Name	Flags	Card.	Type	Description & Constraints
CoverageEligibilityResponse	C	0..*	ILCoreCoverageEligibilityResponse	ILCore CoverageEligibilityResponse Profile purpose-validation: אם יש insurance.identifier או insurance.reference ומדובר ב- purpose=validation אז חייבים להיות תאריכים.
purpose		1..1	code	auth-requirements | benefits | discovery | validation Binding: T17 EligibilityResponse Purpose codes (required)
patient
identifier
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
requestor
identifier
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
request		1..1	Reference(T17 Request)	Eligibility request reference
insurer
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
insurance
coverage		1..1	Reference(T17 Obligation)	Insurance information
benefitPeriod
start		1..1	dateTime	Starting time with inclusive boundary
end		1..1	dateTime	End time with inclusive boundary, if not ongoing
item
productOrService
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 Binding: קוד מוצר או שירות (required)
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
modifier		0..*	CodeableConcept	Product or service billing modifiers Binding: Tofes17 Reject Codes (extensible)
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:moh		0..1	Coding	Code defined by a terminology system Binding: Tofes17 Reject Codes (required)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.health.gov.il/cs/moh-form17-issue-code
code		1..1	code	Symbol in syntax defined by the system
excluded		1..1	boolean	Excluded from the plan
error
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
issue-regards		0..1	(Complex)	Issue Regards URL: http://fhir.outburn.co.il/StructureDefinition/issue-regards
Slices for value[x]		1..1	Coding	Value of extension Slice: Unordered, Open by type:$this
value[x]:valueCoding		1..1	Coding	Value of extension
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
code		1..1	CodeableConcept	Error code detailing processing issues Binding: Tofes17 Error Codes (extensible)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
CoverageEligibilityResponse.purpose	required	T17eligibilityresponsePurpose http://ig.fhir-il-community.org/T17/ValueSet/t17-eligibilityresponse-purpose from this IG
CoverageEligibilityResponse.insurance.item.productOrService.coding:moh	required	MedicalServiceMoH http://fhir.health.gov.il/ValueSet/medical-service-moh
CoverageEligibilityResponse.insurance.item.modifier	extensible	Tofes17RejectCodes http://fhir.health.gov.il/ValueSet/tofes17-reject-codes from this IG
CoverageEligibilityResponse.insurance.item.modifier.coding:moh	required	Tofes17RejectCodes http://fhir.health.gov.il/ValueSet/tofes17-reject-codes from this IG
CoverageEligibilityResponse.error.code	extensible	Tofes17ErrorCodes http://fhir.health.gov.il/ValueSet/tofes17-error-codes from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
purpose-validation	error	CoverageEligibilityResponse	אם יש insurance.identifier או insurance.reference ומדובר ב- purpose=validation אז חייבים להיות תאריכים. : (insurance.identifier.exists() or insurance.reference.exists()) and (purpose.coding.system = 'http://hl7.org/fhir/eligibilityresponse-purpose' and purpose.coding.code = 'validation') implies insurance.benefitPeriod.exists()

Name	Flags	Card.	Type	Description & Constraints
CoverageEligibilityResponse	C	0..*	ILCoreCoverageEligibilityResponse	ILCore CoverageEligibilityResponse Profile purpose-validation: אם יש insurance.identifier או insurance.reference ומדובר ב- purpose=validation אז חייבים להיות תאריכים.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
purpose	Σ	1..1	code	auth-requirements | benefits | discovery | validation Binding: T17 EligibilityResponse Purpose codes (required)
patient	Σ	1..1	Reference(ILCore Patient Profile)	Intended recipient of products and services
created	Σ	1..1	dateTime	Response creation date
request	Σ	1..1	Reference(T17 Request)	Eligibility request reference
outcome	Σ	1..1	code	queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing.
insurer	Σ	1..1	Reference(ILCore Organization Profile)	Coverage issuer
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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CoverageEligibilityResponse.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.purpose	required	T17eligibilityresponsePurpose http://ig.fhir-il-community.org/T17/ValueSet/t17-eligibilityresponse-purpose from this IG
CoverageEligibilityResponse.outcome	required	ClaimProcessingCodes http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.insurer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	CoverageEligibilityResponse	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CoverageEligibilityResponse	If 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-4	error	CoverageEligibilityResponse	If 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-5	error	CoverageEligibilityResponse	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CoverageEligibilityResponse	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
purpose-validation	error	CoverageEligibilityResponse	אם יש insurance.identifier או insurance.reference ומדובר ב- purpose=validation אז חייבים להיות תאריכים. : (insurance.identifier.exists() or insurance.reference.exists()) and (purpose.coding.system = 'http://hl7.org/fhir/eligibilityresponse-purpose' and purpose.coding.code = 'validation') implies insurance.benefitPeriod.exists()

