CoverageEligibilityResponse resource (FHIR R4)

CoverageEligibilityResponse is the FHIR R4 resource for this resource provides eligibility and plan details from the processing of an CoverageEligibilityRequest resource.

Resource	CoverageEligibilityResponse
FHIR version	R4 (4.0.1)
Canonical URL	http://hl7.org/fhir/StructureDefinition/CoverageEligibilityResponse
Required elements	status (1..1), purpose (1..*), patient (1..1), created (1..1), request (1..1), outcome (1..1), insurer (1..1)

Example

{
  "resourceType": "CoverageEligibilityResponse",
  "id": "coverageeligibilityresponse-ba8b8aea7432848548abed314566504a",
  "status": "active",
  "purpose": [
    "auth-requirements"
  ],
  "patient": {
    "reference": "Patient/patient-1a05727a03b249f91f71528414a6adb8"
  },
  "created": "2026-07-01T12:00:00Z",
  "request": {
    "reference": "CoverageEligibilityRequest/coverageeligibilityrequest-c238f0ef9a5ba85b9780e8b74d17564d"
  },
  "outcome": "queued",
  "insurer": {
    "reference": "Organization/organization-0ebcc97138aa5171c04be3ba810c1263"
  }
}

Generated by the Pidgeon engine: pidgeon generate CoverageEligibilityResponse --seed 20260722.

Validation context

strict pidgeon validate grades a CoverageEligibilityResponse instance against the base R4 structure definition: missing required elements raise REQUIRED_FIELD_MISSING and cardinality violations raise CARDINALITY_MIN or CARDINALITY_MAX.(REQUIRED_FIELD_MISSING)

This answer, in your terminal

pidgeon lookup CoverageEligibilityResponse

Wire it into your AI agent:

claude mcp add pidgeon -- npx -y @pidgeonhealth/mcp

Download Post free to browse this reference with generation attached.