Healthcare Financial Services IG Edition 1
0.4.0 - STU-Ballot with Updates Saudi Arabia flag

Healthcare Financial Services IG Edition 1 - Local Development build (v0.4.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Nphies CoverageEligibilityRequest

Official URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/eligibility-request Version: 0.4.0
Draft as of 2025-10-12 Computable Name: NphiesCoverageEligibilityRequest

Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

Coverage Eligibility Request Profile

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CoverageEligibilityRequest C 0..* CoverageEligibilityRequest CoverageEligibilityRequest resource
Constraints: ksa-purpose-unique-code, BV-00437, BV-00538
... id Σ 1..1 id Logical id of this artifact
Max Length:64
... meta Σ 1..1 Meta Metadata about the resource
.... profile Σ 1..* DP_canonical(StructureDefinition) Profiles this resource claims to conform to
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
.... extension:newborn S 0..1 boolean Newborn
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-newborn
.... extension:transfer S 0..1 boolean Transfer
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transfer
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 1..1 DP_Identifier_A 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.
Required Pattern: active
... priority 1..1 DP_CodeableConcept Desired processing priority
Binding: ProcessPriorityCodes (required)
... purpose Σ 1..* DP_code auth-requirements | benefits | discovery | validation
Binding: EligibilityRequestPurpose (required)
... patient Σ 1..1 DP_Reference_1or2a(Nphies Patient) Intended recipient of products and services
.... reference SΣC 0..1 string Literal reference, Relative, internal or absolute URL
Max Length:250
.... identifier SΣ 0..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 .
..... type Σ 1..1 DP_CodeableConcept Description of identifier
Binding: Patient Identifier Type (required)
..... system Σ 1..1 DP_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
Max Length:50
.... display Σ 0..1 string Text alternative for the resource
Max Length:200
... Slices for serviced[x] 1..1 Estimated date or dates of service
Slice: Unordered, Closed by type:$this
.... servicedDate date
.... servicedPeriod Period
.... serviced[x]:servicedDate S 0..1 DP_date Estimated date or dates of service
.... serviced[x]:servicedPeriod S 0..1 DP_Period_2 Estimated date or dates of service
... created Σ 1..1 DP_dateTime Creation date
... provider 1..1 DP_Reference_1or2a(Nphies Provider Organization) Party responsible for the request
.... reference SΣC 0..1 string Literal reference, Relative, internal or absolute URL
Max Length:250
.... identifier SΣ 0..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 .
..... type Σ 1..1 DP_CodeableConcept Description of identifier
Binding: Identifier Type Codes (required)
..... system Σ 1..1 DP_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
Max Length:50
.... display Σ 0..1 string Text alternative for the resource
Max Length:200
... insurer Σ 1..1 DP_Reference_1or2a(Nphies Insurer Organization) Coverage issuer
.... reference SΣC 0..1 string Literal reference, Relative, internal or absolute URL
Max Length:250
.... identifier SΣ 0..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 .
..... type Σ 1..1 DP_CodeableConcept Description of identifier
Binding: Identifier Type Codes (required)
..... system Σ 1..1 DP_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
Max Length:50
.... display Σ 0..1 string Text alternative for the resource
Max Length:200
... facility S 0..1 DP_Reference_1(Nphies Location) Servicing facility
... insurance S 0..* BackboneElement Patient insurance information
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... coverage 1..1 DP_Reference_1(Nphies Coverage) Insurance information

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CoverageEligibilityRequest.​status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​priority Base required Process Priority Codes 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​purpose Base required EligibilityRequestPurpose 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​patient.identifier.use Base required IdentifierUse 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​patient.identifier.type Base required Patient Identifier Type 📦0.4.0 This IG
CoverageEligibilityRequest.​provider.identifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​provider.identifier.​type Base required IdentifierType 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​insurer.identifier.use Base required IdentifierUse 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​insurer.identifier.type Base required IdentifierType 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
BV-00437 error CoverageEligibilityRequest Either CoverageEligibilityRequest.servicedDate or CoverageEligibilityRequest.servicedPeriod SHALL exist. serviced.ofType(date).exists() xor serviced.ofType(Period).exists()
BV-00538 error CoverageEligibilityRequest CoverageEligibilityRequest.status SHALL use the fixed value 'active'. status.exists() implies status = 'active'
dom-2 error CoverageEligibilityRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CoverageEligibilityRequest 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 CoverageEligibilityRequest 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 CoverageEligibilityRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CoverageEligibilityRequest 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()
ksa-purpose-unique-code error CoverageEligibilityRequest Purpose code values must be unique. purpose.exists() implies purpose.isDistinct()