Name	Flags	Card.	Type	Description & Constraints
CoverageEligibilityResponse	C	0..*	ILCoreCoverageEligibilityResponse	ILCore CoverageEligibilityResponse Profile purpose-validation: אם יש insurance.identifier או insurance.reference ומדובר ב- purpose=validation אז חייבים להיות תאריכים.
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
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
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		0..*	Identifier	Business Identifier for coverage eligiblity request
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
purpose	Σ	1..1	code	auth-requirements | benefits | discovery | validation Binding: T17 EligibilityResponse 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	Response creation date
requestor		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
request	Σ	1..1	Reference(T17 Request)	Eligibility request reference
outcome	Σ	1..1	code	queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing.
disposition		0..1	string	Disposition Message
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	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
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
coverage	Σ	1..1	Reference(T17 Obligation)	Insurance information
inforce		0..1	boolean	Coverage inforce indicator
benefitPeriod		0..1	Period	When the benefits are applicable
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	1..1	dateTime	Starting time with inclusive boundary
end	ΣC	1..1	dateTime	End time with inclusive boundary, if not ongoing
item	C	0..*	BackboneElement	Benefits and authorization details ces-1: SHALL contain a category or a billcode but not both.
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
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision etc.
productOrService		0..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 Binding: קוד מוצר או שירות (required)
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: Tofes17 Reject Codes (extensible)
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	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:moh	Σ	0..1	Coding	Code defined by a terminology system Binding: Tofes17 Reject Codes (required)
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/moh-form17-issue-code
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
provider		0..1	Reference(ILCore Practitioner Profile | ILCore PractitionerRole Profile)	Performing practitioner
excluded		1..1	boolean	Excluded from the plan
name		0..1	string	Short name for the benefit
description		0..1	string	Description of the benefit or services covered
network		0..1	CodeableConcept	In or out of network Binding: NetworkTypeCodes (example): Code to classify in or out of network services.
unit		0..1	CodeableConcept	Individual or family Binding: UnitTypeCodes (example): Unit covered/serviced - individual or family.
term		0..1	CodeableConcept	Annual or lifetime Binding: BenefitTermCodes (example): Coverage unit - annual, lifetime.
benefit		0..*	BackboneElement	Benefit Summary
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
type		1..1	CodeableConcept	Benefit classification Binding: BenefitTypeCodes (example): Deductable, visits, co-pay, etc.
allowed[x]		0..1		Benefits allowed
allowedUnsignedInt			unsignedInt
allowedString			string
allowedMoney			Money
used[x]		0..1		Benefits used
usedUnsignedInt			unsignedInt
usedString			string
usedMoney			Money
authorizationRequired		0..1	boolean	Authorization required flag
authorizationSupporting		0..*	CodeableConcept	Type of required supporting materials Binding: CoverageEligibilityResponseAuthSupportCodes (example): Type of supporting information to provide with a preauthorization.
authorizationUrl		0..1	uri	Preauthorization requirements endpoint
preAuthRef		0..1	string	Preauthorization reference
form		0..1	CodeableConcept	Printed form identifier Binding: Form Codes (example): The forms codes.
error		0..*	BackboneElement	Processing errors
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
issue-regards		0..1	(Complex)	Issue Regards URL: http://fhir.outburn.co.il/StructureDefinition/issue-regards
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://fhir.outburn.co.il/StructureDefinition/issue-regards"
Slices for value[x]		1..1	Coding	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCoding		1..1	Coding	Value of extension
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Error code detailing processing issues Binding: Tofes17 Error Codes (extensible)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CoverageEligibilityResponse.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
CoverageEligibilityResponse.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.purpose	required	T17eligibilityresponsePurpose http://ig.fhir-il-community.org/T17/ValueSet/t17-eligibilityresponse-purpose from this IG
CoverageEligibilityResponse.patient.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
CoverageEligibilityResponse.patient.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.patient.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
CoverageEligibilityResponse.requestor.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
CoverageEligibilityResponse.requestor.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.requestor.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
CoverageEligibilityResponse.outcome	required	ClaimProcessingCodes http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.insurer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
CoverageEligibilityResponse.insurer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.insurer.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
CoverageEligibilityResponse.insurance.item.category	example	BenefitCategoryCodes http://hl7.org/fhir/ValueSet/ex-benefitcategory from the FHIR Standard
CoverageEligibilityResponse.insurance.item.productOrService	example	USCLSCodes http://hl7.org/fhir/ValueSet/service-uscls from the FHIR Standard
CoverageEligibilityResponse.insurance.item.productOrService.coding:moh	required	MedicalServiceMoH http://fhir.health.gov.il/ValueSet/medical-service-moh
CoverageEligibilityResponse.insurance.item.modifier	extensible	Tofes17RejectCodes http://fhir.health.gov.il/ValueSet/tofes17-reject-codes from this IG
CoverageEligibilityResponse.insurance.item.modifier.coding:moh	required	Tofes17RejectCodes http://fhir.health.gov.il/ValueSet/tofes17-reject-codes from this IG
CoverageEligibilityResponse.insurance.item.network	example	NetworkTypeCodes http://hl7.org/fhir/ValueSet/benefit-network from the FHIR Standard
CoverageEligibilityResponse.insurance.item.unit	example	UnitTypeCodes http://hl7.org/fhir/ValueSet/benefit-unit from the FHIR Standard
CoverageEligibilityResponse.insurance.item.term	example	BenefitTermCodes http://hl7.org/fhir/ValueSet/benefit-term from the FHIR Standard
CoverageEligibilityResponse.insurance.item.benefit.type	example	BenefitTypeCodes http://hl7.org/fhir/ValueSet/benefit-type from the FHIR Standard
CoverageEligibilityResponse.insurance.item.authorizationSupporting	example	CoverageEligibilityResponseAuthSupportCodes http://hl7.org/fhir/ValueSet/coverageeligibilityresponse-ex-auth-support from the FHIR Standard
CoverageEligibilityResponse.form	example	Form Codes http://hl7.org/fhir/ValueSet/forms from the FHIR Standard
CoverageEligibilityResponse.error.code	extensible	Tofes17ErrorCodes http://fhir.health.gov.il/ValueSet/tofes17-error-codes from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
ces-1	error	CoverageEligibilityResponse.insurance.item	SHALL contain a category or a billcode but not both. : category.exists() xor productOrService.exists()
dom-2	error	CoverageEligibilityResponse	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CoverageEligibilityResponse	If 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-4	error	CoverageEligibilityResponse	If 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-5	error	CoverageEligibilityResponse	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CoverageEligibilityResponse	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
purpose-validation	error	CoverageEligibilityResponse	אם יש insurance.identifier או insurance.reference ומדובר ב- purpose=validation אז חייבים להיות תאריכים. : (insurance.identifier.exists() or insurance.reference.exists()) and (purpose.coding.system = 'http://hl7.org/fhir/eligibilityresponse-purpose' and purpose.coding.code = 'validation') implies insurance.benefitPeriod.exists()

