Extensions for Using Data Elements from FHIR R4 in FHIR STU3
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Extensions for Using Data Elements from FHIR R4 in FHIR STU3 - Downloaded Version null See the Directory of published versions

Extension: ExtensionCoverage_CostToBeneficiary - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 0

Definitions for the ext-R4-Coverage.costToBeneficiary extension.

Guidance on how to interpret the contents of this table can be foundhere

0. Extension
Definition

R4: Coverage.costToBeneficiary (new:BackboneElement)


Optional Extension Element - found in all resources.

ShortR4: Patient payments for services/products (new)Optional Extensions Element
Comments

Element Coverage.costToBeneficiary has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.

Control0..*
This element is affected by the following invariants: ele-1
Is Modifierfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
2. Extension.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the element. In order 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.

ShortExtensionAdditional Content defined by implementations
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.

Control10..*
TypeExtension
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Extension.extension:type
    Slice Nametype
    Definition

    R4: Coverage.costToBeneficiary.type (new:CodeableConcept)

    ShortR4: Cost category (new)Additional Content defined by implementations
    Comments

    Element Coverage.costToBeneficiary.type is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.type has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example visit, specialist visits, emergency, inpatient care, etc.

    Control0..1*
    TypeExtension
    Requirements

    Needed to identify the category associated with the amount for the patient. Element Coverage.costToBeneficiary.type is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.type has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    6. Extension.extension:type.url
    Definition

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

    Shortidentifies the meaning of the extension
    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.

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuetype
    8. Extension.extension:type.value[x]
    Definition

    The category of patient centric costs associated with treatment.


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

    ShortCost categoryValue of extension
    Comments

    For example visit, specialist visits, emergency, inpatient care, etc.

    Control0..1
    BindingUnless not suitable, these codes SHALL be taken from For codes, see R4CoverageCopayTypeForR3 (0.1.0)
    (extensible to http://hl7.org/fhir/uv/xver/ValueSet/R4-coverage-copay-type-for-R3|0.1.0)

    The types of services to which patient copayments are specified.

    TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    10. Extension.extension:value
    Slice Namevalue
    Definition

    R4: Coverage.costToBeneficiary.value[x] (new:Money, Quantity[SimpleQuantity])

    ShortR4: The amount or percentage due from the beneficiary (new)Additional Content defined by implementations
    Comments

    Element Coverage.costToBeneficiary.value[x] is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.value[x] has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.value[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.

    Control10..1*
    TypeExtension
    Requirements

    Needed to identify the amount for the patient associated with the category. Element Coverage.costToBeneficiary.value[x] is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.value[x] has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.value[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    12. Extension.extension:value.url
    Definition

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

    Shortidentifies the meaning of the extension
    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.

    Control1..1
    Typeuri
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Fixed Valuevalue
    14. Extension.extension:value.value[x]
    Definition

    The amount due from the patient for the cost category.


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

    ShortThe amount or percentage due from the beneficiaryValue of extension
    Comments

    Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.

    Control10..1
    TypeChoice of: Quantity(SimpleQuantity), Money, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    16. Extension.extension:exception
    Slice Nameexception
    Definition

    R4: Coverage.costToBeneficiary.exception (new:BackboneElement)

    ShortR4: Exceptions for patient payments (new)Additional Content defined by implementations
    Comments

    Element Coverage.costToBeneficiary.exception is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.exception has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    Control0..*
    TypeExtension
    Requirements

    Required by providers to manage financial transaction with the patient. Element Coverage.costToBeneficiary.exception is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.exception has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

    18. Extension.extension:exception.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the element. In order 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.

    ShortExtensionAdditional Content defined by implementations
    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.

    Control10..*
    TypeExtension
    Alternate Namesextensions, user content
    SlicingThis element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 20. Extension.extension:exception.extension:type
      Slice Nametype
      Definition

      R4: Coverage.costToBeneficiary.exception.type (new:CodeableConcept)

      ShortR4: Exception category (new)Additional Content defined by implementations
      Comments

      Element Coverage.costToBeneficiary.exception.type is part of an existing definition because parent element Coverage.costToBeneficiary.exception requires a cross-version extension. Element Coverage.costToBeneficiary.exception.type has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

      Control10..1*
      TypeExtension
      Requirements

      Needed to identify the exception associated with the amount for the patient. Element Coverage.costToBeneficiary.exception.type is part of an existing definition because parent element Coverage.costToBeneficiary.exception requires a cross-version extension. Element Coverage.costToBeneficiary.exception.type has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

      22. Extension.extension:exception.extension:type.url
      Definition

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

      Shortidentifies the meaning of the extension
      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.