This structure is derived from CoverageEligibilityRequest

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CoverageEligibilityRequest C 0..* CoverageEligibilityRequest CoverageEligibilityRequest resource
Constraints: ksa-purpose-unique-code, BV-00437, BV-00538
... id 1..1 id Logical id of this artifact
Max Length:64
... meta 1..1 Meta Metadata about the resource
.... profile 1..* DP_canonical(StructureDefinition) Profiles this resource claims to conform to
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:newborn S 0..1 boolean Newborn
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-newborn
.... extension:transfer S 0..1 boolean Transfer
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transfer
... status 1..1 code active | cancelled | draft | entered-in-error
Required Pattern: active
... priority 1..1 DP_CodeableConcept Desired processing priority
Binding: ProcessPriorityCodes (required)
... purpose 1..* DP_code auth-requirements | benefits | discovery | validation
Binding: EligibilityRequestPurpose (required)
... patient 1..1 DP_Reference_1or2a(Nphies Patient) Intended recipient of products and services
.... identifier
..... type 1..1 DP_CodeableConcept Description of identifier
Binding: Patient Identifier Type (required)
... Slices for serviced[x] 1..1 date, Period Estimated date or dates of service
Slice: Unordered, Open by type:$this
.... serviced[x]:servicedDate S 0..1 DP_date Estimated date or dates of service
.... serviced[x]:servicedPeriod S 0..1 DP_Period_2 Estimated date or dates of service
... created 1..1 DP_dateTime Creation date
... provider 1..1 DP_Reference_1or2a(Nphies Provider Organization) Party responsible for the request
.... identifier
..... type 1..1 DP_CodeableConcept Description of identifier
Binding: Identifier Type Codes (required)
... insurer 1..1 DP_Reference_1or2a(Nphies Insurer Organization) Coverage issuer
.... identifier
..... type 1..1 DP_CodeableConcept Description of identifier
Binding: Identifier Type Codes (required)
... facility S 0..1 DP_Reference_1(Nphies Location) Servicing facility
... insurance S 0..* BackboneElement Patient insurance information
.... coverage 1..1 DP_Reference_1(Nphies Coverage) Insurance information

