Extensions for Using Data Elements from FHIR R4B in FHIR STU3
0.1.0 - STU International flag

Extensions for Using Data Elements from FHIR R4B in FHIR STU3 - Downloaded Version null See the Directory of published versions

Resource Profile: Profile_R4B_Coverage_R3

Official URL: http://hl7.org/fhir/4.3/StructureDefinition/profile-Coverage Version: 0.1.0
Standards status: Trial-use Maturity Level: 0 Computable Name: Profile_R4B_Coverage_R3

This cross-version profile allows R4B Coverage content to be represented via FHIR STU3 Coverage resources.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costToBeneficiary 0..* (Complex) R4B: Patient payments for services/products (new)
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.costToBeneficiary
.... extension:subrogation 0..1 boolean R4B: Reimbursement to insurer (new)
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.subrogation
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Coverage.status Base required Financial Resource Status Codes 📍3.0.2 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-1 error Coverage If the resource is contained in another resource, it SHALL NOT contain any narrative contained.text.empty()
dom-2 error Coverage If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Coverage If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4 error Coverage 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()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() | (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... meta
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:meta 0..1 Meta R4B: meta additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.meta
... text
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:text 0..1 (Complex) R4B: text additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.text
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costToBeneficiary 0..* (Complex) R4B: Patient payments for services/products (new)
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.costToBeneficiary
.... extension:subrogation 0..1 boolean R4B: Reimbursement to insurer (new)
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.subrogation
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:identifier 0..* Identifier R4B: Business Identifier for the coverage additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.identifier
... policyHolder
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:policyHolder 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: policyHolder
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... subscriber
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:subscriber 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: subscriber additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... beneficiary
.... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:beneficiary 1..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: Plan beneficiary additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... period
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:period 0..1 Period R4B: period additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.period
... payor
.... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:payor 1..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: Issuer of the policy
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... contract
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:contract 0..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: contract additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:meta 0..1 Meta R4B: meta additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.meta
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... profile Σ 0..* uri Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
.... tag Σ 0..* Coding Tags applied to this resource
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:text 0..1 (Complex) R4B: text additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.text
.... status 1..1 code generated | extensions | additional | empty
Binding: NarrativeStatus (required): The status of a resource narrative
.... div C 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costToBeneficiary 0..* (Complex) R4B: Patient payments for services/products (new)
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.costToBeneficiary
.... extension:subrogation 0..1 boolean R4B: Reimbursement to insurer (new)
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.subrogation
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier The primary coverage ID
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:identifier 0..* Identifier R4B: Business Identifier for the coverage additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.identifier
.... use ?!Σ 0..1 code usual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 0..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... status ?!Σ 0..1 code active | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (required): A code specifying the state of the resource instance.
... type Σ 0..1 CodeableConcept Type of coverage such as medical or accident
Binding: Coverage Type and Self-Pay Codes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
... policyHolder Σ 0..1 Reference(Patient | RelatedPerson | Organization) Owner of the policy
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:policyHolder 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: policyHolder
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... subscriber Σ 0..1 Reference(Patient | RelatedPerson) Subscriber to the policy
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:subscriber 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: subscriber additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... subscriberId Σ 0..1 string ID assigned to the Subscriber
... beneficiary Σ 0..1 Reference(Patient) Plan Beneficiary
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:beneficiary 1..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: Plan beneficiary additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... relationship 0..1 CodeableConcept Beneficiary relationship to the Subscriber
Binding: Policyholder Relationship Codes (example): The relationship between the Policyholder and the Beneficiary (insured/covered party/patient).
... period Σ 0..1 Period Coverage start and end dates
