Profile Comparison between http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-coverage vs http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-coverage

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage	http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|7.0.0	Values Differ
copyright
date	2024-12-11T18:49:53+00:00	2025-08-06T17:27:13+00:00	Values Differ
description	This profile specifies constraints on the Coverage resource to support coverage requirements discovery.
experimental	false
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	CRDCoverage
publisher	HL7 International / Financial Management
purpose
status	active
title	CRD Coverage
type	Coverage
url	http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-coverage
version	2.1.0	2.2.0-ballot	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	R Type	R Description & Constraints	Comments
Coverage	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)	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)
id	Σ	0..1	id	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. Additional Bindings Purpose ?? Max Binding		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
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
Slices for identifier	SΣ	0..*	Identifier	Member ID and other identifiers Slice: Unordered, Open by pattern:type	SΣ	0..*	Identifier	Member ID and other identifiers Slice: Unordered, Open by pattern:type
status	?!SΣ	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	SΣ	0..1	CodeableConcept	Coverage category such as medical or accident Binding: ?? (extensible): US Public Health Data Consortium Source of Payment Codes	SΣ	0..1	CodeableConcept	Coverage category such as medical or accident Binding: ?? (extensible): US Public Health Data Consortium Source of Payment Codes
policyHolder	SΣ	0..1	Reference(CRD Patient | CRD Organization)	Owner of the policy	SΣ	0..1	Reference(CRD Patient | CRD Organization)	Owner of the policy
subscriber	SΣ	0..1	Reference(CRD Patient)	Subscriber to the policy	SΣ	0..1	Reference(CRD Patient)	Subscriber to the policy
subscriberId	SΣC	0..1	string	ID assigned to the subscriber	SΣC	0..1	string	ID assigned to the subscriber
beneficiary	SΣ	1..1	Reference(CRD Patient)	Plan beneficiary	SΣ	1..1	Reference(CRD Patient)	Plan beneficiary
dependent	SΣ	0..1	string	Dependent number	SΣ	0..1	string	Dependent number
relationship	S	1..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: ?? (extensible)	S	1..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: ?? (extensible)
period	SΣ	0..1	Period	Coverage start and end dates	SΣ	0..1	Period	Coverage start and end dates
payor	SΣ	1..1	Reference(CRD Patient | CRD Organization)	Issuer of the policy	SΣ	1..1	Reference(CRD Organization)	Issuer of the policy	Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient], CanonicalType[http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-organization]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-organization]])
Slices for class	S	0..*	BackboneElement	Additional coverage classifications Slice: Unordered, Open by pattern:type	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	SΣ	0..1	positiveInt	Relative order of the coverage	SΣ	0..1	positiveInt	Relative order of the coverage
network	SΣ	0..1	string	Insurer network	SΣ	0..1	string	Insurer network
costToBeneficiary		0..0				0..0
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