Profile Comparison between http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan vs http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/StructureDefinition/InsurancePlan
copyright
date	2020-12-20T06:12:23+00:00	2022-04-04T13:08:02+00:00	Values Differ
description	An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits). InsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.
experimental
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	PlannetInsurancePlan
publisher	HL7 Financial Management Working Group
purpose
status	active
title	Plan-Net InsurancePlan
type	InsurancePlan
url	http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan
version	1.0.0	1.1.0	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	L Type	L Description & Constraints	Comments
InsurancePlan	I	0..*	InsurancePlan	Details of a Health Insurance product/plan provided by an organization network-or-plan-Network: If an insuranceplan does not define a network, than each plan must define one plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.	I	0..*	InsurancePlan	Details of a Health Insurance product/plan provided by an organization network-or-plan-Network: If an insuranceplan does not define a network, then each plan must define one plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.
id	Σ	0..1	string	Logical id of this artifact	Σ	0..1	string	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource	Σ	0..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	Σ	1..1	instant	When the resource version last changed	Σ	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
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
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) Max Binding: AllLanguages: A human language.		0..1	code	Language of the resource content Binding: CommonLanguages (preferred) Max Binding: AllLanguages: 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
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored	?!	0..*	Extension	Extensions that cannot be ignored
identifier	ΣI	0..*	Identifier	Business Identifier for Product	ΣI	0..*	Identifier	Business Identifier for Product
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	SΣ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.	SΣ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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	SΣ	0..1	string	The value that is unique Example General: 123456	SΣ	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	SΣ	0..1	Reference(Organization)	Organization that issued id (may be just text)	SΣ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. Fixed Value: active	?!SΣ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. Fixed Value: active
type	SΣ	1..1	CodeableConcept	Product Type Binding: Insurance Product Type VS (extensible)	SΣ	1..1	CodeableConcept	Product Type Binding: Insurance Product Type VS (extensible)
name	SΣI	0..1	string	Official name	SΣI	0..1	string	Official name
alias	S	0..*	string	Alternate names	S	0..*	string	Alternate names
period		0..1	Period	When the product is available	S	0..1	Period	When the product is available	Elements differ in definition for mustSupport: 'false' vs 'true'
ownedBy	SΣ	1..1	Reference(Plan-Net Organization)	Plan issuer	SΣ	1..1	Reference(Plan-Net Organization)	Plan issuer	Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Organization]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Organization]])
administeredBy	SΣ	1..1	Reference(Plan-Net Organization)	Product administrator	SΣ	1..1	Reference(Plan-Net Organization)	Product administrator	Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Organization]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Organization]])
coverageArea	SΣ	0..*	Reference(Plan-Net Location)	Where product applies	SΣ	0..*	Reference(Plan-Net Location)	Where product applies	Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Location]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Location]])
contact	S	0..*	BackboneElement	Contact for the product	S	0..*	BackboneElement	Contact for the product
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
purpose		0..1	CodeableConcept	The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party.		0..1	CodeableConcept	The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party.
name	S	0..1	HumanName	A name associated with the contact	S	0..1	HumanName	A name associated with the contact
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 | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.	?!Σ	0..1	code	usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name.
text	SΣ	0..1	string	Text representation of the full name	SΣ	0..1	string	Text representation of the full name
family	Σ	0..1	string	Family name (often called 'Surname')	Σ	0..1	string	Family name (often called 'Surname')
given	Σ	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name	Σ	0..*	string	Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name
prefix	Σ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name	Σ	0..*	string	Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name
suffix	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name	Σ	0..*	string	Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name
period	Σ	0..1	Period	Time period when name was/is in use	Σ	0..1	Period	Time period when name was/is in use
telecom	S	0..*	ContactPoint	Contact details (telephone, email, etc.) for a contact	S	0..*	ContactPoint	Contact details (telephone, email, etc.) for a contact
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
system	SΣI	0..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.	SΣI	0..1	code	phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point.
value	SΣ	0..1	string	The actual contact point details	SΣ	0..1	string	The actual contact point details
use	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.	?!Σ	0..1	code	home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point.
