CoverageEligibilityResponse

Last updated: 2 Dec 2024

The CoverageEligibilityResponse resource provides eligibility and plan details from processing a CoverageEligibilityRequest resource. It combines key information from a payor as to whether a Coverage is in-force, and optionally the nature of the Policy benefit details as well as the ability for the insurer to indicate whether the insurance provides benefits for requested types of services or requires preauthorization and if so what supporting information may be required.

https://hl7.org/fhir/R4/coverageeligibilityresponse.html

Endpoints

get

/CoverageEligibilityResponse/{id}

get

/CoverageEligibilityResponse

get

/CoverageEligibilityResponse/{id}

CoverageEligibilityResponse read

Path Parameters

id required

string

The unique identifier for the CoverageEligibilityResponse

Response Payload Attributes

resourceType

string

The FHIR Resource name.

string

The identifier of the CoverageEligibilityResponse.

status

string

Status of the resource.

Value Options Supported:

active
entered-in-error

purpose

array[string]

Reason for the request, will always be [“benefits”]

patient

json

Patient resource the CoverageEligibilityResponse is for.

Click to view child attributes

reference

string

The reference string of the patient in the format of "Patient/a39cafb9d1b445be95a2e2548e12a787".

type

string

Type the reference refers to (e.g. “Patient”).

created

datetime

Response creation date.

request

json

CoverageEligibilityRequest reference the elibibility response is for.

Click to view child attributes

reference

string

The reference string of the request in the format of "CoverageEligibilityRequest/cd98975b-6cd4-413d-ab65-1fc5eec76762".

type

string

Type the reference refers to (e.g. “CoverageEligibilityRequest”).

outcome

string

Outcome of the request processing, if an error occurs it will be marked as “error” othervise it will be marked as “complete”.

Value Options Supported:

error
complete

insurer

json

Coverage issuer.

Click to view child attributes

string

Payor ID for the Coverage issuer.

string

Text alternative for the resource.

insurance

array[json]

Patient insurance information. This includes the Coverage reference, extension for plan name and an array of items containing benefits and authorization details returned from Claim.MD.

The amount of information surfaced here depends on the what the payor supports. Our clearinghouse (Claim.md) performs these eligibility checks, but not all coverages will support real-time eligibility checks. For more information on coverages within Canvas, see this article.

Click to view child attributes

coverage

json

Insurance information.

Click to view child attributes

reference

string

The reference string of the coverage in the format of "Coverage/4a86f580-e192-489a-a9f0-7c915fc67111".

type

string

Type the reference refers to (e.g. “Coverage”).

extension

array[json]

Canvas supports a plan name extension on this resource for read and search interactions.

Click to view child attributes

url

string

Reference that defines the content of this object.

Value Options Supported:

http://schemas.canvasmedical.com/fhir/extensions/active-health-benefit-plan-coverage-description

valueString

string

The plan name of the insurance.

item

array[json]

Array of items containing benefits and authorization details.

Click to view child attributes

name

string

Short name for the benefit

unit

json

Individual or family.

Click to view child attributes

coding

array[json]

Code defined by a terminology system.

Click to view child attributes

system

string

The system url of the coding.

Value Options Supported:

http://terminology.hl7.org/CodeSystem/benefit-unit

code

string

The code of the benefit unit.

Value Options Supported:

individual
family

display

string

The display name of the coding.

Value Options Supported:

Individual
Family

text

string

Plain text representation of the concept.

Value Options Supported:

Individual
Family

network

json

In or out of network.

Click to view child attributes

coding

array[json]

Code defined by a terminology system.

Click to view child attributes

system

string

The system url of the coding.

Value Options Supported:

http://terminology.hl7.org/CodeSystem/benefit-unit

code

string

The code of the benefit network.

Value Options Supported:

display

string

The display name of the coding.

Value Options Supported:

In Network
Out of Network

text

string

Plain text representation of the concept.

Value Options Supported:

In Network
Out of Network

benefit

array[json]

Benefit Summary.

Click to view child attributes

type

json

Benefit classification.

Click to view child attributes

text

string

Plain text representation of the concept.

