This page is part of the Quality Improvement Core Framework (v4.1.0: STU 4) based on FHIR R4. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions

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Resource Profile: QICoreCoverage - Mappings

Mappings for the qicore-coverage resource profile.

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

QICoreCoverage
Coverage	Event
identifier	Event.identifier
status	Event.status
beneficiary	Event.subject
period	Event.occurrence[x]

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

QICoreCoverage
Coverage	Entity. Role, or Act, Coverage
text	Act.text?
contained	N/A
extension	N/A
modifierExtension	N/A
identifier	.id
status	Act.status
period	Act.effectiveTime
class
id	n/a
extension	n/a
modifierExtension	N/A
costToBeneficiary
id	n/a
extension	n/a
modifierExtension	N/A
exception
id	n/a
extension	n/a
modifierExtension	N/A
contract	n/a

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

QICoreCoverage
Coverage
identifier	FiveWs.identifier
status	FiveWs.status
type	FiveWs.class
policyHolder	FiveWs.subject[x], FiveWs.subject
subscriber	FiveWs.subject[x], FiveWs.subject
subscriberId	FiveWs.subject[x], FiveWs.subject
beneficiary	FiveWs.subject[x], FiveWs.subject
period	FiveWs.done[x]
payor	FiveWs.author

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

QICoreCoverage
Coverage
identifier	C02
policyHolder	D01 through D09
subscriber	D01 through D09
subscriberId	D01 through D09
beneficiary	D01 through D09
dependent	C17
relationship	C03
payor	A05
class
value	C11 (Division,Section)
name	C11 (Division,Section)
network	D10
costToBeneficiary
value[x]	C11 (Division,Section)
contract	D01 through D09

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

QICoreCoverage
Coverage
identifier	IN1-2
type	IN1-15
policyHolder	IN1-16, 18, 19-name of insured, address, date of birth
subscriber	IN1-16, 18, 19-name of insured, address, date of birth
subscriberId	IN1-16, 18, 19-name of insured, address, date of birth
beneficiary	IN1-16, 18, 19-name of insured, address, date of birth
dependent	- No exact HL7 v2 equivalent concept seems to exist;
period	IN1-12 / IN1-13
payor	IN1-3
class
value	IN1-8
name	IN1-8
order	- No exact HL7 v2 equivalent concept seems to exist;
costToBeneficiary
value[x]	IN1-8
contract	IN1-16, 18, 19

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

QICoreCoverage
Coverage
identifier	C.32, C.33, C.39
policyHolder	C.35
subscriber	C.35
subscriberId	C.35
beneficiary	C.35
payor	C.30
class
value	C.31
name	C.31
costToBeneficiary
value[x]	C.31
contract	C.35