SHACoverageEligibilityResponse
type: StructureDefinition
node role: treeRoot
id:
  v: SHACoverageEligibilityResponse
text:
  status:
    v: extensions
  div: Generated Narrative: StructureDefinition SHACoverageEligibilityResponse Name Flags Card. Type Description & Constraints CoverageEligibilityResponse 0..* CoverageEligibilityResponse CoverageEligibilityResponse resource id 1..1 id A logical identifier for the messageHeader resource. meta 1..1 Meta Metadata about a resource profile 1..* canonical(StructureDefinition) Profiles this resource claims to conform to Slices for extension 0..* Extension Optional Extensions Element Slice: Unordered, Open by value:url siteEligibility 0..* CodeableConcept SiteEligibility URL: https://shr.tiberbuapps.com/fhir/StructureDefinition/site-eligibility identifier 1..1 Identifier A business unique identifier for the CoverageEligibilityResponse resource. status 1..1 code Financial Resource Status Code. Must use the fixed value 'active' Required Pattern: active purpose 1..* code EligibilityResponsePurpose patient 1..1 Reference(SHAPatient) Intended recipient of products and services. A reference Patient resource Slices for serviced[x] 0..1 date, Period Estimated date or dates of service Slice: Unordered, Open by type:$this serviced[x]:servicedDate 0..1 date The date or dates when the enclosed suite of services were performed or completed. serviced[x]:servicedPeriod 0..1 Period The period when the enclosed suite of services were performed or completed. created 1..1 dateTime Creation date of this CoverageEligibilityRequest request 1..1 Reference(SHACoverageEligibilityRequest) Eligibility request reference. A reference to the CoverageEligibilityRequest message outcome 1..1 code Payer processing outcome. disposition 0..1 string A human readable description of the status of the adjudication. insurer 1..1 Reference(SHAOrganization) Coverage issuer. A reference to the payor organization license issed by the regulator and maintained in the registry. Use the reference.identifier for well know identifiers. insurance 0..* BackboneElement Financial instruments for reimbursement for the health care prod…
url:
  v: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHACoverageEligibilityResponse
version:
  v: 0.1.0
name:
  v: SHACoverageEligibilityResponse
title:
  v: SHACoverageEligibilityResponse
status:
  v: draft
date:
  v: 2024-09-06T09:59:02+00:00
publisher:
  v: intellisoftkenya
contact:
  name:
    v: intellisoftkenya
  telecom:
    system:
      v: url
    value:
      v: http://example.org/example-publisher
description:
  v: An example of a CoverageEligibilityResponse profile
fhir version:
  v: 4.0.1
mapping:
  identity:
    v: workflow
  uri:
    v: http://hl7.org/fhir/workflow
  name:
    v: Workflow Pattern
mapping:
  identity:
    v: w5
  uri:
    v: http://hl7.org/fhir/fivews
  name:
    v: FiveWs Pattern Mapping
mapping:
  identity:
    v: cdanetv4
  uri:
    v: http://www.cda-adc.ca/en/services/cdanet/
  name:
    v: Canadian Dental Association eclaims standard
mapping:
  identity:
    v: rim
  uri:
    v: http://hl7.org/v3
  name:
    v: RIM Mapping
kind:
  v: resource
abstract:
  v: false
type:
  v: CoverageEligibilityResponse
base definition:
  v: http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse
  link: http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse
derivation:
  v: constraint
snapshot:
  element:
    id:
      v: CoverageEligibilityResponse
    path:
      v: CoverageEligibilityResponse
    short:
      v: CoverageEligibilityResponse resource
    definition:
      v: This resource provides eligibility and plan details from the processing of an CoverageEligibilityRequest resource.
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: CoverageEligibilityResponse
      min:
        v: 0
      max:
        v: *
    constraint:
      key:
        v: dom-2
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL NOT contain nested Resources
      expression:
        v: contained.contained.empty()
      xpath:
        v: not(parent::f:contained and f:contained)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    constraint:
      key:
        v: dom-3
      severity:
        v: error
      human:
        v: 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
      expression:
        v: 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()
      xpath:
        v: not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    constraint:
      key:
        v: dom-4
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
      expression:
        v: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
      xpath:
        v: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    constraint:
      key:
        v: dom-5
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a security label
      expression:
        v: contained.meta.security.empty()
      xpath:
        v: not(exists(f:contained/*/f:meta/f:security))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    constraint:
      key:
        v: dom-6
      severity:
        v: warning
      human:
        v: A resource should have narrative for robust management
      expression:
        v: text.`div`.exists()
      xpath:
        v: exists(f:text/h:div)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        link: http://hl7.org/fhir/StructureDefinition/DomainResource
    is modifier:
      v: false
    is summary:
      v: false
    mapping:
      identity:
        v: rim
      map:
        v: Entity. Role, or Act
    mapping:
      identity:
        v: workflow
      map:
        v: Event
  element:
    id:
      v: CoverageEligibilityResponse.id
    path:
      v: CoverageEligibilityResponse.id
    short:
      v: A logical identifier for the messageHeader resource.
    definition:
      v: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
    comment:
      v: The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
    min:
      v: 1
    max:
      v: 1
    base:
      path:
        v: Resource.id
      min:
        v: 0
      max:
        v: 1
    type:
      code:
        v: http://hl7.org/fhirpath/System.String

v: true

v: When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.

