CMS ACCESS Model API
0.9.0 - ci-build

CMS ACCESS Model API - Local Development build (v0.9.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## : Check Eligibility Request - XML Representation

Active as of 2026-03-06

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    <OperationDefinition xmlns="http://hl7.org/fhir">
      <id value="CheckEligibility"/>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: OperationDefinition CheckEligibility</b></p><a name="CheckEligibility"> </a><a name="hcCheckEligibility"> </a><p>URL: [base]/Patient/$check-eligibility</p><p>Input parameters Profile:<a href="StructureDefinition-access-check-eligibility-in.html">ACCESS Check Eligibility Request Parameters</a></p><h3>Parameters</h3><table class="grid"><tr><td><b>Use</b></td><td><b>Name</b></td><td><b>Scope</b></td><td><b>Cardinality</b></td><td><b>Type</b></td><td><b>Binding</b></td><td><b>Documentation</b></td></tr><tr><td>IN</td><td>participantID</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#Identifier">Identifier</a></td><td/><td><div><p>ACCESS participant identifier. Must follow the pattern ACCESS#### where #### represents exactly 4 digits (e.g., ACCESS0001, ACCESS1234).</p>
    </div></td></tr><tr><td>IN</td><td>payerID</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#Identifier">Identifier</a></td><td/><td><div><p>Payer ID for the patient.</p>
    </div></td></tr><tr><td>IN</td><td>patient</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/patient.html">Patient</a></td><td/><td><div><p>Patient information.  It <strong>SHOULD</strong> contain the Medicare Beneficiary Identifier (MBI).</p>
    </div></td></tr><tr><td>IN</td><td>track</td><td/><td>1..1</td><td><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td><a href="ValueSet-ACCESSTrackVS.html">ACCESS Model Tracks Value Set</a> (Required)</td><td><div><p>ACCESS track for which eligibility is being checked.</p>
    </div></td></tr><tr><td>IN</td><td>condition</td><td/><td>0..*</td><td><a href="http://hl7.org/fhir/R4/condition.html">Condition</a></td><td/><td><div><p>Patient's conditions.</p>
    </div></td></tr></table></div>
      </text>
      <url
           value="https://globalalliantinc.com/access/OperationDefinition/CheckEligibility"/>
      <version value="0.9.0"/>
      <name value="CheckEligibility"/>
      <title value="Check Eligibility Request"/>
      <status value="active"/>
      <kind value="operation"/>
      <date value="2026-03-06T16:03:26-05:00"/>
      <publisher value="Global Alliant, Inc."/>
      <contact>
        <name value="Global Alliant, Inc."/>
        <telecom>
          <system value="url"/>
          <value value="https://globalalliantinc.com"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="david.h@globalalliantinc.org"/>
        </telecom>
      </contact>
      <description
                   value="The **$check-eligibility** operation allows a participant to submit basic information on a patient who they believe will be a good candidate for the ACCESS model and who wants to be part of the ACCESS Model. The participant can use this API to do a quick check on which patients may be eligible before officially submitting the patient's information for consideration and inclusion in the ACCESS Model."/>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="US"/>
          <display value="United States of America"/>
        </coding>
      </jurisdiction>
      <code value="check-eligibility"/>
      <resource value="Patient"/>
      <system value="false"/>
      <type value="true"/>
      <instance value="false"/>
      <inputProfile
                    value="https://globalalliantinc.com/access/StructureDefinition/access-check-eligibility-in|0.9.0"/>
      <parameter>
        <name value="participantID"/>
        <use value="in"/>
        <min value="1"/>
        <max value="1"/>
        <documentation
                       value="ACCESS participant identifier. Must follow the pattern ACCESS#### where #### represents exactly 4 digits (e.g., ACCESS0001, ACCESS1234)."/>
        <type value="Identifier"/>
      </parameter>
      <parameter>
        <name value="payerID"/>
        <use value="in"/>
        <min value="1"/>
        <max value="1"/>
        <documentation value="Payer ID for the patient."/>
        <type value="Identifier"/>
      </parameter>
      <parameter>
        <name value="patient"/>
        <use value="in"/>
        <min value="1"/>
        <max value="1"/>
        <documentation
                       value="Patient information.  It **SHOULD** contain the Medicare Beneficiary Identifier (MBI)."/>
        <type value="Patient"/>
      </parameter>
      <parameter>
        <name value="track"/>
        <use value="in"/>
        <min value="1"/>
        <max value="1"/>
        <documentation
                       value="ACCESS track for which eligibility is being checked."/>
        <type value="CodeableConcept"/>
        <binding>
          <strength value="required"/>
          <valueSet
                    value="https://globalalliantinc.com/access/ValueSet/ACCESSTrackVS|0.9.0"/>
        </binding>
      </parameter>
      <parameter>
        <name value="condition"/>
        <use value="in"/>
        <min value="0"/>
        <max value="*"/>
        <documentation value="Patient's conditions."/>
        <type value="Condition"/>
      </parameter>
    </OperationDefinition>