This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v0.1.0: STU 1 Ballot 1) based on FHIR v3.5.0. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

This is a pre-release version (Ballot 1) of Coverage Requirements Discovery (CRD) R1/STU. There is no current official version.
For a full list of available versions, see the Directory of published versions .

StructureDefinition: CRD Coverage

The official URL for this profile is: 

http://hl7.org/fhir/us/davinci-crd/STU3/StructureDefinition/profile-coverage-deident-stu3

Formal Views of Profile Content

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

This structure is derived from Coverage

Summary

Must-Support: 7 elements
Prohibited: 21 elements

Structures

This structure refers to these other structures:

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..*
... identifier 0..0
... status S0..1code
... type S0..1CodeableConcept
... policyHolder 0..0
... subscriber 0..0
... subscriberId 0..0
... beneficiary 0..0
... relationship 0..0
... period S0..1Period
... payor S0..*Reference(CRD Patient | CRD Organization)
... grouping S0..1BackboneElement
.... group 0..0
.... groupDisplay 0..0
.... subGroup 0..0
.... subGroupDisplay 0..0
.... plan S0..1string
.... planDisplay S0..1string
.... subPlan 0..0
.... subPlanDisplay 0..0
.... class 0..0
.... classDisplay 0..0
.... subClass 0..0
.... subClassDisplay 0..0
... dependent 0..0
... sequence 0..0
... order 0..0
... network 0..0
... contract 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage I0..*Insurance or medical plan or a payment agreement
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ0..1codeactive | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (required)
... type SΣ0..1CodeableConceptType of coverage such as medical or accident
Binding: Coverage Type and Self-Pay Codes (preferred)
... period SΣ0..1PeriodCoverage start and end dates
... payor SΣ0..*Reference(CRD Patient | CRD Organization)Identifier for the plan or agreement issuer
... grouping SI0..1BackboneElementAdditional coverage classifications
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... plan SΣ0..1stringAn identifier for the plan
.... planDisplay SΣ0..1stringDisplay text for the plan

doco Documentation for this format

This structure is derived from Coverage

Summary

Must-Support: 7 elements
Prohibited: 21 elements

Structures

This structure refers to these other structures:

Differential View

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..*
... identifier 0..0
... status S0..1code
... type S0..1CodeableConcept
... policyHolder 0..0
... subscriber 0..0
... subscriberId 0..0
... beneficiary 0..0
... relationship 0..0
... period S0..1Period
... payor S0..*Reference(CRD Patient | CRD Organization)
... grouping S0..1BackboneElement
.... group 0..0
.... groupDisplay 0..0
.... subGroup 0..0
.... subGroupDisplay 0..0
.... plan S0..1string
.... planDisplay S0..1string
.... subPlan 0..0
.... subPlanDisplay 0..0
.... class 0..0
.... classDisplay 0..0
.... subClass 0..0
.... subClassDisplay 0..0
... dependent 0..0
... sequence 0..0
... order 0..0
... network 0..0
... contract 0..0

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage I0..*Insurance or medical plan or a payment agreement
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ0..1codeactive | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (required)
... type SΣ0..1CodeableConceptType of coverage such as medical or accident
Binding: Coverage Type and Self-Pay Codes (preferred)
... period SΣ0..1PeriodCoverage start and end dates
... payor SΣ0..*Reference(CRD Patient | CRD Organization)Identifier for the plan or agreement issuer
... grouping SI0..1BackboneElementAdditional coverage classifications
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... plan SΣ0..1stringAn identifier for the plan
.... planDisplay SΣ0..1stringDisplay text for the plan

doco Documentation for this format

 

Other representations of profile: Schematron

Terminology Bindings

PathNameConformanceValueSet
Coverage.languageCommon LanguagesextensibleCommon Languages
Coverage.statusFinancial Resource Status CodesrequiredFinancial Resource Status Codes
Coverage.typeCoverage Type and Self-Pay CodespreferredCoverage Type and Self-Pay Codes

Constraints

IdPathDetailsRequirements
dom-2CoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-1CoverageIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-4CoverageIf 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-3CoverageIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
ele-1Coverage.groupingAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())