Value Options Supported:

Co-Insurance
Co-Payment
Active Coverage
Deductible
Out of Pocket (Stop Loss)
Limitations
Contact following entity for eligibility or benefit information
(Incomplete Information)

allowedString

string

Benefits allowed.

Used for Co-Insurance benefit types.

allowedMoney

json

Benefits allowed.

Used for Co-Payment, Deductible, or Out of Pocket benefit types.

Click to view child attributes

value

decimal

Numerical value (with implicit precision)

allowedUnsignedInt

unsignedInt

Benefits allowed.

Used for Limitations benefit types.

usedMoney

json

Benefits used.

Used for Deductible or Out of Pocket benefit types.

Click to view child attributes

value

decimal

Numerical value (with implicit precision)

usedUnsignedInt

unsignedInt

Benefits used.

Used for Limitations benefit types.

Responses

200 OK

Request was successful.

Errors

401 Unauthorized

The request requires user authentication.

403 Forbidden

The request requires user authorization.

404 Not Found

The requested resource was not found.

get

/CoverageEligibilityResponse

CoverageEligibilityResponse search

Query Parameters

_id

string

The Canvas resource identifier of the CoverageEligibilityResponse.

patient

string

The patient reference associated with the CoverageEligibilityResponse in the format Patient/a39cafb9d1b445be95a2e2548e12a787.

request

string

The coverage eligibility request reference associated with the CoverageEligibilityResponse in the format "CoverageEligibilityRequest/cd98975b-6cd4-413d-ab65-1fc5eec76762".

Response Payload Attributes

resourceType

string

The FHIR Resource name.

type

string

This element and value designate that the bundle is a search response. Search result bundles will always have the Bundle.type of searchset .

total

integer

The number of resources that match the search parameter.

link

array[json]

Attributes relevant to pagination, see our Pagination page for more detail.

Click to view child attributes

relation

enum [self|first|next|last]

The relation of the page search

url

The search url for the specific relation

entry

array[json]

The results bundle that lists out each object returned in the search

Click to view child attributes

resource

json

The attributes specific to the resource type, see the Attributes section below

Attributes

resourceType

string

The FHIR Resource name.

string

The identifier of the CoverageEligibilityResponse.

status

string

Status of the resource.

Value Options Supported:

active
entered-in-error

purpose

array[string]

Reason for the request, will always be [“benefits”]

patient

json

Patient resource the CoverageEligibilityResponse is for.

Click to view child attributes

reference

string

The reference string of the patient in the format of "Patient/a39cafb9d1b445be95a2e2548e12a787".

type

string

Type the reference refers to (e.g. “Patient”).

created

datetime

Response creation date.

request

json

CoverageEligibilityRequest reference the elibibility response is for.

Click to view child attributes

reference

string

The reference string of the request in the format of "CoverageEligibilityRequest/cd98975b-6cd4-413d-ab65-1fc5eec76762".

type

string

Type the reference refers to (e.g. “CoverageEligibilityRequest”).

outcome

string

Outcome of the request processing, if an error occurs it will be marked as “error” othervise it will be marked as “complete”.

Value Options Supported:

error
complete

insurer

json

Coverage issuer.

Click to view child attributes

string

Payor ID for the Coverage issuer.

string

Text alternative for the resource.

insurance

array[json]

Click to view child attributes

coverage

json

Insurance information.

Click to view child attributes

reference

string

The reference string of the coverage in the format of "Coverage/4a86f580-e192-489a-a9f0-7c915fc67111".

type

string

Type the reference refers to (e.g. “Coverage”).

extension

array[json]

Canvas supports a plan name extension on this resource for read and search interactions.

Click to view child attributes

url

string

Reference that defines the content of this object.

Value Options Supported:

http://schemas.canvasmedical.com/fhir/extensions/active-health-benefit-plan-coverage-description

valueString

string

The plan name of the insurance.

item

array[json]

Array of items containing benefits and authorization details.

Click to view child attributes

name

string

Short name for the benefit

unit

json

Individual or family.

Click to view child attributes

coding

array[json]

Code defined by a terminology system.

Click to view child attributes

system

string

The system url of the coding.

Value Options Supported:

http://terminology.hl7.org/CodeSystem/benefit-unit

code

string

The code of the benefit unit.

Value Options Supported:

individual
family

display

string

The display name of the coding.

Value Options Supported:

Individual
Family

text

string

Plain text representation of the concept.

Value Options Supported:

Individual
Family

network

json

In or out of network.

Click to view child attributes

coding

array[json]

Code defined by a terminology system.

Click to view child attributes

system

string

The system url of the coding.

Value Options Supported:

http://terminology.hl7.org/CodeSystem/benefit-unit

code

string

The code of the benefit network.

Value Options Supported:

display

string

The display name of the coding.

Value Options Supported:

In Network
Out of Network

text

string

Plain text representation of the concept.

Value Options Supported:

In Network
Out of Network

benefit

array[json]

Benefit Summary.

Click to view child attributes

type

json

Benefit classification.

Click to view child attributes

text

string

Plain text representation of the concept.

Value Options Supported:

Co-Insurance
Co-Payment
Active Coverage
Deductible
Out of Pocket (Stop Loss)
Limitations
Contact following entity for eligibility or benefit information
(Incomplete Information)

allowedString

string

Benefits allowed.

Used for Co-Insurance benefit types.

allowedMoney

json

Benefits allowed.

Used for Co-Payment, Deductible, or Out of Pocket benefit types.

Click to view child attributes

value

decimal

Numerical value (with implicit precision)

allowedUnsignedInt

unsignedInt

Benefits allowed.

Used for Limitations benefit types.

usedMoney

json

Benefits used.

Used for Deductible or Out of Pocket benefit types.

Click to view child attributes

value

decimal

Numerical value (with implicit precision)

usedUnsignedInt

unsignedInt

Benefits used.

Used for Limitations benefit types.

Responses

200 OK

Request was successful.

Errors

400 Bad Request

The request was invalid or cannot be otherwise served. An accompanying error message will explain further.

401 Unauthorized

The request requires user authentication.

403 Forbidden

The request requires user authorization.

curl --request GET \
     --url 'https://fumage-example.canvasmedical.com/CoverageEligibilityResponse/<id>' \
     --header 'Authorization: Bearer <token>' \
     --header 'accept: application/json'

import requests

url = "https://fumage-example.canvasmedical.com/CoverageEligibilityResponse/<id>"

headers = {
    "accept": "application/json",
    "Authorization": "Bearer <token>"
}

response = requests.get(url, headers=headers)

print(response.text)

