CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
2.0.0 - STU 2 US

This page is part of the CARIN Blue Button Implementation Guide (v2.0.0: STU 2) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: Coverage Example 1 - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Coverage;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "Coverage1"];
  fhir:Resource.meta [
     fhir:Meta.lastUpdated [ fhir:value "2020-10-30T09:48:01.8462752-04:00"^^xsd:dateTime ];
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|2.0.0";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|2.0.0>     ]
  ];
  fhir:Resource.language [ fhir:value "en-US"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\"><p><b>Generated Narrative: Coverage</b><a name=\"Coverage1\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Coverage &quot;Coverage1&quot; Updated &quot;2020-10-30 09:48:01-0400&quot;  (Language &quot;en-US&quot;) </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-C4BB-Coverage.html\">C4BB Coverage (version 2.0.0)</a></p></div><p><b>identifier</b>: An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501</p><p><b>status</b>: active</p><p><b>policyHolder</b>: <a href=\"Patient-Patient1.html\">Patient/Patient1</a> &quot; EXAMPLE1&quot;</p><p><b>subscriber</b>: <a href=\"Patient-Patient1.html\">Patient/Patient1</a> &quot; EXAMPLE1&quot;</p><p><b>subscriberId</b>: 888009335</p><p><b>beneficiary</b>: <a href=\"Patient-Patient1.html\">Patient/Patient1</a> &quot; EXAMPLE1&quot;</p><p><b>dependent</b>: 01</p><p><b>relationship</b>: Self <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>period</b>: 2020-01-01 --&gt; (ongoing)</p><p><b>payor</b>: <a href=\"Organization-Payer2.html\">Organization/Payer2: UPMC Health Plan</a> &quot;UPMC Health Plan&quot;</p><blockquote><p><b>class</b></p><p><b>type</b>: An employee group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#group &quot;Group&quot;)</span></p><p><b>value</b>: MCHMO1</p><p><b>name</b>: MEDICARE HMO PLAN</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: A specific suite of benefits. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#plan &quot;Plan&quot;)</span></p><p><b>value</b>: GR5</p><p><b>name</b>: GR5-HMO DEDUCTIBLE</p></blockquote><p><b>network</b>: GR5-HMO DEDUCTIBLE</p></div>"
  ];
  fhir:Coverage.identifier [
     fhir:index 0;
     fhir:Identifier.type [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ];
         fhir:Coding.code [ fhir:value "MB" ];
         fhir:Coding.display [ fhir:value "Member Number" ]       ];
       fhir:CodeableConcept.text [ fhir:value "An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier." ]     ];
     fhir:Identifier.system [ fhir:value "https://www.upmchealthplan.com/fhir/memberidentifier" ];
     fhir:Identifier.value [ fhir:value "88800933501" ];
     fhir:Identifier.assigner [
       fhir:Reference.reference [ fhir:value "Organization/Payer2" ];
       fhir:Reference.display [ fhir:value "UPMC Health Plan" ]     ]
  ];
  fhir:Coverage.status [ fhir:value "active"];
  fhir:Coverage.policyHolder [
     fhir:Reference.reference [ fhir:value "Patient/Patient1" ]
  ];
  fhir:Coverage.subscriber [
     fhir:Reference.reference [ fhir:value "Patient/Patient1" ]
  ];
  fhir:Coverage.subscriberId [ fhir:value "888009335"];
  fhir:Coverage.beneficiary [
     fhir:Reference.reference [ fhir:value "Patient/Patient1" ]
  ];
  fhir:Coverage.dependent [ fhir:value "01"];
  fhir:Coverage.relationship [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/subscriber-relationship" ];
       fhir:Coding.code [ fhir:value "self" ]     ];
     fhir:CodeableConcept.text [ fhir:value "Self" ]
  ];
  fhir:Coverage.period [
     fhir:Period.start [ fhir:value "2020-01-01"^^xsd:date ]
  ];
  fhir:Coverage.payor [
     fhir:index 0;
     fhir:Reference.reference [ fhir:value "Organization/Payer2" ];
     fhir:Reference.display [ fhir:value "UPMC Health Plan" ]
  ];
  fhir:Coverage.class [
     fhir:index 0;
     fhir:Coverage.class.type [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/coverage-class" ];
         fhir:Coding.code [ fhir:value "group" ];
         fhir:Coding.display [ fhir:value "Group" ]       ];
       fhir:CodeableConcept.text [ fhir:value "An employee group" ]     ];
     fhir:Coverage.class.value [ fhir:value "MCHMO1" ];
     fhir:Coverage.class.name [ fhir:value "MEDICARE HMO PLAN" ]
  ], [
     fhir:index 1;
     fhir:Coverage.class.type [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/coverage-class" ];
         fhir:Coding.code [ fhir:value "plan" ];
         fhir:Coding.display [ fhir:value "Plan" ]       ];
       fhir:CodeableConcept.text [ fhir:value "A specific suite of benefits." ]     ];
     fhir:Coverage.class.value [ fhir:value "GR5" ];
     fhir:Coverage.class.name [ fhir:value "GR5-HMO DEDUCTIBLE" ]
  ];
  fhir:Coverage.network [ fhir:value "GR5-HMO DEDUCTIBLE"].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.