CARIN Digital Insurance Card
2.0.0-ballot - STU 2 Ballot

CARIN Digital Insurance Card - Downloaded Version 2.0.0-ballot See the Directory of published versions

## Extension: Supporting image

Official URL: http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension | Version: 2.0.0-ballot
Standards status: Trial-use | Maturity Level: 2 | Computable Name: SupportingImage
Other Identifiers: OID:2.16.840.1.113883.4.642.40.9.42.15

This extension enables payers to provide other supporting images found on a member’s physicial insurance card. A supporting image may be displayed by consuming applications when rendering the coverage information for use by the health plan member. These images may communicate additional information to the member such as the type of coverage provided or partner logos. The extension also allows for the health plan to provide a Label for the image which can be displayed in the consuming application as well as a Description of the content in the image file. Detailed descriptions are encouraged to assist with accessibility.

Context of Use

This extension may be used on the following element(s):

- Element ID Coverage

#### Supporting Image Extension

The Supporting Image extension enables payers to provide images associated with a member's physical insurance card as part of the Coverage resource. A common use case is providing images of the front and back of the insurance card so that members can access a digital copy of their card through consuming applications.

##### Structure

Each instance of the Supporting Image extension contains three sub-extensions:

Sub-extension | Type | Card. | Description
--- | --- | --- | ---
`label` | string | 1..1 | A short label identifying the image (e.g., "Front of insurance card", "Back of insurance card").
`description` | string | 1..1 | A detailed description of the image content. Detailed descriptions are encouraged to assist with accessibility.
`image` | Attachment or Reference(DocumentReference) | 1..1 | The image data provided as an inline Attachment (with contentType and base64-encoded data) or as a reference to a DocumentReference resource.

##### Recording Front and Back of Card Images

To provide images of the front and back of a physical insurance card, include two instances of the Supporting Image extension on the Coverage resource. Use the `label` sub-extension to identify which side of the card the image represents and the `description` sub-extension to provide accessible text describing the image content.

Example: Front and back card images using inline Attachments

    {
      "resourceType": "Coverage",
      "extension": [
        {
          "extension": [
            {
              "url": "label",
              "valueString": "Front of insurance card"
            },
            {
              "url": "description",
              "valueString": "Image of the front of the member's physical insurance card showing plan name, member ID, and group number"
            },
            {
              "url": "image",
              "valueAttachment": {
                "contentType": "image/jpeg",
                "data": "<base64-encoded image data>"
              }
            }
          ],
          "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
        },
        {
          "extension": [
            {
              "url": "label",
              "valueString": "Back of insurance card"
            },
            {
              "url": "description",
              "valueString": "Image of the back of the member's physical insurance card showing claims address, customer service numbers, and pharmacy information"
            },
            {
              "url": "image",
              "valueAttachment": {
                "contentType": "image/jpeg",
                "data": "<base64-encoded image data>"
              }
            }
          ],
          "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
        }
      ]
    }

##### Guidance

- The extension is repeatable (0..*) on the Coverage resource, allowing multiple images to be attached.
- When providing card images, use descriptive `label` values such as "Front of insurance card" and "Back of insurance card" so that consuming applications can display them appropriately.
- The `description` sub-extension SHOULD contain sufficient detail for accessibility purposes (e.g., screen readers). Describe the key information visible on the card image.
- When providing inline image data, the `contentType` and `data` elements of the Attachment are required. Common content types include `image/jpeg` and `image/png`.
- Alternatively, the image may be provided as a reference to a DocumentReference resource if the payer prefers not to embed the image data inline.
- This extension may also be used for other supporting images beyond card front/back, such as images that communicate the type of coverage provided or partner logos.

Usage info

Usages:

- Use this Extension: C4DIC Coverage
- Examples for this Extension: Coverage/Example-Coverage-FSH and Coverage/Example-Coverage1

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

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

- Text Summary
- Differential Table
- Snapshot Table
- All

This structure is derived from Extension

Summary

Complex Extension: This extension enables payers to provide other supporting images found on a member's physicial insurance card. A supporting image may be displayed by consuming applications when rendering the coverage information for use by the health plan member. These images may communicate additional information to the member such as the type of coverage provided or partner logos. The extension also allows for the health plan to provide a Label for the image which can be displayed in the consuming application as well as a Description of the content in the image file. Detailed descriptions are encouraged to assist with accessibility.

