## Intersection of http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage and http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage

This is the set of resources that conform to both QICore Coverage (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage) and QICore Coverage (http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage).

### Structure

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Coverage | C | 0..* |  | Insurance or medical plan or a payment agreement Constraints: us-core-15
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Member ID and other identifiers
status | ?!S Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance.
type | S Σ | 0..1 | CodeableConcept | (QI) Coverage category such as medical or accident Binding: ?? (extensible): Categories of types of health care payor entities as defined by the US Public Health Data Consortium SOP code system
policyHolder | Σ | 0..1 | Reference(QICore Patient | QICore Organization | QICore RelatedPerson | #sd-qicore-patient-qicore-patient) | (QI) Owner of the policy
subscriber | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy
subscriberId | S Σ | 0..1 | string | (QI) ID assigned to the subscriber
beneficiary | S Σ | 1..1 | Reference(QICore Patient | #sd-qicore-patient-qicore-patient) | (QI) Plan beneficiary
dependent | Σ | 0..1 | string | Dependent number
relationship | S | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible)
period | S Σ | 0..1 | Period | (QI) Coverage start and end dates
payor | S Σ | 1..1 | Reference(QICore Patient | QICore Organization | QICore RelatedPerson | #sd-qicore-patient-qicore-patient) | (QI) Issuer of the policy
class | S | 0..* | BackboneElement | Additional coverage classifications
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc.
value | Σ | 1..1 | string | Value associated with the type
name | Σ | 0..1 | string | Human readable description of the type and value
order | Σ | 0..1 | positiveInt | Relative order of the coverage
network | Σ | 0..1 | string | Insurer network
costToBeneficiary |  | 0..* | BackboneElement | Patient payments for services/products
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified.
value[x] | Σ | 1..1 |  | The amount or percentage due from the beneficiary
valueQuantity |  |  | Quantity(SimpleQuantity | ?gen-e2?) |
valueMoney |  |  | Money(SimpleQuantity) |
exception |  | 0..* | BackboneElement | Exceptions for patient payments
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | Σ | 1..1 | CodeableConcept | Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays.
period | Σ | 0..1 | Period | The effective period of the exception
subrogation |  | 0..1 | boolean | Reimbursement to insurer
contract |  | 0..* | Reference(Contract) | Contract details
Documentation for this format