rank	Σ	0..1	positiveInt	Specify preferred order of use (1 = highest)	Σ	0..1	positiveInt	Specify preferred order of use (1 = highest)
period	Σ	0..1	Period	Time period when the contact point was/is in use	Σ	0..1	Period	Time period when the contact point was/is in use
address		0..1	Address	Visiting or postal addresses for the contact		0..1	Address	Visiting or postal addresses for the contact
endpoint	S	0..*	Reference(Plan-Net Endpoint)	Technical endpoint	S	0..*	Reference(Plan-Net Endpoint)	Technical endpoint	Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Endpoint]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Endpoint]])
network	S	0..*	Reference(Plan-Net Network)	What networks are Included	S	0..*	Reference(Plan-Net Network)	What networks are Included	Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Network]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Network]])
coverage		0..*	BackboneElement	Coverage details		0..*	BackboneElement	Coverage details
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		1..1	CodeableConcept	Type of coverage		1..1	CodeableConcept	Type of coverage
network		0..*	Reference(Organization)	What networks provide coverage		0..*	Reference(Organization)	What networks provide coverage
benefit		1..*	BackboneElement	List of benefits		1..*	BackboneElement	List of benefits
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		1..1	CodeableConcept	Type of benefit		1..1	CodeableConcept	Type of benefit
requirement		0..1	string	Referral requirements		0..1	string	Referral requirements
limit		0..*	BackboneElement	Benefit limits		0..*	BackboneElement	Benefit limits
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
value		0..1	Quantity	Maximum value allowed		0..1	Quantity	Maximum value allowed
code		0..1	CodeableConcept	Benefit limit details		0..1	CodeableConcept	Benefit limit details
plan		0..*	BackboneElement	Cost sharing details for the plan		0..*	BackboneElement	Cost sharing details for the plan
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
identifier	Σ	0..*	Identifier	Business Identifier for Product	Σ	0..*	Identifier	Business Identifier for Product
type	S	0..1	CodeableConcept	Categorization of the cost sharing for the plan Binding: Insurance Plan TypeVS (extensible)	S	0..1	CodeableConcept	Categorization of the cost sharing for the plan Binding: Insurance Plan TypeVS (extensible)
coverageArea	SΣ	0..*	Reference(Plan-Net Location)	Where product applies	SΣ	0..*	Reference(Plan-Net Location)	Where product applies	Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Location]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Location]])
network		0..*	Reference(Plan-Net Network)	What networks provide coverage		0..*	Reference(Plan-Net Network)	What networks provide coverage	Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Network]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Network]])
generalCost		0..*	BackboneElement	Overall costs		0..*	BackboneElement	Overall costs
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		0..1	CodeableConcept	Type of cost		0..1	CodeableConcept	Type of cost
groupSize		0..1	positiveInt	Number of enrollees		0..1	positiveInt	Number of enrollees
cost		0..1	Money	Cost value		0..1	Money	Cost value
comment		0..1	string	Additional cost information		0..1	string	Additional cost information
specificCost		0..*	BackboneElement	Specific costs		0..*	BackboneElement	Specific costs
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
category		1..1	CodeableConcept	General category of benefit		1..1	CodeableConcept	General category of benefit
benefit		0..*	BackboneElement	Benefits list		0..*	BackboneElement	Benefits list
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		1..1	CodeableConcept	Type of specific benefit		1..1	CodeableConcept	Type of specific benefit
cost		0..*	BackboneElement	List of the costs		0..*	BackboneElement	List of the costs
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		1..1	CodeableConcept	Type of cost		1..1	CodeableConcept	Type of cost
applicability		0..1	CodeableConcept	in-network | out-of-network | other Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers.		0..1	CodeableConcept	in-network | out-of-network | other Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers.
qualifiers		0..*	CodeableConcept	Additional information about the cost		0..*	CodeableConcept	Additional information about the cost
value		0..1	Quantity	The actual cost value		0..1	Quantity	The actual cost value
Documentation for this format