      Control1..1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valuetype
      24. Extension.extension:exception.extension:type.value[x]
      Definition

      The code for the specific exception.


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

      ShortException categoryValue of extension
      Control10..1
      BindingFor example codes, see For codes, see R4CoverageFinancialExceptionForR3 (0.1.0)
      (example to http://hl7.org/fhir/uv/xver/ValueSet/R4-coverage-financial-exception-for-R3|0.1.0)

      The types of exceptions from the part or full value of financial obligations such as copays.

      TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      26. Extension.extension:exception.extension:period
      Slice Nameperiod
      Definition

      R4: Coverage.costToBeneficiary.exception.period (new:Period)

      ShortR4: The effective period of the exception (new)Additional Content defined by implementations
      Comments

      Element Coverage.costToBeneficiary.exception.period is part of an existing definition because parent element Coverage.costToBeneficiary.exception requires a cross-version extension. Element Coverage.costToBeneficiary.exception.period has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception.period has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

      Control0..1*
      TypeExtension
      Requirements

      Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs. Element Coverage.costToBeneficiary.exception.period is part of an existing definition because parent element Coverage.costToBeneficiary.exception requires a cross-version extension. Element Coverage.costToBeneficiary.exception.period has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception.period has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

      28. Extension.extension:exception.extension:period.url
      Definition

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

      Shortidentifies the meaning of the extension
      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.

      Control1..1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valueperiod
      30. Extension.extension:exception.extension:period.value[x]
      Definition

      The timeframe during when the exception is in force.


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

      ShortThe effective period of the exceptionValue of extension
      Control0..1
      TypePeriod, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal, CodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      32. Extension.extension:exception.url
      Definition

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

      Shortidentifies the meaning of the extension
      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.

      Control1..1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valueexception
      34. Extension.extension:exception.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).

      ShortValue of extension
      Control0..01
      TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      36. Extension.url
      Definition

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

      Shortidentifies the meaning of the extension
      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.

      Control1..1
      Typeuri
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      XML FormatIn the XML format, this property is represented as an attribute.
      Fixed Valuehttp://hl7.org/fhir/4.0/StructureDefinition/extension-Coverage.costToBeneficiary
      38. 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).

      ShortValue of extension
      Control0..01
      TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

      Guidance on how to interpret the contents of this table can be foundhere

      0. Extension
      Definition

      R4: Coverage.costToBeneficiary (new:BackboneElement)

      ShortR4: Patient payments for services/products (new)
      Comments

      Element Coverage.costToBeneficiary has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.

      Control0..*
      Is Modifierfalse
      2. Extension.extension
      Control1..*
      SlicingThis element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 4. Extension.extension:type
        Slice Nametype
        Definition

        R4: Coverage.costToBeneficiary.type (new:CodeableConcept)

        ShortR4: Cost category (new)
        Comments

        Element Coverage.costToBeneficiary.type is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.type has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example visit, specialist visits, emergency, inpatient care, etc.

        Control0..1
        Requirements

        Needed to identify the category associated with the amount for the patient. Element Coverage.costToBeneficiary.type is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.type has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

        6. Extension.extension:type.url
        Control1..1
        Fixed Valuetype
        8. Extension.extension:type.value[x]
        Definition

        The category of patient centric costs associated with treatment.

        ShortCost category
        Comments

        For example visit, specialist visits, emergency, inpatient care, etc.

        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from R4CoverageCopayTypeForR3 (0.1.0)
        (extensible to http://hl7.org/fhir/uv/xver/ValueSet/R4-coverage-copay-type-for-R3|0.1.0)

        The types of services to which patient copayments are specified.

