CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
2.1.0 - STU 2.1 United States of America flag

CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®), published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-bb/ and changes regularly. See the Directory of published versions

Example Coverage: Dental Coverage Example1

Page standards status: Informative

Generated Narrative: Coverage CoverageDental1

Last updated: 2021-01-01 14:22:01+0000; Language: en-US

Profile: C4BB Coverageversion: null2.1.0)

identifier: Member Number/210300002

status: Active

type: dental care policy

policyHolder: Member 01 Test Male, DoB: 1943-01-01 ( An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501)

subscriber: Member 01 Test Male, DoB: 1943-01-01 ( An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501)

subscriberId: 10300007

beneficiary: Member 01 Test Male, DoB: 1943-01-01 ( An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.: 88800933501)

dependent: 01

relationship: Self

period: 2021-01-01 --> 2021-12-31

payor: Organization INSURANCE COMPANY XYZ

class

type: An employee group

value: 10300007

name: Transcorp - dental

class

type: Plan

value: 66783JJT

name: INSURANCE COMPANY XYZ - PRIME

network: INSURANCE COMPANY XYZ - PRIME

Notes:

Instance: CoverageDental1
InstanceOf: http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|2.1.0
Title: "Dental Coverage Example1"
Description: "Dental Coverage Example1"
Usage: #example
* meta.lastUpdated = "2021-01-01T14:22:01.0314215+00:00"
* language = #en-US
* identifier
  * type = http://terminology.hl7.org/CodeSystem/v2-0203#MB
  * system = "https://www.xxxhealthplan.com/fhir/memberidentifier"
  * value = "210300002"
* status = #active
* type = http://terminology.hl7.org/CodeSystem/v3-ActCode#DENTAL
  * text = "dental care policy"
* policyHolder = Reference(Patient2)
* subscriber = Reference(Patient2)
* subscriberId = "10300007"
* beneficiary = Reference(Patient2)
* dependent = "01"
* relationship = http://terminology.hl7.org/CodeSystem/subscriber-relationship#self
* period
  * start = "2021-01-01"
  * end = "2021-12-31"
* payor = Reference(DentalPayer1)
* class[0]
  * type = http://terminology.hl7.org/CodeSystem/coverage-class#group
    * text = "An employee group"
  * value = "10300007"
  * name = "Transcorp - dental"
* class[+]
  * type = http://terminology.hl7.org/CodeSystem/coverage-class#plan
    * text = "Plan"
  * value = "66783JJT"
  * name = "INSURANCE COMPANY XYZ - PRIME"
* network = "INSURANCE COMPANY XYZ - PRIME"