FHIR © HL7.org  |  Server Home  |  Health Intersections FHIR Server v1.0.197  |  FHIR Version 3.0.1  | User: ANONYMOUS (Unknown)  

History Record

XML or JSON representation

Links: First Previous Next Last  (4 found). Search: http://test.fhir.org/r3/EligibilityResponse/_history?&_prior=2017-12-12T08:16:37Z&_format=text/xhtml&history-id=82885a54-3628-48e6-a20b-269fafe163 

SQL (for debugging): Insert into SearchEntries Select 7021, Ids.ResourceKey, Versions.ResourceVersionKey, RIGHT ('0000000000000'+CAST(Versions.ResourceVersionKey AS VARCHAR(14)),14) as sort, null, null from Versions, Ids, Sessions where Ids.ResourceTypeKey = 41 and Versions.ResourceKey = Ids.ResourceKey and Versions.SessionKey = Sessions.SessionKey order by ResourceVersionKey DESC

EligibilityResponse "E2500" Version "1"

Created by SYSTEM () at 11/28/2017 8:30:40 AM(UTC)

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the EligibilityResponse.

<?xml version="1.0" encoding="UTF-8"?>
<EligibilityResponse xmlns="http://hl7.org/fhir">
  <id value="E2500"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2017-11-28T08:30:40Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the EligibilityResponse.</div>
  </text>
  <identifier>
    <system value="http://www.BenefitsInc.com/fhir/eligibilityresponse"/>
    <value value="881234"/>
  </identifier>
  <status value="active"/>
  <created value="2014-08-16"/>
  <request>
    <reference value="http://www.BenefitsInc.com/fhir/eligibility/225476332402"/>
  </request>
  <outcome>
    <coding>
      <system value="http://hl7.org/fhir/remittance-outcome"/>
      <code value="complete"/>
    </coding>
  </outcome>
  <disposition value="Policy is currently in-force."/>
  <insurer>
    <reference value="Organization/2"/>
  </insurer>
  <inforce value="true"/>
</EligibilityResponse>

EligibilityResponse "E2503" Version "1"

Created by SYSTEM () at 11/28/2017 8:30:40 AM(UTC)

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the EligibilityResponse.

<?xml version="1.0" encoding="UTF-8"?>
<EligibilityResponse xmlns="http://hl7.org/fhir">
  <id value="E2503"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2017-11-28T08:30:40Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the EligibilityResponse.</div>
  </text>
  <identifier>
    <system value="http://www.BenefitsInc.com/fhir/eligibilityresponse"/>
    <value value="8812343"/>
  </identifier>
  <status value="active"/>
  <created value="2014-09-16"/>
  <requestProvider>
    <identifier>
      <system value="http://national.org/provider"/>
      <value value="PR9876"/>
    </identifier>
  </requestProvider>
  <requestOrganization>
    <identifier>
      <system value="http://national.org/clinic"/>
      <value value="OR1234"/>
    </identifier>
  </requestOrganization>
  <request>
    <reference value="http://www.BenefitsInc.com/fhir/eligibility/225476332406"/>
  </request>
  <outcome>
    <coding>
      <system value="http://hl7.org/fhir/remittance-outcome"/>
      <code value="error"/>
    </coding>
  </outcome>
  <disposition value="Eligibiliy request could not be processed, please address errors before submitting."/>
  <insurer>
    <reference value="Organization/2"/>
  </insurer>
  <form>
    <coding>
      <system value="http://national.org/form"/>
      <code value="ELRSP/2017/01"/>
    </coding>
  </form>
  <error>
    <code>
      <coding>
        <system value="http://hl7.org/fhir/adjudication-error"/>
        <code value="a001"/>
      </coding>
    </code>
  </error>
</EligibilityResponse>

EligibilityResponse "E2501" Version "1"

Created by SYSTEM () at 11/28/2017 8:30:40 AM(UTC)

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the EligibilityResponse.

