FHIR Release 3 (STU)

This page is part of the FHIR Specification (v3.0.2: STU 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

13.1.6 Resource Coverage - Mappings

Financial Management Work GroupMaturity Level: N/ABallot Status: InformativeCompartments: Patient, RelatedPerson

Mappings:

RIM Mapping

HL7 v2 Mapping

Canadian Dental Association eclaims standard

Canadian Pharmacy Associaiton eclaims standard

Workflow Mapping

Mappings for the coverage resource.

13.1.6.1 Mappings for RIM Mapping (http://hl7.org/v3)

CoverageCoverage
    identifier
    status
    type
    policyHolder
    subscriber
    subscriberId
    beneficiary
    relationship
    period
    payor
    grouping
        group
        groupDisplay
        subGroup
        subGroupDisplay
        plan
        planDisplay
        subPlan
        subPlanDisplay
        class
        classDisplay
        subClass
        subClassDisplay
    dependent
    sequence
    order
    network
    contract

13.1.6.2 Mappings for HL7 v2 Mapping (http://hl7.org/v2)

Coverage
    identifierIN1-2
    status
    typeIN1-15
    policyHolderIN1-16, 18, 19-name of insured, address, date of birth
    subscriberIN1-16, 18, 19-name of insured, address, date of birth
    subscriberIdIN1-16, 18, 19-name of insured, address, date of birth
    beneficiaryIN1-16, 18, 19-name of insured, address, date of birth
    relationship
    periodIN1-12 / IN1-13
    payorIN1-3
    grouping
        groupIN1-8
        groupDisplayIN1-8
        subGroupIN1-8
        subGroupDisplayIN1-8
        planIN1-35
        planDisplayIN1-35
        subPlanIN1-10
        subPlanDisplayIN1-10
        classIN1-35
        classDisplayIN1-35
        subClassIN1-35
        subClassDisplayIN1-35
    dependent- No exact HL7 v2 equivalent concept seems to exist;
    sequenceNo HL7 v2 equivalent concept seems to exist
    order- No exact HL7 v2 equivalent concept seems to exist;
    network
    contractIN1-16, 18, 19

13.1.6.3 Mappings for Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/)

Coverage
    identifierC02
    status
    type
    policyHolderD01 through D09
    subscriberD01 through D09
    subscriberIdD01 through D09
    beneficiaryD01 through D09
    relationshipC03
    period
    payorA05
    grouping
        groupC11 (Division,Section)
        groupDisplayC11 (Division,Section)
        subGroup
        subGroupDisplay
        planC01
        planDisplayC01
        subPlan
        subPlanDisplay
        classC01
        classDisplayC01
        subClassC01
        subClassDisplayC01
    dependentC17
    sequenceD11
    order
    networkD10
    contractD01 through D09

13.1.6.4 Mappings for Canadian Pharmacy Associaiton eclaims standard (http://www.pharmacists.ca/)

Coverage
    identifierC.32, C.33, C.39
    status
    type
    policyHolderC.35
    subscriberC.35
    subscriberIdC.35
    beneficiaryC.35
    relationship
    period
    payorC.30
    grouping
        groupC.31
        groupDisplayC.31
        subGroup
        subGroupDisplay
        plan
        planDisplay
        subPlan
        subPlanDisplay
        class
        classDisplay
        subClass
        subClassDisplay
    dependent
    sequence
    order
    network
    contractC.35

13.1.6.5 Mappings for Workflow Mapping (http://hl7.org/fhir/workflow)

CoverageEvent
    identifierEvent.identifier
    statusEvent.status
    type
    policyHolder
    subscriber
    subscriberId
    beneficiaryEvent.subject
    relationship
    periodEvent.occurrence
    payor
    grouping
        group
        groupDisplay
        subGroup
        subGroupDisplay
        plan
        planDisplay
        subPlan
        subPlanDisplay
        class
        classDisplay
        subClass
        subClassDisplay
    dependent
    sequence
    order
    network
    contract