0.3.0 - Second STU ballot

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. The current version which supercedes this version is 1.0.0. 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.

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:

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..*
... text 0..0
... identifier 0..0
... status S1..1code
... type S0..1CodeableConcept
... policyHolder 0..0
... subscriber 0..0
... subscriberId 0..0
... beneficiary 0..0
... dependent 0..0
... relationship 0..0
... period S0..1Period
... payor S1..*Reference(CRD Deidentified Patient | OrganizationR4)
... class S0..1BackboneElement
.... type S1..1CodeableConceptFixed Value: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/coverage-class","code":"plan"}]} (Plan)
.... value S1..1string
.... name S0..1string
... order 0..0
... network 0..0
... costToBeneficiary 0..0
... subrogation 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: CommonLanguages (preferred)
Max Binding: AllLanguages
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required)
... type SΣ0..1CodeableConceptCoverage category such as medical or accident
Binding: CoverageTypeAndSelf-PayCodes (preferred)
... period SΣ0..1PeriodCoverage start and end dates
... payor SΣ1..*Reference(CRD Deidentified Patient | OrganizationR4)Issuer of the policy
... class SI0..1BackboneElementAdditional coverage classifications
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type SΣ1..1CodeableConceptType 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 SΣ1..1stringValue associated with the type
.... name SΣ0..1stringHuman readable description of the type and value

doco 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:

Differential View

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..*
... text 0..0
... identifier 0..0
... status S1..1code
... type S0..1CodeableConcept
... policyHolder 0..0
... subscriber 0..0
... subscriberId 0..0
... beneficiary 0..0
... dependent 0..0
... relationship 0..0
... period S0..1Period
... payor S1..*Reference(CRD Deidentified Patient | OrganizationR4)
... class S0..1BackboneElement
.... type S1..1CodeableConceptFixed Value: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/coverage-class","code":"plan"}]} (Plan)
.... value S1..1string
.... name S0..1string
... order 0..0
... network 0..0
... costToBeneficiary 0..0
... subrogation 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: CommonLanguages (preferred)
Max Binding: AllLanguages
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required)
... type SΣ0..1CodeableConceptCoverage category such as medical or accident
Binding: CoverageTypeAndSelf-PayCodes (preferred)
... period SΣ0..1PeriodCoverage start and end dates
... payor SΣ1..*Reference(CRD Deidentified Patient | OrganizationR4)Issuer of the policy
... class SI0..1BackboneElementAdditional coverage classifications
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type SΣ1..1CodeableConceptType 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 SΣ1..1stringValue associated with the type
.... name SΣ0..1stringHuman readable description of the type and value

doco Documentation for this format

 

Other representations of profile: Schematron

Terminology Bindings

PathConformanceValueSet / Code
Coverage.statusrequiredFinancialResourceStatusCodes
Coverage.typepreferredCoverageTypeAndSelf-PayCodes
Coverage.class.typeextensibleFixed Value: plan

Constraints

IdPathDetailsRequirements
dom-2CoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.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 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-6CoverageA resource should have narrative for robust management
: text.div.exists()
dom-5CoverageIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
ele-1Coverage.classAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Coverage.costToBeneficiary.exceptionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())