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
CoverageEligibilityRequest.​priority Base required Process Priority Codes 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​purpose Base required EligibilityRequestPurpose 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​patient.identifier.type Base required Patient Identifier Type 📦0.4.0 This IG
CoverageEligibilityRequest.​provider.identifier.​type Base required IdentifierType 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​insurer.identifier.type Base required IdentifierType 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
BV-00437 error CoverageEligibilityRequest Either CoverageEligibilityRequest.servicedDate or CoverageEligibilityRequest.servicedPeriod SHALL exist. serviced.ofType(date).exists() xor serviced.ofType(Period).exists()
BV-00538 error CoverageEligibilityRequest CoverageEligibilityRequest.status SHALL use the fixed value 'active'. status.exists() implies status = 'active'
ksa-purpose-unique-code error CoverageEligibilityRequest Purpose code values must be unique. purpose.exists() implies purpose.isDistinct()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CoverageEligibilityRequest C 0..* CoverageEligibilityRequest CoverageEligibilityRequest resource
Constraints: ksa-purpose-unique-code, BV-00437, BV-00538
... id Σ 1..1 id Logical id of this artifact
Max Length:64
... meta Σ 1..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 1..* DP_canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
... 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
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:newborn S 0..1 boolean Newborn
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-newborn
.... extension:transfer S 0..1 boolean Transfer
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transfer
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 1..1 DP_Identifier_A 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.
Required Pattern: active
... priority 1..1 DP_CodeableConcept Desired processing priority
Binding: ProcessPriorityCodes (required)
... purpose Σ 1..* DP_code auth-requirements | benefits | discovery | validation
Binding: EligibilityRequestPurpose (required)
... patient Σ 1..1 DP_Reference_1or2a(Nphies Patient) 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 SΣC 0..1 string Literal reference, Relative, internal or absolute URL
Max Length:250
.... 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 SΣ 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 1..1 DP_CodeableConcept Description of identifier
Binding: Patient Identifier Type (required)
..... system Σ 1..1 DP_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
Max Length:50
..... 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
Max Length:200
... Slices for serviced[x] 1..1 Estimated date or dates of service
Slice: Unordered, Closed by type:$this
.... servicedDate date
.... servicedPeriod Period
.... serviced[x]:servicedDate S 0..1 DP_date Estimated date or dates of service
.... serviced[x]:servicedPeriod S 0..1 DP_Period_2 Estimated date or dates of service
... created Σ 1..1 DP_dateTime Creation date
... enterer 0..1 Reference(Practitioner | PractitionerRole) Author
... provider 1..1 DP_Reference_1or2a(Nphies Provider Organization) 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 SΣC 0..1 string Literal reference, Relative, internal or absolute URL
Max Length:250
.... 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 SΣ 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 1..1 DP_CodeableConcept Description of identifier
Binding: Identifier Type Codes (required)
..... system Σ 1..1 DP_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
Max Length:50
..... 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
Max Length:200
... insurer Σ 1..1 DP_Reference_1or2a(Nphies Insurer Organization) 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 SΣC 0..1 string Literal reference, Relative, internal or absolute URL
Max Length:250
.... 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 SΣ 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 1..1 DP_CodeableConcept Description of identifier
Binding: Identifier Type Codes (required)
..... system Σ 1..1 DP_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
Max Length:50
..... 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
Max Length:200
... facility S 0..1 DP_Reference_1(Nphies Location) Servicing facility
... supportingInfo 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(Resource) Data to be provided
.... appliesToAll 0..1 boolean Applies to all items
... insurance S 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 DP_Reference_1(Nphies Coverage) Insurance information
.... businessArrangement 0..1 string Additional provider contract number
... item 0..* 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 0..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
.... 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(Practitioner | PractitionerRole) Perfoming practitioner
.... quantity 0..1 SimpleQuantity(4.0.1) 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
..... diagnosis[x] 0..1 Nature of illness or problem
Binding: ICD-10Codes (example): ICD10 Diagnostic codes.
...... diagnosisCodeableConcept CodeableConcept
...... diagnosisReference Reference(Condition)
.... detail 0..* Reference(Resource) Product or service details

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CoverageEligibilityRequest.​meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​language Base preferred Common Languages 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​priority Base required Process Priority Codes 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​purpose Base required EligibilityRequestPurpose 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​patient.type Base extensible ResourceType 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​patient.identifier.use Base required IdentifierUse 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​patient.identifier.type Base required Patient Identifier Type 📦0.4.0 This IG
CoverageEligibilityRequest.​provider.type Base extensible ResourceType 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​provider.identifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​provider.identifier.​type Base required IdentifierType 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​insurer.type Base extensible ResourceType 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​insurer.identifier.use Base required IdentifierUse 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​insurer.identifier.type Base required IdentifierType 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​item.category Base example Benefit Category Codes 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​item.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​item.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​item.diagnosis.diagnosis[x] Base example ICD-10 Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
BV-00437 error CoverageEligibilityRequest Either CoverageEligibilityRequest.servicedDate or CoverageEligibilityRequest.servicedPeriod SHALL exist. serviced.ofType(date).exists() xor serviced.ofType(Period).exists()
BV-00538 error CoverageEligibilityRequest CoverageEligibilityRequest.status SHALL use the fixed value 'active'. status.exists() implies status = 'active'
dom-2 error CoverageEligibilityRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CoverageEligibilityRequest 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 CoverageEligibilityRequest 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 CoverageEligibilityRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CoverageEligibilityRequest 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()
ksa-purpose-unique-code error CoverageEligibilityRequest Purpose code values must be unique. purpose.exists() implies purpose.isDistinct()

This structure is derived from CoverageEligibilityRequest

Summary

Mandatory: 7 elements
Must-Support: 6 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of CoverageEligibilityRequest.serviced[x]