v: id

v: false

v: true

id:
  v: CoverageEligibilityResponse.meta
path:
  v: CoverageEligibilityResponse.meta
short:
  v: Metadata about a resource
definition:
  v: The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Resource.meta
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Meta
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: CoverageEligibilityResponse.meta.id
path:
  v: CoverageEligibilityResponse.meta.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value:
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: CoverageEligibilityResponse.meta.extension
path:
  v: CoverageEligibilityResponse.meta.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: CoverageEligibilityResponse.meta.versionId
path:
  v: CoverageEligibilityResponse.meta.versionId
short:
  v: Version specific identifier
definition:
  v: The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
comment:
  v: The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Meta.versionId
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: id
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: CoverageEligibilityResponse.meta.lastUpdated
path:
  v: CoverageEligibilityResponse.meta.lastUpdated
short:
  v: When the resource version last changed
definition:
  v: When the resource last changed - e.g. when the version changed.
comment:
  v: This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http://hl7.org/fhir/R4/http.html#read) interaction.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Meta.lastUpdated
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: instant
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: CoverageEligibilityResponse.meta.source
path:
  v: CoverageEligibilityResponse.meta.source
short:
  v: Identifies where the resource comes from
definition:
  v: A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
comment:
  v: In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Meta.source
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: CoverageEligibilityResponse.meta.profile
path:
  v: CoverageEligibilityResponse.meta.profile
short:
  v: Profiles this resource claims to conform to
definition:
  v: A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).
comment:
  v: It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
min:
  v: 1
max:
  v: *
base:
  path:
    v: Meta.profile
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: canonical
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/StructureDefinition
    link: http://hl7.org/fhir/StructureDefinition/StructureDefinition
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: CoverageEligibilityResponse.meta.security
path:
  v: CoverageEligibilityResponse.meta.security
short:
  v: Security Labels applied to this resource
definition:
  v: Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
comment:
  v: The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Meta.security
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: SecurityLabels
  strength:
    v: extensible
  description:
    v: Security Labels from the Healthcare Privacy and Security Classification System.
  value set:
    v: http://hl7.org/fhir/ValueSet/security-labels
    link: http://hl7.org/fhir/ValueSet/security-labels

id:
  v: CoverageEligibilityResponse.meta.tag
path:
  v: CoverageEligibilityResponse.meta.tag
short:
  v: Tags applied to this resource
definition:
  v: Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
comment:
  v: The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Meta.tag
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Coding
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: Tags
  strength:
    v: example
  description:
    v: Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
  value set:
    v: http://hl7.org/fhir/ValueSet/common-tags
    link: http://hl7.org/fhir/ValueSet/common-tags

id:
  v: CoverageEligibilityResponse.implicitRules
path:
  v: CoverageEligibilityResponse.implicitRules
short:
  v: A set of rules under which this content was created
definition:
  v: A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
comment:
  v: Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.implicitRules
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
is summary:
  v: true

id:
  v: CoverageEligibilityResponse.language
path:
  v: CoverageEligibilityResponse.language
short:
  v: Language of the resource content
definition:
  v: The base language in which the resource is written.
comment:
  v: Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.language
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet
    value:
      v: http://hl7.org/fhir/ValueSet/all-languages
      link: http://hl7.org/fhir/ValueSet/all-languages
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: Language
  strength:
    v: preferred
  description:
    v: A human language.
  value set:
    v: http://hl7.org/fhir/ValueSet/languages
    link: http://hl7.org/fhir/ValueSet/languages

id:
  v: CoverageEligibilityResponse.text
path:
  v: CoverageEligibilityResponse.text
short:
  v: Text summary of the resource, for human interpretation
definition:
  v: A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
comment:
  v: Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
alias:
  v: narrative
alias:
  v: html
alias:
  v: xhtml
alias:
  v: display
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Narrative
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: Act.text?

id:
  v: CoverageEligibilityResponse.contained
path:
  v: CoverageEligibilityResponse.contained
short:
  v: Contained, inline Resources
definition:
  v: These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
comment:
  v: This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
alias:
  v: inline resources
alias:
  v: anonymous resources
alias:
  v: contained resources
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.contained
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Resource
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: CoverageEligibilityResponse.extension
path:
  v: CoverageEligibilityResponse.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  ordered:
    v: false
  rules:
    v: open
short:
  v: Optional Extensions Element
definition:
  v: An Extension
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.extension:siteEligibility
path:
  v: CoverageEligibilityResponse.extension
slice name:
  v: siteEligibility
short:
  v: SiteEligibility
definition:
  v: An extension to indicate whether the patient is eligible or not eligible and why
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
  profile:
    v: https://shr.tiberbuapps.com/fhir/StructureDefinition/site-eligibility
    link: https://shr.tiberbuapps.com/fhir/StructureDefinition/site-eligibility
condition:
  v: ele-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false

id:
  v: CoverageEligibilityResponse.modifierExtension
path:
  v: CoverageEligibilityResponse.modifierExtension
short:
  v: Extensions that cannot be ignored
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: CoverageEligibilityResponse.identifier
path:
  v: CoverageEligibilityResponse.identifier
short:
  v: A business unique identifier for the CoverageEligibilityResponse resource.
definition:
  v: A unique identifier assigned to this coverage eligiblity request.
requirements:
  v: Allows coverage eligibility requests to be distinguished and referenced.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.identifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: workflow
  map:
    v: Event.identifier
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.identifier

id:
  v: CoverageEligibilityResponse.status
path:
  v: CoverageEligibilityResponse.status
short:
  v: Financial Resource Status Code. Must use the fixed value 'active'
definition:
  v: The status of the resource instance.
comment:
  v: This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
requirements:
  v: Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.status
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
pattern:
  v: active
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: EligibilityResponseStatus
  strength:
    v: required
  description:
    v: A code specifying the state of the resource instance.
  value set:
    v: http://hl7.org/fhir/ValueSet/fm-status|4.0.1
    link: 4.0
    link: .1
mapping:
  identity:
    v: workflow
  map:
    v: Event.status
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.status

