Coverage - FHIR v5.0.0-cibuild

FHIR Extensions Pack v5.1.0-snapshot1 (2024-03-12)

This page is part of the FHIR Core Extensions Registry (v5.1.0-snapshot1: Release 5.1) based on FHIR (HL7® FHIR® Standard) v5.0.0. The current version which supersedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

13.1.29 Resource Coverage - Conversions

Financial Management

Work Group

Maturity Level: N/A

Standards Status: Informative

Security Category: N/A

Compartments: N/A

Following are maps for converting between the equivalent R4B resource and this R5 resource.

Maps to Coverage

FML Conversion for Coverage: R5 to R4 (Ready for Use/Trial Use)

/// url = 'http://hl7.org/fhir/StructureMap/Coverage5to4'
/// name = 'Coverage5to4'
/// title = 'FML Conversion for Coverage: R5 to R4'
/// status = 'active'

conceptmap "CoverageStatus" {
  prefix s = "http://hl7.org/fhir/fm-status"
  prefix t = "http://hl7.org/fhir/4.0/fm-status"

  s:active - t:active
  s:cancelled - t:cancelled
  s:draft - t:draft
  s:"entered-in-error" - t:"entered-in-error"
}

uses "http://hl7.org/fhir/StructureDefinition/Coverage" alias CoverageR5 as source
uses "http://hl7.org/fhir/4.0/StructureDefinition/Coverage" alias CoverageR4 as target

imports "http://hl7.org/fhir/StructureMap/*5to4"

group Coverage(source src : CoverageR5, target tgt : CoverageR4) extends DomainResource <<type+>> {
  src.identifier -> tgt.identifier;
  src.status as v -> tgt.status = translate(v, '#CoverageStatus', 'code');
  src.type -> tgt.type; // src.kind as v -> tgt.kind = translate(v, '#CoverageKind', 'code');
  src.policyHolder -> tgt.policyHolder;
  src.subscriber -> tgt.subscriber;
  src.subscriberId as s -> tgt then {
    s.value -> tgt.subscriberId;
  };
  src.beneficiary -> tgt.beneficiary;
  src.dependent -> tgt.dependent;
  src.relationship -> tgt.relationship;
  src.period -> tgt.period;
  src.class as s -> tgt.class as t then CoverageClass(s, t); // src.insurer -> tgt.insurer;
  src.order -> tgt.order;
  src.network -> tgt.network;
  src.costToBeneficiary as s -> tgt.costToBeneficiary as t then CoverageCostToBeneficiary(s, t);
  src.subrogation -> tgt.subrogation;
  src.contract -> tgt.contract;
}

// group CoveragePaymentBy(source src, target tgt) extends BackboneElement {
// src.party -> tgt.party;
// src.responsibility -> tgt.responsibility;
// }
group CoverageClass(source src, target tgt) extends BackboneElement {
  src.type -> tgt.type;
  src.value as s -> tgt then {
    s.value -> tgt.value;
  };
  src.name -> tgt.name;
}

group CoverageCostToBeneficiary(source src, target tgt) extends BackboneElement {
  src.type -> tgt.type;
  src.value : Quantity -> tgt.value; // src.category -> tgt.category;
  src.value : Money -> tgt.value;
  src.exception as s -> tgt.exception as t then CoverageCostToBeneficiaryException(s, t);
}

group CoverageCostToBeneficiaryException(source src, target tgt) extends BackboneElement {
  src.type -> tgt.type;
  src.period -> tgt.period;
}

FML Conversion for Coverage: R5 to R4B (Ready for Use/Trial Use)