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:period 0..1 Period R4B: period additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.period
.... start ΣC 0..1 dateTime Starting time with inclusive boundary
.... end ΣC 0..1 dateTime End time with inclusive boundary, if not ongoing
... payor Σ 0..* Reference(Organization | Patient | RelatedPerson) Identifier for the plan or agreement issuer
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:payor 1..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: Issuer of the policy
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... grouping 0..1 BackboneElement Additional coverage classifications
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
.... group Σ 0..1 string An identifier for the group
.... groupDisplay Σ 0..1 string Display text for an identifier for the group
.... subGroup Σ 0..1 string An identifier for the subsection of the group
.... subGroupDisplay Σ 0..1 string Display text for the subsection of the group
.... plan Σ 0..1 string An identifier for the plan
.... planDisplay Σ 0..1 string Display text for the plan
.... subPlan Σ 0..1 string An identifier for the subsection of the plan
.... subPlanDisplay Σ 0..1 string Display text for the subsection of the plan
.... class Σ 0..1 string An identifier for the class
.... classDisplay Σ 0..1 string Display text for the class
.... subClass Σ 0..1 string An identifier for the subsection of the class
.... subClassDisplay Σ 0..1 string Display text for the subsection of the subclass
... dependent Σ 0..1 string Dependent number
... sequence Σ 0..1 string The plan instance or sequence counter
... order Σ 0..1 positiveInt Relative order of the coverage
... network Σ 0..1 string Insurer network
... contract 0..* Reference(Contract) Contract details
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:contract 0..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: contract additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Coverage.meta.security Base extensible All Security Labels 📍3.0.2 FHIR Std.
Coverage.meta.tag Base example Common Tags 📍3.0.2 FHIR Std.
Coverage.language Base extensible Common Languages 📍3.0.2 FHIR Std.
Coverage.text.status Base required NarrativeStatus 📍3.0.2 FHIR Std.
Coverage.identifier.​use Base required IdentifierUse 📍3.0.2 FHIR Std.
Coverage.identifier.​type Base extensible Identifier Type Codes 📍3.0.2 FHIR Std.
Coverage.status Base required Financial Resource Status Codes 📍3.0.2 FHIR Std.
Coverage.type Base preferred Coverage Type and Self-Pay Codes 📍3.0.2 FHIR Std.
Coverage.relationship Base example Policyholder Relationship Codes 📍3.0.2 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-1 error Coverage If the resource is contained in another resource, it SHALL NOT contain any narrative contained.text.empty()
dom-2 error Coverage If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Coverage If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4 error Coverage 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()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() | (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
txt-1 error Coverage.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlchecks()
txt-2 error Coverage.text.div The narrative SHALL have some non-whitespace content htmlchecks()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costToBeneficiary 0..* (Complex) R4B: Patient payments for services/products (new)
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.costToBeneficiary
.... extension:subrogation 0..1 boolean R4B: Reimbursement to insurer (new)
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.subrogation
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Coverage.status Base required Financial Resource Status Codes 📍3.0.2 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-1 error Coverage If the resource is contained in another resource, it SHALL NOT contain any narrative contained.text.empty()
dom-2 error Coverage If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Coverage If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4 error Coverage 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()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() | (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... meta
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:meta 0..1 Meta R4B: meta additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.meta
... text
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:text 0..1 (Complex) R4B: text additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.text
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costToBeneficiary 0..* (Complex) R4B: Patient payments for services/products (new)
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.costToBeneficiary
.... extension:subrogation 0..1 boolean R4B: Reimbursement to insurer (new)
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.subrogation
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:identifier 0..* Identifier R4B: Business Identifier for the coverage additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.identifier
... policyHolder
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:policyHolder 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: policyHolder
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... subscriber
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:subscriber 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: subscriber additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... beneficiary
.... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:beneficiary 1..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: Plan beneficiary additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... period
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:period 0..1 Period R4B: period additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.period
... payor
.... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:payor 1..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: Issuer of the policy
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
... contract
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:contract 0..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: contract additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:meta 0..1 Meta R4B: meta additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.meta