{
  "resourceType": "CoverageEligibilityResponse",
  "id": "9ad12f4e-4f35-4f54-8b4f-036516488191",
  "status": "active",
  "purpose": [
      "benefits"
  ],
  "patient": {
      "reference": "Patient/b41c7cda738d440cb55e0e6cb67499a1",
      "type": "Patient"
  },
  "created": "2023-09-19T18:16:39.551617+00:00",
  "request": {
      "reference": "CoverageEligibilityRequest/d7254641-e363-488c-91fa-b93a6170b9e0",
      "type": "CoverageEligibilityRequest"
  },
  "outcome": "complete",
  "insurer": {
      "identifier": "1111",
      "display": "Payer ID: 1111"
  },
  "insurance": [
    {
      "extension": [
        {
          "url": "http://schemas.canvasmedical.com/fhir/extensions/active-health-benefit-plan-coverage-description",
          "valueString": "Humana Gold Plus"
        }
      ],
      "coverage": {
          "reference": "Coverage/4a86f580-e192-489a-a9f0-7c915fc67111",
          "type": "Coverage"
      },
      "item": [
        {
          "network": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                "code": "in",
                "display": "In Network"
              }
            ],
            "text": "In Network"
          },
          "unit": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/benefit-unit",
                "code": "individual",
                "display": "Individual"
              }
            ],
            "text": "Individual"
          },
          "benefit": [
            {
              "type": {
                  "text": "Co-Payment"
              },
              "allowedMoney": {
                  "value": 333
              }
            },
            {
              "type": {
                  "text": "Co-Insurance"
              },
              "allowedString": "0.0%"
            }
          ]
        },
        {
          "network": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                "code": "in",
                "display": "In Network"
              }
            ],
            "text": "In Network"
          },
          "unit": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/benefit-unit",
                  "code": "individual",
                  "display": "Individual"
                }
              ],
              "text": "Individual"
          },
            "benefit": [
              {
                "type": {
                    "text": "Co-Insurance"
                },
                "allowedString": "0.0%"
              },
              {
                "type": {
                    "text": "Co-Insurance"
                },
                "allowedString": "0.0%"
              },
              {
                "type": {
                    "text": "Co-Insurance"
                },
                "allowedString": "0.0%"
              }
            ]
        },
        {
          "benefit": [
            {
              "type": {
                  "text": "Benefit Description (Incomplete information)"
              }
            }
          ]
        },
        {
          "benefit": [
            {
              "type": {
                  "text": "Active Coverage"
              }
            }
          ]
        },
        {
          "network": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                  "code": "in",
                  "display": "In Network"
                }
              ],
              "text": "In Network"
          },
          "benefit": [
            {
              "type": {
                  "text": "Active Coverage"
              }
            },
            {
              "type": {
                  "text": "Primary Care Provider (Incomplete information)"
              }
            },
            {
              "type": {
                  "text": "Benefit Description (Incomplete information)"
              }
            },
            {
              "type": {
                  "text": "Benefit Disclaimer (Incomplete information)"
              }
            }
          ]
        },
        {
          "name": "Dental Care",
          "network": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                  "code": "in",
                  "display": "In Network"
                }
              ],
              "text": "In Network"
          },
          "unit": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/benefit-unit",
                  "code": "individual",
                  "display": "Individual"
                }
              ],
              "text": "Individual"
          },
          "benefit": [
            {
              "type": {
                  "text": "Active Coverage"
              }
            }
          ]
        },
        {
          "name": "Health Benefit Plan Coverage",
          "network": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                  "code": "in",
                  "display": "In Network"
                }
              ],
              "text": "In Network"
          },
          "unit": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/benefit-unit",
                  "code": "individual",
                  "display": "Individual"
                }
              ],
              "text": "Individual"
          },
          "benefit": [
            {
              "type": {
                  "text": "Deductible (Incomplete information)"
              }
            },
            {
              "type": {
                  "text": "Deductible"
              },
              "allowedMoney": {
                  "value": 6900
              },
              "usedMoney": {
                  "value": 0.0
              }
            },
            {
              "type": {
                  "text": "Active Coverage"
              }
            },
            {
              "type": {
                  "text": "Out of Pocket (Stop Loss)"
              },
              "allowedMoney": {
                  "value": 6900
              },
              "usedMoney": {
                  "value": 0.0
              }
            },
            {
              "type": {
                  "text": "Out of Pocket (Stop Loss)"
              },
              "allowedMoney": {
                  "value": 6900
              },
              "usedMoney": {
                  "value": 0.0
              }
            }
          ]
        },
        {
          "name": "Health Benefit Plan Coverage",
          "network": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                  "code": "in",
                  "display": "In Network"
                }
              ],
              "text": "In Network"
          },
          "benefit": [
            {
              "type": {
                  "text": "Benefit Description (Incomplete information)"
              }
            }
          ]
        },
        {
          "name": "Physician Visit - Well",
          "network": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                  "code": "in",
                  "display": "In Network"
                }
              ],
              "text": "In Network"
          },
          "benefit": [
            {
              "type": {
                  "text": "Non-Covered (Incomplete information)"
              }
            }
          ]
        },
        {
          "name": "Professional (Physician) Visit - Office",
          "network": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                  "code": "in",
                  "display": "In Network"
                }
              ],
              "text": "In Network"
          },
          "unit": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/benefit-unit",
                  "code": "individual",
                  "display": "Individual"
                }
              ],
              "text": "Individual"
          },
          "benefit": [
            {
              "type": {
                  "text": "Co-Insurance"
              },
              "allowedString": "0.0%"
            }
          ]
        },
        {
          "name": "Professional (Physician) Visit - Office",
          "network": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                  "code": "in",
                  "display": "In Network"
                }
              ],
              "text": "In Network"
          },
          "benefit": [
            {
              "type": {
                  "text": "Non-Covered (Incomplete information)"
              }
            },
            {
              "type": {
                  "text": "Active Coverage"
              }
            }
          ]
        }
      ]
    }
  ]
}

{
  "resourceType": "OperationOutcome",
  "issue": [
    {
      "severity": "error",
      "code": "unknown",
      "details": {
        "text": "Authentication failed"
      }
    }
  ]
}

