abstractbaseDefinition- Values Differ
copyright- Values Differ
datedescription- Values Differ
experimentalfhirVersionjurisdiction
jurisdiction[0]kindnamepublisher- Values Differ
purposestatustitle- Values Differ
typeurlversion- Values Differ
| Left: | Da Vinci Admit/Transfer/Discharge Notification Coverage Profile (http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/adt-notification-coverage) |
| Right: | Da Vinci Admit/Discharge/Transfer Notification Coverage Profile (http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/adt-notification-coverage) |
| Error | StructureDefinition.version | Values for version differ: '1.0.0' vs '1.1.0-preview' |
| Information | StructureDefinition.title | Values for title differ: 'Da Vinci Admit/Transfer/Discharge Notification Coverage Profile' vs 'Da Vinci Admit/Discharge/Transfer Notification Coverage Profile' |
| Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 International - Infrastructure and Messaging Work Group' vs 'HL7 International / Infrastructure And Messaging' |
| Information | StructureDefinition.copyright | Values for copyright differ: 'Used by permission of HL7 International - Infrastructure and Messaging Work Group, all rights reserved Creative Commons License' vs 'Used by permission of HL7 International, all rights reserved Creative Commons License' |
| Error | StructureDefinition.baseDefinition | Values for baseDefinition differ: 'http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-coverage' vs 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage' |
| Information | StructureDefinition.definition | Values for definition differ: 'This is the Coverage profile which is used to provide insurance information for scheduling an appointment and/or registering a patient.' vs 'Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.' |
| Information | StructureDefinition.short | Values for short differ: 'Also known as Member identifier' vs 'Member ID and other identifiers' |
| Information | StructureDefinition.comment | Values for comment differ: 'This must be filled in when known' vs 'The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependant.' |
| Information | StructureDefinition.comment | Values for comment differ: 'This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid.' vs 'The `Coverage.status` alone does not indicate whether an individual's coverage is terminated or that the individual is not covered. The `Coverage.period` needs to be considered as well.' |
| Warning | Coverage.status | Elements differ in definition for mustSupport: 'false' vs 'true' |
| Warning | Coverage.type | Elements differ in definition for mustSupport: 'false' vs 'true' |
| Information | StructureDefinition.short | Values for short differ: 'Subscriber ID' vs 'ID assigned to the subscriber' |
| Information | StructureDefinition.requirements | Values for requirements differ: 'The subscriber Id is a number that is needed by the payor to associate the attestation with the member in their system.' vs 'The insurer requires this identifier on correspondance and claims (digital and otherwise).' |
| Information | StructureDefinition.requirements | Values for requirements differ: 'This would usually be the US Core Patient Resource for which the service was performed.' vs 'This is the party who receives treatment for which the costs are reimbursed under the coverage.' |
| Information | StructureDefinition.comment | Values for comment differ: 'Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others.' vs 'Relationship of the member to the person insured (subscriber)' |
| Warning | Coverage.relationship | Elements differ in definition for mustSupport: 'false' vs 'true' |
| Information | Coverage.relationship | Element minimum cardinalities differ: '0' vs '1' |
| Warning | Coverage.period | Elements differ in definition for mustSupport: 'false' vs 'true' |
| Information | StructureDefinition.comment | Values for comment differ: 'May provide multiple identifiers such as insurance company identifier or business identifier (BIN number). For selfpay it may provide multiple paying persons and/or organizations.' vs 'Issuer of the Policy' |
| Information | Coverage.payor | Element maximum cardinalities differ: '2147483647' vs '1' |
| Warning | Coverage.class | Elements differ in definition for mustSupport: 'false' vs 'true' |
| Name | Value | Comments | |
|---|---|---|---|
| abstract | false | ||
| baseDefinition | http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-coverage | http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage |
|
| copyright | Used by permission of HL7 International - Infrastructure and Messaging Work Group, all rights reserved Creative Commons License | Used by permission of HL7 International, all rights reserved Creative Commons License |
|
| date | 2020-08-24 | ||
| description | The Da Vinci Admit/Transfer/Discharge Notification Coverage Profile is based on the [HRex Coverage Profile](http://build.fhir.org/ig/HL7/davinci-ehrx/StructureDefinition-hrex-coverage.html) and constrains the Patient resource referenced by the `Coverage.beneficiary` element to be found in the same message Bundle. | The Da Vinci Admit/Discharge/Transfer Notification Coverage Profile is based on the [HRex Coverage Profile](http://build.fhir.org/ig/HL7/davinci-ehrx/StructureDefinition-hrex-coverage.html) and constrains the Patient resource referenced by the `Coverage.beneficiary` element to be found in the same message Bundle. The Da Vinci Admit/Discharge/Transfer Notification Coverage Profile is based on the US Core Coverage Profile and complies with US Core versions 6.1.0, and 7.0.0. It constrains the resources referenced by the `Coverage.beneficiary` element to the US Core Patient Profile. It also constrains the referenced resource to be an entry in the message Bundle that it populates. |
