<?xml version=“1.0” encoding=“UTF-8”?><ProcessResponse xmlns=“hl7.org/fhir”>
<id value="SR2349"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the ProcessResponse</div> </text> <identifier> <system value="http://www.BenefitsInc.com/fhir/processresponse"/> <value value="ER987634"/> </identifier> <status value="active"/> <created value="2014-07-14"/> <organization> <reference value="Organization/2"/> </organization> <request> <reference value="http://happyvalley.com/fhir/claim/12204"/> </request> <outcome> <coding> <system value="http://hl7.org/fhir/processoutcomecodes"/> <code value="error"/> </coding> </outcome> <disposition value="Referred to claim not found on system."/> <requestProvider> <identifier> <system value="http://npid.org/providerid"/> <value value="AZ43258"/> </identifier> </requestProvider> <requestOrganization> <reference value="Organization/1"/> </requestOrganization> <form> <coding> <system value="http://ncforms.org/formid"/> <code value="PRRESP/2016/01"/> </coding> </form> <processNote> <type> <coding> <system value="http://hl7.org/fhir/note-type"/> <code value="print"/> </coding> </type> <text value="Please check the submitted payor identification and local claim number."/> </processNote> <error> <coding> <system value="http://hl7.org/fhir/adjudication-error"/> <code value="a001"/> </coding> </error>
</ProcessResponse>