R4 Ballot #1 (Mixed Normative/Trial use)
AdministrationThis page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions 
| Patient Administration Work Group | Maturity Level: N/A | Ballot Status: Informative | Compartments: Not linked to any defined compartments |
StructureDefinition for productplan
{
"resourceType": "StructureDefinition",
"id": "ProductPlan",
"meta": {
"lastUpdated": "2018-04-03T12:05:46.262+10:00"
},
"text": {
"status": "generated",
"div": "<div>!-- Snipped for Brevity --></div>"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-ballot-status",
"valueString": "Draft"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 0
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "pa"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/ProductPlan",
"name": "ProductPlan",
"status": "draft",
"date": "2018-04-03T12:05:46+10:00",
"publisher": "Health Level Seven International (Patient Administration)",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://hl7.org/fhir"
}
]
},
{
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/pafm/index.cfm"
}
]
}
],
"description": "Details of a Health Insurance product/plan provided by an organization.",
"fhirVersion": "3.3.0",
"mapping": [
{
"identity": "w5",
"uri": "http://hl7.org/fhir/fivews",
"name": "FiveWs Pattern"
},
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
}
],
"kind": "resource",
"abstract": false,
"type": "ProductPlan",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"derivation": "specialization",
"snapshot": {
"element": [
{
"id": "ProductPlan",
"path": "ProductPlan",
"short": "Details of a Health Insurance product/plan provided by an organization",
"definition": "Details of a Health Insurance product/plan provided by an organization.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan",
"min": 0,
"max": "*"
},
"constraint": [
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "DomainResource"
},
{
"key": "dom-1",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain any narrative",
"expression": "contained.text.empty()",
"xpath": "not(parent::f:contained and f:text)",
"source": "DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"expression": "contained.all(('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists())",
"xpath": "not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "DomainResource"
},
{
"key": "ppn-1",
"severity": "error",
"human": "The organization SHALL at least have a name or an id, and possibly more than one",
"expression": "(identifier.count() + name.count()) > 0",
"xpath": "count(f:identifier | f:name) > 0"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
}
]
},
{
"id": "ProductPlan.id",
"path": "ProductPlan.id",
"short": "Logical id of this artifact",
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "id"
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "ProductPlan.meta",
"path": "ProductPlan.meta",
"short": "Metadata about the resource",
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "ProductPlan.implicitRules",
"path": "ProductPlan.implicitRules",
"short": "A set of rules under which this content was created",
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true
},
{
"id": "ProductPlan.language",
"path": "ProductPlan.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueReference": {
"reference": "http://hl7.org/fhir/ValueSet/all-languages"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "extensible",
"description": "A human language.",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/languages"
}
},
{
"id": "ProductPlan.text",
"path": "ProductPlan.text",
"short": "Text summary of the resource, for human interpretation",
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"dom-1"
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "ProductPlan.contained",
"path": "ProductPlan.contained",
"short": "Contained, inline Resources",
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ProductPlan.extension",
"path": "ProductPlan.extension",
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ProductPlan.modifierExtension",
"path": "ProductPlan.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isModifierReason": "Not known why this is labelled a modifier",
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ProductPlan.identifier",
"path": "ProductPlan.identifier",
"short": "Identifies this product/plan across multiple systems",
"definition": "Identifier for the product/plan that is used to identify it across multiple disparate systems.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"condition": [
"ppn-1"
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "rim",
"map": ".scopes[Role](classCode=IDENT)"
}
]
},
{
"id": "ProductPlan.status",
"path": "ProductPlan.status",
"short": "draft | active | retired | unknown",
"definition": "Whether the organization's record is still in active use.",
"requirements": "Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.status",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"meaningWhenMissing": "Default interpretation is active.",
