir-il-community.org/T17/ValueSet/t17-eligibilityrequest-purpose
from this IG
CoverageEligibilityRequest.supportingInfo:doc-ref-recommendation.information.typeextensiblePattern: DocumentReference
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:appointment.information.typeextensiblePattern: Appointment
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:cov-elig-req-previous.information.typeextensiblePattern: CoverageEligibilityRequest
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:cov-elig-req-previous.information.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.item.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorCoverageEligibilityRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageEligibilityRequestIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCoverageEligibilityRequestIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCoverageEligibilityRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCoverageEligibilityRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. CoverageEligibilityRequest 0..* ILCoreCoverageEligibilityRequest ILCore CoverageEligibilityRequest Profile
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 1..* Identifier Business Identifier for coverage eligiblity request
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

.... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.

... priority 0..1 CodeableConcept Desired processing priority
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: STAT, normal, Deferred.

... purpose Σ 1..1 code auth-requirements | benefits | discovery | validation
Binding: T17 EligibilityRequest Purpose codes (required)
... patient Σ 1..1 Reference(ILCore Patient Profile) Intended recipient of products and services
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... display Σ 0..1 string Text alternative for the resource
... serviced[x] 0..1 Estimated date or dates of service
.... servicedDate date
.... servicedPeriod Period
... created Σ 1..1 dateTime Creation date
... enterer 0..1 Reference(ILCore Practitioner Profile | ILCore PractitionerRole Profile) Author
... provider 0..1 Reference(ILCore Practitioner Profile | ILCore PractitionerRole Profile | ILCore Organization Profile) Party responsible for the request
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... display Σ 0..1 string Text alternative for the resource
... insurer Σ 1..1 Reference(ILCore Organization Profile) Coverage issuer
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... display Σ 0..1 string Text alternative for the resource
... facility 0..1 Reference(T17 Requested Location) Servicing facility
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... Slices for supportingInfo 0..* BackboneElement Supporting information
Slice: Unordered, Closed by type:$this.resolve()
.... supportingInfo:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(Resource) Data to be provided
..... appliesToAll 0..1 boolean Applies to all items
.... supportingInfo:doc-ref-recommendation 0..* BackboneElement Supporting information
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(T17 Visit Summary) Data to be provided
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
...... type Σ 1..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).


Required Pattern: DocumentReference
...... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
...... display Σ 0..1 string Text alternative for the resource
..... appliesToAll 0..1 boolean Applies to all items
.... supportingInfo:appointment 0..1 BackboneElement Supporting information
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(T17 Booked Appointment) Data to be provided
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... reference ΣC 1..1 string Literal reference, Relative, internal or absolute URL
...... type Σ 1..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).


Required Pattern: Appointment
...... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
...... display Σ 0..1 string Text alternative for the resource
..... appliesToAll 0..1 boolean Applies to all items
.... supportingInfo:cov-elig-req-previous 0..1 BackboneElement Supporting information
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Information instance identifier
..... information 1..1 Reference(T17 Request) Data to be provided
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
...... type Σ 1..1 uri Type the reference refers to (e.g. "Patient")
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).


Required Pattern: CoverageEligibilityRequest
...... identifier Σ 1..1 Identifier Logical reference, when literal reference is not known
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

....... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

....... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
....... value Σ 1..1 string The value that is unique
Example General: 123456
....... period Σ 0..1 Period Time period when id is/was valid for use
....... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
...... display Σ 0..1 string Text alternative for the resource
..... appliesToAll 0..1 boolean Applies to all items
... insurance 0..* BackboneElement Patient insurance information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... focal 0..1 boolean Applicable coverage
.... coverage 1..1 Reference(Coverage) Insurance information
.... businessArrangement 0..1 string Additional provider contract number
... item 1..* BackboneElement Item to be evaluated for eligibiity
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... supportingInfoSequence 0..* positiveInt Applicable exception or supporting information
.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision etc.

