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This page is part of the Pharmacist Care Plan FHIR IG (v0.1.0: STU 1 Draft) based on FHIR v3.1.0. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

This is a pre-release of a future version of the Pharmacist Care Plan FHIR IG (expected to be STU 1). There is no current official version.
For a full list of available versions, see the Directory of published versions .

D.4.1 StructureDefinition: PhCP-Coverage

D.4.1.1 Formal Views of Profile Content

The official URL for this profile is: 

http://hl7.org/fhir/STU3/us/phcp/StructureDefinition/PhCP-Coverage

This profile builds on Coverage.

This profile was published on Sat Jul 22 06:02:00 AEST 2017 as a draft by null.

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

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage I1..*Insurance or medical plan or a payment agreement
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ1..*IdentifierThe primary coverage ID
... status ?!Σ0..1codeactive | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (required)
... type Σ1..1CodeableConceptType of coverage such as medical or accident
Binding: Coverage Type and Self-Pay Codes (preferred)
... policyHolder Σ0..1Reference(Patient), Reference(RelatedPerson), Reference(Organization)Owner of the policy
... subscriber Σ1..1Reference(US Core Patient Profile)Subscriber to the policy
... subscriberId Σ1..1stringID assigned to the Subscriber
... beneficiary Σ0..1Reference(Patient)Plan Beneficiary
... relationship 0..1CodeableConceptBeneficiary relationship to the Subscriber
Binding: Policyholder Relationship Codes (example)
... period Σ0..1PeriodCoverage start and end dates
... payor Σ1..*Reference(US Core Organization Core Profile), Reference(Patient), Reference(RelatedPerson)Identifier for the plan or agreement issuer
... grouping I1..1BackboneElementAdditional coverage classifications
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... group Σ0..1stringAn identifier for the group
.... groupDisplay Σ0..1stringDisplay text for an identifier for the group
.... subGroup Σ0..1stringAn identifier for the subsection of the group
.... subGroupDisplay Σ0..1stringDisplay text for the subsection of the group
.... plan Σ0..1stringAn identifier for the plan
.... planDisplay Σ0..1stringDisplay text for the plan
.... subPlan Σ0..1stringAn identifier for the subsection of the plan
.... subPlanDisplay Σ0..1stringDisplay text for the subsection of the plan
.... class Σ0..1stringAn identifier for the class
.... classDisplay Σ0..1stringDisplay text for the class
.... subClass Σ0..1stringAn identifier for the subsection of the class
.... subClassDisplay Σ0..1stringDisplay text for the subsection of the subclass
... dependent Σ0..1stringDependent number
... sequence Σ0..1stringThe plan instance or sequence counter
... order Σ0..1positiveIntRelative order of the coverage
... network Σ0..1stringInsurer network
... contract 0..*Reference(Contract)Contract details

doco Documentation for this format

This structure is derived from Coverage

This structure is derived from Coverage

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage I1..*Insurance or medical plan or a payment agreement
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ1..*IdentifierThe primary coverage ID
... status ?!Σ0..1codeactive | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (required)
... type Σ1..1CodeableConceptType of coverage such as medical or accident
Binding: Coverage Type and Self-Pay Codes (preferred)
... policyHolder Σ0..1Reference(Patient), Reference(RelatedPerson), Reference(Organization)Owner of the policy
... subscriber Σ1..1Reference(US Core Patient Profile)Subscriber to the policy
... subscriberId Σ1..1stringID assigned to the Subscriber
... beneficiary Σ0..1Reference(Patient)Plan Beneficiary
... relationship 0..1CodeableConceptBeneficiary relationship to the Subscriber
Binding: Policyholder Relationship Codes (example)
... period Σ0..1PeriodCoverage start and end dates
... payor Σ1..*Reference(US Core Organization Core Profile), Reference(Patient), Reference(RelatedPerson)Identifier for the plan or agreement issuer
... grouping I1..1BackboneElementAdditional coverage classifications
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... group Σ0..1stringAn identifier for the group
.... groupDisplay Σ0..1stringDisplay text for an identifier for the group
.... subGroup Σ0..1stringAn identifier for the subsection of the group
.... subGroupDisplay Σ0..1stringDisplay text for the subsection of the group
.... plan Σ0..1stringAn identifier for the plan
.... planDisplay Σ0..1stringDisplay text for the plan
.... subPlan Σ0..1stringAn identifier for the subsection of the plan
.... subPlanDisplay Σ0..1stringDisplay text for the subsection of the plan
.... class Σ0..1stringAn identifier for the class
.... classDisplay Σ0..1stringDisplay text for the class
.... subClass Σ0..1stringAn identifier for the subsection of the class
.... subClassDisplay Σ0..1stringDisplay text for the subsection of the subclass
... dependent Σ0..1stringDependent number
... sequence Σ0..1stringThe plan instance or sequence counter
... order Σ0..1positiveIntRelative order of the coverage
... network Σ0..1stringInsurer network
... contract 0..*Reference(Contract)Contract details

doco Documentation for this format

 

D.4.1.2 Terminology Bindings

Terminology Bindings

PathNameConformanceValueSet
Coverage.languageCommon LanguagesextensibleCommon Languages
Coverage.statusFinancial Resource Status CodesrequiredFinancial Resource Status Codes
Coverage.typeCoverage Type and Self-Pay CodespreferredCoverage Type and Self-Pay Codes
Coverage.relationshipPolicyholder Relationship CodesexamplePolicyholder Relationship Codes

D.4.1.3 Constraints

Constraints

IdPathDetailsRequirements
dom-2CoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-1CoverageIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-4CoverageIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3CoverageIf 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()
ele-1Coverage.groupingAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
.