- description: string: An Extension
- image: Attachment, Reference: An Extension
- label: string: An Extension

Maturity: 2

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Supporting image
extension |  | 3..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:description |  | 1..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "description"
value[x] |  | 0..1 | string | Value of extension
extension:image |  | 1..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "image"
Slices for value[x] |  | 0..1 |  | Value of extension Slice: Unordered, Open by type:$this
valueAttachment |  |  | Attachment |
valueReference |  |  | Reference(DocumentReference) |
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueAttachment |  | 0..1 | Attachment | Value of extension
contentType |  | 1..1 | code | Mime type of the content, with charset etc.
data |  | 1..1 | base64Binary | Data inline, base64ed
value[x]:valueReference |  | 0..1 | Reference(DocumentReference) | Value of extension
reference |  | 1..1 | string | Literal reference, Relative, internal or absolute URL
extension:label |  | 1..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "label"
value[x] |  | 0..1 | string | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Supporting image
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 3..* | Extension | Extension Slice: Unordered, Open by value:url
extension:description |  | 1..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "description"
value[x] |  | 0..1 | string | Value of extension
extension:image |  | 1..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "image"
Slices for value[x] |  | 0..1 |  | Value of extension Slice: Unordered, Closed by type:$this
valueAttachment |  |  | Attachment |
valueReference |  |  | Reference(DocumentReference) |
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueAttachment |  | 0..1 | Attachment | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
contentType | Σ | 1..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language | Σ | 0..1 | code | Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Example General: en-AU
data |  | 1..1 | base64Binary | Data inline, base64ed
url | Σ | 0..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided)
hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed)
title | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo
creation | Σ | 0..1 | dateTime | Date attachment was first created
value[x]:valueReference |  | 0..1 | Reference(DocumentReference) | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
extension:label |  | 1..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "label"
value[x] |  | 0..1 | string | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: This extension enables payers to provide other supporting images found on a member's physicial insurance card. A supporting image may be displayed by consuming applications when rendering the coverage information for use by the health plan member. These images may communicate additional information to the member such as the type of coverage provided or partner logos. The extension also allows for the health plan to provide a Label for the image which can be displayed in the consuming application as well as a Description of the content in the image file. Detailed descriptions are encouraged to assist with accessibility.

- description: string: An Extension
- image: Attachment, Reference: An Extension
- label: string: An Extension

Maturity: 2

Differential View

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Supporting image
extension |  | 3..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:description |  | 1..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "description"
value[x] |  | 0..1 | string | Value of extension
extension:image |  | 1..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "image"
Slices for value[x] |  | 0..1 |  | Value of extension Slice: Unordered, Open by type:$this
valueAttachment |  |  | Attachment |
valueReference |  |  | Reference(DocumentReference) |
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueAttachment |  | 0..1 | Attachment | Value of extension
contentType |  | 1..1 | code | Mime type of the content, with charset etc.
data |  | 1..1 | base64Binary | Data inline, base64ed
value[x]:valueReference |  | 0..1 | Reference(DocumentReference) | Value of extension
reference |  | 1..1 | string | Literal reference, Relative, internal or absolute URL
extension:label |  | 1..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "label"
value[x] |  | 0..1 | string | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Supporting image
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 3..* | Extension | Extension Slice: Unordered, Open by value:url
extension:description |  | 1..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "description"
value[x] |  | 0..1 | string | Value of extension
extension:image |  | 1..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "image"
Slices for value[x] |  | 0..1 |  | Value of extension Slice: Unordered, Closed by type:$this
valueAttachment |  |  | Attachment |
valueReference |  |  | Reference(DocumentReference) |
Slices for value[x] |  |  |  | Content/Rules for all slices
value[x]:valueAttachment |  | 0..1 | Attachment | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
contentType | Σ | 1..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language | Σ | 0..1 | code | Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Example General: en-AU
data |  | 1..1 | base64Binary | Data inline, base64ed
url | Σ | 0..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided)
hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed)
title | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo
creation | Σ | 0..1 | dateTime | Date attachment was first created
value[x]:valueReference |  | 0..1 | Reference(DocumentReference) | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
extension:label |  | 1..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "label"
value[x] |  | 0..1 | string | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
Documentation for this format

Other representations of profile: CSV, Excel, Schematron

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:image.​value[x]:valueAttachment.​contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
Extension.extension:image.​value[x]:valueAttachment.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Extension.extension:image.​value[x]:valueReference.​type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression