{
"resourceType": "CoverageEligibilityResponse", "id": "E2503", "identifier": [ { "system": "http://www.BenefitsInc.com/fhir/coverageeligibilityresponse", "value": "8812343" } ], "status": "active", "purpose": [ "validation" ], "patient": { "reference": "Patient/f201" }, "created": "2014-09-16", "requestor": { "identifier": { "system": "http://national.org/clinic", "value": "OR1234" } }, "request": { "reference": "http://www.BenefitsInc.com/fhir/CoverageEligibilityRequest/225476332406" }, "outcome": "error", "disposition": "Eligibiliy request could not be processed, please address errors before submitting.", "insurer": { "reference": "Organization/2" }, "form": { "coding": [ { "system": "http://national.org/form", "code": "ELRSP/2017/01" } ] }, "error": [ { "code": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/adjudication-error", "code": "a001" } ] } } ], "meta": { "tag": [ { "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason", "code": "HTEST", "display": "test health data" } ] }
}