id:
  v: CoverageEligibilityResponse.purpose
path:
  v: CoverageEligibilityResponse.purpose
short:
  v: EligibilityResponsePurpose
definition:
  v: Code to specify whether requesting: prior authorization requirements for some service categories or billing codes; benefits for coverages specified or discovered; discovery and return of coverages for the patient; and/or validation that the specified coverage is in-force at the date/period specified or 'now' if not specified.
requirements:
  v: To indicate the processing actions requested.
min:
  v: 1
max:
  v: *
base:
  path:
    v: CoverageEligibilityResponse.purpose
  min:
    v: 1
  max:
    v: *
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: EligibilityResponsePurpose
  strength:
    v: required
  description:
    v: A code specifying the types of information being requested.
  value set:
    v: http://hl7.org/fhir/ValueSet/eligibilityresponse-purpose|4.0.1
    link: 4.0
    link: .1
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.class

id:
  v: CoverageEligibilityResponse.patient
path:
  v: CoverageEligibilityResponse.patient
short:
  v: Intended recipient of products and services. A reference Patient resource
definition:
  v: The party who is the beneficiary of the supplied coverage and for whom eligibility is sought.
requirements:
  v: Required to provide context and coverage validation.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.patient
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHAPatient
    link: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHAPatient
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.subject
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject[x]
mapping:
  identity:
    v: cdanetv4
  map:
    v: C06,C07,C08, C05, C04
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.subject

id:
  v: CoverageEligibilityResponse.serviced[x]
path:
  v: CoverageEligibilityResponse.serviced[x]
slicing:
  discriminator:
    type:
      v: type
    path:
      v: $this
  ordered:
    v: false
  rules:
    v: closed
short:
  v: Estimated date or dates of service
definition:
  v: The date or dates when the enclosed suite of services were performed or completed.
requirements:
  v: Required to provide time context for the request.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.serviced[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
type:
  code:
    v: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.done[x]
mapping:
  identity:
    v: cdanetv4
  map:
    v: F09

id:
  v: CoverageEligibilityResponse.serviced[x]:servicedDate
path:
  v: CoverageEligibilityResponse.serviced[x]
slice name:
  v: servicedDate
short:
  v: The date or dates when the enclosed suite of services were performed or completed.
definition:
  v: The date or dates when the enclosed suite of services were performed or completed.
requirements:
  v: Required to provide time context for the request.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.serviced[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.done[x]
mapping:
  identity:
    v: cdanetv4
  map:
    v: F09

id:
  v: CoverageEligibilityResponse.serviced[x]:servicedPeriod
path:
  v: CoverageEligibilityResponse.serviced[x]
slice name:
  v: servicedPeriod
short:
  v: The period when the enclosed suite of services were performed or completed.
definition:
  v: The date or dates when the enclosed suite of services were performed or completed.
requirements:
  v: Required to provide time context for the request.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.serviced[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.done[x]
mapping:
  identity:
    v: cdanetv4
  map:
    v: F09

id:
  v: CoverageEligibilityResponse.created
path:
  v: CoverageEligibilityResponse.created
short:
  v: Creation date of this CoverageEligibilityRequest
definition:
  v: The date this resource was created.
requirements:
  v: Need to record a timestamp for use by both the recipient and the issuer.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.created
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: dateTime
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.recorded

id:
  v: CoverageEligibilityResponse.requestor
path:
  v: CoverageEligibilityResponse.requestor
short:
  v: Party responsible for the request
definition:
  v: The provider which is responsible for the request.
comment:
  v: Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.requestor
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner
    link: http://hl7.org/fhir/StructureDefinition/Practitioner
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole
    link: http://hl7.org/fhir/StructureDefinition/PractitionerRole
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization
    link: http://hl7.org/fhir/StructureDefinition/Organization
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.source
mapping:
  identity:
    v: cdanetv4
  map:
    v: B01

id:
  v: CoverageEligibilityResponse.request
path:
  v: CoverageEligibilityResponse.request
short:
  v: Eligibility request reference. A reference to the CoverageEligibilityRequest message
definition:
  v: Reference to the original request resource.
requirements:
  v: Needed to allow the response to be linked to the request.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.request
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHACoverageEligibilityRequest
    link: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHACoverageEligibilityRequest
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.basedOn
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.why[x]
mapping:
  identity:
    v: cdanetv4
  map:
    v: A02|G01

id:
  v: CoverageEligibilityResponse.outcome
path:
  v: CoverageEligibilityResponse.outcome
short:
  v: Payer processing outcome.
definition:
  v: The outcome of the request processing.
comment:
  v: The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete).
requirements:
  v: To advise the requestor of an overall processing outcome.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.outcome
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: RemittanceOutcome
  strength:
    v: required
  description:
    v: The outcome of the processing.
  value set:
    v: http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1
    link: 4.0
    link: .1

id:
  v: CoverageEligibilityResponse.disposition
path:
  v: CoverageEligibilityResponse.disposition
short:
  v: A human readable description of the status of the adjudication.
definition:
  v: A human readable description of the status of the adjudication.
requirements:
  v: Provided for user display.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.disposition
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: workflow
  map:
    v: Event.note

