<?xml version=“1.0” encoding=“UTF-8”?> <CommunicationRequest xmlns=“hl7.org/fhir”>

<id value="fm-solicit"/>
<meta>
  <security>
    <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
    <code value="HTEST"/>
    <display value="test health data"/>
  </security>
</meta>

<!--  insert contents here  -->

  <contained>
  <Organization>
    <id value="provider"/>
    <identifier>
      <system value="http://www.jurisdiction.com/provideroffices"/>
      <value value="3456"/>
    </identifier>
  </Organization>
</contained>

<contained>
  <Organization>
    <id value="payor"/>
    <identifier>
      <system value="http://www.jurisdiction.com/insurer"/>
      <value value="123456"/>
    </identifier>
  </Organization>
</contained>

<contained>
  <Practitioner>
    <id value="requester"/>
    <identifier>
       <value value="6789"/>
    </identifier>
  </Practitioner>
</contained>
<!--  body of the resource  -->

<identifier>
  <system value="http://www.jurisdiction.com/insurer/123456"/>
  <value value="ABC123"/> <!--  this is the value to which the response will refer  -->
</identifier>
 <basedOn>
  <display value="EligibilityRequest"/>
</basedOn>
 <replaces>
  <display value="prior CommunicationRequest"/>
</replaces>
<groupIdentifier>
     <value value="12345"/>
</groupIdentifier>
<status value="active"/>

<category>
   <coding>
     <system value="http://acme.org/messagetypes"/>
     <code value="SolicitedAttachmentRequest"/>
   </coding>
</category>
<priority value="routine"/>
<medium>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/v3-ParticipationMode"/>
    <code value="WRITTEN"/>
    <display value="written"/>
  </coding>
  <text value="written"/>
</medium>

<encounter>
  <reference value="Encounter/example"/>
</encounter>
<payload>
  <contentString value="Please provide the accident report and any associated pictures to support your Claim# DEF5647."/>
</payload>
<occurrenceDateTime value="2016-06-10T11:01:10-08:00"/>
<authoredOn value="2016-06-10T11:01:10-08:00"/>
<requester>
              <reference value="#requester"/>
 </requester>
 <recipient>
    <reference value="#provider"/>
</recipient>
 <sender>
   <reference value="#payor"/>
 </sender>

</CommunicationRequest>