This is the set of resources that conform to either of the profiles QICore Coverage (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage) and QICore Coverage (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage). E.g. what you have to deal with if you get resources conforming to one of them
Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
---|---|---|---|---|
![]() ![]() | C | 0..* | Insurance or medical plan or a payment agreement Constraints: us-core-15 | |
![]() ![]() ![]() | Σ | 0..1 | Meta | Metadata about the resource |
![]() ![]() ![]() | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
![]() ![]() ![]() | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language. | |
![]() ![]() ![]() | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |
![]() ![]() ![]() | 0..* | Resource | Contained, inline Resources | |
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() | ?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() ![]() | SΣ | 0..* | Identifier | Member ID and other identifiers |
![]() ![]() ![]() | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. |
![]() ![]() ![]() | SΣ | 0..1 | CodeableConcept | (QI) Coverage category such as medical or accident Binding: ?? (extensible): Categories of types of health care payor entities as defined by the US Public Health Data Consortium SOP code system |
![]() ![]() ![]() | Σ | 0..1 | Reference(QICore Patient | QICore Organization | QICore RelatedPerson | #sd-qicore-patient-qicore-patient) | left: (QI-Core) Owner of the policy; right: (QI) Owner of the policy |
![]() ![]() ![]() | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy |
![]() ![]() ![]() | SΣ | 0..1 | string | (QI) ID assigned to the subscriber |
![]() ![]() ![]() | SΣ | 1..1 | Reference(QICore Patient | #sd-qicore-patient-qicore-patient) | (QI) Plan beneficiary |
![]() ![]() ![]() | Σ | 0..1 | string | Dependent number |
![]() ![]() ![]() | S | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible) |
![]() ![]() ![]() | SΣ | 0..1 | Period | (QI) Coverage start and end dates |
![]() ![]() ![]() | SΣ | 1..1 | Reference(QICore Patient | QICore Organization | QICore RelatedPerson | #sd-qicore-patient-qicore-patient) | (QI) Issuer of the policy |
![]() ![]() ![]() | S | 0..* | BackboneElement | Additional coverage classifications |
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc. |
![]() ![]() ![]() ![]() | Σ | 1..1 | string | Value associated with the type |
![]() ![]() ![]() ![]() | Σ | 0..1 | string | Human readable description of the type and value |
![]() ![]() ![]() | Σ | 0..1 | positiveInt | Relative order of the coverage |
![]() ![]() ![]() | Σ | 0..1 | string | Insurer network |
![]() ![]() ![]() | 0..* | BackboneElement | Patient payments for services/products | |
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified. |
![]() ![]() ![]() ![]() | Σ | 1..1 | The amount or percentage due from the beneficiary | |
![]() ![]() ![]() ![]() ![]() | Quantity(SimpleQuantity) | |||
![]() ![]() ![]() ![]() ![]() | Money | |||
![]() ![]() ![]() ![]() | 0..* | BackboneElement | Exceptions for patient payments | |
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() ![]() ![]() | Σ | 1..1 | CodeableConcept | Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays. |
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | Period | The effective period of the exception |
![]() ![]() ![]() | 0..1 | boolean | Reimbursement to insurer | |
![]() ![]() ![]() | 0..* | Reference(Contract) | Contract details | |
![]() |