        TypeCodeableConcept
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        10. Extension.extension:value
        Slice Namevalue
        Definition

        R4: Coverage.costToBeneficiary.value[x] (new:Money, Quantity[SimpleQuantity])

        ShortR4: The amount or percentage due from the beneficiary (new)
        Comments

        Element Coverage.costToBeneficiary.value[x] is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.value[x] has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.value[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.

        Control1..1
        Requirements

        Needed to identify the amount for the patient associated with the category. Element Coverage.costToBeneficiary.value[x] is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.value[x] has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.value[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

        12. Extension.extension:value.url
        Control1..1
        Fixed Valuevalue
        14. Extension.extension:value.value[x]
        Definition

        The amount due from the patient for the cost category.

        ShortThe amount or percentage due from the beneficiary
        Comments

        Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.

        Control1..1
        TypeChoice of: Quantity(SimpleQuantity), Money
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        16. Extension.extension:exception
        Slice Nameexception
        Definition

        R4: Coverage.costToBeneficiary.exception (new:BackboneElement)

        ShortR4: Exceptions for patient payments (new)
        Comments

        Element Coverage.costToBeneficiary.exception is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.exception has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

        Control0..*
        Requirements

        Required by providers to manage financial transaction with the patient. Element Coverage.costToBeneficiary.exception is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.exception has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

        18. Extension.extension:exception.extension
        Control1..*
        SlicingThis element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 20. Extension.extension:exception.extension:type
          Slice Nametype
          Definition

          R4: Coverage.costToBeneficiary.exception.type (new:CodeableConcept)

          ShortR4: Exception category (new)
          Comments

          Element Coverage.costToBeneficiary.exception.type is part of an existing definition because parent element Coverage.costToBeneficiary.exception requires a cross-version extension. Element Coverage.costToBeneficiary.exception.type has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

          Control1..1
          Requirements

          Needed to identify the exception associated with the amount for the patient. Element Coverage.costToBeneficiary.exception.type is part of an existing definition because parent element Coverage.costToBeneficiary.exception requires a cross-version extension. Element Coverage.costToBeneficiary.exception.type has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

          22. Extension.extension:exception.extension:type.url
          Control1..1
          Fixed Valuetype
          24. Extension.extension:exception.extension:type.value[x]
          Definition

          The code for the specific exception.

          ShortException category
          Control1..1
          BindingFor example codes, see R4CoverageFinancialExceptionForR3 (0.1.0)
          (example to http://hl7.org/fhir/uv/xver/ValueSet/R4-coverage-financial-exception-for-R3|0.1.0)

          The types of exceptions from the part or full value of financial obligations such as copays.

          TypeCodeableConcept
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          26. Extension.extension:exception.extension:period
          Slice Nameperiod
          Definition

          R4: Coverage.costToBeneficiary.exception.period (new:Period)

          ShortR4: The effective period of the exception (new)
          Comments

          Element Coverage.costToBeneficiary.exception.period is part of an existing definition because parent element Coverage.costToBeneficiary.exception requires a cross-version extension. Element Coverage.costToBeneficiary.exception.period has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception.period has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

          Control0..1
          Requirements

          Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs. Element Coverage.costToBeneficiary.exception.period is part of an existing definition because parent element Coverage.costToBeneficiary.exception requires a cross-version extension. Element Coverage.costToBeneficiary.exception.period has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception.period has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

          28. Extension.extension:exception.extension:period.url
          Control1..1
          Fixed Valueperiod
          30. Extension.extension:exception.extension:period.value[x]
          Definition

          The timeframe during when the exception is in force.

          ShortThe effective period of the exception
          Control0..1
          TypePeriod
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          32. Extension.extension:exception.url
          Control1..1
          Fixed Valueexception
          34. Extension.extension:exception.value[x]
          Control0..0
          36. Extension.url
          Control1..1
          Fixed Valuehttp://hl7.org/fhir/4.0/StructureDefinition/extension-Coverage.costToBeneficiary
          38. Extension.value[x]
          Control0..0

          Guidance on how to interpret the contents of this table can be foundhere

          0. Extension
          Definition

          R4: Coverage.costToBeneficiary (new:BackboneElement)

          ShortR4: Patient payments for services/products (new)
          Comments

          Element Coverage.costToBeneficiary has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.