/// url = 'http://hl7.org/fhir/StructureMap/Coverage5to4B'
/// name = 'Coverage5to4B'
/// title = 'FML Conversion for Coverage: R5 to R4B'
/// status = 'active'

conceptmap "CoverageStatus" {
  prefix s = "http://hl7.org/fhir/fm-status"
  prefix t = "http://hl7.org/fhir/4.3/fm-status"

  s:active - t:active
  s:cancelled - t:cancelled
  s:draft - t:draft
  s:"entered-in-error" - t:"entered-in-error"
}

uses "http://hl7.org/fhir/StructureDefinition/Coverage" alias CoverageR5 as source
uses "http://hl7.org/fhir/4.3/StructureDefinition/Coverage" alias CoverageR4B as target

imports "http://hl7.org/fhir/StructureMap/*5to4B"

group Coverage(source src : CoverageR5, target tgt : CoverageR4B) extends DomainResource <<type+>> {
  src.identifier -> tgt.identifier;
  src.status as v -> tgt.status = translate(v, '#CoverageStatus', 'code');
  src.type -> tgt.type; // src.kind as v -> tgt.kind = translate(v, '#CoverageKind', 'code');
  src.policyHolder -> tgt.policyHolder;
  src.subscriber -> tgt.subscriber;
  src.subscriberId as s -> tgt then {
    s.value -> tgt.subscriberId;
  };
  src.beneficiary -> tgt.beneficiary;
  src.dependent -> tgt.dependent;
  src.relationship -> tgt.relationship;
  src.period -> tgt.period;
  src.class as s -> tgt.class as t then CoverageClass(s, t); // src.insurer -> tgt.insurer;
  src.order -> tgt.order;
  src.network -> tgt.network;
  src.costToBeneficiary as s -> tgt.costToBeneficiary as t then CoverageCostToBeneficiary(s, t);
  src.subrogation -> tgt.subrogation;
  src.contract -> tgt.contract;
}

// group CoveragePaymentBy(source src, target tgt) extends BackboneElement {
// src.party -> tgt.party;
// src.responsibility -> tgt.responsibility;
// }
group CoverageClass(source src, target tgt) extends BackboneElement {
  src.type -> tgt.type;
  src.value as s -> tgt then {
    s.value -> tgt.value;
  };
  src.name -> tgt.name;
}

group CoverageCostToBeneficiary(source src, target tgt) extends BackboneElement {
  src.type -> tgt.type;
  src.value : Quantity -> tgt.value; // src.category -> tgt.category;
  src.value : Money -> tgt.value;
  src.exception as s -> tgt.exception as t then CoverageCostToBeneficiaryException(s, t);
}

group CoverageCostToBeneficiaryException(source src, target tgt) extends BackboneElement {
  src.type -> tgt.type;
  src.period -> tgt.period;
}

Maps from Coverage

FML Conversion for Coverage: R4B to R5 (Ready for Use/Trial Use)

/// url = 'http://hl7.org/fhir/StructureMap/Coverage4Bto5'
/// name = 'Coverage4Bto5'
/// title = 'FML Conversion for Coverage: R4B to R5'
/// status = 'active'

conceptmap "CoverageStatus" {
  prefix s = "http://hl7.org/fhir/4.3/fm-status"
  prefix t = "http://hl7.org/fhir/fm-status"

  s:active - t:active
  s:cancelled - t:cancelled
  s:draft - t:draft
  s:"entered-in-error" - t:"entered-in-error"
}

uses "http://hl7.org/fhir/4.3/StructureDefinition/Coverage" alias CoverageR4B as source
uses "http://hl7.org/fhir/StructureDefinition/Coverage" alias CoverageR5 as target

imports "http://hl7.org/fhir/StructureMap/*4Bto5"

group Coverage(source src : CoverageR4B, target tgt : CoverageR5) extends DomainResource <<type+>> {
  src.identifier -> tgt.identifier;
  src.status as v -> tgt.status = translate(v, '#CoverageStatus', 'code');
  src.type -> tgt.type; // src.kind as v -> tgt.kind = translate(v, '#CoverageKind', 'code');
  src.policyHolder -> tgt.policyHolder;
  src.subscriber -> tgt.subscriber;
  src.subscriberId as s ->  tgt.subscriberId as t,  t.value = s;
  src.beneficiary -> tgt.beneficiary;
  src.dependent -> tgt.dependent;
  src.relationship -> tgt.relationship;
  src.period -> tgt.period;
  src.class as s -> tgt.class as t then CoverageClass(s, t); // src.insurer -> tgt.insurer;
  src.order -> tgt.order;
  src.network -> tgt.network;
  src.costToBeneficiary as s -> tgt.costToBeneficiary as t then CoverageCostToBeneficiary(s, t);
  src.subrogation -> tgt.subrogation;
  src.contract -> tgt.contract;
}

