abstractbaseDefinitioncopyrightdate- Values Differ
descriptionexperimentalfhirVersionjurisdiction
jurisdiction[0]kindnamepublisherpurposestatustitletypeurlversion- Values Differ
| Left: | C4DIC Coverage (http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage) |
| Right: | C4DIC Coverage (http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage) |
| Error | StructureDefinition.version | Values for version differ: '0.1.0' vs '1.0.0' |
| Information | StructureDefinition.date | Values for date differ: '2021-12-06T22:19:18+00:00' vs '2022-07-13T17:22:13+00:00' |
| Name | Value | Comments | |
|---|---|---|---|
| abstract | false | ||
| baseDefinition | http://hl7.org/fhir/StructureDefinition/Coverage | ||
| copyright | |||
| date | 2021-12-06T22:19:18+00:00 | 2022-07-13T17:22:13+00:00 |
|
| description | Data that reflect a payer’s coverage of the member. | ||
| experimental | |||
| fhirVersion | 4.0.1 | ||
| jurisdiction | |||
| jurisdiction[0] | urn:iso:std:iso:3166#US | ||
| kind | resource | ||
| name | C4DICCoverage | ||
| publisher | HL7 Payer/Provider Information Exchange Working Group (PIE WG) | ||
| purpose | |||
| status | active | ||
| title | C4DIC Coverage | ||
| type | Coverage | ||
| url | http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage | ||
| version | 0.1.0 | 1.0.0 |
|
| Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | L Type | L Description & Constraints | Comments | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
 Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | 0..* | Coverage | Insurance or medical plan or a payment agreement | |||||||||||
 id | Σ | 0..1 | string | Logical id of this artifact | Σ | 0..1 | string | Logical id of this artifact | |||||||||
 meta | SΣ | 1..1 | Meta | Metadata about the resource | SΣ | 1..1 | Meta | Metadata about the resource | |||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
 Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| versionId | Σ | 0..1 | id | Version specific identifier | Σ | 0..1 | id | Version specific identifier | |||||||||
| lastUpdated | SΣ | 1..1 | instant | When the resource version last changed | SΣ | 1..1 | instant | When the resource version last changed | |||||||||
| source | Σ | 0..1 | uri | Identifies where the resource comes from | Σ | 0..1 | uri | Identifies where the resource comes from | |||||||||
| Slices for profile | Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to Slice: Unordered, Open by pattern:$this | Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to Slice: Unordered, Open by pattern:$this | |||||||||
| 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. | 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: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (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 | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |||||||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||||||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
| contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||||||||
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
| Slices for identifier | SΣ | 1..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by pattern:type | SΣ | 1..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by pattern:type | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | |||||||||
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: C4DICCoverageIdentifierType (extensible) | Σ | 0..1 | CodeableConcept | Description of identifier Binding: C4DIC Coverage Identifier Type (extensible) | |||||||||
| system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | 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 | 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 | 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) | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | |||||||||
| status | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | |||||||||
| type | SΣ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. Required Pattern: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/v3-ActCode","code":"HIP"}]} | SΣ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: CoverageTypeAndSelf-PayCodes (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 | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | |||||||||
| subscriber | SΣ | 1..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | SΣ | 1..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| reference | SΣI | 1..1 | string | Literal reference, Relative, internal or absolute URL | SΣI | 1..1 | string | Literal reference, Relative, internal or absolute URL | |||||||||
| type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | |||||||||
| identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | |||||||||
| display | Σ | 0..1 | string | Text alternative for the resource | Σ | 0..1 | string | Text alternative for the resource | |||||||||
| subscriberId | SΣ | 1..1 | string | ID assigned to the subscriber | SΣ | 1..1 | string | ID assigned to the subscriber | |||||||||
| beneficiary | SΣ | 1..1 | Reference(C4DIC Patient) | Plan beneficiary | SΣ | 1..1 | Reference(C4DIC Patient) | Plan beneficiary | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
| reference | SΣI | 1..1 | string | Literal reference, Relative, internal or absolute URL | SΣI | 1..1 | string | Literal reference, Relative, internal or absolute URL | |||||||||
| type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). | |||||||||
| identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | |||||||||
| display | Σ | 0..1 | string | Text alternative for the resource | Σ | 0..1 | string | Text alternative for the resource | |||||||||
| dependent | SΣ | 0..1 | string | Dependent number | SΣ | 0..1 | string | Dependent number | |||||||||
| relationship | S | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (required) | S | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (required) | |||||||||
| period | SΣ | 0..1 | Period | Coverage start and end dates | SΣ | 0..1 | Period | Coverage start and end dates | |||||||||
| payor | SΣ | 1..1 | Reference(C4DIC Organization) | Issuer of the policy | SΣ | 1..1 | Reference(C4DIC Organization) | Issuer of the policy | |||||||||
| Slices for class | S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by pattern:type | S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by pattern:type | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: C4DICCoverageClassVS (required) | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: C4DIC Coverage Class (required) | |||||||||
| value | Σ | 1..1 | string | Value associated with the type | Σ | 1..1 | string | Value associated with the type | |||||||||
| name | Σ | 0..1 | string | Human readable description of the type and value | Σ | 0..1 | string | Human readable description of the type and value | |||||||||
| order | Σ | 0..1 | positiveInt | Relative order of the coverage | Σ | 0..1 | positiveInt | Relative order of the coverage | |||||||||
| network | Σ | 0..1 | string | Insurer network | Σ | 0..1 | string | Insurer network | |||||||||
| costToBeneficiary | S | 0..* | BackboneElement | Patient payments for services/products | S | 0..* | BackboneElement | Patient payments for services/products | |||||||||
| id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| type | SΣ | 1..1 | CodeableConcept | Cost category Binding: C4DICCopayTypeVS (extensible) | SΣ | 1..1 | CodeableConcept | Cost category Binding: C4DIC Copay Type (extensible) | |||||||||
| Slices for value[x] | Σ | 1..1 | Money | The amount or percentage due from the beneficiary Slice: Unordered, Closed by type:$this | Σ | 1..1 | Money | The amount or percentage due from the beneficiary Slice: Unordered, Closed by type:$this | |||||||||
 exception | 0..* | BackboneElement | Exceptions for patient payments | 0..* | BackboneElement | Exceptions for patient payments | |||||||||||
 id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
| extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
| type | Σ | 1..1 | CodeableConcept | Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays. | Σ | 1..1 | CodeableConcept | Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays. | |||||||||
| period | Σ | 0..1 | Period | The effective period of the exception | Σ | 0..1 | Period | The effective period of the exception | |||||||||
| subrogation | 0..1 | boolean | Reimbursement to insurer | 0..1 | boolean | Reimbursement to insurer | |||||||||||
| contract | 0..* | Reference(Contract) | Contract details | 0..* | Reference(Contract) | Contract details | |||||||||||
| Documentation for this format | |||||||||||||||||