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Logical Model: DTR Supported Payers

A logical model describing the listing of payers currently supported by the DTR app.

Purpose:

This logical model is NOT a FHIR data structure for information exchange. Instead, it is a model of the information that the DTR app will maintain for the Payers that are supported by the app. (See the Determination of Payers Supported by a DTR App section of the Formal Specification)

The Payer Identifier used in structures based on this model SHALL be the same as the ones that are returned by the endpoint discovery mechanism defined in HRex.

Usage:

• This Logical Model Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

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

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints
DTRSupportedPayers		0..*	Base	DTR Supported Payers Instances of this logical model are not marked to be the target of a Reference
payer		0..*	BackboneElement	Supported Payer ele-1: All FHIR elements must have a @value or children
@id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
name		1..1	string	Name of the payer
identifier		1..1	Identifier	Identifier of the payer ele-1: All FHIR elements must have a @value or children
@id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identifier namespace for this payer ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	Specific identifier value for this payer ele-1: All FHIR elements must have a @value or children Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use ele-1: All FHIR elements must have a @value or children
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text) ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DTRSupportedPayers.payer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DTRSupportedPayers.payer.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard

This structure is derived from Base

Name	Flags	Card.	Type	Description & Constraints
DTRSupportedPayers		0..*	Base	DTR Supported Payers Instances of this logical model are not marked to be the target of a Reference
payer		0..*	BackboneElement	Supported Payer
name		1..1	string	Name of the payer
identifier		1..1	Identifier	Identifier of the payer
system		1..1	uri	Identifier namespace for this payer
value		1..1	string	Specific identifier value for this payer
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
DTRSupportedPayers		0..*	Base	DTR Supported Payers Instances of this logical model are not marked to be the target of a Reference
payer		0..*	BackboneElement	Supported Payer
@id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
name		1..1	string	Name of the payer
identifier		1..1	Identifier	Identifier of the payer
@id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	Identifier namespace for this payer Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	Specific identifier value for this payer Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DTRSupportedPayers.payer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DTRSupportedPayers.payer.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard

This structure is derived from Base

Summary

Mandatory: 0 element(4 nested mandatory elements)

Maturity: 1

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
DTRSupportedPayers		0..*	Base	DTR Supported Payers Instances of this logical model are not marked to be the target of a Reference
payer		0..*	BackboneElement	Supported Payer ele-1: All FHIR elements must have a @value or children
@id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
name		1..1	string	Name of the payer
identifier		1..1	Identifier	Identifier of the payer ele-1: All FHIR elements must have a @value or children
@id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. ele-1: All FHIR elements must have a @value or children
system	Σ	1..1	uri	Identifier namespace for this payer ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	Specific identifier value for this payer ele-1: All FHIR elements must have a @value or children Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use ele-1: All FHIR elements must have a @value or children
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text) ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DTRSupportedPayers.payer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DTRSupportedPayers.payer.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard

Differential View

This structure is derived from Base

Name	Flags	Card.	Type	Description & Constraints
DTRSupportedPayers		0..*	Base	DTR Supported Payers Instances of this logical model are not marked to be the target of a Reference
payer		0..*	BackboneElement	Supported Payer
name		1..1	string	Name of the payer
identifier		1..1	Identifier	Identifier of the payer
system		1..1	uri	Identifier namespace for this payer
value		1..1	string	Specific identifier value for this payer
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
DTRSupportedPayers		0..*	Base	DTR Supported Payers Instances of this logical model are not marked to be the target of a Reference
payer		0..*	BackboneElement	Supported Payer
@id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
name		1..1	string	Name of the payer
identifier		1..1	Identifier	Identifier of the payer
@id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	Identifier namespace for this payer Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	Specific identifier value for this payer Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DTRSupportedPayers.payer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
DTRSupportedPayers.payer.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard

This structure is derived from Base

Summary

Mandatory: 0 element(4 nested mandatory elements)

Maturity: 1

Other representations of profile: CSV, Excel