<?xml version="1.0" encoding="UTF-8"?>
<EligibilityResponse xmlns="http://hl7.org/fhir">
  <id value="E2501"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2017-11-28T08:30:40Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the EligibilityResponse.</div>
  </text>
  <identifier>
    <system value="http://www.BenefitsInc.com/fhir/eligibilityresponse"/>
    <value value="881234"/>
  </identifier>
  <status value="active"/>
  <created value="2014-08-16"/>
  <request>
    <reference value="http://www.BenefitsInc.com/fhir/eligibility/225476332402"/>
  </request>
  <outcome>
    <coding>
      <system value="http://hl7.org/fhir/remittance-outcome"/>
      <code value="complete"/>
    </coding>
  </outcome>
  <disposition value="Policy is currently in-force."/>
  <insurer>
    <reference value="Organization/2"/>
  </insurer>
  <inforce value="true"/>
  <insurance>
    <benefitBalance>
      <category>
        <coding>
          <system value="http://hl7.org/fhir/benefit-category"/>
          <code value="medical"/>
        </coding>
      </category>
      <subCategory>
        <coding>
          <system value="http://hl7.org/fhir/benefit-subcategory"/>
          <code value="30"/>
          <display value="Health Benefit Plan Coverage"/>
        </coding>
      </subCategory>
      <network>
        <coding>
          <system value="http://hl7.org/fhir/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://hl7.org/fhir/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://hl7.org/fhir/benefit-term"/>
          <code value="annual"/>
        </coding>
      </term>
      <financial>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="500000"/>
          <system value="urn:iso:std:iso:4217"/>
          <code value="SAR"/>
        </allowedMoney>
      </financial>
      <financial>
        <type>
          <coding>
            <code value="copay-maximum"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="100"/>
          <system value="urn:iso:std:iso:4217"/>
          <code value="SAR"/>
        </allowedMoney>
      </financial>
      <financial>
        <type>
          <coding>
            <code value="copay-percent"/>
          </coding>
        </type>
        <allowedUnsignedInt value="20"/>
      </financial>
    </benefitBalance>
    <benefitBalance>
      <category>
        <coding>
          <system value="http://hl7.org/fhir/benefit-category"/>
          <code value="medical"/>
        </coding>
      </category>
      <subCategory>
        <coding>
          <system value="http://hl7.org/fhir/benefit-subcategory"/>
          <code value="69"/>
          <display value="Maternity"/>
        </coding>
      </subCategory>
      <network>
        <coding>
          <system value="http://hl7.org/fhir/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://hl7.org/fhir/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://hl7.org/fhir/benefit-term"/>
          <code value="annual"/>
        </coding>
      </term>
      <financial>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="15000"/>
          <system value="urn:iso:std:iso:4217"/>
          <code value="SAR"/>
        </allowedMoney>
      </financial>
    </benefitBalance>
    <benefitBalance>
      <category>
        <coding>
          <system value="http://hl7.org/fhir/benefit-category"/>
          <code value="oral"/>
        </coding>
      </category>
      <subCategory>
        <coding>
          <system value="http://hl7.org/fhir/benefit-subcategory"/>
          <code value="F3"/>
          <display value="Dental Coverage"/>
        </coding>
      </subCategory>
      <network>
        <coding>
          <system value="http://hl7.org/fhir/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://hl7.org/fhir/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://hl7.org/fhir/benefit-term"/>
          <code value="annual"/>
        </coding>
      </term>
      <financial>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="2000"/>
          <system value="urn:iso:std:iso:4217"/>
          <code value="SAR"/>
        </allowedMoney>
      </financial>
    </benefitBalance>
    <benefitBalance>
      <category>
        <coding>
          <system value="http://hl7.org/fhir/benefit-category"/>
          <code value="vision"/>
        </coding>
      </category>
      <subCategory>
        <coding>
          <system value="http://hl7.org/fhir/benefit-subcategory"/>
          <code value="F6"/>
          <display value="Vision Coverage"/>
        </coding>
      </subCategory>
      <network>
        <coding>
          <system value="http://hl7.org/fhir/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://hl7.org/fhir/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://hl7.org/fhir/benefit-term"/>
          <code value="annual"/>
        </coding>
      </term>
      <financial>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="400"/>
          <system value="urn:iso:std:iso:4217"/>
          <code value="SAR"/>
        </allowedMoney>
      </financial>
    </benefitBalance>
    <benefitBalance>
      <category>
        <coding>
          <system value="http://hl7.org/fhir/benefit-category"/>
          <code value="vision"/>
        </coding>
      </category>
      <subCategory>
        <coding>
          <system value="http://hl7.org/fhir/benefit-subcategory"/>
          <code value="49"/>
          <display value="Hospital Room and Board"/>
        </coding>
      </subCategory>
      <network>
        <coding>
          <system value="http://hl7.org/fhir/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://hl7.org/fhir/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://hl7.org/fhir/benefit-term"/>
          <code value="day"/>
        </coding>
      </term>
      <financial>
        <type>
          <coding>
            <code value="room"/>
          </coding>
        </type>
        <allowedString value="shared"/>
      </financial>
      <financial>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="600"/>
          <system value="urn:iso:std:iso:4217"/>
          <code value="SAR"/>
        </allowedMoney>
      </financial>
    </benefitBalance>
  </insurance>
</EligibilityResponse>

