Union of http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage and http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage

This is the set of resources that conform to either of the profiles US Core Coverage Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage) and BSeR Coverage (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage). E.g. what you have to deal with if you get resources conforming to one of them

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage C0..*Insurance or medical plan or a payment agreement
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
us-core-15: Member Id in Coverage.identifier or Coverage.subscriberId SHALL be present
... meta Σ0..1MetaMetadata about the resource
ele-1: All FHIR elements must have a @value or children
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... language 0..1codeLanguage of the resource content
Binding: ?? (preferred): A human language.


ele-1: All FHIR elements must have a @value or children
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... identifier SΣ0..*IdentifierMember ID and other identifiers
ele-1: All FHIR elements must have a @value or children
... status ?!SΣ1..1codeleft: active | cancelled | draft | entered-in-error; right: (USCDI) active | cancelled | draft | entered-in-error
Binding: ?? (required): A code specifying the state of the resource instance.


ele-1: All FHIR elements must have a @value or children
... type SΣ0..1CodeableConceptCoverage category such as medical or accident
Binding: ?? (extensible): US Public Health Data Consortium Source of Payment Codes


ele-1: All FHIR elements must have a @value or children
... policyHolder Σ0..1Reference(Patient | RelatedPerson | Organization)Owner of the policy
ele-1: All FHIR elements must have a @value or children
... subscriber SΣ0..1Reference(Patient | RelatedPerson)Subscriber to the policy
ele-1: All FHIR elements must have a @value or children
... subscriberId SΣ0..1stringID assigned to the subscriber
ele-1: All FHIR elements must have a @value or children
... beneficiary SΣ1..1Reference(US Core Patient Profile)Plan beneficiary
ele-1: All FHIR elements must have a @value or children
... dependent Σ0..1stringDependent number
ele-1: All FHIR elements must have a @value or children
... relationship S1..1CodeableConceptBeneficiary relationship to the subscriber
Binding: ?? (extensible)
ele-1: All FHIR elements must have a @value or children
... period SΣ0..1PeriodCoverage start and end dates
ele-1: All FHIR elements must have a @value or children
... payor SΣ1..1Reference(US Core Organization Profile S | US Core Patient Profile | US Core RelatedPerson Profile)Issuer of the policy
ele-1: All FHIR elements must have a @value or children
... class S0..*BackboneElementAdditional coverage classifications
ele-1: All FHIR elements must have a @value or children
.... extension 0..*ExtensionAdditional content defined by implementations
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... type Σ1..1CodeableConceptType of class such as 'group' or 'plan'
Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc.


ele-1: All FHIR elements must have a @value or children
.... value Σ1..1stringValue associated with the type
ele-1: All FHIR elements must have a @value or children
.... name Σ0..1stringHuman readable description of the type and value
ele-1: All FHIR elements must have a @value or children
... order Σ0..1positiveIntRelative order of the coverage
ele-1: All FHIR elements must have a @value or children
... network Σ0..1stringInsurer network
ele-1: All FHIR elements must have a @value or children
... costToBeneficiary 0..*BackboneElementPatient payments for services/products
ele-1: All FHIR elements must have a @value or children
.... extension 0..*ExtensionAdditional content defined by implementations
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... type Σ0..1CodeableConceptCost category
Binding: ?? (extensible): The types of services to which patient copayments are specified.


ele-1: All FHIR elements must have a @value or children
.... value[x] Σ1..1The amount or percentage due from the beneficiary
ele-1: All FHIR elements must have a @value or children
..... valueQuantityQuantity(SimpleQuantity)
..... valueMoneyMoney
.... exception 0..*BackboneElementExceptions for patient payments
ele-1: All FHIR elements must have a @value or children
..... extension 0..*ExtensionAdditional content defined by implementations
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... type Σ1..1CodeableConceptException category
Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays.


ele-1: All FHIR elements must have a @value or children
..... period Σ0..1PeriodThe effective period of the exception
ele-1: All FHIR elements must have a @value or children
... subrogation 0..1booleanReimbursement to insurer
ele-1: All FHIR elements must have a @value or children
... contract 0..*Reference(Contract)Contract details
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format