Profile Comparison between http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage vs http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/StructureDefinition/Coverage
copyright
date	2020-03-02T22:24:28+00:00	2023-07-31T02:26:57+00:00	Values Differ
description	Coverage high-level identifiers and descriptors of an insurance plan underwriting some or all of the cost of the referral services provided.	This Coverage profile represents identifiers and descriptors of an insurance plan underwriting some or all of the cost of the referral services provided.	Values Differ
experimental		false	Added the item 'false'
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]		urn:iso:std:iso:3166#US	Added the item 'urn:iso:std:iso:3166#US'
kind	resource
name	BSeR_Coverage	BSeRCoverage	Values Differ
publisher	HL7 International - Public Health Work Group	HL7 Public Health Working Group	Values Differ
purpose
status	active
title	BSeR Coverage
type	Coverage
url	http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage
version	1.0.0	2.0.0-ballot	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	L Type	L Description & Constraints	Comments
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement		0..*	Coverage	Insurance or medical plan or a payment agreement
id	Σ	0..1	string	Logical id of this artifact	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..1	Identifier	Business Identifier for the coverage	SΣ	0..*	Identifier	Member ID and other identifiers Slice: Unordered, Open by pattern:type	Elements differ in short: 'Business Identifier for the coverage' vs 'Member ID and other identifiers' Elements differ in definition for mustSupport: 'false' vs 'true' Element maximum cardinalities differ: '1' vs '2147483647'
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: ?? (required)	?!SΣ	1..1	code	(USCDI) active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance.	Elements differ in short: 'active | cancelled | draft | entered-in-error' vs '(USCDI) active | cancelled | draft | entered-in-error' Elements differ in comments: 'This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid.' vs 'The `Coverage.status` alone does not indicate whether an individual's coverage is terminated or that the individual is not covered. The `Coverage.period` needs to be considered as well.' Elements differ in definition for mustSupport: 'false' vs 'true'
type	Σ	1..1	CodeableConcept	Coverage category such as medical or accident Binding: ?? (extensible)	SΣ	0..1	CodeableConcept	Coverage category such as medical or accident Binding: ?? (extensible)	Elements differ in definition for mustSupport: 'false' vs 'true' Element minimum cardinalities differ: '1' vs '0'
policyHolder	Σ	0..1	Reference(Patient | RelatedPerson | Organization)	Owner of the policy	Σ	0..1	Reference(Patient | RelatedPerson | Organization)	Owner of the policy
subscriber	Σ	1..1	Reference(RelatedPerson)	Subscriber to the policy	SΣ	0..1	Reference(US Core Patient Profile | US Core RelatedPerson Profile)	Subscriber to the policy	Elements differ in definition: 'The subscriber is the policy holder of the insurance plan. The role of subscriber is played by a related person. When the patient is the subscriber the relationship of related person to patient is 'self'.' vs 'The subscriber is the policy holder of the insurance plan. When the beneficiary Patient is not the subscriber use RelatedPerson.' Elements differ in definition for mustSupport: 'false' vs 'true' Element minimum cardinalities differ: '1' vs '0' Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/RelatedPerson]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson]])
subscriberId	Σ	0..1	string	ID assigned to the subscriber	SΣ	0..1	string	ID assigned to the subscriber	Elements differ in definition for mustSupport: 'false' vs 'true'
beneficiary	Σ	1..1	Reference(US Core Patient Profile)	Plan beneficiary	SΣ	1..1	Reference(US Core Patient Profile)	Plan beneficiary	Elements differ in definition for mustSupport: 'false' vs 'true'
dependent	Σ	0..1	string	Dependent number	Σ	0..1	string	Dependent number
relationship		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).	S	1..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: ?? (extensible)	Elements differ in comments: 'Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others.' vs 'Relationship of the member to the person insured (subscriber)' Elements differ in definition for mustSupport: 'false' vs 'true' Element minimum cardinalities differ: '0' vs '1'
period	Σ	0..1	Period	Coverage start and end dates	SΣ	0..1	Period	Coverage start and end dates	Elements differ in definition for mustSupport: 'false' vs 'true'
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	1..1	dateTime	Starting time with inclusive boundary	ΣC	0..1	dateTime	Starting time with inclusive boundary	Element minimum cardinalities differ: '1' vs '0'
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
payor	Σ	1..1	Reference(BSeR Organization)	Issuer of the policy	SΣ	1..1	Reference(US Core Organization Profile | US Core Patient Profile | US Core RelatedPerson Profile)	Issuer of the policy	Elements differ in definition for mustSupport: 'false' vs 'true'
class		0..*	BackboneElement	Additional coverage classifications	S	0..*	BackboneElement	Additional coverage classifications Slice: Unordered, Open by pattern:type	Elements differ in definition for mustSupport: 'false' vs 'true'
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: ?? (extensible)	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc.
value	Σ	1..1	string	Value associated with the type	Σ	1..1	string	Value associated with the type
name	Σ	0..1	string	Human readable description of the type and value	Σ	0..1	string	Human readable description of the type and value
order	Σ	0..1	positiveInt	Relative order of the coverage	Σ	0..1	positiveInt	Relative order of the coverage
network	Σ	0..1	string	Insurer network	Σ	0..1	string	Insurer network
costToBeneficiary		0..*	BackboneElement	Patient payments for services/products		0..*	BackboneElement	Patient payments for services/products
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	CodeableConcept	Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified.	Σ	0..1	CodeableConcept	Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified.
value[x]	Σ	1..1	??, Money	The amount or percentage due from the beneficiary	Σ	1..1	??, Money	The amount or percentage due from the beneficiary
exception		0..*	BackboneElement	Exceptions for patient payments		0..*	BackboneElement	Exceptions for patient payments
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays.	Σ	1..1	CodeableConcept	Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays.
period	Σ	0..1	Period	The effective period of the exception	Σ	0..1	Period	The effective period of the exception
subrogation		0..1	boolean	Reimbursement to insurer		0..1	boolean	Reimbursement to insurer
contract		0..*	Reference(Contract)	Contract details		0..*	Reference(Contract)	Contract details
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