          Control0..*
          This element is affected by the following invariants: ele-1
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          2. 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.

          Shortxml:id (or equivalent in JSON)
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          4. Extension.extension
          Definition

          An Extension

          ShortExtension
          Control1..*
          TypeExtension
          SlicingThis element introduces a set of slices on Extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 6. Extension.extension:type
            Slice Nametype
            Definition

            R4: Coverage.costToBeneficiary.type (new:CodeableConcept)

            ShortR4: Cost category (new)
            Comments

            Element Coverage.costToBeneficiary.type is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.type has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). For example visit, specialist visits, emergency, inpatient care, etc.

            Control0..1
            TypeExtension
            Requirements

            Needed to identify the category associated with the amount for the patient. Element Coverage.costToBeneficiary.type is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.type has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

            8. Extension.extension:type.id
            Definition

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

            Shortxml:id (or equivalent in JSON)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            XML FormatIn the XML format, this property is represented as an attribute.
            10. Extension.extension:type.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. In order 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.

            ShortAdditional Content defined by implementations
            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.

            Control0..*
            TypeExtension
            Alternate Namesextensions, user content
            SlicingThis element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 12. Extension.extension:type.url
              Definition

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

              Shortidentifies the meaning of the extension
              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.

              Control1..1
              Typeuri
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              Fixed Valuetype
              14. Extension.extension:type.value[x]
              Definition

              The category of patient centric costs associated with treatment.

              ShortCost category
              Comments

              For example visit, specialist visits, emergency, inpatient care, etc.

              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from R4CoverageCopayTypeForR3 (0.1.0)
              (extensible to http://hl7.org/fhir/uv/xver/ValueSet/R4-coverage-copay-type-for-R3|0.1.0)

              The types of services to which patient copayments are specified.

              TypeCodeableConcept
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              16. Extension.extension:value
              Slice Namevalue
              Definition

              R4: Coverage.costToBeneficiary.value[x] (new:Money, Quantity[SimpleQuantity])

              ShortR4: The amount or percentage due from the beneficiary (new)
              Comments

              Element Coverage.costToBeneficiary.value[x] is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.value[x] has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.value[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.

              Control1..1
              TypeExtension
              Requirements

              Needed to identify the amount for the patient associated with the category. Element Coverage.costToBeneficiary.value[x] is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.value[x] has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.value[x] has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

              18. Extension.extension:value.id
              Definition

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

              Shortxml:id (or equivalent in JSON)
              Control0..1
              Typestring
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              XML FormatIn the XML format, this property is represented as an attribute.
              20. Extension.extension:value.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. In order 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.

              ShortAdditional Content defined by implementations
              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.

              Control0..*
              TypeExtension
              Alternate Namesextensions, user content
              SlicingThis element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 22. Extension.extension:value.url
                Definition

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

                Shortidentifies the meaning of the extension
                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.

                Control1..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                Fixed Valuevalue
                24. Extension.extension:value.value[x]
                Definition

                The amount due from the patient for the cost category.

                ShortThe amount or percentage due from the beneficiary
                Comments

                Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.

                Control1..1
                TypeChoice of: Quantity(SimpleQuantity), Money
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                26. Extension.extension:exception
                Slice Nameexception
                Definition

                R4: Coverage.costToBeneficiary.exception (new:BackboneElement)

                ShortR4: Exceptions for patient payments (new)
                Comments

                Element Coverage.costToBeneficiary.exception is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.exception has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                Control0..*
                TypeExtension
                Requirements

                Required by providers to manage financial transaction with the patient. Element Coverage.costToBeneficiary.exception is part of an existing definition because parent element Coverage.costToBeneficiary requires a cross-version extension. Element Coverage.costToBeneficiary.exception has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                28. Extension.extension:exception.id
                Definition

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

                Shortxml:id (or equivalent in JSON)
                Control0..1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                XML FormatIn the XML format, this property is represented as an attribute.
                30. Extension.extension:exception.extension
                Definition

                An Extension

                ShortExtension
                Control1..*
                TypeExtension
                SlicingThis element introduces a set of slices on Extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 32. Extension.extension:exception.extension:type
                  Slice Nametype
                  Definition