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CoverageEligibilityRequest C 0..* CoverageEligibilityRequest CoverageEligibilityRequest resource
Constraints: ksa-purpose-unique-code, BV-00437, BV-00538
... id Σ 1..1 id Logical id of this artifact
Max Length:64
... meta Σ 1..1 Meta Metadata about the resource
.... profile Σ 1..* DP_canonical(StructureDefinition) Profiles this resource claims to conform to
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
.... extension:newborn S 0..1 boolean Newborn
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-newborn
.... extension:transfer S 0..1 boolean Transfer
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transfer
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 1..1 DP_Identifier_A 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.
Required Pattern: active
... priority 1..1 DP_CodeableConcept Desired processing priority
Binding: ProcessPriorityCodes (required)
... purpose Σ 1..* DP_code auth-requirements | benefits | discovery | validation
Binding: EligibilityRequestPurpose (required)
... patient Σ 1..1 DP_Reference_1or2a(Nphies Patient) Intended recipient of products and services
.... reference SΣC 0..1 string Literal reference, Relative, internal or absolute URL
Max Length:250
.... identifier SΣ 0..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 .
..... type Σ 1..1 DP_CodeableConcept Description of identifier
Binding: Patient Identifier Type (required)
..... system Σ 1..1 DP_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
Max Length:50
.... display Σ 0..1 string Text alternative for the resource
Max Length:200
... Slices for serviced[x] 1..1 Estimated date or dates of service
Slice: Unordered, Closed by type:$this
.... servicedDate date
.... servicedPeriod Period
.... serviced[x]:servicedDate S 0..1 DP_date Estimated date or dates of service
.... serviced[x]:servicedPeriod S 0..1 DP_Period_2 Estimated date or dates of service
... created Σ 1..1 DP_dateTime Creation date
... provider 1..1 DP_Reference_1or2a(Nphies Provider Organization) Party responsible for the request
.... reference SΣC 0..1 string Literal reference, Relative, internal or absolute URL
Max Length:250
.... identifier SΣ 0..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 .
..... type Σ 1..1 DP_CodeableConcept Description of identifier
Binding: Identifier Type Codes (required)
..... system Σ 1..1 DP_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
Max Length:50
.... display Σ 0..1 string Text alternative for the resource
Max Length:200
... insurer Σ 1..1 DP_Reference_1or2a(Nphies Insurer Organization) Coverage issuer
.... reference SΣC 0..1 string Literal reference, Relative, internal or absolute URL
Max Length:250
.... identifier SΣ 0..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 .
..... type Σ 1..1 DP_CodeableConcept Description of identifier
Binding: Identifier Type Codes (required)
..... system Σ 1..1 DP_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
Max Length:50
.... display Σ 0..1 string Text alternative for the resource
Max Length:200
... facility S 0..1 DP_Reference_1(Nphies Location) Servicing facility
... insurance S 0..* BackboneElement Patient insurance information
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... coverage 1..1 DP_Reference_1(Nphies Coverage) Insurance information

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CoverageEligibilityRequest.​status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​priority Base required Process Priority Codes 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​purpose Base required EligibilityRequestPurpose 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​patient.identifier.use Base required IdentifierUse 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​patient.identifier.type Base required Patient Identifier Type 📦0.4.0 This IG
CoverageEligibilityRequest.​provider.identifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​provider.identifier.​type Base required IdentifierType 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​insurer.identifier.use Base required IdentifierUse 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​insurer.identifier.type Base required IdentifierType 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
BV-00437 error CoverageEligibilityRequest Either CoverageEligibilityRequest.servicedDate or CoverageEligibilityRequest.servicedPeriod SHALL exist. serviced.ofType(date).exists() xor serviced.ofType(Period).exists()
BV-00538 error CoverageEligibilityRequest CoverageEligibilityRequest.status SHALL use the fixed value 'active'. status.exists() implies status = 'active'
dom-2 error CoverageEligibilityRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CoverageEligibilityRequest 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 CoverageEligibilityRequest 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 CoverageEligibilityRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CoverageEligibilityRequest 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()
ksa-purpose-unique-code error CoverageEligibilityRequest Purpose code values must be unique. purpose.exists() implies purpose.isDistinct()