{
  "resourceType": "OperationOutcome",
  "issue": [
    {
      "severity": "error",
      "code": "forbidden",
      "details": {
        "text": "Authorization failed"
      }
    }
  ]
}

{
  "resourceType": "OperationOutcome",
  "issue": [
    {
      "severity": "error",
      "code": "not-found",
      "details": {
        "text": "Unknown CoverageEligibilityResponse resource 'c152eeb7-f204-4e28-acb5-c7e85390b17e'"
      }
    }
  ]
}

curl --request GET \
     --url 'https://fumage-example.canvasmedical.com/Group?request=CoverageEligibilityRequest/b41c7cda738d440cb55e0e6cb67499a1' \
     --header 'Authorization: Bearer <token>' \
     --header 'accept: application/json'

import requests

url = "https://fumage-example.canvasmedical.com/Group?request=CoverageEligibilityRequest/b41c7cda738d440cb55e0e6cb67499a1"

headers = {
    "accept": "application/json",
    "Authorization": "Bearer <token>"
}

response = requests.get(url, headers=headers)

print(response.text)

{
  "resourceType": "Bundle",
  "type": "searchset",
  "total": 1,
  "entry": [
    {
      "resource": {
        "resourceType": "CoverageEligibilityResponse",
        "id": "9ad12f4e-4f35-4f54-8b4f-036516488191",
        "status": "active",
        "purpose": [
            "benefits"
        ],
        "patient": {
            "reference": "Patient/b41c7cda738d440cb55e0e6cb67499a1",
            "type": "Patient"
        },
        "created": "2023-09-19T18:16:39.551617+00:00",
        "request": {
            "reference": "CoverageEligibilityRequest/d7254641-e363-488c-91fa-b93a6170b9e0",
            "type": "CoverageEligibilityRequest"
        },
        "outcome": "complete",
        "insurer": {
            "identifier": "1111",
            "display": "Payer ID: 1111"
        },
        "insurance": [
          {
            "extension": [
              {
                "url": "http://schemas.canvasmedical.com/fhir/extensions/active-health-benefit-plan-coverage-description",
                "valueString": "Humana Gold Plus"
              }
            ],
            "coverage": {
                "reference": "Coverage/4a86f580-e192-489a-a9f0-7c915fc67111",
                "type": "Coverage"
            },
            "item": [
              {
                "network": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                      "code": "in",
                      "display": "In Network"
                    }
                  ],
                  "text": "In Network"
                },
                "unit": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/benefit-unit",
                      "code": "individual",
                      "display": "Individual"
                    }
                  ],
                  "text": "Individual"
                },
                "benefit": [
                  {
                    "type": {
                        "text": "Co-Payment"
                    },
                    "allowedMoney": {
                        "value": 333
                    }
                  },
                  {
                    "type": {
                        "text": "Co-Insurance"
                    },
                    "allowedString": "0.0%"
                  }
                ]
              },
              {
                "network": {
                  "coding": [
                    {
                      "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                      "code": "in",
                      "display": "In Network"
                    }
                  ],
                  "text": "In Network"
                },
                "unit": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/benefit-unit",
                        "code": "individual",
                        "display": "Individual"
                      }
                    ],
                    "text": "Individual"
                },
                  "benefit": [
                    {
                      "type": {
                          "text": "Co-Insurance"
                      },
                      "allowedString": "0.0%"
                    },
                    {
                      "type": {
                          "text": "Co-Insurance"
                      },
                      "allowedString": "0.0%"
                    },
                    {
                      "type": {
                          "text": "Co-Insurance"
                      },
                      "allowedString": "0.0%"
                    }
                  ]
              },
              {
                "benefit": [
                  {
                    "type": {
                        "text": "Benefit Description (Incomplete information)"
                    }
                  }
                ]
              },
              {
                "benefit": [
                  {
                    "type": {
                        "text": "Active Coverage"
                    }
                  }
                ]
              },
              {
                "network": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                        "code": "in",
                        "display": "In Network"
                      }
                    ],
                    "text": "In Network"
                },
                "benefit": [
                  {
                    "type": {
                        "text": "Active Coverage"
                    }
                  },
                  {
                    "type": {
                        "text": "Primary Care Provider (Incomplete information)"
                    }
                  },
                  {
                    "type": {
                        "text": "Benefit Description (Incomplete information)"
                    }
                  },
                  {
                    "type": {
                        "text": "Benefit Disclaimer (Incomplete information)"
                    }
                  }
                ]
              },
              {
                "name": "Dental Care",
