Healthcare Financial Services IG Edition 1
0.3.0 - STU-Ballot Saudi Arabia flag

Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Coverage Eligibility Request #1 - XML Representation

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<CoverageEligibilityRequest xmlns="http://hl7.org/fhir">
  <id value="19596"/>
  <meta>
    <profile
             value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/eligibility-request|0.3.0"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CoverageEligibilityRequest 19596</b></p><a name="19596"> </a><a name="hc19596"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-eligibility-request.html">Nphies CoverageEligibilityRequestversion: null0.3.0)</a></p></div><p><b>identifier</b>: <code>http://saudigeneralhospital.com.sa/identifiers/coverageeligibilityrequest</code>/req_161959</p><p><b>status</b>: Active</p><p><b>priority</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}">Normal</span></p><p><b>purpose</b>: Coverage Validation, Coverage benefits</p><p><b>patient</b>: <a href="Patient-123454186.html">Ahmad Khaled Abbas(official) Male, DoB: 1984-12-25 ( Passport Number: G12345678)</a></p><p><b>serviced</b>: 2023-07-15 --&gt; 2023-07-16</p><p><b>created</b>: 2023-07-15</p><p><b>provider</b>: <a href="Organization-b1b3432921324f97af3be9fd0b1a14ae.html">Organization Saudi General Hospital</a></p><p><b>insurer</b>: <a href="Organization-bff3aa1fbd3648619ac082357bf135db.html">Organization Saudi National Insurance</a></p><p><b>facility</b>: <a href="Location-2be1133308ed422a9923931c5a475f63.html">Location Saudi General Hospital</a></p><h3>Insurances</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Coverage</b></td></tr><tr><td style="display: none">*</td><td><a href="Coverage-1333.html">Coverage: identifier = http://sni.com.sa/identifiers/memberid#0000000001; status = active; type = extended healthcare; dependent = 01; relationship = Self; network = Golden C</a></td></tr></table></div>
  </text>
  <identifier>
    <system
            value="http://saudigeneralhospital.com.sa/identifiers/coverageeligibilityrequest"/>
    <value value="req_161959"/>
  </identifier>
  <status value="active"/>
  <priority>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/processpriority"/>
      <code value="normal"/>
    </coding>
  </priority>
  <purpose value="validation"/>
  <purpose value="benefits"/>
  <patient>🔗 
    <reference value="Patient/123454186"/>
  </patient>
  <servicedPeriod>
    <start value="2023-07-15"/>
    <end value="2023-07-16"/>
  </servicedPeriod>
  <created value="2023-07-15"/>
  <provider>🔗 
    <reference value="Organization/b1b3432921324f97af3be9fd0b1a14ae"/>
  </provider>
  <insurer>🔗 
    <reference value="Organization/bff3aa1fbd3648619ac082357bf135db"/>
  </insurer>
  <facility>🔗 
    <reference value="Location/2be1133308ed422a9923931c5a475f63"/>
  </facility>
  <insurance>
    <coverage>🔗 
      <reference value="Coverage/1333"/>
    </coverage>
  </insurance>
</CoverageEligibilityRequest>