Health Insurance Policy
{
"resourceType" : "Contract",
"id" : "INS-101",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>Plan: Your Choice Split Copay (Non-Grandfathered)</p>\n <p>Certificate Form Number: YCSCWLN (01-2017)</p>\n </div>"
},
"identifier" : [{
"system" : "http://xyz-insurance.com/forms",
"value" : "YCSCWLN(01-2017)"
}],
"applies" : {
"start" : "2017-01-01"
},
"subject" : [{
"reference" : "Patient/1"
}],
"type" : {
"coding" : [{
"system" : "http://terminology.hl7.org/CodeSystem/contract-type",
"code" : "healthinsurance",
"display" : "Health Insurance"
}]
},
"term" : [{
"offer" : {
"text" : "The benefits, limitations, exclusions and other coverage provisions in this booklet are subject to the terms of our contract with the Group. This booklet is a part of that contract, which is on file in the Group's office."
},
"asset" : [{
"type" : [{
"coding" : [{
"system" : "urn:ietf:rfc:3986",
"code" : "urn:uuid:3a48c68c-318d-4c68-8471-4a3c10fcb41b",
"display" : "RicardianContract"
}]
}],
"subtype" : [{
"text" : "sample"
}],
"period" : [{
"start" : "2017-06-01"
}],
"valuedItem" : [{
"entityCodeableConcept" : {
"text" : "Ford Bobcat"
},
"identifier" : {
"system" : "http://somewhere.motor-vehicle.com/vin",
"value" : "XXSVT34-7665t952236"
},
"effectiveTime" : "1995",
"quantity" : {
"value" : 1
},
"unitPrice" : {
"value" : 200.00,
"currency" : "CAD"
},
"factor" : 1.0,
"points" : 1.0,
"net" : {
"value" : 200.00,
"currency" : "CAD"
}
}]
}],
"group" : [{
"offer" : {
"text" : "Eligible Providers"
}
},
{
"offer" : {
"text" : "Responsibility for Payment"
}
},
{
"offer" : {
"text" : "List of Benefits"
},
"group" : [{
"offer" : {
"text" : "Copays"
},
"group" : [{
"offer" : {
"text" : "Emergency Room Copay"
}
},
{
"offer" : {
"text" : "Professional Visit Copay"
}
}]
},
{
"offer" : {
"text" : "Calendar Year Deductible"
}
},
{
"offer" : {
"text" : "Out-Of-Pocket Maximum"
}
},
{
"offer" : {
"text" : "Medical Services"
},
"group" : [{
"offer" : {
"text" : "Ambulance Services"
}
},
{
"offer" : {
"text" : "Dental Services"
}
},
{
"offer" : {
"text" : "Diagnostic Services"
}
},
{
"offer" : {
"text" : "Emergency Room Services"
}
},
{
"offer" : {
"text" : "Hospital Inpatient Care"
}
}]
}]
}]
}]
}
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.