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because it is a status element that contains codes which means that the resource should not be treated as valid",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "PublicationStatus"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "required",
"description": "The lifecycle status of an artifact.",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/publication-status"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "rim",
"map": ".status"
}
]
},
{
"id": "ProductPlan.type",
"path": "ProductPlan.type",
"short": "Kind of product/plan",
"definition": "The type of product/plan.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.type",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProductPlanType"
}
],
"strength": "example",
"description": "Used to categorize the product/plan",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/productplan-type"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".code"
}
]
},
{
"id": "ProductPlan.name",
"path": "ProductPlan.name",
"short": "Official name",
"definition": "Official name of the product/plan (as designated by the owner).",
"comment": "If the name of the product/plan changes, consider putting the old name in the alias column so that it can still be located through searches.",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.name",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"condition": [
"ppn-1"
],
"isModifier": false,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".name"
}
]
},
{
"id": "ProductPlan.alias",
"path": "ProductPlan.alias",
"short": "A list of alternate names that the product/plan is known as, or was known as in the past",
"definition": "A list of alternate names that the product/plan is known as, or was known as in the past.",
"comment": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the product/plan.",
"requirements": "Over time products/plans go through many changes and can be known by different names.\n\nFor searching knowing previous names that the product/plan was known by can be very useful.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.alias",
"min": 0,
"max": "*"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".name"
}
]
},
{
"id": "ProductPlan.period",
"path": "ProductPlan.period",
"short": "The time period the product/plan is available",
"definition": "The period of time that the product is available.",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.period",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Period"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.ownedBy",
"path": "ProductPlan.ownedBy",
"short": "Owner of the product/plan",
"definition": "Owner of the product/plan (typically a payer).",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.ownedBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "ProductPlan.administeredBy",
"path": "ProductPlan.administeredBy",
"short": "Administrator of the product/plan",
"definition": "Administrator of the product/plan (e.g. self-insured employer plan administered by a TPA).",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.administeredBy",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "ProductPlan.address",
"path": "ProductPlan.address",
"short": "An address for the organization",
"definition": "An address for the organization.",
"comment": "Organization may have multiple addresses with different uses or applicable periods. The use code home is not to be used.",
"requirements": "May need to keep track of the organization's addresses for contacting, billing or reporting requirements.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.address",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Address"
}
],
"condition": [
"ppn-2"
],
"constraint": [
{
"key": "ppn-2",
"severity": "error",
"human": "An address of an organization can never be of use 'home'",
"expression": "where(use = 'home').empty()",
"xpath": "count(f:use[@value='home']) = 0"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".address"
}
]
},
{
"id": "ProductPlan.coverageArea",
"path": "ProductPlan.coverageArea",
"short": "The geographic region in which this product/plan is available",
"definition": "The geographic region in which this product/plan is available.",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.coverageArea",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Location"
]
}
],
"isModifier": false,
"isSummary": true
},
{
"id": "ProductPlan.contact",
"path": "ProductPlan.contact",
"short": "Contact for the product/plan for a certain purpose",
"definition": "Contact for the product/plan for a certain purpose.",
"comment": "Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.",
"requirements": "Need to keep track of assigned contact points within bigger organization.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.contact",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": ".contactParty"
}
]
},
{
"id": "ProductPlan.contact.id",
"path": "ProductPlan.contact.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.contact.extension",
"path": "ProductPlan.contact.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.contact.modifierExtension",
"path": "ProductPlan.contact.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ProductPlan.contact.purpose",
"path": "ProductPlan.contact.purpose",