Summary

Mandatory: 3 elements(17 nested mandatory elements)
Fixed: 3 elements

Structures

This structure refers to these other structures:

• T17 Request (http://ig.fhir-il-community.org/T17/StructureDefinition/t17-request)
• T17 Obligation (http://ig.fhir-il-community.org/T17/StructureDefinition/t17-obligation)

Extensions

This structure refers to these extensions:

• http://fhir.outburn.co.il/StructureDefinition/issue-regards

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of CoverageEligibilityResponse.insurance.item.productOrService.coding
• The element 1 is sliced based on the value of CoverageEligibilityResponse.insurance.item.modifier.coding
• The element 1 is sliced based on the value of CoverageEligibilityResponse.error.extension.value[x]

Name	Flags	Card.	Type	Description & Constraints
CoverageEligibilityResponse	C	0..*	ILCoreCoverageEligibilityResponse	ILCore CoverageEligibilityResponse Profile purpose-validation: אם יש insurance.identifier או insurance.reference ומדובר ב- purpose=validation אז חייבים להיות תאריכים.
purpose		1..1	code	auth-requirements | benefits | discovery | validation Binding: T17 EligibilityResponse Purpose codes (required)
patient
identifier
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
requestor
identifier
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
request		1..1	Reference(T17 Request)	Eligibility request reference
insurer
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
insurance
coverage		1..1	Reference(T17 Obligation)	Insurance information
benefitPeriod
start		1..1	dateTime	Starting time with inclusive boundary
end		1..1	dateTime	End time with inclusive boundary, if not ongoing
item
productOrService
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 Binding: קוד מוצר או שירות (required)
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
modifier		0..*	CodeableConcept	Product or service billing modifiers Binding: Tofes17 Reject Codes (extensible)
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:moh		0..1	Coding	Code defined by a terminology system Binding: Tofes17 Reject Codes (required)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.health.gov.il/cs/moh-form17-issue-code
code		1..1	code	Symbol in syntax defined by the system
excluded		1..1	boolean	Excluded from the plan
error
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
issue-regards		0..1	(Complex)	Issue Regards URL: http://fhir.outburn.co.il/StructureDefinition/issue-regards
Slices for value[x]		1..1	Coding	Value of extension Slice: Unordered, Open by type:$this
value[x]:valueCoding		1..1	Coding	Value of extension
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
code		1..1	CodeableConcept	Error code detailing processing issues Binding: Tofes17 Error Codes (extensible)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
CoverageEligibilityResponse.purpose	required	T17eligibilityresponsePurpose http://ig.fhir-il-community.org/T17/ValueSet/t17-eligibilityresponse-purpose from this IG
CoverageEligibilityResponse.insurance.item.productOrService.coding:moh	required	MedicalServiceMoH http://fhir.health.gov.il/ValueSet/medical-service-moh
CoverageEligibilityResponse.insurance.item.modifier	extensible	Tofes17RejectCodes http://fhir.health.gov.il/ValueSet/tofes17-reject-codes from this IG
CoverageEligibilityResponse.insurance.item.modifier.coding:moh	required	Tofes17RejectCodes http://fhir.health.gov.il/ValueSet/tofes17-reject-codes from this IG
CoverageEligibilityResponse.error.code	extensible	Tofes17ErrorCodes http://fhir.health.gov.il/ValueSet/tofes17-error-codes from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
purpose-validation	error	CoverageEligibilityResponse	אם יש insurance.identifier או insurance.reference ומדובר ב- purpose=validation אז חייבים להיות תאריכים. : (insurance.identifier.exists() or insurance.reference.exists()) and (purpose.coding.system = 'http://hl7.org/fhir/eligibilityresponse-purpose' and purpose.coding.code = 'validation') implies insurance.benefitPeriod.exists()

