CH ORF (R4)
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CH ORF (R4), published by HL7 Switzerland. This guide is not an authorized publication; it is the continuous build for version 3.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7ch/ch-orf/ and changes regularly. See the Directory of published versions

Resource Profile: ChOrfCoverage - Mappings

Active as of 2024-05-17

Mappings for the ch-orf-coverage resource profile.

Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

ChOrfCoverage
CoverageEvent
   identifierEvent.identifier
   statusEvent.status
   beneficiaryEvent.subject
   periodEvent.occurrence[x]

Mappings for RIM Mapping (http://hl7.org/v3)

ChOrfCoverage
CoverageEntity. Role, or Act, Coverage
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifier.id
      idn/a
      extensionn/a
      useRole.code or implied by context
      typeRole.code or implied by context
         idn/a
         extensionn/a
         codingunion(., ./translation)
            idn/a
            extensionn/a
            system./codeSystem
            version./codeSystemVersion
            code./code
            displayCV.displayName
            userSelectedCD.codingRationale
         text./originalText[mediaType/code="text/plain"]/data
      systemII.root or Role.id.root
      valueII.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
      periodRole.effectiveTime or implied by context
      assignerII.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
   identifier (insuranceCardNumber)n/a, II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
   statusAct.status
   periodAct.effectiveTime
   class
      idn/a
      extensionn/a
      modifierExtensionN/A
   costToBeneficiary
      idn/a
      extensionn/a
      modifierExtensionN/A
      exception
         idn/a
         extensionn/a
         modifierExtensionN/A
   contractn/a

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

ChOrfCoverage
Coverage
   identifierFiveWs.identifier
   statusFiveWs.status
   typeFiveWs.class
   policyHolderFiveWs.subject[x], FiveWs.subject
   subscriberFiveWs.subject[x], FiveWs.subject
   subscriberIdFiveWs.subject[x], FiveWs.subject
   beneficiaryFiveWs.subject[x], FiveWs.subject
   periodFiveWs.done[x]
   payorFiveWs.author

Mappings for Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/)

ChOrfCoverage
Coverage
   identifierC02
   policyHolderD01 through D09
   subscriberD01 through D09
   subscriberIdD01 through D09
   beneficiaryD01 through D09
   dependentC17
   relationshipC03
   payorA05
   class
      valueC11 (Division,Section)
      nameC11 (Division,Section)
   networkD10
   costToBeneficiary
      value[x]C11 (Division,Section)
   contractD01 through D09

Mappings for HL7 v2 Mapping (http://hl7.org/v2)

ChOrfCoverage
Coverage
   identifierIN1-2
      useN/A
      typeCX.5
         codingC*E.1-8, C*E.10-22
            systemC*E.3
            versionC*E.7
            codeC*E.1
            displayC*E.2 - but note this is not well followed
            userSelectedSometimes implied by being first
         textC*E.9. But note many systems use C*E.2 for this
      systemCX.4 / EI-2-4
      valueCX.1 / EI.1
      periodCX.7 + CX.8
      assignerCX.4 / (CX.4,CX.9,CX.10)
   identifier (insuranceCardNumber)CX / EI (occasionally, more often EI maps to a resource id or a URL)
   typeIN1-15
   policyHolderIN1-16, 18, 19-name of insured, address, date of birth
   subscriberIN1-16, 18, 19-name of insured, address, date of birth
   subscriberIdIN1-16, 18, 19-name of insured, address, date of birth
   beneficiaryIN1-16, 18, 19-name of insured, address, date of birth
   dependent- No exact HL7 v2 equivalent concept seems to exist;
   periodIN1-12 / IN1-13
   payorIN1-3
   class
      valueIN1-8
      nameIN1-8
   order- No exact HL7 v2 equivalent concept seems to exist;
   costToBeneficiary
      value[x]IN1-8
   contractIN1-16, 18, 19

Mappings for Canadian Pharmacy Associaiton eclaims standard (http://www.pharmacists.ca/)

ChOrfCoverage
Coverage
   identifierC.32, C.33, C.39
   policyHolderC.35
   subscriberC.35
   subscriberIdC.35
   beneficiaryC.35
   payorC.30
   class
      valueC.31
      nameC.31
   costToBeneficiary
      value[x]C.31
   contractC.35