id:
  v: CoverageEligibilityResponse.insurer
path:
  v: CoverageEligibilityResponse.insurer
short:
  v: Coverage issuer. A reference to the payor organization license issed by the regulator and maintained in the registry. Use the reference.identifier for well know identifiers.
definition:
  v: The Insurer who issued the coverage in question and is the author of the response.
requirements:
  v: Need to identify the author.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurer
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHAOrganization
    link: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHAOrganization
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: CoverageEligibilityResponse.insurance
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint
  value:
    v: 380;0
path:
  v: CoverageEligibilityResponse.insurance
short:
  v: Financial instruments for reimbursement for the health care products and services.
definition:
  v: Financial instruments for reimbursement for the health care products and services.
comment:
  v: All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.
requirements:
  v: There must be at least one coverage for which eligibility is requested.
min:
  v: 0
max:
  v: *
base:
  path:
    v: CoverageEligibilityResponse.insurance
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.id
path:
  v: CoverageEligibilityResponse.insurance.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value:
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: CoverageEligibilityResponse.insurance.extension
path:
  v: CoverageEligibilityResponse.insurance.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  ordered:
    v: false
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.extension:siteEligibility
path:
  v: CoverageEligibilityResponse.insurance.extension
slice name:
  v: siteEligibility
short:
  v: SiteEligibility
definition:
  v: An extension to indicate whether the patient is eligible or not eligible and why
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
  profile:
    v: https://shr.tiberbuapps.com/fhir/StructureDefinition/site-eligibility
    link: https://shr.tiberbuapps.com/fhir/StructureDefinition/site-eligibility
condition:
  v: ele-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.modifierExtension
path:
  v: CoverageEligibilityResponse.insurance.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: CoverageEligibilityResponse.insurance.coverage
path:
  v: CoverageEligibilityResponse.insurance.coverage
short:
  v: Insurance information. A Reference to the insurance coverage resource
definition:
  v: Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.
requirements:
  v: Required to allow the adjudicator to locate the correct policy and history within their information system.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.coverage
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHACoverage
    link: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHACoverage
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: CoverageEligibilityResponse.insurance.inforce
path:
  v: CoverageEligibilityResponse.insurance.inforce
short:
  v: A flag to indicate if the insurance coverage supplied is expected to be inforce as of the service date supplied or today if no service date supplied.
definition:
  v: Flag indicating if the coverage provided is inforce currently if no service date(s) specified or for the whole duration of the service dates.
requirements:
  v: Needed to convey the answer to the eligibility validation request.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.inforce
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.benefitPeriod
path:
  v: CoverageEligibilityResponse.insurance.benefitPeriod
short:
  v: When the benefits are applicable
definition:
  v: The term of the benefits documented in this response.
requirements:
  v: Needed as coverages may be multi-year while benefits tend to be annual therefore a separate expression of the benefit period is needed.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.benefitPeriod
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.benefitPeriod.id
path:
  v: CoverageEligibilityResponse.insurance.benefitPeriod.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value:
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: CoverageEligibilityResponse.insurance.benefitPeriod.extension
path:
  v: CoverageEligibilityResponse.insurance.benefitPeriod.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: CoverageEligibilityResponse.insurance.benefitPeriod.start
path:
  v: CoverageEligibilityResponse.insurance.benefitPeriod.start
short:
  v: start date of the benefits
definition:
  v: The start of the period. The boundary is inclusive.
comment:
  v: If the low element is missing, the meaning is that the low boundary is not known.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Period.start
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime
condition:
  v: per-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: DR.1
mapping:
  identity:
    v: rim
  map:
    v: ./low

id:
  v: CoverageEligibilityResponse.insurance.benefitPeriod.end
path:
  v: CoverageEligibilityResponse.insurance.benefitPeriod.end
short:
  v: end date of the benefits
definition:
  v: The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
comment:
  v: The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Period.end
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime
meaning when missing:
  v: If the end of the period is missing, it means that the period is ongoing
condition:
  v: per-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: DR.2
mapping:
  identity:
    v: rim
  map:
    v: ./high

id:
  v: CoverageEligibilityResponse.insurance.item
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint
  value:
    v: 340;120
path:
  v: CoverageEligibilityResponse.insurance.item
short:
  v: Benefits and authorization details
definition:
  v: Benefits and optionally current balances, and authorization details by category or service.
min:
  v: 0
max:
  v: *
base:
  path:
    v: CoverageEligibilityResponse.insurance.item
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ces-1
  severity:
    v: error
  human:
    v: SHALL contain a category or a billcode but not both.
  expression:
    v: category.exists() xor productOrService.exists()
  xpath:
    v: exists(f:category) or exists(f:productOrService)
  source:
    v: http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse
    link: http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.id
path:
  v: CoverageEligibilityResponse.insurance.item.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value:
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: CoverageEligibilityResponse.insurance.item.extension
path:
  v: CoverageEligibilityResponse.insurance.item.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: CoverageEligibilityResponse.insurance.item.modifierExtension
path:
  v: CoverageEligibilityResponse.insurance.item.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: CoverageEligibilityResponse.insurance.item.category
path:
  v: CoverageEligibilityResponse.insurance.item.category
short:
  v: Benefit classification. Code to identify the general type of benefits under which products and services are provided. Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.
definition:
  v: Code to identify the general type of benefits under which products and services are provided.
comment:
  v: Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.
requirements:
  v: Needed to convey the category of service or product for which eligibility is sought.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.category
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: BenefitCategory
  strength:
    v: example
  description:
    v: Benefit categories such as: oral, medical, vision etc.
  value set:
    v: http://hl7.org/fhir/ValueSet/ex-benefitcategory
    link: http://hl7.org/fhir/ValueSet/ex-benefitcategory

