VhDir Implementation Guide CI Build: STU2 Ballot

This page is part of the Validated Healthcare Directory FHIR IG (v0.2.0: STU 1 Ballot 2) based on FHIR v3.5.0. . For a full list of available versions, see the Directory of published versions

Definitions for the StructureDefinition-vhdir-insuranceplan Profile.

InsurancePlan
Definition

Details of a Health Insurance product/plan provided by an organization.

Control0..*
InvariantsDefined on this element
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (: text.div.exists())
ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one (: (identifier.count() + name.count()) > 0)
InsurancePlan.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typeid
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

InsurancePlan.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Control0..1
TypeMeta
InsurancePlan.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Control0..1
Typeuri
Is Modifiertrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

InsurancePlan.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHOULD be taken from Common Languages
Typecode
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

InsurancePlan.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

InsurancePlan.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

InsurancePlan.extension
Definition

An Extension

Control0..*
TypeExtension
InsurancePlan.extension ([CanonicalType[http://hl7.org/fhir/uv/vhdir/StructureDefinition/usage-restriction]])
Definition

Identifies and conveys information about restrictions on the use or release of exchanged information, e.g. information that can only be shared under particular condition, such as a signed data use agreement between parties

Control0..* This element is affected by the following invariants: ele-1
Type (Extension Type: Reference(VhdirRestriction))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
InsurancePlan.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.identifier
Definition

Business identifiers assigned to this health insurance product which remain constant as the resource is updated and propagates from server to server.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..* This element is affected by the following invariants: ipn-1
TypeIdentifier
InsurancePlan.identifier.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.identifier.extension
Definition

An Extension

Control0..*
TypeExtension
InsurancePlan.identifier.extension ([CanonicalType[http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status]])
Definition

Describes the status of an identifier

Control0..1 This element is affected by the following invariants: ele-1
Type (Extension Type: code)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
InsurancePlan.identifier.extension.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.identifier.extension.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.identifier.extension.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
InsurancePlan.identifier.extension.valueCode(valueCode)
Definition

Describes the status of an identifier

Control1..1
BindingFor example codes, see VhDirIdentifierStatus
Typecode
InsurancePlan.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingIdentifies the purpose for this identifier, if known .
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

InsurancePlan.identifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control0..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

InsurancePlan.identifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control0..1
Typeuri
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InsurancePlan.identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control0..1
Typestring
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InsurancePlan.identifier.period
Definition

Time period during which identifier is/was valid for use.

Control0..1
TypePeriod
InsurancePlan.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(VhdirOrganization)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

InsurancePlan.status
Definition

The current state of the health insurance product.

Control1..1
BindingThe lifecycle status of an artifact.
The codes SHALL be taken from PublicationStatus
Typecode
Is Modifiertrue
Requirements

Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.

Meaning if MissingDefault interpretation is active.
InsurancePlan.type
Definition

The kind of health insurance product.

Control0..*
BindingUsed to categorize the product/plan.
For example codes, see InsurancePlanType
TypeCodeableConcept
InsurancePlan.name
Definition

Official name of the health insurance product as designated by the owner.

Control0..1 This element is affected by the following invariants: ipn-1
Typestring
Comments

If the name of the product/plan changes, consider putting the old name in the alias column so that it can still be located through searches.

InsurancePlan.alias
Definition

A list of alternate names that the product is known as, or was known as in the past.

Control0..*
Typestring
Requirements

Over time products/plans go through many changes and can be known by different names.

For searching knowing previous names that the product/plan was known by can be very useful.

Comments

There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the product/plan.

InsurancePlan.period
Definition

The period of time that the health insurance product is available.

Control0..1
TypePeriod
InsurancePlan.ownedBy
Definition

The entity that is providing the health insurance product and underwriting the risk. This is typically an insurance carriers, other third-party payers, or health plan sponsors comonly referred to as 'payers'.

Control1..1
TypeReference(VhdirOrganization)
Alternate NamesPayer
InsurancePlan.administeredBy
Definition

An organization which administer other services such as underwriting, customer service and/or claims processing on behalf of the health insurance product owner.

Control1..1
TypeReference(VhdirOrganization)
InsurancePlan.coverageArea
Definition

The geographic region in which a health insurance product's benefits apply.

Control0..*
TypeReference(VhdirLocation)
InsurancePlan.contact
Definition

The contact for the health insurance product for a certain purpose.

Control0..*
TypeBackboneElement
Requirements

Need to keep track of assigned contact points within bigger organization.

Comments

Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
InsurancePlan.contact.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.contact.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.contact.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.contact.purpose
Definition

Indicates a purpose for which the contact can be reached.

