{ "resourceType" : "Bundle", "id" : "CoverageEligibilityResponseBundle-validation-example-01", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponseBundle"] }, "identifier" : { "value" : "bc3c6c57-2053-4d0e-ac40-139ccccff645" }, "type" : "collection", "timestamp" : "2025-03-07T15:32:26.605+05:30", "entry" : [{ "fullUrl" : "urn:uuid:4ecd2358-0fe4-40d7-a76c-9e1b00af2bed", "resource" : { "resourceType" : "CoverageEligibilityResponse", "id" : "4ecd2358-0fe4-40d7-a76c-9e1b00af2bed", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse"] }, "language" : "en", "text" : { "status" : "generated", "div" : "

Generated Narrative: CoverageEligibilityResponse 4ecd2358-0fe4-40d7-a76c-9e1b00af2bed

Language: en

Profile: CoverageEligibilityResponse

status: Active

purpose: Coverage Validation

patient: Patient

created: 2025-03-07

requestor: Organization

request: CoverageEligibilityRequest-validation

outcome: Processing Complete

disposition: Policy is currently in-force.

insurer: Organization

Insurances

-CoverageInforceBenefitPeriod
*Coveragetrue2023-09-07 --> 2026-08-07
" }, "status" : "active", "purpose" : ["validation"], "patient" : { "reference" : "urn:uuid:6e479103-c550-4303-bab0-a06b6d8924e0", "display" : "Patient" }, "created" : "2025-03-07", "requestor" : { "reference" : "urn:uuid:9307fb56-4fa4-4c26-aa54-643686fd3ef4", "display" : "Organization" }, "request" : { "reference" : "urn:uuid:efac0538-908f-4bb1-807a-0f037321bef4", "display" : "CoverageEligibilityRequest-validation" }, "outcome" : "complete", "disposition" : "Policy is currently in-force.", "insurer" : { "reference" : "urn:uuid:160d35ce-4380-4c35-b1d2-cd792babb281", "display" : "Organization" }, "insurance" : [{ "coverage" : { "reference" : "urn:uuid:23ce58e6-ce30-4a7f-ad97-85494a05fcef", "display" : "Coverage" }, "inforce" : true, "benefitPeriod" : { "start" : "2023-09-07", "end" : "2026-08-07" } }] } }, { "fullUrl" : "urn:uuid:6e479103-c550-4303-bab0-a06b6d8924e0", "resource" : { "resourceType" : "Patient", "id" : "6e479103-c550-4303-bab0-a06b6d8924e0", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Patient 6e479103-c550-4303-bab0-a06b6d8924e0

Adarsh Agrawal Male, DoB: 1981-01-12 ( Adhaar number: 7225-4829-5255)

Contact Detail+919818512600
" }, "identifier" : [{ "type" : { "coding" : [{ "system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code", "code" : "ADN", "display" : "Adhaar number" }] }, "system" : "https://uidai.gov.in/", "value" : "7225-4829-5255" }], "name" : [{ "text" : "Adarsh Agrawal" }], "telecom" : [{ "system" : "phone", "value" : "+919818512600", "use" : "home" }], "gender" : "male", "birthDate" : "1981-01-12" } }, { "fullUrl" : "urn:uuid:fa95a74b-8175-43b6-8898-de37270bfffa", "resource" : { "resourceType" : "Practitioner", "id" : "fa95a74b-8175-43b6-8898-de37270bfffa", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Practitioner fa95a74b-8175-43b6-8898-de37270bfffa

identifier: Medical License number/21-1521-3828-3227

name: Dr. Aayush Agrawal

" }, "identifier" : [{ "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "MD", "display" : "Medical License number" }] }, "system" : "https://doctor.ndhm.gov.in", "value" : "21-1521-3828-3227" }], "name" : [{ "text" : "Dr. Aayush Agrawal" }] } }, { "fullUrl" : "urn:uuid:efac0538-908f-4bb1-807a-0f037321bef4", "resource" : { "resourceType" : "CoverageEligibilityRequest", "id" : "efac0538-908f-4bb1-807a-0f037321bef4", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest"] }, "language" : "en", "text" : { "status" : "generated", "div" : "

Generated Narrative: CoverageEligibilityRequest efac0538-908f-4bb1-807a-0f037321bef4

Language: en

Profile: CoverageEligibilityRequest

identifier: 7612345

status: Active

priority: Normal

purpose: Coverage Validation

patient: Patient

created: 2025-03-07 11:01:00+0500

enterer: Practitioner

provider: Organization

insurer: Organization

facility: Location

Insurances

-FocalCoverage
*trueBundle: identifier = bc3c6c57-2053-4d0e-ac40-139ccccff645; type = collection; timestamp = 2025-03-07 15:32:26+0530
" }, "identifier" : [{ "value" : "7612345" }], "status" : "active", "priority" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/processpriority", "code" : "normal", "display" : "Normal" }] }, "purpose" : ["validation"], "patient" : { "reference" : "urn:uuid:6e479103-c550-4303-bab0-a06b6d8924e0", "display" : "Patient" }, "created" : "2025-03-07T11:01:00+05:00", "enterer" : { "reference" : "urn:uuid:fa95a74b-8175-43b6-8898-de37270bfffa", "display" : "Practitioner" }, "provider" : { "reference" : "urn:uuid:9307fb56-4fa4-4c26-aa54-643686fd3ef4", "display" : "Organization" }, "insurer" : { "reference" : "urn:uuid:160d35ce-4380-4c35-b1d2-cd792babb281", "display" : "Organization" }, "facility" : { "reference" : "urn:uuid:94036e9a-0e67-4b95-b1a0-410d0da90a5b", "display" : "Location" }, "insurance" : [{ "focal" : true, "coverage" : { "reference" : "urn:uuid:23ce58e6-ce30-4a7f-ad97-85494a05fcef" } }] } }, { "fullUrl" : "urn:uuid:160d35ce-4380-4c35-b1d2-cd792babb281", "resource" : { "resourceType" : "Organization", "id" : "160d35ce-4380-4c35-b1d2-cd792babb281", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Organization 160d35ce-4380-4c35-b1d2-cd792babb281

identifier: Registry of Hospitals in Network of Insurance (ROHINI) ID/4567878

type: Insurance Company

name: XYZ Insurance Co. Ltd.