"short": "The type of contact",
"definition": "Indicates a purpose for which the contact can be reached.",
"requirements": "Need to distinguish between multiple contact persons.",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.contact.purpose",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": false,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ContactPartyType"
}
],
"strength": "extensible",
"description": "The purpose for which you would contact a contact party",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/contactentity-type"
},
"mapping": [
{
"identity": "rim",
"map": "./type"
}
]
},
{
"id": "ProductPlan.contact.name",
"path": "ProductPlan.contact.name",
"short": "A name associated with the contact",
"definition": "A name associated with the contact.",
"requirements": "Need to be able to track the person by name.",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.contact.name",
"min": 0,
"max": "1"
},
"type": [
{
"code": "HumanName"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./name"
}
]
},
{
"id": "ProductPlan.contact.telecom",
"path": "ProductPlan.contact.telecom",
"short": "Contact details (telephone, email, etc.) for a contact",
"definition": "A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.",
"requirements": "People have (primary) ways to contact them in some way such as phone, email.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.contact.telecom",
"min": 0,
"max": "*"
},
"type": [
{
"code": "ContactPoint"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./telecom"
}
]
},
{
"id": "ProductPlan.contact.address",
"path": "ProductPlan.contact.address",
"short": "Visiting or postal addresses for the contact",
"definition": "Visiting or postal addresses for the contact.",
"requirements": "May need to keep track of a contact party's address for contacting, billing or reporting requirements.",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.contact.address",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Address"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "./addr"
}
]
},
{
"id": "ProductPlan.coverage",
"path": "ProductPlan.coverage",
"short": "Details about the coverage offered by the insurance product",
"definition": "Details about the coverage offered by the insurance product.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.coverage",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.coverage.id",
"path": "ProductPlan.coverage.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.coverage.extension",
"path": "ProductPlan.coverage.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.coverage.modifierExtension",
"path": "ProductPlan.coverage.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ProductPlan.coverage.type",
"path": "ProductPlan.coverage.type",
"short": "Type of coverage",
"definition": "Type of coverage (Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health).",
"min": 1,
"max": "1",
"base": {
"path": "ProductPlan.coverage.type",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.coverage.benefit",
"path": "ProductPlan.coverage.benefit",
"short": "Specific benefits under this type of coverage",
"definition": "Specific benefits under this type of coverage.",
"min": 1,
"max": "*",
"base": {
"path": "ProductPlan.coverage.benefit",
"min": 1,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.coverage.benefit.id",
"path": "ProductPlan.coverage.benefit.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.coverage.benefit.extension",
"path": "ProductPlan.coverage.benefit.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.coverage.benefit.modifierExtension",
"path": "ProductPlan.coverage.benefit.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ProductPlan.coverage.benefit.type",
"path": "ProductPlan.coverage.benefit.type",
"short": "Type of benefit",
"definition": "Type of benefit (primary care; speciality care; inpatient; outpatient).",
"min": 1,
"max": "1",
"base": {
"path": "ProductPlan.coverage.benefit.type",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.coverage.benefit.item",
"path": "ProductPlan.coverage.benefit.item",
"short": "Specific benefit and related value",
"definition": "Specific benefit and related value.",
"min": 1,
"max": "*",
"base": {
"path": "ProductPlan.coverage.benefit.item",
"min": 1,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.coverage.benefit.item.id",
"path": "ProductPlan.coverage.benefit.item.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.coverage.benefit.item.extension",
"path": "ProductPlan.coverage.benefit.item.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.coverage.benefit.item.modifierExtension",
"path": "ProductPlan.coverage.benefit.item.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ProductPlan.coverage.benefit.item.code",
"path": "ProductPlan.coverage.benefit.item.code",
"short": "Coded Details of the specific benefit (days; visits)",
"definition": "Coded Details of the specific benefit (days; visits).",
"min": 1,
"max": "1",
"base": {
"path": "ProductPlan.coverage.benefit.item.code",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.coverage.benefit.item.benefitValue",
