0.3.0 - Second STU ballot

This page is part of a downloaded copy of this specification. This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v0.3.0: STU 1 Ballot 2) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

## StructureDefinition: CoverageDeidentR4

The official URL for this profile is:

    http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-coverage-deident-r4

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Text Summary
- Differential Table
- Snapshot Table
- All

This structure is derived from Coverage

Summary

Mandatory: 0 element (1 nested mandatory element)
Must-Support: 8 elements
Fixed Value: 1 element
Prohibited: 13 elements

Structures

This structure refers to these other structures:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient-deident-r4

This structure is derived from Coverage

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Coverage |  | 0..* |  |
text |  | 0..0 |  |
identifier |  | 0..0 |  |
status | S | 1..1 | code |
type | S | 0..1 | CodeableConcept |
policyHolder |  | 0..0 |  |
subscriber |  | 0..0 |  |
subscriberId |  | 0..0 |  |
beneficiary |  | 0..0 |  |
dependent |  | 0..0 |  |
relationship |  | 0..0 |  |
period | S | 0..1 | Period |
payor | S | 1..* | Reference(CRD Deidentified Patient | OrganizationR4) |
class | S | 0..1 | BackboneElement |
type | S | 1..1 | CodeableConcept | Fixed Value: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/coverage-class","code":"plan"}]} (Plan)
value | S | 1..1 | string |
name | S | 0..1 | string |
order |  | 0..0 |  |
network |  | 0..0 |  |
costToBeneficiary |  | 0..0 |  |
subrogation |  | 0..0 |  |
contract |  | 0..0 |  |
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Coverage | I | 0..* |  | Insurance or medical plan or a payment agreement
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required)
type | S Σ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: CoverageTypeAndSelf-PayCodes (preferred)
period | S Σ | 0..1 | Period | Coverage start and end dates
payor | S Σ | 1..* | Reference(CRD Deidentified Patient | OrganizationR4) | Issuer of the policy
class | S I | 0..1 | BackboneElement | Additional coverage classifications
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible) Fixed Value: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/coverage-class","code":"plan"}]} (Plan)
value | S Σ | 1..1 | string | Value associated with the type
name | S Σ | 0..1 | string | Human readable description of the type and value
Documentation for this format

This structure is derived from Coverage

Summary

Mandatory: 0 element (1 nested mandatory element)
Must-Support: 8 elements
Fixed Value: 1 element
Prohibited: 13 elements

Structures

This structure refers to these other structures:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient-deident-r4

Differential View

This structure is derived from Coverage

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Coverage |  | 0..* |  |
text |  | 0..0 |  |
identifier |  | 0..0 |  |
status | S | 1..1 | code |
type | S | 0..1 | CodeableConcept |
policyHolder |  | 0..0 |  |
subscriber |  | 0..0 |  |
subscriberId |  | 0..0 |  |
beneficiary |  | 0..0 |  |
dependent |  | 0..0 |  |
relationship |  | 0..0 |  |
period | S | 0..1 | Period |
payor | S | 1..* | Reference(CRD Deidentified Patient | OrganizationR4) |
class | S | 0..1 | BackboneElement |
type | S | 1..1 | CodeableConcept | Fixed Value: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/coverage-class","code":"plan"}]} (Plan)
value | S | 1..1 | string |
name | S | 0..1 | string |
order |  | 0..0 |  |
network |  | 0..0 |  |
costToBeneficiary |  | 0..0 |  |
subrogation |  | 0..0 |  |
contract |  | 0..0 |  |
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Coverage | I | 0..* |  | Insurance or medical plan or a payment agreement
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required)
type | S Σ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: CoverageTypeAndSelf-PayCodes (preferred)
period | S Σ | 0..1 | Period | Coverage start and end dates
payor | S Σ | 1..* | Reference(CRD Deidentified Patient | OrganizationR4) | Issuer of the policy
class | S I | 0..1 | BackboneElement | Additional coverage classifications
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible) Fixed Value: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/coverage-class","code":"plan"}]} (Plan)
value | S Σ | 1..1 | string | Value associated with the type
name | S Σ | 0..1 | string | Human readable description of the type and value
Documentation for this format

Other representations of profile: Schematron

### Terminology Bindings

Path | Conformance | ValueSet / Code
Coverage.status | required | FinancialResourceStatusCodes
Coverage.type | preferred | CoverageTypeAndSelf-PayCodes
Coverage.class.type | extensible | Fixed Value: plan

### Constraints

Id | Path | Details | Requirements
dom-2 | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-4 | Coverage | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-3 | Coverage | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-6 | Coverage | A resource should have narrative for robust management : text.div.exists() |
dom-5 | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
ele-1 | Coverage.class | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ele-1 | Coverage.costToBeneficiary.exception | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |