Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

• Narrative Content
• XML
• JSON
• TTL

: Coverage to Match Example 1 - JSON Representation

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{
  "resourceType" : "Coverage",
  "id" : "CoverageMatchExample1",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-coverage"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Coverage for Robert Johnson - Subscriber ID: 12345678, Previous Health Plan, PPO-GOLD</p></div>"
  },
  "status" : "draft",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code" : "HIP",
        "display" : "health insurance plan policy"
      }
    ]
  },
  "subscriber" : {
    🔗 "reference" : "Patient/patient-prov-001"
  },
  "subscriberId" : "12345678",
  "beneficiary" : {
    🔗 "reference" : "Patient/patient-prov-001"
  },
  "relationship" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code" : "self"
      }
    ]
  },
  "period" : {
    "start" : "2023-01-01",
    "end" : "2023-12-31"
  },
  "payor" : [
    {
      "identifier" : {
        "system" : "http://hl7.org/fhir/sid/us-npi",
        "value" : "9876543210"
      },
      "display" : "Previous Health Plan"
    }
  ],
  "class" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "group"
          }
        ]
      },
      "value" : "EMPLOY-12345"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "plan"
          }
        ]
      },
      "value" : "PPO-GOLD"
    }
  ]
}