|
| experimental | false | ||
| fhirVersion | 4.0.1 | ||
| jurisdiction | |||
| jurisdiction[0] | urn:iso:std:iso:3166#US | ||
| kind | resource | ||
| name | ADTNotificationCoverageProfile | ||
| publisher | HL7 International - Infrastructure and Messaging Work Group | HL7 International / Infrastructure And Messaging |
|
| purpose | |||
| status | active | ||
| title | Da Vinci Admit/Transfer/Discharge Notification Coverage Profile | Da Vinci Admit/Discharge/Transfer Notification Coverage Profile |
|
| type | Coverage | ||
| url | http://hl7.org/fhir/us/davinci-alerts/StructureDefinition/adt-notification-coverage | ||
| version | 1.0.0 | 1.1.0-preview |
|
| Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
 Coverage | 0..* | HRexCoverage | Insurance or medical plan or a payment agreement | C | 0..* | USCoreCoverageProfile(7.0.0) | Insurance or medical plan or a payment agreement This profile also complies with the profile US Core Coverage Profile (6.1.0) us-core-15: Member Id in Coverage.identifier or Coverage.subscriberId SHALL be present | ||||||||||
 id | Σ | 0..1 | string | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact | |||||||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |||||||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |||||||||
| language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| |||||||||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
| contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
 extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
| identifier | SΣ | 0..* | Identifier | Also known as Member identifier | SΣ | 0..* | Identifier | Member ID and other identifiers Slice: Unordered, Open by pattern:type | |||||||||
| status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. |
| ||||||||
| type | Σ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. | SΣ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (extensible): US Public Health Data Consortium Source of Payment Codes |
| ||||||||
| policyHolder | Σ | 0..1 | Reference(US Core Patient Profile(3.1.0) | HRex Organization Profile | RelatedPerson) | Owner of the policy | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | |||||||||
| subscriber | Σ | 0..1 | Reference(US Core Patient Profile(3.1.0)) | Subscriber to the policy | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | |||||||||
| subscriberId | SΣ | 0..1 | string | Subscriber ID | SΣC | 0..1 | string | ID assigned to the subscriber | |||||||||
| beneficiary | SΣ | 1..1 | Reference(US Core Patient Profile(3.1.0)) {b} | Plan beneficiary | SΣ | 1..1 | Reference(US Core Patient Profile(7.0.0)) {b} | Plan beneficiary | |||||||||
| dependent | Σ | 0..1 | string | Dependent number | Σ | 0..1 | string | Dependent number | |||||||||
| relationship | 0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | S | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible) |
| |||||||||
| period | Σ | 0..1 | Period | Coverage start and end dates | SΣ | 0..1 | Period | Coverage start and end dates |
| ||||||||
| payor | SΣ | 1..* | Reference(HRex Organization Profile) | Issuer of the policy | SΣ | 1..1 | Reference(US Core Organization Profile(7.0.0) S | US Core Patient Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0)) | Issuer of the policy |
| ||||||||
| class | 0..* | BackboneElement | Additional coverage classifications | S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by pattern:type |
| |||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc. | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc. | |||||||||
| value | Σ | 1..1 | string | Value associated with the type | Σ | 1..1 | string | Value associated with the type | |||||||||
| name | Σ | 0..1 | string | Human readable description of the type and value | Σ | 0..1 | string | Human readable description of the type and value | |||||||||
| order | Σ | 0..1 | positiveInt | Relative order of the coverage | Σ | 0..1 | positiveInt | Relative order of the coverage | |||||||||
| network | Σ | 0..1 | string | Insurer network | Σ | 0..1 | string | Insurer network | |||||||||
| costToBeneficiary | 0..* | BackboneElement | Patient payments for services/products | 0..* | BackboneElement | Patient payments for services/products | |||||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| type | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified. | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified. | |||||||||
| value[x] | Σ | 1..1 | ??, Money | The amount or percentage due from the beneficiary | Σ | 1..1 | ??, Money | The amount or percentage due from the beneficiary | |||||||||
| exception | 0..* | BackboneElement | Exceptions for patient payments | 0..* | BackboneElement | Exceptions for patient payments | |||||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| type | Σ | 1..1 | CodeableConcept | Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays. | Σ | 1..1 | CodeableConcept | Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays. | |||||||||
| period | Σ | 0..1 | Period | The effective period of the exception | Σ | 0..1 | Period | The effective period of the exception | |||||||||
| subrogation | 0..1 | boolean | Reimbursement to insurer | 0..1 | boolean | Reimbursement to insurer | |||||||||||
| contract | 0..* | Reference(Contract) | Contract details | 0..* | Reference(Contract) | Contract details | |||||||||||
| Documentation for this format | |||||||||||||||||