Name	Flags	Card.	Type	Description & Constraints
CoverageEligibilityResponse	C	0..*	ILCoreCoverageEligibilityResponse	ILCore CoverageEligibilityResponse Profile purpose-validation: אם יש insurance.identifier או insurance.reference ומדובר ב- purpose=validation אז חייבים להיות תאריכים.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
purpose	Σ	1..1	code	auth-requirements | benefits | discovery | validation Binding: T17 EligibilityResponse Purpose codes (required)
patient	Σ	1..1	Reference(ILCore Patient Profile)	Intended recipient of products and services
created	Σ	1..1	dateTime	Response creation date
request	Σ	1..1	Reference(T17 Request)	Eligibility request reference
outcome	Σ	1..1	code	queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing.
insurer	Σ	1..1	Reference(ILCore Organization Profile)	Coverage issuer
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
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CoverageEligibilityResponse.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.purpose	required	T17eligibilityresponsePurpose http://ig.fhir-il-community.org/T17/ValueSet/t17-eligibilityresponse-purpose from this IG
CoverageEligibilityResponse.outcome	required	ClaimProcessingCodes http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.insurer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	CoverageEligibilityResponse	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CoverageEligibilityResponse	If 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-4	error	CoverageEligibilityResponse	If 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-5	error	CoverageEligibilityResponse	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CoverageEligibilityResponse	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
purpose-validation	error	CoverageEligibilityResponse	אם יש insurance.identifier או insurance.reference ומדובר ב- purpose=validation אז חייבים להיות תאריכים. : (insurance.identifier.exists() or insurance.reference.exists()) and (purpose.coding.system = 'http://hl7.org/fhir/eligibilityresponse-purpose' and purpose.coding.code = 'validation') implies insurance.benefitPeriod.exists()