Differential View

This structure is derived from CoverageEligibilityRequest

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CoverageEligibilityRequest C 0..* CoverageEligibilityRequest CoverageEligibilityRequest resource
Constraints: ksa-purpose-unique-code, BV-00437, BV-00538
... id 1..1 id Logical id of this artifact
Max Length:64
... meta 1..1 Meta Metadata about the resource
.... profile 1..* DP_canonical(StructureDefinition) Profiles this resource claims to conform to
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:newborn S 0..1 boolean Newborn
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-newborn
.... extension:transfer S 0..1 boolean Transfer
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transfer
... status 1..1 code active | cancelled | draft | entered-in-error
Required Pattern: active
... priority 1..1 DP_CodeableConcept Desired processing priority
Binding: ProcessPriorityCodes (required)
... purpose 1..* DP_code auth-requirements | benefits | discovery | validation
Binding: EligibilityRequestPurpose (required)
... patient 1..1 DP_Reference_1or2a(Nphies Patient) Intended recipient of products and services
.... identifier
..... type 1..1 DP_CodeableConcept Description of identifier
Binding: Patient Identifier Type (required)
... Slices for serviced[x] 1..1 date, Period Estimated date or dates of service
Slice: Unordered, Open by type:$this
.... serviced[x]:servicedDate S 0..1 DP_date Estimated date or dates of service
.... serviced[x]:servicedPeriod S 0..1 DP_Period_2 Estimated date or dates of service
... created 1..1 DP_dateTime Creation date
... provider 1..1 DP_Reference_1or2a(Nphies Provider Organization) Party responsible for the request
.... identifier
..... type 1..1 DP_CodeableConcept Description of identifier
Binding: Identifier Type Codes (required)
... insurer 1..1 DP_Reference_1or2a(Nphies Insurer Organization) Coverage issuer
.... identifier
..... type 1..1 DP_CodeableConcept Description of identifier
Binding: Identifier Type Codes (required)
... facility S 0..1 DP_Reference_1(Nphies Location) Servicing facility
... insurance S 0..* BackboneElement Patient insurance information
.... coverage 1..1 DP_Reference_1(Nphies Coverage) Insurance information

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
CoverageEligibilityRequest.​priority Base required Process Priority Codes 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​purpose Base required EligibilityRequestPurpose 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​patient.identifier.type Base required Patient Identifier Type 📦0.4.0 This IG
CoverageEligibilityRequest.​provider.identifier.​type Base required IdentifierType 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​insurer.identifier.type Base required IdentifierType 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
BV-00437 error CoverageEligibilityRequest Either CoverageEligibilityRequest.servicedDate or CoverageEligibilityRequest.servicedPeriod SHALL exist. serviced.ofType(date).exists() xor serviced.ofType(Period).exists()
BV-00538 error CoverageEligibilityRequest CoverageEligibilityRequest.status SHALL use the fixed value 'active'. status.exists() implies status = 'active'
ksa-purpose-unique-code error CoverageEligibilityRequest Purpose code values must be unique. purpose.exists() implies purpose.isDistinct()