telecom: +91 243 2634 1234, contact@xyz.org

" }, "identifier" : [{ "type" : { "coding" : [{ "system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code", "code" : "ROHINI", "display" : "Registry of Hospitals in Network of Insurance (ROHINI) ID" }] }, "system" : "https://rohini.iib.gov.in/", "value" : "4567878" }], "type" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/organization-type", "code" : "ins", "display" : "Insurance Company" }] }], "name" : "XYZ Insurance Co. Ltd.", "telecom" : [{ "system" : "phone", "value" : "+91 243 2634 1234", "use" : "work" }, { "system" : "email", "value" : "contact@xyz.org", "use" : "work" }] } }, { "fullUrl" : "urn:uuid:9307fb56-4fa4-4c26-aa54-643686fd3ef4", "resource" : { "resourceType" : "Organization", "id" : "9307fb56-4fa4-4c26-aa54-643686fd3ef4", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Organization 9307fb56-4fa4-4c26-aa54-643686fd3ef4

identifier: Provider number/1234567890

type: Healthcare Provider

name: XYZ Hospital Co. Ltd.

telecom: +91 243 2634 1278, contact@xyz.org

" }, "identifier" : [{ "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0203", "code" : "PRN", "display" : "Provider number" }] }, "system" : "https://facility.ndhm.gov.in", "value" : "1234567890" }], "type" : [{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/organization-type", "code" : "prov", "display" : "Healthcare Provider" }] }], "name" : "XYZ Hospital Co. Ltd.", "telecom" : [{ "system" : "phone", "value" : "+91 243 2634 1278", "use" : "work" }, { "system" : "email", "value" : "contact@xyz.org", "use" : "work" }] } }, { "fullUrl" : "urn:uuid:94036e9a-0e67-4b95-b1a0-410d0da90a5b", "resource" : { "resourceType" : "Location", "id" : "94036e9a-0e67-4b95-b1a0-410d0da90a5b", "text" : { "status" : "generated", "div" : "

Generated Narrative: Location 94036e9a-0e67-4b95-b1a0-410d0da90a5b

identifier: B1-S.F2

status: Active

name: South Wing, second floor

alias: IndiaFirst Life Insurance Co. Ltd., South Wing, second floor

description: Second floor of the Old South Wing, formerly in use by Psychiatry

mode: Instance

telecom: ph: 2328(Work), fax: 2329(Work), http://sampleorg.com/southwing

address: 91, Building A Pune 451855 IND (work)

physicalType: Wing

Positions

-LongitudeLatitudeAltitude
*-83.694569142.254754780

managingOrganization: Organization

" }, "identifier" : [{ "value" : "B1-S.F2" }], "status" : "active", "name" : "South Wing, second floor", "alias" : ["IndiaFirst Life Insurance Co. Ltd., South Wing, second floor"], "description" : "Second floor of the Old South Wing, formerly in use by Psychiatry", "mode" : "instance", "telecom" : [{ "system" : "phone", "value" : "2328", "use" : "work" }, { "system" : "fax", "value" : "2329", "use" : "work" }, { "system" : "url", "value" : "http://sampleorg.com/southwing", "use" : "work" }], "address" : { "use" : "work", "line" : ["91, Building A"], "city" : "Pune", "postalCode" : "451855", "country" : "IND" }, "physicalType" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/location-physical-type", "code" : "wi", "display" : "Wing" }] }, "position" : { "longitude" : -83.6945691, "latitude" : 42.25475478, "altitude" : 0 }, "managingOrganization" : { "reference" : "urn:uuid:9307fb56-4fa4-4c26-aa54-643686fd3ef4", "display" : "Organization" } } }, { "fullUrl" : "urn:uuid:23ce58e6-ce30-4a7f-ad97-85494a05fcef", "resource" : { "resourceType" : "Coverage", "id" : "23ce58e6-ce30-4a7f-ad97-85494a05fcef", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Coverage"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Coverage 23ce58e6-ce30-4a7f-ad97-85494a05fcef

identifier: https://xyzinsurance.in/policynumber//235037120

status: Active

type: health insurance plan policy

subscriber: Patient

subscriberId: ABC123456BI007

beneficiary: Patient

relationship: Self

period: ?? --> 2026-03-17

payor: Organization

" }, "identifier" : [{ "system" : "https://xyzinsurance.in/policynumber/", "value" : "235037120" }], "status" : "active", "type" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode", "code" : "HIP", "display" : "health insurance plan policy" }] }, "subscriber" : { "reference" : "urn:uuid:6e479103-c550-4303-bab0-a06b6d8924e0", "display" : "Patient" }, "subscriberId" : "ABC123456BI007", "beneficiary" : { "reference" : "urn:uuid:6e479103-c550-4303-bab0-a06b6d8924e0", "display" : "Patient" }, "relationship" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship", "code" : "self" }] }, "period" : { "end" : "2026-03-17" }, "payor" : [{ "reference" : "urn:uuid:160d35ce-4380-4c35-b1d2-cd792babb281", "display" : "Organization" }] } }] }