Name	Flags	Card.	Type	Description & Constraints
CoverageEligibilityResponse	C	0..*	ILCoreCoverageEligibilityResponse	ILCore CoverageEligibilityResponse Profile purpose-validation: אם יש insurance.identifier או insurance.reference ומדובר ב- purpose=validation אז חייבים להיות תאריכים.
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
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
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		0..*	Identifier	Business Identifier for coverage eligiblity request
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
purpose	Σ	1..1	code	auth-requirements | benefits | discovery | validation Binding: T17 EligibilityResponse 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	Response creation date
requestor		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
request	Σ	1..1	Reference(T17 Request)	Eligibility request reference
outcome	Σ	1..1	code	queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing.
disposition		0..1	string	Disposition Message
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	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
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
coverage	Σ	1..1	Reference(T17 Obligation)	Insurance information
inforce		0..1	boolean	Coverage inforce indicator
benefitPeriod		0..1	Period	When the benefits are applicable
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	1..1	dateTime	Starting time with inclusive boundary
end	ΣC	1..1	dateTime	End time with inclusive boundary, if not ongoing
item	C	0..*	BackboneElement	Benefits and authorization details ces-1: SHALL contain a category or a billcode but not both.
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
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision etc.
productOrService		0..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 Binding: קוד מוצר או שירות (required)
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: Tofes17 Reject Codes (extensible)
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	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system
coding:moh	Σ	0..1	Coding	Code defined by a terminology system Binding: Tofes17 Reject Codes (required)
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/moh-form17-issue-code
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
provider		0..1	Reference(ILCore Practitioner Profile | ILCore PractitionerRole Profile)	Performing practitioner
excluded		1..1	boolean	Excluded from the plan
name		0..1	string	Short name for the benefit
description		0..1	string	Description of the benefit or services covered
network		0..1	CodeableConcept	In or out of network Binding: NetworkTypeCodes (example): Code to classify in or out of network services.
unit		0..1	CodeableConcept	Individual or family Binding: UnitTypeCodes (example): Unit covered/serviced - individual or family.
term		0..1	CodeableConcept	Annual or lifetime Binding: BenefitTermCodes (example): Coverage unit - annual, lifetime.
benefit		0..*	BackboneElement	Benefit Summary
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
type		1..1	CodeableConcept	Benefit classification Binding: BenefitTypeCodes (example): Deductable, visits, co-pay, etc.
allowed[x]		0..1		Benefits allowed
allowedUnsignedInt			unsignedInt
allowedString			string
allowedMoney			Money
used[x]		0..1		Benefits used
usedUnsignedInt			unsignedInt
usedString			string
usedMoney			Money
authorizationRequired		0..1	boolean	Authorization required flag
authorizationSupporting		0..*	CodeableConcept	Type of required supporting materials Binding: CoverageEligibilityResponseAuthSupportCodes (example): Type of supporting information to provide with a preauthorization.
authorizationUrl		0..1	uri	Preauthorization requirements endpoint
preAuthRef		0..1	string	Preauthorization reference
form		0..1	CodeableConcept	Printed form identifier Binding: Form Codes (example): The forms codes.
error		0..*	BackboneElement	Processing errors
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
issue-regards		0..1	(Complex)	Issue Regards URL: http://fhir.outburn.co.il/StructureDefinition/issue-regards
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://fhir.outburn.co.il/StructureDefinition/issue-regards"
Slices for value[x]		1..1	Coding	Value of extension Slice: Unordered, Closed by type:$this