Control0..1
BindingThe purpose for which you would contact a contact party.
The codes SHALL be taken from ContactEntityType; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

Need to distinguish between multiple contact persons.

InsurancePlan.contact.name
Definition

A name associated with the contact.

Control0..1
TypeHumanName
Requirements

Need to be able to track the person by name.

InsurancePlan.contact.name.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.contact.name.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.contact.name.use
Definition

Identifies the purpose for this name.

Control0..1
BindingThe use of a human name.
The codes SHALL be taken from NameUse
Typecode
Is Modifiertrue
Requirements

Allows the appropriate name for a particular context of use to be selected from among a set of names.

Comments

Applications can assume that a name is current unless it explicitly says that it is temporary or old.

InsurancePlan.contact.name.text
Definition

Specifies the entire name as it should be displayed e.g. on an application UI. This may be provided instead of or as well as the specific parts.

Control0..1
Typestring
Requirements

A renderable, unencoded form.

Comments

Can provide both a text representation and parts. Applications updating a name SHALL ensure that when both text and parts are present, no content is included in the text that isn't found in a part.

InsurancePlan.contact.name.family
Definition

The part of a name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Control1..1
Typestring
Alternate Namessurname
Comments

Family Name may be decomposed into specific parts using extensions (de, nl, es related cultures).

InsurancePlan.contact.name.given
Definition

Given name.

Control1..*
Typestring
Alternate Namesfirst name, middle name
Comments

If only initials are recorded, they may be used in place of the full name parts. Initials may be separated into multiple given names but often aren't due to paractical limitations. This element is not called "first name" since given names do not always come first.

InsurancePlan.contact.name.prefix
Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the start of the name.

Control0..*
Typestring
InsurancePlan.contact.name.suffix
Definition

Part of the name that is acquired as a title due to academic, legal, employment or nobility status, etc. and that appears at the end of the name.

Control0..*
Typestring
InsurancePlan.contact.name.period
Definition

Indicates the period of time when this name was valid for the named person.

Control0..1
TypePeriod
Requirements

Allows names to be placed in historical context.

InsurancePlan.contact.telecom
Definition

A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.

Control0..*
TypeContactPoint
Requirements

People have (primary) ways to contact them in some way such as phone, email.

InsurancePlan.contact.telecom.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.contact.telecom.extension
Definition

An Extension

Control0..*
TypeExtension
InsurancePlan.contact.telecom.extension ([CanonicalType[http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-viaintermediary]])
Definition

Represents an external point of contact responsible for handling communications with this entity

Control0..1 This element is affected by the following invariants: ele-1
Type (Extension Type: Reference(VhdirPractitionerRole | VhdirOrganization | VhdirOrganizationAffiliation | VhdirLocation))
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
InsurancePlan.contact.telecom.extension.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.contact.telecom.extension.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.contact.telecom.extension.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-viaintermediary
InsurancePlan.contact.telecom.extension.valueReference(valueReference)
Definition

Represents an external point of contact responsible for handling communications with this entity

Control1..1
TypeReference(VhdirPractitionerRole | VhdirOrganization | VhdirOrganizationAffiliation | VhdirLocation)
InsurancePlan.contact.telecom.extension ([CanonicalType[http://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-availabletime]])
Definition

Time period when the contact point is to be used

Control0..* This element is affected by the following invariants: ele-1
Type (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ParameterDefinition, DataRequirement, RelatedArtifact, ContactDetail, Contributor, TriggerDefinition, Expression, UsageContext, Dosage)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
InsurancePlan.contact.telecom.extension.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.contact.telecom.extension.extension
Definition

An Extension

Control0..*
TypeExtension
InsurancePlan.contact.telecom.extension.extension(daysOfWeek)
Definition

Days of the week - mon|tue|wed|thu|fri|sat|sun

Control0..*
TypeExtension
InsurancePlan.contact.telecom.extension.extension.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.contact.telecom.extension.extension.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.contact.telecom.extension.extension.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed ValuedaysOfWeek
InsurancePlan.contact.telecom.extension.extension.valueCode(valueCode)
Definition

Days of the week - mon|tue|wed|thu|fri|sat|sun

Control1..1
BindingThe codes SHALL be taken from DaysOfWeek
Typecode
InsurancePlan.contact.telecom.extension.extension(allDay)
Definition

Always available? e.g. 24 hour service

Control0..1
TypeExtension
InsurancePlan.contact.telecom.extension.extension.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.contact.telecom.extension.extension.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.contact.telecom.extension.extension.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed ValueallDay
InsurancePlan.contact.telecom.extension.extension.valueBoolean(valueBoolean)
Definition

Always available? e.g. 24 hour service

Control1..1
Typeboolean
InsurancePlan.contact.telecom.extension.extension(availableStartTime)
Definition