EligibilityResponse "E2502" Version "1"

Created by SYSTEM () at 11/28/2017 8:30:40 AM(UTC)

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the EligibilityResponse.

<?xml version="1.0" encoding="UTF-8"?>
<EligibilityResponse xmlns="http://hl7.org/fhir">
  <id value="E2502"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2017-11-28T08:30:40Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the EligibilityResponse.</div>
  </text>
  <contained>
    <Patient>
      <id value="patient-1"/>
      <name>
        <use value="official"/>
        <family value="Donald"/>
        <given value="Duck"/>
      </name>
      <gender value="male"/>
      <birthDate value="1986-05-17"/>
      <address>
        <use value="home"/>
        <line value="1234 Main Street"/>
        <city value="Vancouver"/>
        <postalCode value="V2H1Y3"/>
        <country value="CAD"/>
      </address>
    </Patient>
  </contained>
  <contained>
    <Coverage>
      <id value="coverage-1"/>
      <identifier>
        <system value="http://benefitsinc.com/certificate"/>
        <value value="12345"/>
      </identifier>
      <status value="active"/>
      <type>
        <coding>
          <system value="http://hl7.org/fhir/v3/ActCode"/>
          <code value="EHCPOL"/>
        </coding>
      </type>
      <subscriber>
        <reference value="#patient-1"/>
      </subscriber>
      <beneficiary>
        <reference value="#patient-1"/>
      </beneficiary>
      <relationship>
        <coding>
          <code value="self"/>
        </coding>
      </relationship>
      <payor>
        <identifier>
          <system value="http://www.bindb.com/bin"/>
          <value value="123456"/>
        </identifier>
      </payor>
      <grouping>
        <plan value="CBI35"/>
        <planDisplay value="Corporate Baker's Inc. Plan#35"/>
        <subPlan value="123"/>
        <subPlanDisplay value="Trainee Part-time Benefits"/>
      </grouping>
      <dependent value="1"/>
      <sequence value="1"/>
    </Coverage>
  </contained>
  <identifier>
    <system value="http://www.BenefitsInc.com/fhir/eligibilityresponse"/>
    <value value="8812342"/>
  </identifier>
  <status value="active"/>
  <created value="2014-09-16"/>
  <requestProvider>
    <identifier>
      <system value="http://national.org/provider"/>
      <value value="PR9876"/>
    </identifier>
  </requestProvider>
  <requestOrganization>
    <identifier>
      <system value="http://national.org/clinic"/>
      <value value="OR1234"/>
    </identifier>
  </requestOrganization>
  <request>
    <reference value="http://www.BenefitsInc.com/fhir/eligibility/225476332405"/>
  </request>
  <outcome>
    <coding>
      <system value="http://hl7.org/fhir/remittance-outcome"/>
      <code value="complete"/>
    </coding>
  </outcome>
  <disposition value="Policy is currently in-force."/>
  <insurer>
    <reference value="Organization/2"/>
  </insurer>
  <inforce value="true"/>
  <insurance>
    <coverage>
      <reference value="#coverage-1"/>
    </coverage>
    <contract>
      <reference value="http://www.BenefitsInc.com/fhir/contract/NBU22547"/>
    </contract>
    <benefitBalance>
      <category>
        <coding>
          <system value="http://hl7.org/fhir/benefit-category"/>
          <code value="medical"/>
        </coding>
      </category>
      <subCategory>
        <coding>
          <system value="http://hl7.org/fhir/benefit-subcategory"/>
          <code value="30"/>
          <display value="Health Benefit Plan Coverage"/>
        </coding>
      </subCategory>
      <network>
        <coding>