                  R4: Coverage.costToBeneficiary.exception.type (new:CodeableConcept)

                  ShortR4: Exception category (new)
                  Comments

                  Element Coverage.costToBeneficiary.exception.type is part of an existing definition because parent element Coverage.costToBeneficiary.exception requires a cross-version extension. Element Coverage.costToBeneficiary.exception.type has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                  Control1..1
                  TypeExtension
                  Requirements

                  Needed to identify the exception associated with the amount for the patient. Element Coverage.costToBeneficiary.exception.type is part of an existing definition because parent element Coverage.costToBeneficiary.exception requires a cross-version extension. Element Coverage.costToBeneficiary.exception.type has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception.type has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                  34. Extension.extension:exception.extension:type.id
                  Definition

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

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  XML FormatIn the XML format, this property is represented as an attribute.
                  36. Extension.extension:exception.extension:type.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                  ShortAdditional Content defined by implementations
                  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.

                  Control0..*
                  TypeExtension
                  Alternate Namesextensions, user content
                  SlicingThis element introduces a set of slices on Extension.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 38. Extension.extension:exception.extension:type.url
                    Definition

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

                    Shortidentifies the meaning of the extension
                    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.

                    Control1..1
                    Typeuri
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Fixed Valuetype
                    40. Extension.extension:exception.extension:type.value[x]
                    Definition

                    The code for the specific exception.

                    ShortException category
                    Control1..1
                    BindingFor example codes, see R4CoverageFinancialExceptionForR3 (0.1.0)
                    (example to http://hl7.org/fhir/uv/xver/ValueSet/R4-coverage-financial-exception-for-R3|0.1.0)

                    The types of exceptions from the part or full value of financial obligations such as copays.

                    TypeCodeableConcept
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    42. Extension.extension:exception.extension:period
                    Slice Nameperiod
                    Definition

                    R4: Coverage.costToBeneficiary.exception.period (new:Period)

                    ShortR4: The effective period of the exception (new)
                    Comments

                    Element Coverage.costToBeneficiary.exception.period is part of an existing definition because parent element Coverage.costToBeneficiary.exception requires a cross-version extension. Element Coverage.costToBeneficiary.exception.period has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception.period has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                    Control0..1
                    TypeExtension
                    Requirements

                    Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs. Element Coverage.costToBeneficiary.exception.period is part of an existing definition because parent element Coverage.costToBeneficiary.exception requires a cross-version extension. Element Coverage.costToBeneficiary.exception.period has a context of Coverage based on following the parent source element upwards and mapping to Coverage. Element Coverage.costToBeneficiary.exception.period has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).

                    44. Extension.extension:exception.extension:period.id
                    Definition

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

                    Shortxml:id (or equivalent in JSON)
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    XML FormatIn the XML format, this property is represented as an attribute.
                    46. Extension.extension:exception.extension:period.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                    ShortAdditional Content defined by implementations
                    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.

                    Control0..*
                    TypeExtension
                    Alternate Namesextensions, user content
                    SlicingThis element introduces a set of slices on Extension.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 48. Extension.extension:exception.extension:period.url
                      Definition

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

                      Shortidentifies the meaning of the extension
                      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.

                      Control1..1
                      Typeuri
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed Valueperiod
                      50. Extension.extension:exception.extension:period.value[x]
                      Definition

                      The timeframe during when the exception is in force.

                      ShortThe effective period of the exception
                      Control0..1
                      TypePeriod
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      52. Extension.extension:exception.url
                      Definition

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

                      Shortidentifies the meaning of the extension
                      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.

                      Control1..1
                      Typeuri
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed Valueexception
                      54. Extension.extension:exception.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).

                      ShortValue of extension
                      Control0..0
                      TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      56. Extension.url
                      Definition

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

                      Shortidentifies the meaning of the extension
                      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.

                      Control1..1
                      Typeuri
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Fixed Valuehttp://hl7.org/fhir/4.0/StructureDefinition/extension-Coverage.costToBeneficiary
                      58. 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).

                      ShortValue of extension
                      Control0..0
                      TypeChoice of: base64Binary, boolean, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, Meta
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension