QI-Core Implementation Guide: STU 3.2 (v3.2.0 for FHIR 3.0.1)

This page is part of the Quality Improvement Core Framework (v3.2.0: STU 3) based on FHIR (HL7® FHIR® Standard) R3. The current version which supersedes this version is 7.0.1. For a full list of available versions, see the Directory of published versions

D.4.1.4 StructureDefinition: qicore-coverage - Mappings

Mappings for the StructureDefinition-qicore-coverage Profile.

Mappings for Quality Data Model (http://www.healthit.gov/quality-data-model)

QICore-Coverage
CoverageParticipation
   idid
   typecode
   periodparticipationPeriod

Mappings for Workflow Mapping (http://hl7.org/fhir/workflow)

QICore-Coverage
CoverageEvent
   identifierEvent.identifier
   statusEvent.status
   beneficiaryEvent.subject
   periodEvent.occurrence

Mappings for RIM Mapping (http://hl7.org/v3)

QICore-Coverage
CoverageEntity. Role, or Act
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   grouping
      idn/a
      extensionn/a
      modifierExtensionN/A

Mappings for W5 Mapping (http://hl7.org/fhir/w5)

QICore-Coverage
Coveragefinancial.support
   identifierid
   statusstatus
   typeclass
   policyHolderwho.focus
   subscriberwho.focus
   subscriberIdwho.focus
   beneficiarywho.focus
   periodwhen.done
   payorwho.author

Mappings for Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/)

QICore-Coverage
Coverage
   identifierC02
   policyHolderD01 through D09
   subscriberD01 through D09
   subscriberIdD01 through D09
   beneficiaryD01 through D09
   relationshipC03
   payorA05
   grouping
      groupC11 (Division,Section)
      groupDisplayC11 (Division,Section)
      planC01
      planDisplayC01
      classC01
      classDisplayC01
      subClassC01
      subClassDisplayC01
   dependentC17
   sequenceD11
   networkD10
   contractD01 through D09

Mappings for HL7 v2 Mapping (http://hl7.org/v2)

QICore-Coverage
Coverage
   identifierIN1-2
   typeIN1-15
   policyHolderIN1-16, 18, 19-name of insured, address, date of birth
   subscriberIN1-16, 18, 19-name of insured, address, date of birth
   subscriberIdIN1-16, 18, 19-name of insured, address, date of birth
   beneficiaryIN1-16, 18, 19-name of insured, address, date of birth
   periodIN1-12 / IN1-13
   payorIN1-3
   grouping
      groupIN1-8
      groupDisplayIN1-8
      subGroupIN1-8
      subGroupDisplayIN1-8
      planIN1-35
      planDisplayIN1-35
      subPlanIN1-10
      subPlanDisplayIN1-10
      classIN1-35
      classDisplayIN1-35
      subClassIN1-35
      subClassDisplayIN1-35
   dependent- No exact HL7 v2 equivalent concept seems to exist;
   sequenceNo HL7 v2 equivalent concept seems to exist
   order- No exact HL7 v2 equivalent concept seems to exist;
   contractIN1-16, 18, 19

Mappings for Canadian Pharmacy Associaiton eclaims standard (http://www.pharmacists.ca/)

QICore-Coverage
Coverage
   identifierC.32, C.33, C.39
   policyHolderC.35
   subscriberC.35
   subscriberIdC.35
   beneficiaryC.35
   payorC.30
   grouping
      groupC.31
      groupDisplayC.31
   contractC.35