CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
1.1.0 - STU1 Update
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 
@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 "CoverageEx1"];
fhir:Resource.meta [
fhir:Meta.lastUpdated [ fhir:value "2020-10-30T09:48:01.8462752-04:00"^^xsd:dateTime ];
fhir:Meta.source [ fhir:value "Organization/PayerOrganizationExample1" ];
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|1.1.0";
fhir:index 0;
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>: 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-ExamplePatient1.html\">Generated Summary: language: en-US; An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501; active; Member 01 Test ; Phone: 5555555551, Phone: 5555555552, Phone: 5555555553, Phone: 5555555554, Phone: 5555555555, Phone: 5555555556, GXXX@XXXX.com, Fax: 5555555557; gender: male; birthDate: 1943-01-01; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}\">unknown</span></a></p><p><b>subscriber</b>: <a href=\"Patient-ExamplePatient1.html\">Generated Summary: language: en-US; An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501; active; Member 01 Test ; Phone: 5555555551, Phone: 5555555552, Phone: 5555555553, Phone: 5555555554, Phone: 5555555555, Phone: 5555555556, GXXX@XXXX.com, Fax: 5555555557; gender: male; birthDate: 1943-01-01; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}\">unknown</span></a></p><p><b>subscriberId</b>: 888009335</p><p><b>beneficiary</b>: <a href=\"Patient-ExamplePatient1.html\">Generated Summary: language: en-US; An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501; active; Member 01 Test ; Phone: 5555555551, Phone: 5555555552, Phone: 5555555553, Phone: 5555555554, Phone: 5555555555, Phone: 5555555556, GXXX@XXXX.com, Fax: 5555555557; gender: male; birthDate: 1943-01-01; <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>: 2020-01-01 --> (ongoing)</p><p><b>payor</b>: <a href=\"Organization-PayerOrganizationExample1.html\">UPMC Health Plan. Generated Summary: NAIC Code: 95216; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span>; name: UPMC Health Plan; Phone: 1-844-220-4785 TTY: 711, Phone: 1-866-406-8762</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>: MCHMO1</p><p><b>name</b>: MEDICARE HMO PLAN</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/coverage-class plan}\">A specific suite of benefits.</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/PayerOrganizationExample1" ];
fhir:Reference.display [ fhir:value "UPMC Health Plan" ] ]
];
fhir:Coverage.status [ fhir:value "active"];
fhir:Coverage.policyHolder [
fhir:Reference.reference [ fhir:value "Patient/ExamplePatient1" ]
];
fhir:Coverage.subscriber [
fhir:Reference.reference [ fhir:value "Patient/ExamplePatient1" ]
];
fhir:Coverage.subscriberId [ fhir:value "888009335"];
fhir:Coverage.beneficiary [
fhir:Reference.reference [ fhir:value "Patient/ExamplePatient1" ]
];
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/PayerOrganizationExample1" ];
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.
IG © 2020+ HL7 Financial Management Working Group. Package hl7.fhir.us.carin-bb#1.1.0 based on FHIR 4.0.1. Generated 2021-07-02
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