          <system value="http://hl7.org/fhir/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://hl7.org/fhir/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://hl7.org/fhir/benefit-term"/>
          <code value="annual"/>
        </coding>
      </term>
      <financial>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="500000"/>
          <system value="urn:iso:std:iso:4217"/>
          <code value="USD"/>
        </allowedMoney>
        <usedMoney>
          <value value="3748.00"/>
          <system value="urn:iso:std:iso:4217"/>
          <code value="USD"/>
        </usedMoney>
      </financial>
      <financial>
        <type>
          <coding>
            <code value="copay-maximum"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="100"/>
          <system value="urn:iso:std:iso:4217"/>
          <code value="USD"/>
        </allowedMoney>
      </financial>
      <financial>
        <type>
          <coding>
            <code value="copay-percent"/>
          </coding>
        </type>
        <allowedUnsignedInt value="20"/>
      </financial>
    </benefitBalance>
    <benefitBalance>
      <category>
        <coding>
          <system value="http://hl7.org/fhir/benefit-category"/>
          <code value="medical"/>
        </coding>
      </category>
      <subCategory>
        <coding>
          <system value="http://hl7.org/fhir/benefit-subcategory"/>
          <code value="69"/>
          <display value="Maternity"/>
        </coding>
      </subCategory>
      <network>
        <coding>
          <system value="http://hl7.org/fhir/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://hl7.org/fhir/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://hl7.org/fhir/benefit-term"/>
          <code value="annual"/>
        </coding>
      </term>
      <financial>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="15000"/>
          <system value="urn:iso:std:iso:4217"/>
          <code value="USD"/>
        </allowedMoney>
      </financial>
    </benefitBalance>
    <benefitBalance>
      <category>
        <coding>
          <system value="http://hl7.org/fhir/benefit-category"/>
          <code value="oral"/>
        </coding>
      </category>
      <subCategory>
        <coding>
          <system value="http://hl7.org/fhir/benefit-subcategory"/>
          <code value="F3"/>
          <display value="Dental Coverage"/>
        </coding>
      </subCategory>
      <network>
        <coding>
          <system value="http://hl7.org/fhir/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://hl7.org/fhir/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://hl7.org/fhir/benefit-term"/>
          <code value="annual"/>
        </coding>
      </term>
      <financial>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="2000"/>
          <system value="urn:iso:std:iso:4217"/>
          <code value="USD"/>
        </allowedMoney>
      </financial>
    </benefitBalance>
    <benefitBalance>
      <category>
        <coding>
          <system value="http://hl7.org/fhir/benefit-category"/>
          <code value="vision"/>
        </coding>
      </category>
      <subCategory>
        <coding>
          <system value="http://hl7.org/fhir/benefit-subcategory"/>
          <code value="F6"/>
          <display value="Vision Coverage"/>
        </coding>
      </subCategory>
      <excluded value="true"/>
      <name value="Vision"/>
      <description value="Vision products and services such as exams, glasses and contatc lenses."/>
    </benefitBalance>
  </insurance>
  <form>
    <coding>
      <system value="http://national.org/form"/>
      <code value="ELRSP/2017/01"/>
    </coding>
  </form>
</EligibilityResponse>