{ "resourceType" : "Bundle", "id" : "CoverageEligibilityRequestBundle-auth-requirement-example-01", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequestBundle"] }, "identifier" : { "value" : "bc3c6c57-2053-4d0e-ac40-139ccccff645" }, "type" : "collection", "timestamp" : "2025-03-07T15:32:26.605+05:30", "entry" : [{ "fullUrl" : "urn:uuid:a752531b-67ad-4b33-9a8b-e1b9229d1505", "resource" : { "resourceType" : "CoverageEligibilityRequest", "id" : "a752531b-67ad-4b33-9a8b-e1b9229d1505", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest"] }, "language" : "en", "text" : { "status" : "generated", "div" : "

Generated Narrative: CoverageEligibilityRequest a752531b-67ad-4b33-9a8b-e1b9229d1505

Language: en

Profile: CoverageEligibilityRequest

identifier: 7612345

status: Active

priority: Normal

purpose: Coverage auth-requirements

patient: Patient

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

enterer: Practitioner

provider: Organization

insurer: Organization

facility: Location

Insurances

-FocalCoverage
*trueCoverage

item

productOrService: Consultant

Diagnoses

-Diagnosis[x]
*Type 2 diabetes mellitus : Without complications

item

productOrService: Metformin hydrochloride 500 mg prolonged-release oral tablet

Diagnoses

-Diagnosis[x]
*Type 2 diabetes mellitus : Without complications
" }, "identifier" : [{ "value" : "7612345" }], "status" : "active", "priority" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/processpriority", "code" : "normal", "display" : "Normal" }] }, "purpose" : ["auth-requirements"], "patient" : { "reference" : "urn:uuid:a4dbd17d-35f8-4f36-9dac-f276fa75a4c8", "display" : "Patient" }, "created" : "2025-03-07T11:01:00+05:00", "enterer" : { "reference" : "urn:uuid:9ee37afe-e35a-4ee8-80b1-7f4786cdd507", "display" : "Practitioner" }, "provider" : { "reference" : "urn:uuid:48d6ee22-e2bf-427e-878a-19b5f264f46a", "display" : "Organization" }, "insurer" : { "reference" : "urn:uuid:66ec8a06-3a04-454e-bace-0ad07f70405a", "display" : "Organization" }, "facility" : { "reference" : "urn:uuid:ea4f766b-b7c1-476a-8f19-095928b65ca5", "display" : "Location" }, "insurance" : [{ "focal" : true, "coverage" : { "reference" : "urn:uuid:462d36b1-4171-4ebb-871d-94fdb3f7eb11", "display" : "Coverage" } }], "item" : [{ "productOrService" : { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "768839008", "display" : "Consultant" }] }, "diagnosis" : [{ "diagnosisCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/sid/icd-10", "code" : "E11.9", "display" : "Type 2 diabetes mellitus : Without complications" }] } }] }, { "productOrService" : { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "765507008", "display" : "Metformin hydrochloride 500 mg prolonged-release oral tablet" }] }, "diagnosis" : [{ "diagnosisCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/sid/icd-10", "code" : "E11.9", "display" : "Type 2 diabetes mellitus : Without complications" }] } }] }] } }, { "fullUrl" : "urn:uuid:a4dbd17d-35f8-4f36-9dac-f276fa75a4c8", "resource" : { "resourceType" : "Patient", "id" : "a4dbd17d-35f8-4f36-9dac-f276fa75a4c8", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Patient a4dbd17d-35f8-4f36-9dac-f276fa75a4c8

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:9ee37afe-e35a-4ee8-80b1-7f4786cdd507", "resource" : { "resourceType" : "Practitioner", "id" : "9ee37afe-e35a-4ee8-80b1-7f4786cdd507", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Practitioner 9ee37afe-e35a-4ee8-80b1-7f4786cdd507

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:66ec8a06-3a04-454e-bace-0ad07f70405a", "resource" : { "resourceType" : "Organization", "id" : "66ec8a06-3a04-454e-bace-0ad07f70405a", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Organization 66ec8a06-3a04-454e-bace-0ad07f70405a

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:48d6ee22-e2bf-427e-878a-19b5f264f46a", "resource" : { "resourceType" : "Organization", "id" : "48d6ee22-e2bf-427e-878a-19b5f264f46a", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Organization 48d6ee22-e2bf-427e-878a-19b5f264f46a

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:ea4f766b-b7c1-476a-8f19-095928b65ca5", "resource" : { "resourceType" : "Location", "id" : "ea4f766b-b7c1-476a-8f19-095928b65ca5", "text" : { "status" : "generated", "div" : "

Generated Narrative: Location ea4f766b-b7c1-476a-8f19-095928b65ca5

identifier: B1-S.F2

status: Active

name: South Wing, second floor

alias: XYZ Life Hospital 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" : ["XYZ Life Hospital 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:48d6ee22-e2bf-427e-878a-19b5f264f46a", "display" : "Organization" } } }, { "fullUrl" : "urn:uuid:462d36b1-4171-4ebb-871d-94fdb3f7eb11", "resource" : { "resourceType" : "Coverage", "id" : "462d36b1-4171-4ebb-871d-94fdb3f7eb11", "meta" : { "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Coverage"] }, "text" : { "status" : "generated", "div" : "

Generated Narrative: Coverage 462d36b1-4171-4ebb-871d-94fdb3f7eb11

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:a4dbd17d-35f8-4f36-9dac-f276fa75a4c8", "display" : "Patient" }, "subscriberId" : "ABC123456BI007", "beneficiary" : { "reference" : "urn:uuid:a4dbd17d-35f8-4f36-9dac-f276fa75a4c8", "display" : "Patient" }, "relationship" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship", "code" : "self" }] }, "period" : { "end" : "2026-03-17" }, "payor" : [{ "reference" : "urn:uuid:66ec8a06-3a04-454e-bace-0ad07f70405a", "display" : "Organization" }] } }] }