CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
1.1.0 - STU1 Update

This page is part of the CARIN Blue Button Implementation Guide (v1.1.0: STU 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

: Coverage1 - 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 "2020-07-07T13:26:22.0314215+00:00"^^xsd:dateTime ];
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage>     ], [
       fhir:value "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|1.1.0";
       fhir:index 1;
       fhir:link <http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|1.1.0>     ]
  ];
  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</b></p><p><b>identifier</b>: Member Number: 1234-234-1243-12345678901</p><p><b>status</b>: active</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-ActCode HIP}\">health insurance plan policy</span></p><p><b>policyHolder</b>: <a href=\"Patient-Patient1.html\">Generated Summary: language: en-US; Member Number: 1234-234-1243-12345678901, Unique Member ID: 1234-234-1243-12345678901u; active; Johnny Example1 ; Phone: (301)666-1212; gender: male; birthDate: 1986-01-01; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}\">unknown</span></a></p><p><b>subscriber</b>: <a href=\"Patient-Patient1.html\">Generated Summary: language: en-US; Member Number: 1234-234-1243-12345678901, Unique Member ID: 1234-234-1243-12345678901u; active; Johnny Example1 ; Phone: (301)666-1212; gender: male; birthDate: 1986-01-01; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}\">unknown</span></a></p><p><b>subscriberId</b>: 12345678901</p><p><b>beneficiary</b>: <a href=\"Patient-Patient1.html\">Generated Summary: language: en-US; Member Number: 1234-234-1243-12345678901, Unique Member ID: 1234-234-1243-12345678901u; active; Johnny Example1 ; Phone: (301)666-1212; gender: male; birthDate: 1986-01-01; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}\">unknown</span></a></p><p><b>dependent</b>: 01</p><p><b>relationship</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: 2019-01-01 --&gt; 2019-10-31</p><p><b>payor</b>: <a href=\"Organization-Payer1.html\">Generated Summary: language: en-US; National Provider Identifier: 345678, Payer ID: 901234; active; name: Payer 1</a></p><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/coverage-class group}\">An employee group</span></p><p><b>value</b>: 021890</p><p><b>name</b>: Acme Corporation</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/coverage-class plan}\">Plan</span></p><p><b>value</b>: XYZ123</p><p><b>name</b>: XYZ123-UPMC CONSUMER ADVA</p></blockquote><p><b>network</b>: XYZ123-UPMC CONSUMER ADVA</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:Identifier.system [ fhir:value "https://www.xxxhealthplan.com/fhir/memberidentifier" ];
     fhir:Identifier.value [ fhir:value "1234-234-1243-12345678901" ]
  ];
  fhir:Coverage.status [ fhir:value "active"];
  fhir:Coverage.type [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-ActCode" ];
       fhir:Coding.code [ fhir:value "HIP" ]     ];
     fhir:CodeableConcept.text [ fhir:value "health insurance plan policy" ]
  ];
  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 "12345678901"];
  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:Coverage.period [
     fhir:Period.start [ fhir:value "2019-01-01"^^xsd:date ];
     fhir:Period.end [ fhir:value "2019-10-31"^^xsd:date ]
  ];
  fhir:Coverage.payor [
     fhir:index 0;
     fhir:Reference.reference [ fhir:value "Organization/Payer1" ]
  ];
  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:CodeableConcept.text [ fhir:value "An employee group" ]     ];
     fhir:Coverage.class.value [ fhir:value "021890" ];
     fhir:Coverage.class.name [ fhir:value "Acme Corporation" ]
  ], [
     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:CodeableConcept.text [ fhir:value "Plan" ]     ];
     fhir:Coverage.class.value [ fhir:value "XYZ123" ];
     fhir:Coverage.class.name [ fhir:value "XYZ123-UPMC CONSUMER ADVA" ]
  ];
  fhir:Coverage.network [ fhir:value "XYZ123-UPMC CONSUMER ADVA"].

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

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