PREFIX fhir: PREFIX fhirvs: PREFIX xsd: BASE start=@ AND {fhir:nodeRole [fhir:treeRoot]} # CoverageEligibilityResponse resource CLOSED { a [fhir:CoverageEligibilityResponse]; fhir:nodeRole [fhir:treeRoot]?; fhir:Resource.id id?; # Logical id of this artifact fhir:Resource.meta @?; # Metadata about the resource fhir:Resource.implicitRules @?; # A set of rules under which this # content was created fhir:Resource.language @?; # Language of the resource content fhir:DomainResource.text @?; # Text summary of the resource, for # human interpretation fhir:DomainResource.contained @*; # Contained, inline Resources fhir:DomainResource.extension @*; # Additional content defined by # implementations fhir:DomainResource.modifierExtension @*; # Extensions that cannot be ignored fhir:CoverageEligibilityResponse.identifier @*; # Business Identifier for coverage # eligiblity request fhir:CoverageEligibilityResponse.status @ AND {fhir:value @fhirvs:fm-status}; # active | cancelled | draft | # entered-in-error fhir:CoverageEligibilityResponse.purpose @ AND {fhir:value @fhirvs:eligibilityresponse-purpose}+; # auth-requirements | benefits | # discovery | validation fhir:CoverageEligibilityResponse.patient @; # Intended recipient of products and # services ( # Estimated date or dates of service fhir:CoverageEligibilityResponse.servicedDate @ | fhir:CoverageEligibilityResponse.servicedPeriod @ )?; fhir:CoverageEligibilityResponse.created @; # Response creation date fhir:CoverageEligibilityResponse.requestor @?; # Party responsible for the request fhir:CoverageEligibilityResponse.request @; # Eligibility request reference fhir:CoverageEligibilityResponse.outcome @ AND {fhir:value @fhirvs:remittance-outcome}; # queued | complete | error | partial fhir:CoverageEligibilityResponse.disposition @?; # Disposition Message fhir:CoverageEligibilityResponse.insurer @; # Coverage issuer fhir:CoverageEligibilityResponse.insurance @*; # Patient insurance information fhir:CoverageEligibilityResponse.preAuthRef @?; # Preauthorization reference fhir:CoverageEligibilityResponse.form @?; # Printed form identifier fhir:CoverageEligibilityResponse.error @*; # Processing errors fhir:index xsd:integer? # Relative position in a list } # Processing errors CLOSED { fhir:Element.id string?; # Unique id for inter-element # referencing fhir:Element.extension @*; # Additional content defined by # implementations fhir:BackboneElement.modifierExtension @*; # Extensions that cannot be ignored # even if unrecognized fhir:CoverageEligibilityResponse.error.code @; # Error code detailing processing # issues fhir:index xsd:integer? # Relative position in a list } # Patient insurance information CLOSED { fhir:Element.id string?; # Unique id for inter-element # referencing fhir:Element.extension @*; # Additional content defined by # implementations fhir:BackboneElement.modifierExtension @*; # Extensions that cannot be ignored # even if unrecognized fhir:CoverageEligibilityResponse.insurance.coverage @; # Insurance information fhir:CoverageEligibilityResponse.insurance.inforce @?; # Coverage inforce indicator fhir:CoverageEligibilityResponse.insurance.benefitPeriod @?; # When the benefits are applicable fhir:CoverageEligibilityResponse.insurance.item @*; # Benefits and authorization details fhir:index xsd:integer? # Relative position in a list } # Benefits and authorization details CLOSED { fhir:Element.id string?; # Unique id for inter-element # referencing fhir:Element.extension @*; # Additional content defined by # implementations fhir:BackboneElement.modifierExtension @*; # Extensions that cannot be ignored # even if unrecognized fhir:CoverageEligibilityResponse.insurance.item.category @?; # Benefit classification fhir:CoverageEligibilityResponse.insurance.item.productOrService @?; # Billing, service, product, or drug # code fhir:CoverageEligibilityResponse.insurance.item.modifier @*; # Product or service billing # modifiers fhir:CoverageEligibilityResponse.insurance.item.provider @?; # Performing practitioner fhir:CoverageEligibilityResponse.insurance.item.excluded @?; # Excluded from the plan fhir:CoverageEligibilityResponse.insurance.item.name @?; # Short name for the benefit fhir:CoverageEligibilityResponse.insurance.item.description @?; # Description of the benefit or # services covered fhir:CoverageEligibilityResponse.insurance.item.network @?; # In or out of network fhir:CoverageEligibilityResponse.insurance.item.unit @?; # Individual or family fhir:CoverageEligibilityResponse.insurance.item.term @?; # Annual or lifetime fhir:CoverageEligibilityResponse.insurance.item.benefit @*; # Benefit Summary fhir:CoverageEligibilityResponse.insurance.item.authorizationRequired @?; # Authorization required flag fhir:CoverageEligibilityResponse.insurance.item.authorizationSupporting @*; # Type of required supporting # materials fhir:CoverageEligibilityResponse.insurance.item.authorizationUrl @?; # Preauthorization requirements # endpoint fhir:index xsd:integer? # Relative position in a list } # Benefit Summary CLOSED { fhir:Element.id string?; # Unique id for inter-element # referencing fhir:Element.extension @*; # Additional content defined by # implementations fhir:BackboneElement.modifierExtension @*; # Extensions that cannot be ignored # even if unrecognized fhir:CoverageEligibilityResponse.insurance.item.benefit.type @; # Benefit classification ( # Benefits allowed fhir:CoverageEligibilityResponse.insurance.item.benefit.allowedUnsignedInt @ | fhir:CoverageEligibilityResponse.insurance.item.benefit.allowedString @ | fhir:CoverageEligibilityResponse.insurance.item.benefit.allowedMoney @ )?; ( # Benefits used fhir:CoverageEligibilityResponse.insurance.item.benefit.usedUnsignedInt @ | fhir:CoverageEligibilityResponse.insurance.item.benefit.usedString @ | fhir:CoverageEligibilityResponse.insurance.item.benefit.usedMoney @ )?; fhir:index xsd:integer? # Relative position in a list } #---------------------- Data Types ------------------- # Primitive Type date CLOSED { fhir:Element.id string?; # xml:id (or equivalent in JSON) fhir:Element.extension @*; # Additional content defined by # implementations fhir:value date?; # Primitive value for date fhir:index xsd:integer? # Relative position in a list } # Primitive Type dateTime CLOSED { fhir:Element.id string?; # xml:id (or equivalent in JSON) fhir:Element.extension @*; # Additional content defined by # implementations fhir:value dateTime?; # Primitive value for dateTime fhir:index xsd:integer? # Relative position in a list } # Metadata about a resource CLOSED { fhir:Element.id id?; # Unique id for inter-element # referencing fhir:Element.extension @*; # Additional content defined by # implementations fhir:Meta.versionId @?; # Version specific identifier fhir:Meta.lastUpdated @?; # When the resource version last # changed fhir:Meta.source @?; # Identifies where the resource # comes from fhir:Meta.profile @*; # Profiles this resource claims to # conform to fhir:Meta.security @*; # Security Labels applied to this # resource fhir:Meta.tag @*; # Tags applied to this resource fhir:index xsd:integer? # Relative position in a list } # Primitive Type code CLOSED { fhir:Element.id string?; # xml:id (or equivalent in JSON) fhir:Element.extension @*; # Additional content defined by # implementations fhir:value code?; # Primitive value for code fhir:index xsd:integer? # Relative position in a list } # Primitive Type string CLOSED { fhir:Element.id string?; # xml:id (or equivalent in JSON) fhir:Element.extension @*; # Additional content defined by # implementations fhir:value string MAXLENGTH 1048576?; # Primitive value for string fhir:index xsd:integer? # Relative position in a list } # A reference from one resource to another CLOSED { fhir:link IRI?; fhir:Element.id id?; # Unique id for inter-element # referencing fhir:Element.extension @*; # Additional content defined by # implementations fhir:Reference.reference @?; # Literal reference, Relative, # internal or absolute URL fhir:Reference.type @?; # Type the reference refers to (e.g. # "Patient") fhir:Reference.identifier @?; # Logical reference, when literal # reference is not known fhir:Reference.display @?; # Text alternative for the resource fhir:index xsd:integer? # Relative position in a list } # Base Resource {a .+; fhir:Resource.id id?; # Logical id of this artifact fhir:Resource.meta @?; # Metadata about the resource fhir:Resource.implicitRules @?; # A set of rules under which this # content was created fhir:Resource.language @?; # Language of the resource content fhir:index xsd:integer? } # Time range defined by start and end date/time CLOSED { fhir:Element.id id?; # Unique id for inter-element # referencing fhir:Element.extension @*; # Additional content defined by # implementations fhir:Period.start @?; # Starting time with inclusive # boundary fhir:Period.end @?; # End time with inclusive boundary, # if not ongoing fhir:index xsd:integer? # Relative position in a list } # Primitive Type uri CLOSED { fhir:Element.id string?; # xml:id (or equivalent in JSON) fhir:Element.extension @*; # Additional content defined by # implementations fhir:value uri?; # Primitive value for uri fhir:index xsd:integer? # Relative position in a list } # Optional Extensions Element CLOSED { fhir:Element.id id?; fhir:Element.extension @*; fhir:Extension.url uri; ( fhir:Extension.valueBase64Binary @ | fhir:Extension.valueBoolean @ | fhir:Extension.valueCanonical @ | fhir:Extension.valueCode @ | fhir:Extension.valueDate @ | fhir:Extension.valueDateTime @ | fhir:Extension.valueDecimal @ | fhir:Extension.valueId @ | fhir:Extension.valueInstant @ | fhir:Extension.valueInteger @ | fhir:Extension.valueMarkdown @ | fhir:Extension.valueOid @ | fhir:Extension.valuePositiveInt @ | fhir:Extension.valueString @ | fhir:Extension.valueTime @