This is the set of resources that conform to both C4DIC Coverage (http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage) and C4DIC Coverage (http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage).
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
Coverage | 0..* | Insurance or medical plan or a payment agreement dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management | ||||||
meta | SΣ | 1..1 | Meta | Metadata about the resource ele-1: All FHIR elements must have a @value or children | ||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
versionId | Σ | 0..1 | id | Version specific identifier ele-1: All FHIR elements must have a @value or children | ||||
lastUpdated | SΣ | 1..1 | instant | When the resource version last changed ele-1: All FHIR elements must have a @value or children | ||||
source | Σ | 0..1 | uri | Identifies where the resource comes from ele-1: All FHIR elements must have a @value or children | ||||
profile | Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to ele-1: All FHIR elements must have a @value or children | ||||
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. ele-1: All FHIR elements must have a @value or children | ||||
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". ele-1: All FHIR elements must have a @value or children | ||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children | ||||
language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
ele-1: All FHIR elements must have a @value or children | |||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation ele-1: All FHIR elements must have a @value or children | |||||
contained | 0..* | Resource | Contained, inline Resources | |||||
extension | 0..* | Extension | Extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | ||||
identifier | SΣ | 1..* | Identifier | Business Identifier for the coverage ele-1: All FHIR elements must have a @value or children | ||||
extension | 0..* | Extension | Additional content defined by implementations 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: ?? (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: ?? (extensible) ele-1: All FHIR elements must have a @value or children | ||||
system | Σ | 0..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient | ||||
value | Σ | 0..1 | string | The value that is unique 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 | ||||
status | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. ele-1: All FHIR elements must have a @value or children | ||||
type | SΣ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. ele-1: All FHIR elements must have a @value or children | ||||
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy ele-1: All FHIR elements must have a @value or children | ||||
subscriber | SΣ | 1..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy ele-1: All FHIR elements must have a @value or children | ||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
reference | SΣ | 1..1 | string | Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children | ||||
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model). ele-1: All FHIR elements must have a @value or children | ||||
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known ele-1: All FHIR elements must have a @value or children | ||||
display | Σ | 0..1 | string | Text alternative for the resource ele-1: All FHIR elements must have a @value or children | ||||
subscriberId | SΣ | 1..1 | string | ID assigned to the subscriber ele-1: All FHIR elements must have a @value or children | ||||
beneficiary | SΣ | 1..1 | Reference(C4DIC Patient | #sd-C4DIC-Patient-C4DIC-Patient) | Plan beneficiary ele-1: All FHIR elements must have a @value or children | ||||
extension | 0..* | Extension | Additional content defined by implementations ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |||||
reference | SΣ | 1..1 | string | Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children | ||||
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model). ele-1: All FHIR elements must have a @value or children | ||||
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known ele-1: All FHIR elements must have a @value or children | ||||
display | Σ | 0..1 | string | Text alternative for the resource ele-1: All FHIR elements must have a @value or children | ||||
dependent | SΣ | 0..1 | string | Dependent number ele-1: All FHIR elements must have a @value or children | ||||
relationship | S | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (required) ele-1: All FHIR elements must have a @value or children | ||||
period | SΣ | 0..1 | Period | Coverage start and end dates ele-1: All FHIR elements must have a @value or children | ||||
payor | SΣ | 1..1 | Reference(C4DIC Organization | #sd-C4DIC-Organization-C4DIC-Organization) | Issuer of the policy ele-1: All FHIR elements must have a @value or children | ||||
class | S | 0..* | BackboneElement | Additional coverage classifications ele-1: All FHIR elements must have a @value or children | ||||
extension | 0..* | Extension | Additional content defined by implementations 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 | ||||
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (required) ele-1: All FHIR elements must have a @value or children | ||||
value | Σ | 1..1 | string | Value associated with the type ele-1: All FHIR elements must have a @value or children | ||||
name | Σ | 0..1 | string | Human readable description of the type and value ele-1: All FHIR elements must have a @value or children | ||||
order | Σ | 0..1 | positiveInt | Relative order of the coverage ele-1: All FHIR elements must have a @value or children | ||||
network | Σ | 0..1 | string | Insurer network ele-1: All FHIR elements must have a @value or children | ||||
costToBeneficiary | S | 0..* | BackboneElement | Patient payments for services/products ele-1: All FHIR elements must have a @value or children | ||||
extension | 0..* | Extension | Additional content defined by implementations 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 | ||||
type | SΣ | 1..1 | CodeableConcept | Cost category Binding: ?? (extensible) ele-1: All FHIR elements must have a @value or children | ||||
value[x] | SΣ | 1..1 | Money | The amount or percentage due from the beneficiary ele-1: All FHIR elements must have a @value or children | ||||
exception | 0..* | BackboneElement | Exceptions for patient payments ele-1: All FHIR elements must have a @value or children | |||||
extension | 0..* | Extension | Additional content defined by implementations 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 | ||||
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. ele-1: All FHIR elements must have a @value or children | ||||
period | Σ | 0..1 | Period | The effective period of the exception ele-1: All FHIR elements must have a @value or children | ||||
subrogation | 0..1 | boolean | Reimbursement to insurer ele-1: All FHIR elements must have a @value or children | |||||
contract | 0..* | Reference(Contract) | Contract details ele-1: All FHIR elements must have a @value or children | |||||
Documentation for this format |