Opening time of day (ignored if allDay = true)

Control0..1
TypeExtension
InsurancePlan.contact.telecom.extension.extension.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.contact.telecom.extension.extension.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.contact.telecom.extension.extension.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed ValueavailableStartTime
InsurancePlan.contact.telecom.extension.extension.valueTime(valueTime)
Definition

Opening time of day (ignored if allDay = true)

Control1..1
Typetime
InsurancePlan.contact.telecom.extension.extension(availableEndTime)
Definition

Closing time of day (ignored if allDay = true)

Control0..1
TypeExtension
InsurancePlan.contact.telecom.extension.extension.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.contact.telecom.extension.extension.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.contact.telecom.extension.extension.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed ValueavailableEndTime
InsurancePlan.contact.telecom.extension.extension.valueTime(valueTime)
Definition

Closing time of day (ignored if allDay = true)

Control1..1
Typetime
InsurancePlan.contact.telecom.extension.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/uv/vhdir/StructureDefinition/contactpoint-availabletime
InsurancePlan.contact.telecom.extension.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..0
TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ParameterDefinition, DataRequirement, RelatedArtifact, ContactDetail, Contributor, TriggerDefinition, Expression, UsageContext, Dosage
[x] NoteSee Choice of Data Types for further information about how to use [x]
InsurancePlan.contact.telecom.system
Definition

Telecommunications form for contact point - what communications system is required to make use of the contact.

Control1..1 This element is affected by the following invariants: cpt-2
BindingTelecommunications form for contact point.
The codes SHALL be taken from ContactPointSystem
Typecode
InsurancePlan.contact.telecom.value
Definition

The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).

Control1..1
Typestring
Requirements

Need to support legacy numbers that are not in a tightly controlled format.

Comments

Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.

InsurancePlan.contact.telecom.use
Definition

Identifies the purpose for the contact point.

Control0..1
BindingUse of contact point.
The codes SHALL be taken from ContactPointUse
Typecode
Is Modifiertrue
Requirements

Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.

Comments

Applications can assume that a contact is current unless it explicitly says that it is temporary or old.

InsurancePlan.contact.telecom.rank
Definition

Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.

Control0..1
TypepositiveInt
Comments

Note that rank does not necessarily follow the order in which the contacts are represented in the instance.

InsurancePlan.contact.telecom.period
Definition

Time period when the contact point was/is in use.

Control0..1
TypePeriod
InsurancePlan.contact.address
Definition

Visiting or postal addresses for the contact.

Control0..1
TypeAddress
Requirements

May need to keep track of a contact party's address for contacting, billing or reporting requirements.

InsurancePlan.endpoint
Definition

The technical endpoints providing access to services operated for the health insurance product.

Control0..*
TypeReference(VhdirEndpoint)
Requirements

Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.

InsurancePlan.network
Definition

Reference to the network included in the health insurance product.

Control0..*
TypeReference(VhdirNetwork)
Comments

Networks are represented as a hierarchy of organization resources.

InsurancePlan.coverage
Definition

Details about the coverage offered by the insurance product.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
InsurancePlan.coverage.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.coverage.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.coverage.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.coverage.type
Definition

Type of coverage (Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health).

Control1..1
BindingFor example codes, see VhDirCoverageType
TypeCodeableConcept
InsurancePlan.coverage.network
Definition

Reference to the network that providing the type of coverage.

Control0..*
TypeReference(VhdirNetwork)
Comments

Networks are represented as a hierarchy of organization resources.

InsurancePlan.coverage.benefit
Definition

Specific benefits under this type of coverage.

Control1..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
InsurancePlan.coverage.benefit.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.coverage.benefit.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.coverage.benefit.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.coverage.benefit.type
Definition

Type of benefit (primary care; speciality care; inpatient; outpatient).

Control1..1
BindingFor example codes, see VhDirBenefitType
TypeCodeableConcept
InsurancePlan.coverage.benefit.requirement
Definition

The referral requirements to have access/coverage for this benefit.

Control0..1
Typestring
InsurancePlan.coverage.benefit.limit
Definition

The specific limits on the benefit.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
InsurancePlan.coverage.benefit.limit.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.coverage.benefit.limit.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.coverage.benefit.limit.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.coverage.benefit.limit.value
Definition

The maximum amount of a service item a plan will pay for a covered benefit. For examples. wellness visits, or eyeglasses.

Control0..1
TypeQuantity
Comments

May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”.

InsurancePlan.coverage.benefit.limit.code
Definition

The specific limit on the benefit.

Control0..1
BindingFor example codes, see VhDirLimitUnit
TypeCodeableConcept
Comments

Use CodeableConcept.text element if the data is free (uncoded) text.