id:
  v: CoverageEligibilityResponse.insurance.item.productOrService
path:
  v: CoverageEligibilityResponse.insurance.item.productOrService
short:
  v: Billing, service, product, or drug code
definition:
  v: This contains the product, service, drug or other billing code for the item.
comment:
  v: Code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI).
requirements:
  v: Needed to convey the actual service or product for which eligibility is sought.
alias:
  v: Drug Code
alias:
  v: Bill Code
alias:
  v: Service Code
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.productOrService
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: ServiceProduct
  strength:
    v: example
  description:
    v: Allowable service and product codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/service-uscls
    link: http://hl7.org/fhir/ValueSet/service-uscls

id:
  v: CoverageEligibilityResponse.insurance.item.modifier
path:
  v: CoverageEligibilityResponse.insurance.item.modifier
short:
  v: Product or service billing modifiers
definition:
  v: Item typification or modifiers codes to convey additional context for the product or service.
comment:
  v: For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.
requirements:
  v: To support provision of the item or to charge an elevated fee.
min:
  v: 0
max:
  v: *
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.modifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: Modifiers
  strength:
    v: example
  description:
    v: Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
  value set:
    v: http://hl7.org/fhir/ValueSet/claim-modifiers
    link: http://hl7.org/fhir/ValueSet/claim-modifiers

id:
  v: CoverageEligibilityResponse.insurance.item.provider
path:
  v: CoverageEligibilityResponse.insurance.item.provider
short:
  v: Performing practitioner
definition:
  v: The practitioner who is eligible for the provision of the product or service.
requirements:
  v: Needed to convey the eligible provider.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.provider
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner
    link: http://hl7.org/fhir/StructureDefinition/Practitioner
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole
    link: http://hl7.org/fhir/StructureDefinition/PractitionerRole
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.source
mapping:
  identity:
    v: cdanetv4
  map:
    v: B01

id:
  v: CoverageEligibilityResponse.insurance.item.excluded
path:
  v: CoverageEligibilityResponse.insurance.item.excluded
short:
  v: Indicates whether the benefit is excluded by the policy.
definition:
  v: True if the indicated class of service is excluded from the plan, missing or False indicates the product or service is included in the coverage.
requirements:
  v: Needed to identify items that are specifically excluded from the coverage.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.excluded
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.name
path:
  v: CoverageEligibilityResponse.insurance.item.name
short:
  v: Short name for the benefit
definition:
  v: A short name or tag for the benefit.
comment:
  v: For example: MED01, or DENT2.
requirements:
  v: Required to align with other plan names.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.name
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.description
path:
  v: CoverageEligibilityResponse.insurance.item.description
short:
  v: Description of the benefit or services covered
definition:
  v: A richer description of the benefit or services covered.
comment:
  v: For example 'DENT2 covers 100% of basic, 50% of major but excludes Ortho, Implants and Cosmetic services'.
requirements:
  v: Needed for human readable reference.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.description
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.network
path:
  v: CoverageEligibilityResponse.insurance.item.network
short:
  v: In or out of network (Contracted of not contracted)
definition:
  v: Is a flag to indicate whether the benefits refer to in-network providers or out-of-network providers.
requirements:
  v: Needed as in or out of network providers are treated differently under the coverage.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.network
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: BenefitNetwork
  strength:
    v: example
  description:
    v: Code to classify in or out of network services.
  value set:
    v: http://hl7.org/fhir/ValueSet/benefit-network
    link: http://hl7.org/fhir/ValueSet/benefit-network

id:
  v: CoverageEligibilityResponse.insurance.item.unit
path:
  v: CoverageEligibilityResponse.insurance.item.unit
short:
  v: Individual or family
definition:
  v: Indicates if the benefits apply to an individual or to the family.
requirements:
  v: Needed for the understanding of the benefits.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.unit
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: BenefitUnit
  strength:
    v: example
  description:
    v: Unit covered/serviced - individual or family.
  value set:
    v: http://hl7.org/fhir/ValueSet/benefit-unit
    link: http://hl7.org/fhir/ValueSet/benefit-unit

id:
  v: CoverageEligibilityResponse.insurance.item.term
path:
  v: CoverageEligibilityResponse.insurance.item.term
short:
  v: Annual or lifetime
definition:
  v: The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'.
requirements:
  v: Needed for the understanding of the benefits.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.term
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: BenefitTerm
  strength:
    v: example
  description:
    v: Coverage unit - annual, lifetime.
  value set:
    v: http://hl7.org/fhir/ValueSet/benefit-term
    link: http://hl7.org/fhir/ValueSet/benefit-term

id:
  v: CoverageEligibilityResponse.insurance.item.benefit
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint
  value:
    v: 340;320
path:
  v: CoverageEligibilityResponse.insurance.item.benefit
short:
  v: Term for limites such as per day, annual or lifetime
definition:
  v: Benefits used to date.
min:
  v: 0
max:
  v: *
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.benefit
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.id
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value:
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.extension
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.extension
short:
  v: Additional content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.modifierExtension
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.type
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.type
short:
  v: Benefit classification
definition:
  v: Classification of benefit being provided.
comment:
  v: For example: deductible, visits, benefit amount.
requirements:
  v: Needed to convey the nature of the benefit.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.benefit.type
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: BenefitType
  strength:
    v: example
  description:
    v: Deductable, visits, co-pay, etc.
  value set:
    v: http://hl7.org/fhir/ValueSet/benefit-type
    link: http://hl7.org/fhir/ValueSet/benefit-type