"path": "ProductPlan.coverage.benefit.item.benefitValue",
"short": "Value of the specific benefit",
"definition": "Value of the specific benefit.",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.coverage.benefit.item.benefitValue",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan",
"path": "ProductPlan.plan",
"short": "Details about an insurance plan",
"definition": "Details about an insurance plan.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.plan",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan.id",
"path": "ProductPlan.plan.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.plan.extension",
"path": "ProductPlan.plan.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.plan.modifierExtension",
"path": "ProductPlan.plan.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ProductPlan.plan.type",
"path": "ProductPlan.plan.type",
"short": "Type of plan",
"definition": "Type of plan (Platinum; Gold; Silver; Bronze; High Deductable; Low Deductable).",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.plan.type",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan.description",
"path": "ProductPlan.plan.description",
"short": "Additional descriptive content about the plan",
"definition": "Additional descriptive content about the plan.",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.plan.description",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan.premium",
"path": "ProductPlan.plan.premium",
"short": "Plan premium",
"definition": "Plan premium.",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.plan.premium",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Money"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan.category",
"path": "ProductPlan.plan.category",
"short": "List of the costs associated with plan benefits",
"definition": "List of the costs associated with plan benefits.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.plan.category",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan.category.id",
"path": "ProductPlan.plan.category.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.plan.category.extension",
"path": "ProductPlan.plan.category.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.plan.category.modifierExtension",
"path": "ProductPlan.plan.category.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ProductPlan.plan.category.code",
"path": "ProductPlan.plan.category.code",
"short": "General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health)",
"definition": "General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health).",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.plan.category.code",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan.category.benefit",
"path": "ProductPlan.plan.category.benefit",
"short": "List of the specific benefits under this category of benefit",
"definition": "List of the specific benefits under this category of benefit.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.plan.category.benefit",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan.category.benefit.id",
"path": "ProductPlan.plan.category.benefit.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.plan.category.benefit.extension",
"path": "ProductPlan.plan.category.benefit.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.plan.category.benefit.modifierExtension",
"path": "ProductPlan.plan.category.benefit.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ProductPlan.plan.category.benefit.type",
"path": "ProductPlan.plan.category.benefit.type",
"short": "Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care)",
"definition": "Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care).",
"min": 1,
"max": "1",
"base": {
"path": "ProductPlan.plan.category.benefit.type",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan.category.benefit.cost",
"path": "ProductPlan.plan.category.benefit.cost",
"short": "List of the costs associated with a specific benefit",
"definition": "List of the costs associated with a specific benefit.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.plan.category.benefit.cost",
"min": 0,
"max": "*"
},
"type": [
{
"code": "BackboneElement"
}
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan.category.benefit.cost.id",
"path": "ProductPlan.plan.category.benefit.cost.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.plan.category.benefit.cost.extension",
"path": "ProductPlan.plan.category.benefit.cost.extension",
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "ProductPlan.plan.category.benefit.cost.modifierExtension",
"path": "ProductPlan.plan.category.benefit.cost.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "ProductPlan.plan.category.benefit.cost.type",
"path": "ProductPlan.plan.category.benefit.cost.type",
"short": "Type of cost (copay; individual cap; family cap; coinsurance; deductible)",
"definition": "Type of cost (copay; individual cap; family cap; coinsurance; deductible).",
"min": 1,
"max": "1",
"base": {
"path": "ProductPlan.plan.category.benefit.cost.type",
"min": 1,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan.category.benefit.cost.applicability",
"path": "ProductPlan.plan.category.benefit.cost.applicability",
