Profile Comparison between http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage vs http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/StructureDefinition/Coverage	http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage	Values Differ
copyright
date	2022-11-28T15:16:46+00:00	2024-07-27T20:09:37+08:00	Values Differ
description	Data that reflect a payer’s coverage that was effective as of the date of service or the date of admission of the claim.
experimental
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	C4BBCoverage
publisher	HL7 Financial Management Working Group	HL7 International / Financial Management	Values Differ
purpose
status	active
title	C4BB Coverage
type	Coverage
url	http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage
version	2.0.0	2.1.0-snapshot1	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	R Type	R Description & Constraints	Comments
Coverage	C	0..*	Coverage	Insurance or medical plan or a payment agreement coverage-meta-profile-version: Coverage: meta.profile with canonical and major.minor. version required.	C	0..*	USCoreCoverageProfile	Insurance or medical plan or a payment agreement us-core-15: Member Id in Coverage.identifier or Coverage.subscriberId SHALL be present
id	Σ	0..1	id	Logical id of this artifact	Σ	0..1	id	Logical id of this artifact
meta	SΣ	1..1	Meta	Metadata about the resource	SΣ	1..1	Meta	Metadata about the resource
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
versionId	Σ	0..1	id	Version specific identifier	Σ	0..1	id	Version specific identifier
lastUpdated	SΣ	1..1	instant	When the resource version last changed	SΣ	1..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to	Σ	1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System.	Σ	0..*	Coding	Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".	Σ	0..*	Coding	Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
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	SΣ	0..*	Identifier	Member ID and other identifiers	SΣ	0..*	Identifier	Member ID and other identifiers Slice: Unordered, Open by pattern:type
status	?!SΣ	1..1	code	active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance.	?!SΣ	1..1	code	(USCDI) active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance.
type	Σ	0..1	CodeableConcept	Coverage category such as medical or accident Binding: ?? (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.	SΣ	0..1	CodeableConcept	(USCDI) Coverage category such as medical or accident Binding: ?? (extensible): US Public Health Data Consortium Source of Payment Codes	Elements differ in definition for mustSupport: 'false' vs 'true'
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	0..1	Reference(Patient | RelatedPerson)	Subscriber to the policy	Σ	0..1	Reference(Patient | RelatedPerson)	Subscriber to the policy
subscriberId	SΣ	1..1	string	ID assigned to the subscriber	SΣC	1..1	string	(USCDI) ID assigned to the subscriber
beneficiary	SΣ	1..1	Reference(C4BB Patient)	Plan beneficiary	SΣ	1..1	Reference(C4BB Patient)	(USCDI) Plan beneficiary
dependent	Σ	0..1	string	Dependent number	Σ	0..1	string	Dependent number
relationship	S	1..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: ?? (required)	S	1..1	CodeableConcept	(USCDI) Beneficiary relationship to the subscriber Binding: ?? (required)
period	SΣ	0..1	Period	Coverage start and end dates	SΣ	0..1	Period	(USCDI) Coverage start and end dates
payor	SΣ	1..1	Reference(C4BB Organization)	Issuer of the policy	SΣ	1..1	Reference(C4BB Organization)	(USCDI) Issuer of the policy
Slices for class	S	0..*	BackboneElement	Additional coverage classifications Slice: Unordered, Open by pattern:type	S	0..*	BackboneElement	(USCDI) Additional coverage classifications Slice: Unordered, Open by pattern:type
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): The policy classifications, eg. Group, Plan, Class, etc.	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
Documentation for this format