QI-Core Implementation Guide: STU 4 (v4.0.0 for FHIR 4.0.1)

QI-Core Implementation Guide - This is the current published version.. See the Directory of published versions

D.4.1.4 StructureDefinition: qicore-coverage - Mappings

Mappings for the StructureDefinition-qicore-coverage Profile.

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

QICoreCoverage
CoverageEvent
   identifierEvent.identifier
   statusEvent.status
   beneficiaryEvent.subject
   periodEvent.occurrence[x]

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

QICoreCoverage
CoverageEntity. Role, or Act, Coverage
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifier.id
   statusAct.status
   periodAct.effectiveTime
   class
      idn/a
      extensionn/a
      modifierExtensionN/A
   costToBeneficiary
      idn/a
      extensionn/a
      modifierExtensionN/A
      exception
         idn/a
         extensionn/a
         modifierExtensionN/A
   contractn/a

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

QICoreCoverage
Coverage
   identifierFiveWs.identifier
   statusFiveWs.status
   typeFiveWs.class
   policyHolderFiveWs.subject[x], FiveWs.subject
   subscriberFiveWs.subject[x], FiveWs.subject
   subscriberIdFiveWs.subject[x], FiveWs.subject
   beneficiaryFiveWs.subject[x], FiveWs.subject
   periodFiveWs.done[x]
   payorFiveWs.author

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

QICoreCoverage
Coverage
   identifierC02
   policyHolderD01 through D09
   subscriberD01 through D09
   subscriberIdD01 through D09
   beneficiaryD01 through D09
   dependentC17
   relationshipC03
   payorA05
   class
      valueC11 (Division,Section)
      nameC11 (Division,Section)
   networkD10
   costToBeneficiary
      value[x]C11 (Division,Section)
   contractD01 through D09

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

QICoreCoverage
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
   dependent- No exact HL7 v2 equivalent concept seems to exist;
   periodIN1-12 / IN1-13
   payorIN1-3
   class
      valueIN1-8
      nameIN1-8
   order- No exact HL7 v2 equivalent concept seems to exist;
   costToBeneficiary
      value[x]IN1-8
   contractIN1-16, 18, 19

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

QICoreCoverage
Coverage
   identifierC.32, C.33, C.39
   policyHolderC.35
   subscriberC.35
   subscriberIdC.35
   beneficiaryC.35
   payorC.30
   class
      valueC.31
      nameC.31
   costToBeneficiary
      value[x]C.31
   contractC.35