"The CoverageEligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy." - HL7 FHIR, CoverageEligibilityRequest

Attributes
«TS» PointInTime	dateCreated	"The date when this resource was created." - HL7 FHIR, CoverageEligibilityRequest.created
«IVL_TS» Period	datesOfService	"The date or dates when the enclosed suite of services were performed or completed." - HL7 FHIR, CoverageEligibilityRequest.serviced[x] Note that in FHIR, the data type of this property can be either a DateTime or a Period. In the FHIM, this is modeled as a Period. If a only a date/time is needed, use Period.start and leave Period.end empty.
Participation	enterer	"Person who created the request." - HL7 FHIR, CoverageEligibilityRequest.enterer
ServiceDeliveryLocation	facility	"Facility where the services are intended to be provided." - HL7 FHIR, CoverageEligibilityRequest.facility
«II» Id	identifier	"A unique identifier assigned to this coverage eligiblity request." - HL7 FHIR, CoverageEligibilityRequest.identifier
Organization	insurer	"The Insurer who issued the coverage in question and is the recipient of the request." - HL7 FHIR, CoverageEligibilityRequest.insurer
RequestItem	item	"Service categories or billable services for which benefit details and/or an authorization prior to service delivery may be required by the payor." - HL7 FHIR, CoverageEligibilityRequest.item
CoveredPatient	patient	"The party who is the beneficiary of the supplied coverage and for whom eligibility is sought." - HL7 FHIR, CoverageEligibilityRequest.patient
«CS» Code	priority	"When the requestor expects the processor to complete processing." Possible values include: Immediate; Normal; Deferred. - HL7 FHIR, CoverageEligibilityRequest.priority
HealthcareProvider	provider	"The provider which is responsible for the request." - HL7 FHIR, CoverageEligibilityRequest.provider
«CS» Code	purpose	"Code to specify whether requesting: prior authorization requirements for some service categories or billing codes; benefits for coverages specified or discovered; discovery and return of coverages for the patient; and/or validation that the specified coverage is in-force at the date/period specified or 'now' if not specified." Possible values are: Coverage auth-requirements; Coverage benefits; Coverage Discovery; Coverage Validation. - HL7 FHIR, CoverageEligibilityRequest.purpose
RequestedInsurance	requestedInsurance	"Financial instruments for reimbursement for the health care products and services." - HL7 FHIR, CoverageEligibilityRequest.insurance
«CS» Code	status	"The status of the resource instance." Possible values are: Active; Cancelled; Draft; Entered in Error. - HL7 FHIR, CoverageEligibilityRequest.status
SupportingInformation	supportingInformation	"Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues." - HL7 FHIR, CoverageEligibilityRequest.supportingInfo

 dateCreated

Public «TS» PointInTime dateCreated

"The date when this resource was created." - HL7 FHIR, CoverageEligibilityRequest.created

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	CoverageEligibilityRequest
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	dateCreated
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::dateCreated
Stereotype
Template Parameter
Type	«TS» PointInTime
Upper	1
Upper Value	(1)
Visibility	Public

 datesOfService

Public «IVL_TS» Period datesOfService

"The date or dates when the enclosed suite of services were performed or completed." - HL7 FHIR, CoverageEligibilityRequest.serviced[x]
Note that in FHIR, the data type of this property can be either a DateTime or a Period. In the FHIM, this is modeled as a Period. If a only a date/time is needed, use Period.start and leave Period.end empty.

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	CoverageEligibilityRequest
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	datesOfService
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::datesOfService
Stereotype
Template Parameter
Type	«IVL_TS» Period
Upper	1
Upper Value	(1)
Visibility	Public

 enterer

Public Participation enterer

"Person who created the request." - HL7 FHIR, CoverageEligibilityRequest.enterer

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	CoverageEligibilityRequest
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	enterer
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::enterer
Stereotype
Template Parameter
Type	Participation
Upper	1
Upper Value	(1)
Visibility	Public

 facility

Public ServiceDeliveryLocation facility

"Facility where the services are intended to be provided." - HL7 FHIR, CoverageEligibilityRequest.facility

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	CoverageEligibilityRequest
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	facility
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::facility
Stereotype
Template Parameter
Type	ServiceDeliveryLocation
Upper	1
Upper Value	(1)
Visibility	Public

 identifier

Public «II» Id identifier

"A unique identifier assigned to this coverage eligiblity request." - HL7 FHIR, CoverageEligibilityRequest.identifier