                "network": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                        "code": "in",
                        "display": "In Network"
                      }
                    ],
                    "text": "In Network"
                },
                "unit": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/benefit-unit",
                        "code": "individual",
                        "display": "Individual"
                      }
                    ],
                    "text": "Individual"
                },
                "benefit": [
                  {
                    "type": {
                        "text": "Active Coverage"
                    }
                  }
                ]
              },
              {
                "name": "Health Benefit Plan Coverage",
                "network": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                        "code": "in",
                        "display": "In Network"
                      }
                    ],
                    "text": "In Network"
                },
                "unit": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/benefit-unit",
                        "code": "individual",
                        "display": "Individual"
                      }
                    ],
                    "text": "Individual"
                },
                "benefit": [
                  {
                    "type": {
                        "text": "Deductible (Incomplete information)"
                    }
                  },
                  {
                    "type": {
                        "text": "Deductible"
                    },
                    "allowedMoney": {
                        "value": 6900
                    },
                    "usedMoney": {
                        "value": 0.0
                    }
                  },
                  {
                    "type": {
                        "text": "Active Coverage"
                    }
                  },
                  {
                    "type": {
                        "text": "Out of Pocket (Stop Loss)"
                    },
                    "allowedMoney": {
                        "value": 6900
                    },
                    "usedMoney": {
                        "value": 0.0
                    }
                  },
                  {
                    "type": {
                        "text": "Out of Pocket (Stop Loss)"
                    },
                    "allowedMoney": {
                        "value": 6900
                    },
                    "usedMoney": {
                        "value": 0.0
                    }
                  }
                ]
              },
              {
                "name": "Health Benefit Plan Coverage",
                "network": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                        "code": "in",
                        "display": "In Network"
                      }
                    ],
                    "text": "In Network"
                },
                "benefit": [
                  {
                    "type": {
                        "text": "Benefit Description (Incomplete information)"
                    }
                  }
                ]
              },
              {
                "name": "Physician Visit - Well",
                "network": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                        "code": "in",
                        "display": "In Network"
                      }
                    ],
                    "text": "In Network"
                },
                "benefit": [
                  {
                    "type": {
                        "text": "Non-Covered (Incomplete information)"
                    }
                  }
                ]
              },
              {
                "name": "Professional (Physician) Visit - Office",
                "network": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                        "code": "in",
                        "display": "In Network"
                      }
                    ],
                    "text": "In Network"
                },
                "unit": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/benefit-unit",
                        "code": "individual",
                        "display": "Individual"
                      }
                    ],
                    "text": "Individual"
                },
                "benefit": [
                  {
                    "type": {
                        "text": "Co-Insurance"
                    },
                    "allowedString": "0.0%"
                  }
                ]
              },
              {
                "name": "Professional (Physician) Visit - Office",
                "network": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/benefit-network",
                        "code": "in",
                        "display": "In Network"
                      }
                    ],
                    "text": "In Network"
                },
                "benefit": [
                  {
                    "type": {
                        "text": "Non-Covered (Incomplete information)"
                    }
                  },
                  {
                    "type": {
                        "text": "Active Coverage"
                    }
                  }
                ]
              }
            ]
          }
        ]
      }
    }
  ]
}

{
  "resourceType": "OperationOutcome",
  "id": "101",
  "issue": [
    {
      "severity": "error",
      "code": "invalid",
      "details": {
        "text": "Bad request"
      }
    }
  ]
}

{
  "resourceType": "OperationOutcome",
  "issue": [
    {
      "severity": "error",
      "code": "unknown",
      "details": {
        "text": "Authentication failed"
      }
    }
  ]
}

{
  "resourceType": "OperationOutcome",
  "issue": [
    {
      "severity": "error",
      "code": "forbidden",
      "details": {
        "text": "Authorization failed"
      }
    }
  ]
}