This page is part of the US Core (v7.0.0: STU7) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Page standards status: Informative |
<Coverage xmlns="http://hl7.org/fhir">
<id value="coverage-example"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|7.0.0"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Coverage</b><a name="coverage-example"> </a><a name="hccoverage-example"> </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 "coverage-example" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-us-core-coverage.html">US Core Coverage Profile (version 7.0.0)</a></p></div><p><b>identifier</b>: Member Number/88800933501</p><p><b>status</b>: active</p><p><b>type</b>: PPO <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://nahdo.org/sopt">Source of Payment Typology</a>#3712; <a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html">ActCode</a>#PPO "preferred provider organization policy")</span></p><p><b>subscriberId</b>: 888009335</p><p><b>beneficiary</b>: <a href="Patient-example.html">Patient/example</a> " SHAW"</p><p><b>relationship</b>: Self <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-subscriber-relationship.html">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>period</b>: 2020-01-01 --> (ongoing)</p><p><b>payor</b>: <a href="Organization-acme-payer.html">Organization/acme-payer: Acme Health Plan</a> "Acme Health Plan"</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/5.5.0/CodeSystem-coverage-class.html">Coverage Class Codes</a>#group "Group")</span></p><p><b>value</b>: xyz</p><p><b>name</b>: XYZ employee Group 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/5.5.0/CodeSystem-coverage-class.html">Coverage Class Codes</a>#plan "Plan")</span></p><p><b>value</b>: gold</p><p><b>name</b>: Acme Gold Plan</p></blockquote></div>
</text>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MB"/>
<display value="Member Number"/>
</coding>
</type>
<system value="http://example.org/fhir/memberidentifier"/>
<value value="88800933501"/>
</identifier>
<status value="active"/>
<type>
<coding>
<system value="https://nahdo.org/sopt"/>
<code value="3712"/>
<display value="PPO"/>
</coding>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="PPO"/>
<display value="preferred provider organization policy"/>
</coding>
<text value="PPO"/>
</type>
<subscriberId value="888009335"/>
<beneficiary>🔗
<reference value="Patient/example"/>
</beneficiary>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
</coding>
<text value="Self"/>
</relationship>
<period>
<start value="2020-01-01"/>
</period>
<payor>🔗
<reference value="Organization/acme-payer"/>
<display value="Acme Health Plan"/>
</payor>
<class>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="group"/>
<display value="Group"/>
</coding>
<text value="An employee group"/>
</type>
<value value="xyz"/>
<name value="XYZ employee Group Plan"/>
</class>
<class>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="plan"/>
<display value="Plan"/>
</coding>
<text value="A specific suite of benefits."/>
</type>
<value value="gold"/>
<name value="Acme Gold Plan"/>
</class>
</Coverage>