Profile Comparison between http://hl7.org/fhir/us/directory-attestation/StructureDefinition/NatlDirAttest-InsurancePlan vs http://hl7.org/fhir/us/directory-attestation/StructureDefinition/NatlDirAttest-InsurancePlan

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/us/directory-exchange/StructureDefinition/NatlDirEx-InsurancePlan
copyright
date	2022-08-08T18:05:19+00:00	2022-12-08T23:25:31+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).
experimental
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#US
kind	resource
name	NatlDirAttestInsurancePlan
publisher	HL7 Patient Administration Working Group
purpose
status	active
title	NatDir InsurancePlan
type	InsurancePlan
url	http://hl7.org/fhir/us/directory-attestation/StructureDefinition/NatlDirAttest-InsurancePlan
version	1.0.0-ballot

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	L Type	L Description & Constraints	Comments
InsurancePlan	C	0..*	NatlDirExInsurancePlan	Details of a Health Insurance product/plan provided by an organization	C	0..*	NatlDirExInsurancePlan	Details of a Health Insurance product/plan provided by an organization
id	Σ	0..1	string	Logical id of this artifact	Σ	0..1	id	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): A human language. Additional Bindings Purpose AllLanguages Max Binding		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
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	SΣC	0..*	Identifier	Business Identifier for Product	SΣC	0..*	Identifier	Business Identifier for Product
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. Fixed Value: active	?!Σ	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: InsuranceProductTypeVS (extensible)	SΣ	1..1	CodeableConcept	Product Type Binding: Insurance Product Type Value Set (extensible)
name	SΣC	0..1	string	Official name	SΣC	0..1	string	Official name
alias		0..*	string	Alternate names		0..*	string	Alternate names
period		0..1	Period	When the product is available		0..1	Period	When the product is available
ownedBy	SΣ	1..1	Reference(National Directory Endpoint Qry Exchange Organization)	Plan issuer	SΣ	1..1	Reference(National Directory Endpoint Qry Exchange Organization)	Plan issuer
administeredBy	SΣ	1..1	Reference(National Directory Endpoint Qry Exchange Organization)	Product administrator	SΣ	1..1	Reference(National Directory Endpoint Qry Exchange Organization)	Product administrator
coverageArea	SΣ	0..*	Reference(National Directory Endpoint Qry Exchange Location)	Where product applies	SΣ	0..*	Reference(National Directory Endpoint Qry Exchange Location)	Where product applies
contact		0..*	BackboneElement	Contact for the product		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		0..1	HumanName	A name associated with the contact		0..1	HumanName	A name associated with the contact
telecom		0..*	ContactPoint	Contact details (telephone, email, etc.) for a contact		0..*	ContactPoint	Contact details (telephone, email, etc.) for a contact
address		0..1	Address	Visiting or postal addresses for the contact		0..1	Address	Visiting or postal addresses for the contact
endpoint		0..*	Reference(National Directory Endpoint Qry Exchange Endpoint)	Technical endpoint		0..*	Reference(National Directory Endpoint Qry Exchange Endpoint)	Technical endpoint
network	S	0..*	Reference(National Directory Endpoint Qry Exchange Network)	What networks are Included	S	0..*	Reference(National Directory Endpoint Qry Exchange Network)	What networks are Included
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	S	0..*	Reference(Organization)	What networks provide coverage	S	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	S	1..1	CodeableConcept	Type of benefit	S	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		0..1	CodeableConcept	Categorization of the cost sharing for the plan Binding: InsurancePlanTypeVS (extensible)		0..1	CodeableConcept	Categorization of the cost sharing for the plan Binding: Insurance Plan Type Value Set (extensible)
coverageArea	Σ	0..*	Reference(National Directory Endpoint Qry Exchange Location)	Where product applies	Σ	0..*	Reference(National Directory Endpoint Qry Exchange Location)	Where product applies
network		0..*	Reference(National Directory Endpoint Qry Exchange Network)	What networks provide coverage		0..*	Reference(National Directory Endpoint Qry Exchange Network)	What networks provide coverage
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