InsurancePlan.plan
Definition

Details about an insurance plan.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
InsurancePlan.plan.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.plan.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.plan.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.plan.identifier
Definition

Business identifiers assigned to this health insurance plan which remain constant as the resource is updated and propagates from server to server.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
InsurancePlan.plan.identifier.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.plan.identifier.extension
Definition

An Extension

Control0..*
TypeExtension
InsurancePlan.plan.identifier.extension ([CanonicalType[http://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status]])
Definition

Describes the status of an identifier

Control0..1 This element is affected by the following invariants: ele-1
Type (Extension Type: code)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
InsurancePlan.plan.identifier.extension.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.plan.identifier.extension.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.plan.identifier.extension.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/uv/vhdir/StructureDefinition/identifier-status
InsurancePlan.plan.identifier.extension.valueCode(valueCode)
Definition

Describes the status of an identifier

Control1..1
BindingFor example codes, see VhDirIdentifierStatus
Typecode
InsurancePlan.plan.identifier.use
Definition

The purpose of this identifier.

Control0..1
BindingIdentifies the purpose for this identifier, if known .
The codes SHALL be taken from IdentifierUse
Typecode
Is Modifiertrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

InsurancePlan.plan.identifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control0..1
BindingA coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
The codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable
TypeCodeableConcept
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

InsurancePlan.plan.identifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control0..1
Typeuri
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InsurancePlan.plan.identifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control0..1
Typestring
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InsurancePlan.plan.identifier.period
Definition

Time period during which identifier is/was valid for use.

Control0..1
TypePeriod
InsurancePlan.plan.identifier.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(VhdirOrganization)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

InsurancePlan.plan.type
Definition

Type of plan. For example, "Platinum" or "High Deductable".

Control0..1
BindingFor example codes, see VhDirPlanType
TypeCodeableConcept
InsurancePlan.plan.coverageArea
Definition

The geographic region in which a health insurance plan's benefits apply.

Control0..*
TypeReference(VhdirLocation)
InsurancePlan.plan.network
Definition

Reference to the network that providing the type of coverage.

Control0..*
TypeReference(VhdirNetwork)
Comments

Networks are represented as a hierarchy of organization resources.

InsurancePlan.plan.generalCost
Definition

Overall costs associated with the plan.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
InsurancePlan.plan.generalCost.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.plan.generalCost.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.plan.generalCost.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.plan.generalCost.type
Definition

Type of cost.

Control0..1
BindingFor example codes, see VhDirPlanType
TypeCodeableConcept
InsurancePlan.plan.generalCost.groupSize
Definition

Number of participants enrolled in the plan.

Control0..1
TypepositiveInt
InsurancePlan.plan.generalCost.cost
Definition

Value of the cost.

Control0..1
TypeMoney
InsurancePlan.plan.generalCost.comment
Definition

Additional information about the general costs associated with this plan.

Control0..1
Typestring
InsurancePlan.plan.specificCost
Definition

Costs associated with the coverage provided by the product.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
InsurancePlan.plan.specificCost.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.plan.specificCost.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.plan.specificCost.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.plan.specificCost.category
Definition

General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health).

Control1..1
BindingFor example codes, see VhDirInsPlanCostCategory
TypeCodeableConcept
InsurancePlan.plan.specificCost.benefit
Definition

List of the specific benefits under this category of benefit.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
InsurancePlan.plan.specificCost.benefit.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.plan.specificCost.benefit.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.plan.specificCost.benefit.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.plan.specificCost.benefit.type
Definition

Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care).

Control1..1
BindingFor example codes, see VhDirInsPlanBenefitType
TypeCodeableConcept
InsurancePlan.plan.specificCost.benefit.cost
Definition

List of the costs associated with a specific benefit.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
InsurancePlan.plan.specificCost.benefit.cost.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
InsurancePlan.plan.specificCost.benefit.cost.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.plan.specificCost.benefit.cost.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InsurancePlan.plan.specificCost.benefit.cost.type
Definition

Type of cost (copay; individual cap; family cap; coinsurance; deductible).

Control1..1
BindingFor example codes, see VhDirInsPlanBenefitCostType
TypeCodeableConcept
InsurancePlan.plan.specificCost.benefit.cost.applicability
Definition

Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other).

Control0..1
BindingWhether the cost applies to in-network or out-of-network providers.
The codes SHALL be taken from BenefitCostApplicability
TypeCodeableConcept
InsurancePlan.plan.specificCost.benefit.cost.qualifiers
Definition

Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA).

Control0..*
TypeCodeableConcept
InsurancePlan.plan.specificCost.benefit.cost.value
Definition

The actual cost value. (some of the costs may be represented as percentages rather than currency, e.g. 10% coinsurance).

Control0..1
TypeQuantity