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	CoverageEligibilityRequest
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	*
Name	identifier
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::identifier
Stereotype
Template Parameter
Type	«II» Id
Upper	*
Upper Value	(*)
Visibility	Public

 insurer

Public Organization insurer

"The Insurer who issued the coverage in question and is the recipient of the request." - HL7 FHIR, CoverageEligibilityRequest.insurer

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	CoverageEligibilityRequest
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	1
Lower Value	(1)
Multiplicity	1
Name	insurer
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::insurer
Stereotype
Template Parameter
Type	Organization
Upper	1
Upper Value	(1)
Visibility	Public

 item

Public RequestItem item

"Service categories or billable services for which benefit details and/or an authorization prior to service delivery may be required by the payor." - HL7 FHIR, CoverageEligibilityRequest.item

Constraints:

Properties:

Aggregation	None
Alias
Association	coverageEligibilityRequest_item
Association End
Class	CoverageEligibilityRequest
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	*
Name	item
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::item
Stereotype
Template Parameter
Type	RequestItem
Upper	*
Upper Value	(*)
Visibility	Public

 patient

Public CoveredPatient patient

"The party who is the beneficiary of the supplied coverage and for whom eligibility is sought." - HL7 FHIR, CoverageEligibilityRequest.patient

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	CoverageEligibilityRequest
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	1
Lower Value	(1)
Multiplicity	1
Name	patient
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::patient
Stereotype
Template Parameter
Type	CoveredPatient
Upper	1
Upper Value	(1)
Visibility	Public

 priority

Public «CS» Code priority

"When the requestor expects the processor to complete processing." Possible values include: Immediate; Normal; Deferred. - HL7 FHIR, CoverageEligibilityRequest.priority

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	CoverageEligibilityRequest
Terminologies	[ HL7_FHIR_R4 Process Priority Codes http://hl7.org/fhir/ValueSet/process-priority ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	priority
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::priority
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

 provider

Public HealthcareProvider provider

"The provider which is responsible for the request." - HL7 FHIR, CoverageEligibilityRequest.provider

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	CoverageEligibilityRequest
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	provider
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::provider
Stereotype
Template Parameter
Type	HealthcareProvider
Upper	1
Upper Value	(1)
Visibility	Public

 purpose

Public «CS» Code purpose

"Code to specify whether requesting: prior authorization requirements for some service categories or billing codes; benefits for coverages specified or discovered; discovery and return of coverages for the patient; and/or validation that the specified coverage is in-force at the date/period specified or 'now' if not specified." Possible values are: Coverage auth-requirements; Coverage benefits; Coverage Discovery; Coverage Validation. - HL7 FHIR, CoverageEligibilityRequest.purpose

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	CoverageEligibilityRequest
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	1
Lower Value	(1)
Multiplicity	1..*
Name	purpose
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::purpose
Stereotype
Template Parameter
Type	«CS» Code
Upper	*
Upper Value	(*)
Visibility	Public

 requestedInsurance

Public RequestedInsurance requestedInsurance

"Financial instruments for reimbursement for the health care products and services." - HL7 FHIR, CoverageEligibilityRequest.insurance

Constraints:

Properties:

Aggregation	None
Alias
Association	coverageEligibilityRequest_requestedInsurance
Association End
Class	CoverageEligibilityRequest
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	*
Name	requestedInsurance
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::requestedInsurance
Stereotype
Template Parameter
Type	RequestedInsurance
Upper	*
Upper Value	(*)
Visibility	Public

 status

Public «CS» Code status

"The status of the resource instance." Possible values are: Active; Cancelled; Draft; Entered in Error. - HL7 FHIR, CoverageEligibilityRequest.status

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	CoverageEligibilityRequest
Terminologies	[ HL7_FHIR_R4 Financial Resource Status Codes http://hl7.org/fhir/ValueSet/fm-status ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	1
Lower Value	(1)
Multiplicity	1
Name	status
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::status
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

 supportingInformation

Public SupportingInformation supportingInformation

"Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues." - HL7 FHIR, CoverageEligibilityRequest.supportingInfo

Constraints:

Properties:

Aggregation	None
Alias
Association	coverageEligibilityRequest_supportingInformation
Association End
Class	CoverageEligibilityRequest
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	*
Name	supportingInformation
Name Expression
Namespace	CoverageEligibilityRequest
Opposite
Owner	CoverageEligibilityRequest
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::CoverageEligibilityRequest::supportingInformation
Stereotype
Template Parameter
Type	SupportingInformation
Upper	*
Upper Value	(*)
Visibility	Public