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 @