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... profile Σ 0..* uri Profiles this resource claims to conform to
.... security Σ 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
.... tag Σ 0..* Coding Tags applied to this resource
Binding: Common Tags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:text 0..1 (Complex) R4B: text additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.text
.... status 1..1 code generated | extensions | additional | empty
Binding: NarrativeStatus (required): The status of a resource narrative
.... div C 1..1 xhtml Limited xhtml content
Constraints: txt-1, txt-2
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costToBeneficiary 0..* (Complex) R4B: Patient payments for services/products (new)
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.costToBeneficiary
.... extension:subrogation 0..1 boolean R4B: Reimbursement to insurer (new)
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.subrogation
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier The primary coverage ID
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:identifier 0..* Identifier R4B: Business Identifier for the coverage additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.identifier
.... use ?!Σ 0..1 code usual | official | temp | secondary (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 0..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... status ?!Σ 0..1 code active | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (required): A code specifying the state of the resource instance.
... type Σ 0..1 CodeableConcept Type of coverage such as medical or accident
Binding: Coverage Type and Self-Pay Codes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
... policyHolder Σ 0..1 Reference(Patient | RelatedPerson | Organization) Owner of the policy
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:policyHolder 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: policyHolder
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... subscriber Σ 0..1 Reference(Patient | RelatedPerson) Subscriber to the policy
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:subscriber 0..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: subscriber additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... subscriberId Σ 0..1 string ID assigned to the Subscriber
... beneficiary Σ 0..1 Reference(Patient) Plan Beneficiary
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:beneficiary 1..1 ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: Plan beneficiary additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... relationship 0..1 CodeableConcept Beneficiary relationship to the Subscriber
Binding: Policyholder Relationship Codes (example): The relationship between the Policyholder and the Beneficiary (insured/covered party/patient).
... period Σ 0..1 Period Coverage start and end dates
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:period 0..1 Period R4B: period additional types
URL: http://hl7.org/fhir/4.3/StructureDefinition/extension-Coverage.period
.... start ΣC 0..1 dateTime Starting time with inclusive boundary
.... end ΣC 0..1 dateTime End time with inclusive boundary, if not ongoing
... payor Σ 0..* Reference(Organization | Patient | RelatedPerson) Identifier for the plan or agreement issuer
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:payor 1..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: Issuer of the policy
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... grouping 0..1 BackboneElement Additional coverage classifications
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
.... group Σ 0..1 string An identifier for the group
.... groupDisplay Σ 0..1 string Display text for an identifier for the group
.... subGroup Σ 0..1 string An identifier for the subsection of the group
.... subGroupDisplay Σ 0..1 string Display text for the subsection of the group
.... plan Σ 0..1 string An identifier for the plan
.... planDisplay Σ 0..1 string Display text for the plan
.... subPlan Σ 0..1 string An identifier for the subsection of the plan
.... subPlanDisplay Σ 0..1 string Display text for the subsection of the plan
.... class Σ 0..1 string An identifier for the class
.... classDisplay Σ 0..1 string Display text for the class
.... subClass Σ 0..1 string An identifier for the subsection of the class
.... subClassDisplay Σ 0..1 string Display text for the subsection of the subclass
... dependent Σ 0..1 string Dependent number
... sequence Σ 0..1 string The plan instance or sequence counter
... order Σ 0..1 positiveInt Relative order of the coverage
... network Σ 0..1 string Insurer network
... contract 0..* Reference(Contract) Contract details
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:contract 0..* ?gen-e1? [CanonicalType[http://hl7.org/fhir/StructureDefinition/alternate-reference]] R4B: contract additional types
URL: http://hl7.org/fhir/StructureDefinition/alternate-reference
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Coverage.meta.security Base extensible All Security Labels 📍3.0.2 FHIR Std.
Coverage.meta.tag Base example Common Tags 📍3.0.2 FHIR Std.
Coverage.language Base extensible Common Languages 📍3.0.2 FHIR Std.
Coverage.text.status Base required NarrativeStatus 📍3.0.2 FHIR Std.
Coverage.identifier.​use Base required IdentifierUse 📍3.0.2 FHIR Std.
Coverage.identifier.​type Base extensible Identifier Type Codes 📍3.0.2 FHIR Std.
Coverage.status Base required Financial Resource Status Codes 📍3.0.2 FHIR Std.
Coverage.type Base preferred Coverage Type and Self-Pay Codes 📍3.0.2 FHIR Std.
Coverage.relationship Base example Policyholder Relationship Codes 📍3.0.2 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-1 error Coverage If the resource is contained in another resource, it SHALL NOT contain any narrative contained.text.empty()
dom-2 error Coverage If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Coverage If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4 error Coverage 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()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() | (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
txt-1 error Coverage.text.div The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes htmlchecks()
txt-2 error Coverage.text.div The narrative SHALL have some non-whitespace content htmlchecks()

 

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