{ "resourceType" : "CoverageEligibilityResponse", "id" : "auth-requirements-example-01", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse"] }, "language" : "en", "text" : { "status" : "generated", "div" : "

Generated Narrative: CoverageEligibilityResponse auth-requirements-example-01

Language: en

Profile: CoverageEligibilityResponse

status: Active

purpose: Coverage auth-requirements

patient: ABC Male, DoB: 1981-01-12 ( Medical record number: 22-7225-4829-5255)

created: 2023-09-07

requestor: Practitioner Dr. DEF

request: CoverageEligibilityRequest: identifier = 7612345; status = active; priority = Normal; purpose = auth-requirements; created = 2023-09-07 11:01:00+0500

outcome: Processing Complete

disposition: Policy is currently in-force.

insurer: Organization XYZ Insurance Co. Ltd.

insurance

coverage: Coverage: identifier = https://xyzinsurance.in/policynumber/#235037120; status = active; type = PAY; subscriberId = ABC123456BI007; relationship = Self; period = (?) --> 2026-03-17

inforce: true

benefitPeriod: 2023-09-07 --> 2026-08-07

item

productOrService: Consultant

item

productOrService: Metformin hydrochloride 500 mg prolonged-release oral tablet

" }, "status" : "active", "purpose" : ["auth-requirements"], "patient" : { "reference" : "Patient/example-01" }, "created" : "2023-09-07", "requestor" : { "reference" : "Practitioner/example-01" }, "request" : { "reference" : "CoverageEligibilityRequest/auth-requirement-example-01" }, "outcome" : "complete", "disposition" : "Policy is currently in-force.", "insurer" : { "reference" : "Organization/example-02" }, "insurance" : [{ "coverage" : { "reference" : "Coverage/example-01" }, "inforce" : true, "benefitPeriod" : { "start" : "2023-09-07", "end" : "2026-08-07" }, "item" : [{ "productOrService" : { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "768839008", "display" : "Consultant" }] } }, { "productOrService" : { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "765507008", "display" : "Metformin hydrochloride 500 mg prolonged-release oral tablet" }] } }] }] }