"short": "Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other)",
"definition": "Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other).",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.plan.category.benefit.cost.applicability",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Coding"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan.category.benefit.cost.qualifiers",
"path": "ProductPlan.plan.category.benefit.cost.qualifiers",
"short": "Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA)",
"definition": "Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA).",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.plan.category.benefit.cost.qualifiers",
"min": 0,
"max": "*"
},
"type": [
{
"code": "string"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.plan.category.benefit.cost.value",
"path": "ProductPlan.plan.category.benefit.cost.value",
"short": "The actual cost value",
"definition": "The actual cost value.",
"min": 0,
"max": "1",
"base": {
"path": "ProductPlan.plan.category.benefit.cost.value",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Quantity"
}
],
"isModifier": false,
"isSummary": false
},
{
"id": "ProductPlan.endpoint",
"path": "ProductPlan.endpoint",
"short": "Technical endpoints providing access to services operated for the organization",
"definition": "Technical endpoints providing access to services operated for the organization.",
"requirements": "Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.",
"min": 0,
"max": "*",
"base": {
"path": "ProductPlan.endpoint",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Endpoint"
]
}
],
"isModifier": false,
"isSummary": false,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
}
]
},
"differential": {
"element": [
{
"id": "ProductPlan",
"path": "ProductPlan",
"short": "Details of a Health Insurance product/plan provided by an organization",
"definition": "Details of a Health Insurance product/plan provided by an organization.",
"min": 0,
"max": "*",
"constraint": [
{
"key": "ppn-1",
"severity": "error",
"human": "The organization SHALL at least have a name or an id, and possibly more than one",
"expression": "(identifier.count() + name.count()) > 0",
"xpath": "count(f:identifier | f:name) > 0"
}
]
},
{
"id": "ProductPlan.identifier",
"path": "ProductPlan.identifier",
"short": "Identifies this product/plan across multiple systems",
"definition": "Identifier for the product/plan that is used to identify it across multiple disparate systems.",
"min": 0,
"max": "*",
"type": [
{
"code": "Identifier"
}
],
"condition": [
"ppn-1"
],
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "rim",
"map": ".scopes[Role](classCode=IDENT)"
}
]
},
{
"id": "ProductPlan.status",
"path": "ProductPlan.status",
"short": "draft | active | retired | unknown",
"definition": "Whether the organization's record is still in active use.",
"requirements": "Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.",
"min": 0,
"max": "1",
"type": [
{
"code": "code"
}
],
"meaningWhenMissing": "Default interpretation is active.",
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because it is a status element that contains codes which means that the resource should not be treated as valid",
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "PublicationStatus"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "required",
"description": "The lifecycle status of an artifact.",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/publication-status"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "rim",
"map": ".status"
}
]
},
{
"id": "ProductPlan.type",
"path": "ProductPlan.type",
"short": "Kind of product/plan",
"definition": "The type of product/plan.",
"min": 0,
"max": "*",
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ProductPlanType"
}
],
"strength": "example",
"description": "Used to categorize the product/plan",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/productplan-type"
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "rim",
"map": ".code"
}
]
},
{
"id": "ProductPlan.name",
"path": "ProductPlan.name",
"short": "Official name",
"definition": "Official name of the product/plan (as designated by the owner).",
"comment": "If the name of the product/plan changes, consider putting the old name in the alias column so that it can still be located through searches.",
"min": 0,
"max": "1",
"type": [
{
"code": "string"
}
],
"condition": [
"ppn-1"
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": ".name"
}
]
},
{
"id": "ProductPlan.alias",
"path": "ProductPlan.alias",
"short": "A list of alternate names that the product/plan is known as, or was known as in the past",
"definition": "A list of alternate names that the product/plan is known as, or was known as in the past.",
"comment": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the product/plan.",
"requirements": "Over time products/plans go through many changes and can be known by different names.\n\nFor searching knowing previous names that the product/plan was known by can be very useful.",
"min": 0,
"max": "*",
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": ".name"
}
]
},
{
"id": "ProductPlan.period",