// group CoveragePaymentBy(source src, target tgt) extends BackboneElement {
// src.party -> tgt.party;
// src.responsibility -> tgt.responsibility;
// }
group CoverageClass(source src, target tgt) extends BackboneElement {
  src.type -> tgt.type;
  src.value as s ->  tgt.value as t,  t.value = s "classValue";
  src.name -> tgt.name;
}

group CoverageCostToBeneficiary(source src, target tgt) extends BackboneElement {
  src.type -> tgt.type;
  src.value : Quantity -> tgt.value; // src.category -> tgt.category;
  src.value : Money -> tgt.value;
  src.exception as s -> tgt.exception as t then CoverageCostToBeneficiaryException(s, t);
}

group CoverageCostToBeneficiaryException(source src, target tgt) extends BackboneElement {
  src.type -> tgt.type;
  src.period -> tgt.period;
}

FML Conversion for Coverage: R4 to R5 (Ready for Use/Trial Use)

/// url = 'http://hl7.org/fhir/StructureMap/Coverage4to5'
/// name = 'Coverage4to5'
/// title = 'FML Conversion for Coverage: R4 to R5'
/// status = 'active'

conceptmap "CoverageStatus" {
  prefix s = "http://hl7.org/fhir/4.0/fm-status"
  prefix t = "http://hl7.org/fhir/fm-status"

  s:active - t:active
  s:cancelled - t:cancelled
  s:draft - t:draft
  s:"entered-in-error" - t:"entered-in-error"
}

uses "http://hl7.org/fhir/4.0/StructureDefinition/Coverage" alias CoverageR4 as source
uses "http://hl7.org/fhir/StructureDefinition/Coverage" alias CoverageR5 as target

imports "http://hl7.org/fhir/StructureMap/*4to5"

group Coverage(source src : CoverageR4, target tgt : CoverageR5) extends DomainResource <<type+>> {
  src.identifier -> tgt.identifier;
  src.status as v -> tgt.status = translate(v, '#CoverageStatus', 'code');
  src.type -> tgt.type; // src.kind as v -> tgt.kind = translate(v, '#CoverageKind', 'code');
  src.policyHolder -> tgt.policyHolder;
  src.subscriber -> tgt.subscriber;
  src.subscriberId as s ->  tgt.subscriberId as t,  t.value = s;
  src.beneficiary -> tgt.beneficiary;
  src.dependent -> tgt.dependent;
  src.relationship -> tgt.relationship;
  src.period -> tgt.period;
  src.class as s -> tgt.class as t then CoverageClass(s, t); // src.insurer -> tgt.insurer;
  src.order -> tgt.order;
  src.network -> tgt.network;
  src.costToBeneficiary as s -> tgt.costToBeneficiary as t then CoverageCostToBeneficiary(s, t);
  src.subrogation -> tgt.subrogation;
  src.contract -> tgt.contract;
}

// group CoveragePaymentBy(source src, target tgt) extends BackboneElement {
// src.party -> tgt.party;
// src.responsibility -> tgt.responsibility;
// }
group CoverageClass(source src, target tgt) extends BackboneElement {
  src.type -> tgt.type;
  src.value as s ->  tgt.value as t,  t.value = s "classValue";
  src.name -> tgt.name;
}

group CoverageCostToBeneficiary(source src, target tgt) extends BackboneElement {
  src.type -> tgt.type;
  src.value : Quantity -> tgt.value; // src.category -> tgt.category;
  src.value : Money -> tgt.value;
  src.exception as s -> tgt.exception as t then CoverageCostToBeneficiaryException(s, t);
}

group CoverageCostToBeneficiaryException(source src, target tgt) extends BackboneElement {
  src.type -> tgt.type;
  src.period -> tgt.period;
}