Validated Healthcare Directory
0.2.0 - CI Build
Validated Healthcare Directory
0.2.0 - CI Build
Validated Healthcare Directory, published by HL7 International - Patient Administration Work Group. This is not an authorized publication; it is the continuous build for version 0.2.0). This version is based on the current content of https://github.com/HL7/VhDir/ and changes regularly. See the Directory of published versions
Generated Narrative: InsurancePlan
Resource InsurancePlan "insuranceplan1"
identifier: HIOS product ID: 1234567891 (use: OFFICIAL)
status: active
type: Bronze (VhDir Payer Characteristics Code System#bronze)
name: Patriot PPO Standard
alias: Patriot Plus
period: 2018-06-06 --> 2019-01-01
ownedBy: Organization/homeland: Homeland Health Insurance "Homeland Health Insurance"
administeredBy: Organization/homeland: Homeland Health Insurance "Homeland Health Insurance"
coverageArea: Location/wash-dc-metro: Washington, DC metro area "Washington, DC metro area"
| Purpose | Telecom |
| General information (Contact entity type#PATINF "Patient") | ph: 202-123-5555, info@homelandinc.org |
endpoint: : patriot plan endpoint hub
network:
coverage
type: Coverage related to medical inpatient, outpatient, diagnostic, and preventive care (coverage-type#medical "Medical")
network: Organization/patriotppo: Patriot Preferred Provider Network "Patriot Preferred Provider Network"
benefit
type: Primary care visit to treat an injury or illness (benefit-type#001)
requirement: N/A
Limits
Code unlimited ()
coverage
type: Coverage related to dental care (coverage-type#dental "Dental")
network: Organization/patriotdental: Patriot Dental Provider Network "Patriot Dental Provider Network"
benefit
type: Periodic oral checkup (benefit-type#052 "Basic Dental Care – Adult")
requirement: N/A
Limits
Value Code 2 visit/yr (Details: UCUM code {visit}/a = '{visit}/a') biannual oral checkup ()
plan
identifier: HIOS plan ID: 123456789101112 (use: OFFICIAL)
type: Bronze (planlevel#bronze)
coverageArea: Location/wash-dc-metro: Washington, DC metro area "Washington, DC metro area"
network: Organization/patriotdental: Patriot Dental Provider Network "Patriot Dental Provider Network"
generalCost
type: Deductible (cost-type#deductible)
groupSize: 1
Costs
Value Currency 6200 USD comment: Includes all prescription and medical costs for in-network providers
specificCost
category: Medical (cost-category#medical)
benefit
type: Primary care visit to treat an injury or illness (benefit-type#001)
Costs
Type Applicability Qualifiers Value Copay (cost-type#copay) In Network (Benefit cost applicability#in-network) in-network preferred provider () 50 dollars (Details: urn:iso:std:iso:4217 code USD = 'USD') specificCost
category: Dental (cost-category#dental)
benefit
type: Basic Dental Care – Adult (cost-type#052)
Costs
Type Applicability Qualifiers Value Coinsurance (costing#coinsurance) In Network (Benefit cost applicability#in-network) in-network provider () 10 percent
IG © 2022+ HL7 International - Patient Administration Work Group. Package hl7.fhir.uv.vhdir#0.2.0 based on FHIR 4.0.1. Generated 2023-09-12
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