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
slicing:
  discriminator:
    type:
      v: type
    path:
      v: $this
  ordered:
    v: false
  rules:
    v: closed
short:
  v: Benefits allowed
definition:
  v: The quantity of the benefit which is permitted under the coverage.
requirements:
  v: Needed to convey the benefits offered under the coverage.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: unsignedInt
type:
  code:
    v: string
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]:allowedUnsignedInt
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
slice name:
  v: allowedUnsignedInt
short:
  v: Benefits allowed
definition:
  v: The quantity of the benefit which is permitted under the coverage.
requirements:
  v: Needed to convey the benefits offered under the coverage.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: unsignedInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]:allowedString
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
slice name:
  v: allowedString
short:
  v: Benefits allowed
definition:
  v: The quantity of the benefit which is permitted under the coverage.
requirements:
  v: Needed to convey the benefits offered under the coverage.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]:allowedMoney
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
slice name:
  v: allowedMoney
short:
  v: Benefits allowed
definition:
  v: The quantity of the benefit which is permitted under the coverage.
requirements:
  v: Needed to convey the benefits offered under the coverage.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
slicing:
  discriminator:
    type:
      v: type
    path:
      v: $this
  ordered:
    v: false
  rules:
    v: closed
short:
  v: Benefits used
definition:
  v: The quantity of the benefit which have been consumed to date.
requirements:
  v: Needed to convey the benefits consumed to date.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: unsignedInt
type:
  code:
    v: string
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]:usedUnsignedInt
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
slice name:
  v: usedUnsignedInt
short:
  v: Benefits used
definition:
  v: The quantity of the benefit which have been consumed to date.
requirements:
  v: Needed to convey the benefits consumed to date.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: unsignedInt
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]:usedString
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
slice name:
  v: usedString
short:
  v: Benefits used
definition:
  v: The quantity of the benefit which have been consumed to date.
requirements:
  v: Needed to convey the benefits consumed to date.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]:usedMoney
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
slice name:
  v: usedMoney
short:
  v: Benefits used
definition:
  v: The quantity of the benefit which have been consumed to date.
requirements:
  v: Needed to convey the benefits consumed to date.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.authorizationRequired
path:
  v: CoverageEligibilityResponse.insurance.item.authorizationRequired
short:
  v: Authorization required flag
definition:
  v: A boolean flag indicating whether a preauthorization is required prior to actual service delivery.
requirements:
  v: Needed to convey that preauthorization is required.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.authorizationRequired
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: boolean
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.insurance.item.authorizationSupporting
path:
  v: CoverageEligibilityResponse.insurance.item.authorizationSupporting
short:
  v: Type of required supporting materials
definition:
  v: Codes or comments regarding information or actions associated with the preauthorization.
requirements:
  v: Needed to inform the provider of collateral materials or actions needed for preauthorization.
min:
  v: 0
max:
  v: *
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.authorizationSupporting
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: AuthSupporting
  strength:
    v: example
  description:
    v: Type of supporting information to provide with a preauthorization.
  value set:
    v: http://hl7.org/fhir/ValueSet/coverageeligibilityresponse-ex-auth-support
    link: http://hl7.org/fhir/ValueSet/coverageeligibilityresponse-ex-auth-support

id:
  v: CoverageEligibilityResponse.insurance.item.authorizationUrl
path:
  v: CoverageEligibilityResponse.insurance.item.authorizationUrl
short:
  v: Preauthorization requirements endpoint
definition:
  v: A web location for obtaining requirements or descriptive information regarding the preauthorization.
requirements:
  v: Needed to enable insurers to advise providers of informative information.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.insurance.item.authorizationUrl
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.preAuthRef
path:
  v: CoverageEligibilityResponse.preAuthRef
short:
  v: Preauthorization reference
definition:
  v: A reference from the Insurer to which these services pertain to be used on further communication and as proof that the request occurred.
requirements:
  v: To provide any preauthorization reference for provider use.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.preAuthRef
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: cdanetv4
  map:
    v: F03
mapping:
  identity:
    v: rim
  map:
    v: 23

id:
  v: CoverageEligibilityResponse.form
path:
  v: CoverageEligibilityResponse.form
short:
  v: Printed form identifier
definition:
  v: A code for the form to be used for printing the content.
comment:
  v: May be needed to identify specific jurisdictional forms.
requirements:
  v: Needed to specify the specific form used for producing output for this response.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.form
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: Forms
  strength:
    v: example
  description:
    v: The forms codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/forms
    link: http://hl7.org/fhir/ValueSet/forms
mapping:
  identity:
    v: cdanetv4
  map:
    v: G42

id:
  v: CoverageEligibilityResponse.error
path:
  v: CoverageEligibilityResponse.error
short:
  v: Errors encountered during the processing of the request
definition:
  v: Errors encountered during the processing of the request.
requirements:
  v: Need to communicate processing issues to the requestor.
min:
  v: 0
max:
  v: *
base:
  path:
    v: CoverageEligibilityResponse.error
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.error.id
path:
  v: CoverageEligibilityResponse.error.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
    value:
      v: string
  code:
    v: http://hl7.org/fhirpath/System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: CoverageEligibilityResponse.error.extension
path:
  v: CoverageEligibilityResponse.error.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  ordered:
    v: false
  rules:
    v: open
short:
  v: Optional Extensions Element
definition:
  v: An Extension
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: CoverageEligibilityResponse.error.extension:errorExtensionExpression
path:
  v: CoverageEligibilityResponse.error.extension
slice name:
  v: errorExtensionExpression
short:
  v: ErrorExtensionExpression
definition:
  v: ErrorExtensionExpression
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
  profile:
    v: https://shr.tiberbuapps.com/fhir/StructureDefinition/error-extension-expression
    link: https://shr.tiberbuapps.com/fhir/StructureDefinition/error-extension-expression
condition:
  v: ele-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: false

id:
  v: CoverageEligibilityResponse.error.modifierExtension
path:
  v: CoverageEligibilityResponse.error.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    link: http://hl7.org/fhir/StructureDefinition/Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: CoverageEligibilityResponse.error.code
path:
  v: CoverageEligibilityResponse.error.code
short:
  v: An error code,from a specified code system, which details why the eligibility check could not be performed
definition:
  v: An error code,from a specified code system, which details why the eligibility check could not be performed.
requirements:
  v: Required to convey processing errors.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: CoverageEligibilityResponse.error.code
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    link: http://hl7.org/fhir/StructureDefinition/Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
    value:
      v: AdjudicationError
  strength:
    v: example
  description:
    v: The error codes for adjudication processing.
  value set:
    v: http://hl7.org/fhir/ValueSet/adjudication-error
    link: http://hl7.org/fhir/ValueSet/adjudication-error

element:
  id:
    v: CoverageEligibilityResponse
  path:
    v: CoverageEligibilityResponse
element:
  id:
    v: CoverageEligibilityResponse.id
  path:
    v: CoverageEligibilityResponse.id
  short:
    v: A logical identifier for the messageHeader resource.
  min:
    v: 1
element:
  id:
    v: CoverageEligibilityResponse.meta
  path:
    v: CoverageEligibilityResponse.meta
  short:
    v: Metadata about a resource
  min:
    v: 1
element:
  id:
    v: CoverageEligibilityResponse.meta.profile
  path:
    v: CoverageEligibilityResponse.meta.profile
  min:
    v: 1
element:
  id:
    v: CoverageEligibilityResponse.extension
  path:
    v: CoverageEligibilityResponse.extension
  slicing:
    discriminator:
      type:
        v: value
      path:
        v: url
    ordered:
      v: false
    rules:
      v: open
  short:
    v: Optional Extensions Element
element:
  id:
    v: CoverageEligibilityResponse.extension:siteEligibility
  path:
    v: CoverageEligibilityResponse.extension
  slice name:
    v: siteEligibility
  min:
    v: 0
  max:
    v: *
  type:
    code:
      v: Extension
    profile:
      v: https://shr.tiberbuapps.com/fhir/StructureDefinition/site-eligibility
      link: https://shr.tiberbuapps.com/fhir/StructureDefinition/site-eligibility
element:
  id:
    v: CoverageEligibilityResponse.identifier
  path:
    v: CoverageEligibilityResponse.identifier
  short:
    v: A business unique identifier for the CoverageEligibilityResponse resource.
  min:
    v: 1
  max:
    v: 1
element:
  id:
    v: CoverageEligibilityResponse.status
  path:
    v: CoverageEligibilityResponse.status
  short:
    v: Financial Resource Status Code. Must use the fixed value 'active'
  pattern:
    v: active
element:
  id:
    v: CoverageEligibilityResponse.purpose
  path:
    v: CoverageEligibilityResponse.purpose
  short:
    v: EligibilityResponsePurpose
element:
  id:
    v: CoverageEligibilityResponse.patient
  path:
    v: CoverageEligibilityResponse.patient
  short:
    v: Intended recipient of products and services. A reference Patient resource
  type:
    code:
      v: Reference
    target profile:
      v: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHAPatient
      link: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHAPatient
element:
  id:
    v: CoverageEligibilityResponse.serviced[x]
  path:
    v: CoverageEligibilityResponse.serviced[x]
  slicing:
    discriminator:
      type:
        v: type
      path:
        v: $this
    ordered:
      v: false
    rules:
      v: open
element:
  id:
    v: CoverageEligibilityResponse.serviced[x]:servicedDate
  path:
    v: CoverageEligibilityResponse.serviced[x]
  slice name:
    v: servicedDate
  short:
    v: The date or dates when the enclosed suite of services were performed or completed.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: date
element:
  id:
    v: CoverageEligibilityResponse.serviced[x]:servicedPeriod
  path:
    v: CoverageEligibilityResponse.serviced[x]
  slice name:
    v: servicedPeriod
  short:
    v: The period when the enclosed suite of services were performed or completed.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: Period
element:
  id:
    v: CoverageEligibilityResponse.created
  path:
    v: CoverageEligibilityResponse.created
  short:
    v: Creation date of this CoverageEligibilityRequest
element:
  id:
    v: CoverageEligibilityResponse.request
  path:
    v: CoverageEligibilityResponse.request
  short:
    v: Eligibility request reference. A reference to the CoverageEligibilityRequest message
  type:
    code:
      v: Reference
    target profile:
      v: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHACoverageEligibilityRequest
      link: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHACoverageEligibilityRequest
element:
  id:
    v: CoverageEligibilityResponse.outcome
  path:
    v: CoverageEligibilityResponse.outcome
  short:
    v: Payer processing outcome.
element:
  id:
    v: CoverageEligibilityResponse.disposition
  path:
    v: CoverageEligibilityResponse.disposition
  short:
    v: A human readable description of the status of the adjudication.
element:
  id:
    v: CoverageEligibilityResponse.insurer
  path:
    v: CoverageEligibilityResponse.insurer
  short:
    v: Coverage issuer. A reference to the payor organization license issed by the regulator and maintained in the registry. Use the reference.identifier for well know identifiers.
  type:
    code:
      v: Reference
    target profile:
      v: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHAOrganization
      link: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHAOrganization
element:
  id:
    v: CoverageEligibilityResponse.insurance

v: CoverageEligibilityResponse.insurance

v: Financial instruments for reimbursement for the health care products and services.

