QI-Core Implementation Guide
7.0.2 - STU 7

QI-Core Implementation Guide - Downloaded Version 7.0.2 See the Directory of published versions

## : Coverage example - XML Representation

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    <Coverage xmlns="http://hl7.org/fhir">
      <id value="example"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"/>
      </meta>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Coverage example</b></p><a name="example"> </a><a name="hcexample"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-qicore-coverage.html">QICore Coverage</a></p></div><p><b>identifier</b>: Member Number/?ngen-9?</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{https://nahdo.org/sopt 59}">Other Private Insurance</span></p><p><b>policyHolder</b>: <a href="Patient-example.html">Jim Chalmers  Male, DoB: 1974-12-25 ( Medical record number (use: usual, period: 2001-05-06 --&gt; (ongoing)))</a></p><p><b>subscriber</b>: <a href="Patient-example.html">Jim Chalmers  Male, DoB: 1974-12-25 ( Medical record number (use: usual, period: 2001-05-06 --&gt; (ongoing)))</a></p><p><b>beneficiary</b>: <a href="Patient-example.html">Jim Chalmers  Male, DoB: 1974-12-25 ( Medical record number (use: usual, period: 2001-05-06 --&gt; (ongoing)))</a></p><p><b>dependent</b>: 0</p><p><b>relationship</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}">Self</span></p><p><b>period</b>: 2011-05-23 --&gt; 2012-05-23</p><p><b>payor</b>: <a href="Organization-example.html">Organization Health Level Seven International</a></p><p><b>order</b>: 9</p></div>
      </text>
      <identifier>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
            <code value="MB"/>
          </coding>
        </type>
      </identifier>
      <status value="active"/>
      <type>
        <coding>
          <system value="https://nahdo.org/sopt"/>
          <code value="59"/>
          <display value="Other Private Insurance"/>
        </coding>
      </type>
      <policyHolder>🔗
        <reference value="Patient/example"/>
      </policyHolder>
      <subscriber>🔗
        <reference value="Patient/example"/>
      </subscriber>
      <beneficiary>🔗
        <reference value="Patient/example"/>
      </beneficiary>
      <dependent value="0"/>
      <relationship>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
          <code value="self"/>
        </coding>
      </relationship>
      <period>
        <start value="2011-05-23"/>
        <end value="2012-05-23"/>
      </period>
      <payor>🔗
        <reference value="Organization/example"/>
      </payor>
      <!--  No longer part of the Coverage resource in R4, not clear how to represent this in the R4 resource  -->
      <!-- grouping>
        <group value="CBI35"/>
        <groupDisplay value="Corporate Baker's Inc. Local #35"/>
        <subGroup value="123"/>
        <subGroupDisplay value="Trainee Part-time Benefits"/>
        <plan value="B37FC"/>
        <planDisplay value="Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"/>
        <subPlan value="P7"/>
        <subPlanDisplay value="Includes afterlife benefits"/>
        <class value="SILVER"/>
        <classDisplay value="Silver: Family Plan spouse only"/>
        <subClass value="Tier2"/>
        <subClassDisplay value="Low deductable, max $20 copay"/>
      </grouping -->
      <order value="9"/>
    </Coverage>