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CoverageEligibilityRequest C 0..* CoverageEligibilityRequest CoverageEligibilityRequest resource
Constraints: ksa-purpose-unique-code, BV-00437, BV-00538
... id Σ 1..1 id Logical id of this artifact
Max Length:64
... meta Σ 1..1 Meta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 1..* DP_canonical(StructureDefinition) Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
... 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
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:newborn S 0..1 boolean Newborn
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-newborn
.... extension:transfer S 0..1 boolean Transfer
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transfer
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 1..1 DP_Identifier_A 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.
Required Pattern: active
... priority 1..1 DP_CodeableConcept Desired processing priority
Binding: ProcessPriorityCodes (required)
... purpose Σ 1..* DP_code auth-requirements | benefits | discovery | validation
Binding: EligibilityRequestPurpose (required)
... patient Σ 1..1 DP_Reference_1or2a(Nphies Patient) 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 SΣC 0..1 string Literal reference, Relative, internal or absolute URL
Max Length:250
.... 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 SΣ 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 1..1 DP_CodeableConcept Description of identifier
Binding: Patient Identifier Type (required)
..... system Σ 1..1 DP_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
Max Length:50
..... 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
Max Length:200
... Slices for serviced[x] 1..1 Estimated date or dates of service
Slice: Unordered, Closed by type:$this
.... servicedDate date
.... servicedPeriod Period
.... serviced[x]:servicedDate S 0..1 DP_date Estimated date or dates of service
.... serviced[x]:servicedPeriod S 0..1 DP_Period_2 Estimated date or dates of service
... created Σ 1..1 DP_dateTime Creation date
... enterer 0..1 Reference(Practitioner | PractitionerRole) Author
... provider 1..1 DP_Reference_1or2a(Nphies Provider Organization) 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 SΣC 0..1 string Literal reference, Relative, internal or absolute URL
Max Length:250
.... 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 SΣ 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 1..1 DP_CodeableConcept Description of identifier
Binding: Identifier Type Codes (required)
..... system Σ 1..1 DP_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
Max Length:50
..... 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
Max Length:200
... insurer Σ 1..1 DP_Reference_1or2a(Nphies Insurer Organization) 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 SΣC 0..1 string Literal reference, Relative, internal or absolute URL
Max Length:250
.... 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 SΣ 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 1..1 DP_CodeableConcept Description of identifier
Binding: Identifier Type Codes (required)
..... system Σ 1..1 DP_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
Max Length:50
..... 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
Max Length:200
... facility S 0..1 DP_Reference_1(Nphies Location) Servicing facility
... supportingInfo 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(Resource) Data to be provided
.... appliesToAll 0..1 boolean Applies to all items
... insurance S 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 DP_Reference_1(Nphies Coverage) Insurance information
.... businessArrangement 0..1 string Additional provider contract number
... item 0..* 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 0..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
.... 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(Practitioner | PractitionerRole) Perfoming practitioner
.... quantity 0..1 SimpleQuantity(4.0.1) 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
..... diagnosis[x] 0..1 Nature of illness or problem
Binding: ICD-10Codes (example): ICD10 Diagnostic codes.
...... diagnosisCodeableConcept CodeableConcept
...... diagnosisReference Reference(Condition)
.... detail 0..* Reference(Resource) Product or service details

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CoverageEligibilityRequest.​meta.security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​meta.tag Base example Common Tags 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​language Base preferred Common Languages 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​priority Base required Process Priority Codes 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​purpose Base required EligibilityRequestPurpose 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​patient.type Base extensible ResourceType 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​patient.identifier.use Base required IdentifierUse 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​patient.identifier.type Base required Patient Identifier Type 📦0.4.0 This IG
CoverageEligibilityRequest.​provider.type Base extensible ResourceType 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​provider.identifier.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​provider.identifier.​type Base required IdentifierType 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​insurer.type Base extensible ResourceType 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​insurer.identifier.use Base required IdentifierUse 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​insurer.identifier.type Base required IdentifierType 📦4.0.1 FHIR Std.
CoverageEligibilityRequest.​item.category Base example Benefit Category Codes 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​item.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​item.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
CoverageEligibilityRequest.​item.diagnosis.diagnosis[x] Base example ICD-10 Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
BV-00437 error CoverageEligibilityRequest Either CoverageEligibilityRequest.servicedDate or CoverageEligibilityRequest.servicedPeriod SHALL exist. serviced.ofType(date).exists() xor serviced.ofType(Period).exists()
BV-00538 error CoverageEligibilityRequest CoverageEligibilityRequest.status SHALL use the fixed value 'active'. status.exists() implies status = 'active'
dom-2 error CoverageEligibilityRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error CoverageEligibilityRequest 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 CoverageEligibilityRequest 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 CoverageEligibilityRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice CoverageEligibilityRequest 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()
ksa-purpose-unique-code error CoverageEligibilityRequest Purpose code values must be unique. purpose.exists() implies purpose.isDistinct()

This structure is derived from CoverageEligibilityRequest

Summary

Mandatory: 7 elements
Must-Support: 6 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of CoverageEligibilityRequest.serviced[x]

 

Other representations of profile: CSV, Excel, Schematron