id:
  v: CoverageEligibilityResponse.insurance.extension
path:
  v: CoverageEligibilityResponse.insurance.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  ordered:
    v: false
  rules:
    v: open

id:
  v: CoverageEligibilityResponse.insurance.extension:siteEligibility
path:
  v: CoverageEligibilityResponse.insurance.extension
slice name:
  v: siteEligibility
min:
  v: 0
max:
  v: 1
type:
  code:
    v: Extension
  profile:
    v: https://shr.tiberbuapps.com/fhir/StructureDefinition/site-eligibility
    link: https://shr.tiberbuapps.com/fhir/StructureDefinition/site-eligibility

id:
  v: CoverageEligibilityResponse.insurance.coverage
path:
  v: CoverageEligibilityResponse.insurance.coverage
short:
  v: Insurance information. A Reference to the insurance coverage resource
type:
  code:
    v: Reference
  target profile:
    v: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHACoverage
    link: https://shr.tiberbuapps.com/fhir/StructureDefinition/SHACoverage

id:
  v: CoverageEligibilityResponse.insurance.inforce
path:
  v: CoverageEligibilityResponse.insurance.inforce
short:
  v: A flag to indicate if the insurance coverage supplied is expected to be inforce as of the service date supplied or today if no service date supplied.
min:
  v: 1

id:
  v: CoverageEligibilityResponse.insurance.benefitPeriod.start
path:
  v: CoverageEligibilityResponse.insurance.benefitPeriod.start
short:
  v: start date of the benefits
min:
  v: 1

id:
  v: CoverageEligibilityResponse.insurance.benefitPeriod.end
path:
  v: CoverageEligibilityResponse.insurance.benefitPeriod.end
short:
  v: end date of the benefits
min:
  v: 1

id:
  v: CoverageEligibilityResponse.insurance.item.category
path:
  v: CoverageEligibilityResponse.insurance.item.category
short:
  v: Benefit classification. Code to identify the general type of benefits under which products and services are provided. Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.

id:
  v: CoverageEligibilityResponse.insurance.item.excluded
path:
  v: CoverageEligibilityResponse.insurance.item.excluded
short:
  v: Indicates whether the benefit is excluded by the policy.

id:
  v: CoverageEligibilityResponse.insurance.item.network
path:
  v: CoverageEligibilityResponse.insurance.item.network
short:
  v: In or out of network (Contracted of not contracted)
min:
  v: 1

id:
  v: CoverageEligibilityResponse.insurance.item.unit
path:
  v: CoverageEligibilityResponse.insurance.item.unit
min:
  v: 1

id:
  v: CoverageEligibilityResponse.insurance.item.term
path:
  v: CoverageEligibilityResponse.insurance.item.term
min:
  v: 1

id:
  v: CoverageEligibilityResponse.insurance.item.benefit
path:
  v: CoverageEligibilityResponse.insurance.item.benefit
short:
  v: Term for limites such as per day, annual or lifetime

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
slicing:
  discriminator:
    type:
      v: type
    path:
      v: $this
  ordered:
    v: false
  rules:
    v: open

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]:allowedUnsignedInt
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
slice name:
  v: allowedUnsignedInt
min:
  v: 0
max:
  v: 1
type:
  code:
    v: unsignedInt

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]:allowedString
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
slice name:
  v: allowedString
min:
  v: 0
max:
  v: 1
type:
  code:
    v: string

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]:allowedMoney
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.allowed[x]
slice name:
  v: allowedMoney
min:
  v: 0
max:
  v: 1
type:
  code:
    v: Money

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
slicing:
  discriminator:
    type:
      v: type
    path:
      v: $this
  ordered:
    v: false
  rules:
    v: open

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]:usedUnsignedInt
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
slice name:
  v: usedUnsignedInt
min:
  v: 0
max:
  v: 1
type:
  code:
    v: unsignedInt

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]:usedString
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
slice name:
  v: usedString
min:
  v: 0
max:
  v: 1
type:
  code:
    v: string

id:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]:usedMoney
path:
  v: CoverageEligibilityResponse.insurance.item.benefit.used[x]
slice name:
  v: usedMoney
min:
  v: 0
max:
  v: 1
type:
  code:
    v: Money

id:
  v: CoverageEligibilityResponse.error
path:
  v: CoverageEligibilityResponse.error
short:
  v: Errors encountered during the processing of the request

id:
  v: CoverageEligibilityResponse.error.extension
path:
  v: CoverageEligibilityResponse.error.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  ordered:
    v: false
  rules:
    v: open
short:
  v: Optional Extensions Element

id:
  v: CoverageEligibilityResponse.error.extension:errorExtensionExpression
path:
  v: CoverageEligibilityResponse.error.extension
slice name:
  v: errorExtensionExpression
min:
  v: 0
max:
  v: 1
type:
  code:
    v: Extension
  profile:
    v: https://shr.tiberbuapps.com/fhir/StructureDefinition/error-extension-expression
    link: https://shr.tiberbuapps.com/fhir/StructureDefinition/error-extension-expression

id:
  v: CoverageEligibilityResponse.error.code
path:
  v: CoverageEligibilityResponse.error.code
short:
  v: An error code,from a specified code system, which details why the eligibility check could not be performed