value[x]:valueCoding		1..1	Coding	Value of extension
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	CodeableConcept	Error code detailing processing issues Binding: Tofes17 Error Codes (extensible)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
CoverageEligibilityResponse.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
CoverageEligibilityResponse.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.purpose	required	T17eligibilityresponsePurpose http://ig.fhir-il-community.org/T17/ValueSet/t17-eligibilityresponse-purpose from this IG
CoverageEligibilityResponse.patient.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
CoverageEligibilityResponse.patient.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.patient.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
CoverageEligibilityResponse.requestor.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
CoverageEligibilityResponse.requestor.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.requestor.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
CoverageEligibilityResponse.outcome	required	ClaimProcessingCodes http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.insurer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
CoverageEligibilityResponse.insurer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
CoverageEligibilityResponse.insurer.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
CoverageEligibilityResponse.insurance.item.category	example	BenefitCategoryCodes http://hl7.org/fhir/ValueSet/ex-benefitcategory from the FHIR Standard
CoverageEligibilityResponse.insurance.item.productOrService	example	USCLSCodes http://hl7.org/fhir/ValueSet/service-uscls from the FHIR Standard
CoverageEligibilityResponse.insurance.item.productOrService.coding:moh	required	MedicalServiceMoH http://fhir.health.gov.il/ValueSet/medical-service-moh
CoverageEligibilityResponse.insurance.item.modifier	extensible	Tofes17RejectCodes http://fhir.health.gov.il/ValueSet/tofes17-reject-codes from this IG
CoverageEligibilityResponse.insurance.item.modifier.coding:moh	required	Tofes17RejectCodes http://fhir.health.gov.il/ValueSet/tofes17-reject-codes from this IG
CoverageEligibilityResponse.insurance.item.network	example	NetworkTypeCodes http://hl7.org/fhir/ValueSet/benefit-network from the FHIR Standard
CoverageEligibilityResponse.insurance.item.unit	example	UnitTypeCodes http://hl7.org/fhir/ValueSet/benefit-unit from the FHIR Standard
CoverageEligibilityResponse.insurance.item.term	example	BenefitTermCodes http://hl7.org/fhir/ValueSet/benefit-term from the FHIR Standard
CoverageEligibilityResponse.insurance.item.benefit.type	example	BenefitTypeCodes http://hl7.org/fhir/ValueSet/benefit-type from the FHIR Standard
CoverageEligibilityResponse.insurance.item.authorizationSupporting	example	CoverageEligibilityResponseAuthSupportCodes http://hl7.org/fhir/ValueSet/coverageeligibilityresponse-ex-auth-support from the FHIR Standard
CoverageEligibilityResponse.form	example	Form Codes http://hl7.org/fhir/ValueSet/forms from the FHIR Standard
CoverageEligibilityResponse.error.code	extensible	Tofes17ErrorCodes http://fhir.health.gov.il/ValueSet/tofes17-error-codes from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
ces-1	error	CoverageEligibilityResponse.insurance.item	SHALL contain a category or a billcode but not both. : category.exists() xor productOrService.exists()
dom-2	error	CoverageEligibilityResponse	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	CoverageEligibilityResponse	If 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-4	error	CoverageEligibilityResponse	If 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-5	error	CoverageEligibilityResponse	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	CoverageEligibilityResponse	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
purpose-validation	error	CoverageEligibilityResponse	אם יש insurance.identifier או insurance.reference ומדובר ב- purpose=validation אז חייבים להיות תאריכים. : (insurance.identifier.exists() or insurance.reference.exists()) and (purpose.coding.system = 'http://hl7.org/fhir/eligibilityresponse-purpose' and purpose.coding.code = 'validation') implies insurance.benefitPeriod.exists()