"path": "ProductPlan.period",
"short": "The time period the product/plan is available",
"definition": "The period of time that the product is available.",
"min": 0,
"max": "1",
"type": [
{
"code": "Period"
}
]
},
{
"id": "ProductPlan.ownedBy",
"path": "ProductPlan.ownedBy",
"short": "Owner of the product/plan",
"definition": "Owner of the product/plan (typically a payer).",
"min": 0,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"isSummary": true
},
{
"id": "ProductPlan.administeredBy",
"path": "ProductPlan.administeredBy",
"short": "Administrator of the product/plan",
"definition": "Administrator of the product/plan (e.g. self-insured employer plan administered by a TPA).",
"min": 0,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
"isSummary": true
},
{
"id": "ProductPlan.address",
"path": "ProductPlan.address",
"short": "An address for the organization",
"definition": "An address for the organization.",
"comment": "Organization may have multiple addresses with different uses or applicable periods. The use code home is not to be used.",
"requirements": "May need to keep track of the organization's addresses for contacting, billing or reporting requirements.",
"min": 0,
"max": "*",
"type": [
{
"code": "Address"
}
],
"condition": [
"ppn-2"
],
"constraint": [
{
"key": "ppn-2",
"severity": "error",
"human": "An address of an organization can never be of use 'home'",
"expression": "where(use = 'home').empty()",
"xpath": "count(f:use[@value='home']) = 0"
}
],
"mapping": [
{
"identity": "rim",
"map": ".address"
}
]
},
{
"id": "ProductPlan.coverageArea",
"path": "ProductPlan.coverageArea",
"short": "The geographic region in which this product/plan is available",
"definition": "The geographic region in which this product/plan is available.",
"min": 0,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Location"
]
}
],
"isSummary": true
},
{
"id": "ProductPlan.contact",
"path": "ProductPlan.contact",
"short": "Contact for the product/plan for a certain purpose",
"definition": "Contact for the product/plan for a certain purpose.",
"comment": "Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.",
"requirements": "Need to keep track of assigned contact points within bigger organization.",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
],
"mapping": [
{
"identity": "rim",
"map": ".contactParty"
}
]
},
{
"id": "ProductPlan.contact.purpose",
"path": "ProductPlan.contact.purpose",
"short": "The type of contact",
"definition": "Indicates a purpose for which the contact can be reached.",
"requirements": "Need to distinguish between multiple contact persons.",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "ContactPartyType"
}
],
"strength": "extensible",
"description": "The purpose for which you would contact a contact party",
"valueSetCanonical": "http://hl7.org/fhir/ValueSet/contactentity-type"
},
"mapping": [
{
"identity": "rim",
"map": "./type"
}
]
},
{
"id": "ProductPlan.contact.name",
"path": "ProductPlan.contact.name",
"short": "A name associated with the contact",
"definition": "A name associated with the contact.",
"requirements": "Need to be able to track the person by name.",
"min": 0,
"max": "1",
"type": [
{
"code": "HumanName"
}
],
"mapping": [
{
"identity": "rim",
"map": "./name"
}
]
},
{
"id": "ProductPlan.contact.telecom",
"path": "ProductPlan.contact.telecom",
"short": "Contact details (telephone, email, etc.) for a contact",
"definition": "A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.",
"requirements": "People have (primary) ways to contact them in some way such as phone, email.",
"min": 0,
"max": "*",
"type": [
{
"code": "ContactPoint"
}
],
"mapping": [
{
"identity": "rim",
"map": "./telecom"
}
]
},
{
"id": "ProductPlan.contact.address",
"path": "ProductPlan.contact.address",
"short": "Visiting or postal addresses for the contact",
"definition": "Visiting or postal addresses for the contact.",
"requirements": "May need to keep track of a contact party's address for contacting, billing or reporting requirements.",
"min": 0,
"max": "1",
"type": [
{
"code": "Address"
}
],
"mapping": [
{
"identity": "rim",
"map": "./addr"
}
]
},
{
"id": "ProductPlan.coverage",
"path": "ProductPlan.coverage",
"short": "Details about the coverage offered by the insurance product",
"definition": "Details about the coverage offered by the insurance product.",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "ProductPlan.coverage.type",
"path": "ProductPlan.coverage.type",
"short": "Type of coverage",
"definition": "Type of coverage (Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health).",
"min": 1,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
]
},
{
"id": "ProductPlan.coverage.benefit",
"path": "ProductPlan.coverage.benefit",
"short": "Specific benefits under this type of coverage",
"definition": "Specific benefits under this type of coverage.",
"min": 1,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "ProductPlan.coverage.benefit.type",
"path": "ProductPlan.coverage.benefit.type",
"short": "Type of benefit",
"definition": "Type of benefit (primary care; speciality care; inpatient; outpatient).",
"min": 1,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