.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.

..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... Slices for coding Σ 1..* Coding Code defined by a terminology system
Slice: Unordered, Open by value:system
...... coding:moh Σ 1..1 Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ 1..1 uri Identity of the terminology system
Fixed Value: http://fhir.health.gov.il/cs/medical-service-moh
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 0..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... modifier 0..* CodeableConcept Product or service billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.


.... provider 0..1 Reference(ILCore Practitioner Profile | ILCore PractitionerRole Profile) Perfoming practitioner
.... quantity 0..1 SimpleQuantity Count of products or services
.... unitPrice 0..1 Money Fee, charge or cost per item
.... facility 0..1 Reference(Location | Organization) Servicing facility
.... diagnosis 0..* BackboneElement Applicable diagnosis
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... Slices for diagnosis[x] 0..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD-10Codes (example): ICD10 Diagnostic codes.

...... diagnosisCodeableConcept CodeableConcept
...... diagnosisReference Reference(Condition)
...... diagnosis[x]:diagnosisReference 0..1 Reference(ILCore Condition Profile) Nature of illness or problem
Binding: ICD-10Codes (example): ICD10 Diagnostic codes.

.... detail 0..* Reference(Resource) Product or service details

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
CoverageEligibilityRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
CoverageEligibilityRequest.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
CoverageEligibilityRequest.statusrequiredFinancialResourceStatusCodes
http://hl7.org/fhir/ValueSet/fm-status|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.priorityexampleProcessPriorityCodes
http://hl7.org/fhir/ValueSet/process-priority
from the FHIR Standard
CoverageEligibilityRequest.purposerequiredT17EligibilityrequestPurpose
http://ig.fhir-il-community.org/T17/ValueSet/t17-eligibilityrequest-purpose
from this IG
CoverageEligibilityRequest.patient.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.patient.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.patient.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
CoverageEligibilityRequest.provider.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.provider.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.provider.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
CoverageEligibilityRequest.insurer.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.insurer.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.insurer.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
CoverageEligibilityRequest.facility.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:doc-ref-recommendation.information.typeextensiblePattern: DocumentReference
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:appointment.information.typeextensiblePattern: Appointment
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:cov-elig-req-previous.information.typeextensiblePattern: CoverageEligibilityRequest
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:cov-elig-req-previous.information.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
CoverageEligibilityRequest.supportingInfo:cov-elig-req-previous.information.identifier.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
CoverageEligibilityRequest.item.categoryexampleBenefitCategoryCodes
http://hl7.org/fhir/ValueSet/ex-benefitcategory
from the FHIR Standard
CoverageEligibilityRequest.item.productOrServiceexampleUSCLSCodes
http://hl7.org/fhir/ValueSet/service-uscls
from the FHIR Standard
CoverageEligibilityRequest.item.modifierexampleModifierTypeCodes
http://hl7.org/fhir/ValueSet/claim-modifiers
from the FHIR Standard
CoverageEligibilityRequest.item.diagnosis.diagnosis[x]exampleICD-10Codes
http://hl7.org/fhir/ValueSet/icd-10
from the FHIR Standard
CoverageEligibilityRequest.item.diagnosis.diagnosis[x]:diagnosisReferenceexampleICD-10Codes
http://hl7.org/fhir/ValueSet/icd-10
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorCoverageEligibilityRequestIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageEligibilityRequestIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCoverageEligibilityRequestIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCoverageEligibilityRequestIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCoverageEligibilityRequestA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from ILCoreCoverageEligibilityRequest

Summary

Mandatory: 9 elements(15 nested mandatory elements)
Fixed: 1 element

Structures

This structure refers to these other structures:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of CoverageEligibilityRequest.supportingInfo (Closed)
  • The element 1 is sliced based on the value of CoverageEligibilityRequest.item.productOrService.coding

 

Other representations of profile: CSV, Excel, Schematron