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 #3 - JSON Representation

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{
  "resourceType" : "CoverageEligibilityRequest",
  "id" : "19597",
  "meta" : {
    "profile" : [
      🔗 "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/eligibility-request|0.3.0"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CoverageEligibilityRequest 19597</b></p><a name=\"19597\"> </a><a name=\"hc19597\"> </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_27009</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 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>: 2024-01-12 --&gt; 2024-02-12</p><p><b>created</b>: 2024-02-12</p><p><b>provider</b>: <a href=\"Organization-5025.html\">Organization Saudi Professional Clinic</a></p><p><b>insurer</b>: <a href=\"Organization-bff3aa1fbd3648619ac082357bf135db.html\">Organization Saudi National Insurance</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>"
  },
  "identifier" : [
    {
      "system" : "http://saudigeneralhospital.com.sa/identifiers/coverageeligibilityrequest",
      "value" : "req_27009"
    }
  ],
  "status" : "active",
  "priority" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
        "code" : "normal"
      }
    ]
  },
  "purpose" : [
    "benefits"
  ],
  "patient" : {
    🔗 "reference" : "Patient/123454186"
  },
  "servicedPeriod" : {
    "start" : "2024-01-12",
    "end" : "2024-02-12"
  },
  "created" : "2024-02-12",
  "provider" : {
    🔗 "reference" : "Organization/5025"
  },
  "insurer" : {
    🔗 "reference" : "Organization/bff3aa1fbd3648619ac082357bf135db"
  },
  "insurance" : [
    {
      "coverage" : {
        🔗 "reference" : "Coverage/1333"
      }
    }
  ]
}