]
},
{
"id": "ProductPlan.coverage.benefit.item",
"path": "ProductPlan.coverage.benefit.item",
"short": "Specific benefit and related value",
"definition": "Specific benefit and related value.",
"min": 1,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "ProductPlan.coverage.benefit.item.code",
"path": "ProductPlan.coverage.benefit.item.code",
"short": "Coded Details of the specific benefit (days; visits)",
"definition": "Coded Details of the specific benefit (days; visits).",
"min": 1,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
]
},
{
"id": "ProductPlan.coverage.benefit.item.benefitValue",
"path": "ProductPlan.coverage.benefit.item.benefitValue",
"short": "Value of the specific benefit",
"definition": "Value of the specific benefit.",
"min": 0,
"max": "1",
"type": [
{
"code": "Quantity"
}
]
},
{
"id": "ProductPlan.plan",
"path": "ProductPlan.plan",
"short": "Details about an insurance plan",
"definition": "Details about an insurance plan.",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "ProductPlan.plan.type",
"path": "ProductPlan.plan.type",
"short": "Type of plan",
"definition": "Type of plan (Platinum; Gold; Silver; Bronze; High Deductable; Low Deductable).",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
]
},
{
"id": "ProductPlan.plan.description",
"path": "ProductPlan.plan.description",
"short": "Additional descriptive content about the plan",
"definition": "Additional descriptive content about the plan.",
"min": 0,
"max": "1",
"type": [
{
"code": "string"
}
]
},
{
"id": "ProductPlan.plan.premium",
"path": "ProductPlan.plan.premium",
"short": "Plan premium",
"definition": "Plan premium.",
"min": 0,
"max": "1",
"type": [
{
"code": "Money"
}
]
},
{
"id": "ProductPlan.plan.category",
"path": "ProductPlan.plan.category",
"short": "List of the costs associated with plan benefits",
"definition": "List of the costs associated with plan benefits.",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "ProductPlan.plan.category.code",
"path": "ProductPlan.plan.category.code",
"short": "General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health)",
"definition": "General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health).",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
]
},
{
"id": "ProductPlan.plan.category.benefit",
"path": "ProductPlan.plan.category.benefit",
"short": "List of the specific benefits under this category of benefit",
"definition": "List of the specific benefits under this category of benefit.",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "ProductPlan.plan.category.benefit.type",
"path": "ProductPlan.plan.category.benefit.type",
"short": "Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care)",
"definition": "Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care).",
"min": 1,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
]
},
{
"id": "ProductPlan.plan.category.benefit.cost",
"path": "ProductPlan.plan.category.benefit.cost",
"short": "List of the costs associated with a specific benefit",
"definition": "List of the costs associated with a specific benefit.",
"min": 0,
"max": "*",
"type": [
{
"code": "BackboneElement"
}
]
},
{
"id": "ProductPlan.plan.category.benefit.cost.type",
"path": "ProductPlan.plan.category.benefit.cost.type",
"short": "Type of cost (copay; individual cap; family cap; coinsurance; deductible)",
"definition": "Type of cost (copay; individual cap; family cap; coinsurance; deductible).",
"min": 1,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
]
},
{
"id": "ProductPlan.plan.category.benefit.cost.applicability",
"path": "ProductPlan.plan.category.benefit.cost.applicability",
"short": "Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other)",
"definition": "Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other).",
"min": 0,
"max": "*",
"type": [
{
"code": "Coding"
}
]
},
{
"id": "ProductPlan.plan.category.benefit.cost.qualifiers",
"path": "ProductPlan.plan.category.benefit.cost.qualifiers",
"short": "Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA)",
"definition": "Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA).",
"min": 0,
"max": "*",
"type": [
{
"code": "string"
}
]
},
{
"id": "ProductPlan.plan.category.benefit.cost.value",
"path": "ProductPlan.plan.category.benefit.cost.value",
"short": "The actual cost value",
"definition": "The actual cost value.",
"min": 0,
"max": "1",
"type": [
{
"code": "Quantity"
}
]
},
{
"id": "ProductPlan.endpoint",
"path": "ProductPlan.endpoint",
"short": "Technical endpoints providing access to services operated for the organization",
"definition": "Technical endpoints providing access to services operated for the organization.",
"requirements": "Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.",
"min": 0,
"max": "*",
"type": [
{
"code": "Reference",
"targetProfile": [
"http://hl7.org/fhir/StructureDefinition/Endpoint"
]
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
}
]
}
}
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.
®© HL7.org 2011+. FHIR Mixed Nomative/Trial Use Ballot (v3.3.0-13671) generated on Tue, Apr 3, 2018 12:17+1000. QA Page
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