CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®), published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0-snapshot1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-bb/ and changes regularly. See the Directory of published versions
Page standards status: Informative |
<Coverage xmlns="http://hl7.org/fhir">
<id value="Coverage1"/>
<meta>
<lastUpdated value="2020-10-30T09:48:01.8462752-04:00"/>
<profile
value="http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|2.1.0-snapshot1"/>
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<language value="en-US"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en-US" lang="en-US"><p class="res-header-id"><b>Generated Narrative: Coverage Coverage1</b></p><a name="Coverage1"> </a><a name="hcCoverage1"> </a><a name="Coverage1-en-US"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Last updated: 2020-10-30 09:48:01-0400; Language: en-US</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-C4BB-Coverage.html">C4BB Coverageversion: {0}2.1.0-snapshot1)</a></p></div><p><b>identifier</b>: An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier./88800933501</p><p><b>status</b>: Active</p><p><b>policyHolder</b>: <a href="Patient-Patient1.html">Johnny Example1 Male, DoB: 1986-01-01 ( Member Number)</a></p><p><b>subscriber</b>: <a href="Patient-Patient1.html">Johnny Example1 Male, DoB: 1986-01-01 ( Member Number)</a></p><p><b>subscriberId</b>: 888009335</p><p><b>beneficiary</b>: <a href="Patient-Patient1.html">Johnny Example1 Male, DoB: 1986-01-01 ( Member Number)</a></p><p><b>dependent</b>: 01</p><p><b>relationship</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}">Self</span></p><p><b>period</b>: 2020-01-01 --> (ongoing)</p><p><b>payor</b>: <a href="Organization-Payer2.html">UPMC Health Plan</a></p><blockquote><p><b>class</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/coverage-class group}">An employee group</span></p><p><b>value</b>: MCHMO1</p><p><b>name</b>: MEDICARE HMO PLAN</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}">A specific suite of benefits.</span></p><p><b>value</b>: GR5</p><p><b>name</b>: GR5-HMO DEDUCTIBLE</p></blockquote><p><b>network</b>: GR5-HMO DEDUCTIBLE</p></div>
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<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MB"/>
<display value="Member Number"/>
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<text
value="An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier."/>
</type>
<system value="https://www.upmchealthplan.com/fhir/memberidentifier"/>
<value value="88800933501"/>
<assigner>🔗
<reference value="Organization/Payer2"/>
<display value="UPMC Health Plan"/>
</assigner>
</identifier>
<status value="active"/>
<policyHolder>🔗
<reference value="Patient/Patient1"/>
</policyHolder>
<subscriber>🔗
<reference value="Patient/Patient1"/>
</subscriber>
<subscriberId value="888009335"/>
<beneficiary>🔗
<reference value="Patient/Patient1"/>
</beneficiary>
<dependent value="01"/>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
</coding>
<text value="Self"/>
</relationship>
<period>
<start value="2020-01-01"/>
</period>
<payor>🔗
<reference value="Organization/Payer2"/>
<display value="UPMC Health Plan"/>
</payor>
<class>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="group"/>
<display value="Group"/>
</coding>
<text value="An employee group"/>
</type>
<value value="MCHMO1"/>
<name value="MEDICARE HMO PLAN"/>
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<class>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="plan"/>
<display value="Plan"/>
</coding>
<text value="A specific suite of benefits."/>
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<value value="GR5"/>
<name value="GR5-HMO DEDUCTIBLE"/>
</class>
<network value="GR5-HMO DEDUCTIBLE"/>
</Coverage>