This page is part of the FHIR Specification (v4.2.0: R5 Preview #1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions
. Page versions: R5 R4B R4
| Financial Management Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Not linked to any defined compartments |
Raw Turtle (+ also see Turtle/RDF Format Specification)
Health Insurance Policy
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
<http://hl7.org/fhir/Contract/INS-101> a fhir:Contract;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "INS-101"];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <p>Plan: Your Choice Split Copay (Non-Grandfathered)</p>\n <p>Certificate Form Number: YCSCWLN (01-2017)</p>\n </div>"
];
fhir:Contract.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://xyz-insurance.com/forms" ];
fhir:Identifier.value [ fhir:value "YCSCWLN(01-2017)" ]
];
fhir:Contract.applies [
fhir:Period.start [ fhir:value "2017-01-01"^^xsd:date ]
];
fhir:Contract.subject [
fhir:index 0;
fhir:link <http://hl7.org/fhir/Patient/1>;
fhir:Reference.reference [ fhir:value "Patient/1" ]
];
fhir:Contract.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/contract-type" ];
fhir:Coding.code [ fhir:value "healthinsurance" ];
fhir:Coding.display [ fhir:value "Health Insurance" ]
]
];
fhir:Contract.term [
fhir:index 0;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "The benefits, limitations, exclusions and other coverage provisions in this booklet are subject to the terms of our contract with the Group. This booklet is a part of that contract, which is on file in the Group's office." ]
];
fhir:Contract.term.asset [
fhir:index 0;
fhir:Contract.term.asset.type [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "urn:ietf:rfc:3986" ];
fhir:Coding.code [ fhir:value "RicardianContract" ]
]
];
fhir:Contract.term.asset.subtype [
fhir:index 0;
fhir:CodeableConcept.text [ fhir:value "sample" ]
];
fhir:Contract.term.asset.period [
fhir:index 0;
fhir:Period.start [ fhir:value "2017-06-01"^^xsd:date ]
];
fhir:Contract.term.asset.valuedItem [
fhir:index 0;
fhir:Contract.term.asset.valuedItem.entityCodeableConcept [
fhir:CodeableConcept.text [ fhir:value "Ford Bobcat" ]
];
fhir:Contract.term.asset.valuedItem.identifier [
fhir:Identifier.system [ fhir:value "http://somewhere.motor-vehicle.com/vin" ];
fhir:Identifier.value [ fhir:value "XXSVT34-7665t952236" ]
];
fhir:Contract.term.asset.valuedItem.effectiveTime [ fhir:value "1995"^^xsd:gYear ];
fhir:Contract.term.asset.valuedItem.quantity [
fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ]
];
fhir:Contract.term.asset.valuedItem.unitPrice [
fhir:Money.value [ fhir:value "200.00"^^xsd:decimal ];
fhir:Money.currency [ fhir:value "CAD" ]
];
fhir:Contract.term.asset.valuedItem.factor [ fhir:value "1.0"^^xsd:decimal ];
fhir:Contract.term.asset.valuedItem.points [ fhir:value "1.0"^^xsd:decimal ];
fhir:Contract.term.asset.valuedItem.net [
fhir:Money.value [ fhir:value "200.00"^^xsd:decimal ];
fhir:Money.currency [ fhir:value "CAD" ]
]
]
];
fhir:Contract.term.group [
fhir:index 0;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Eligible Providers" ]
]
], [
fhir:index 1;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Responsibility for Payment" ]
]
], [
fhir:index 2;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "List of Benefits" ]
];
fhir:Contract.term.group [
fhir:index 0;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Copays" ]
];
fhir:Contract.term.group [
fhir:index 0;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Emergency Room Copay" ]
]
], [
fhir:index 1;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Professional Visit Copay" ]
]
]
], [
fhir:index 1;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Calendar Year Deductible" ]
]
], [
fhir:index 2;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Out-Of-Pocket Maximum" ]
]
], [
fhir:index 3;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Medical Services" ]
];
fhir:Contract.term.group [
fhir:index 0;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Ambulance Services" ]
]
], [
fhir:index 1;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Dental Services" ]
]
], [
fhir:index 2;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Diagnostic Services" ]
]
], [
fhir:index 3;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Emergency Room Services" ]
]
], [
fhir:index 4;
fhir:Contract.term.offer [
fhir:Contract.term.offer.text [ fhir:value "Hospital Inpatient Care" ]
]
]
]
]
] .
<http://hl7.org/fhir/Patient/1> a fhir:Patient .
# - ontology header ------------------------------------------------------------
<http://hl7.org/fhir/Contract/INS-101.ttl> a owl:Ontology;
owl:imports fhir:fhir.ttl;
owl:versionIRI <http://build.fhir.org/Contract/INS-101.ttl> .
# -------------------------------------------------------------------------------------
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.