CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
2.1.0-snapshot1 - STU 2.1 prepublication draft United States of America flag

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

: Coverage Example 3 - JSON Representation

Page standards status: Informative

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{
  "resourceType" : "Coverage",
  "id" : "Coverage3",
  "meta" : {
    "lastUpdated" : "2020-07-07T13:26:22.0314215+00:00",
    "profile" : [
      🔗 "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|2.1.0-snapshot1"
    ]
  },
  "language" : "en-US",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en-US\" lang=\"en-US\"><p class=\"res-header-id\"><b>Generated Narrative: Coverage Coverage3</b></p><a name=\"Coverage3\"> </a><a name=\"hcCoverage3\"> </a><a name=\"Coverage3-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: 2020-07-07 13:26:22+0000; 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>: Member Number/1234-234-1243-12345678901</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode HIP}\">health insurance plan policy</span></p><p><b>policyHolder</b>: <a href=\"Patient-Patient2.html\">Member 01 Test  Male, DoB: 1943-01-01 ( An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.:\u00a088800933501)</a></p><p><b>subscriber</b>: <a href=\"Patient-Patient2.html\">Member 01 Test  Male, DoB: 1943-01-01 ( An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.:\u00a088800933501)</a></p><p><b>subscriberId</b>: 12345678901</p><p><b>beneficiary</b>: <a href=\"Patient-Patient2.html\">Member 01 Test  Male, DoB: 1943-01-01 ( An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier.:\u00a088800933501)</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>: 2019-01-01 --&gt; 2019-10-31</p><p><b>payor</b>: <a href=\"Organization-Payer1.html\">Organization Organization Payer 1</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>: 021890</p><p><b>name</b>: Acme Corporation</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}\">Plan</span></p><p><b>value</b>: XYZ123</p><p><b>name</b>: XYZ123-UPMC CONSUMER ADVA</p></blockquote><p><b>network</b>: XYZ123-UPMC CONSUMER ADVA</p></div>"
  },
  "identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MB"
          }
        ]
      },
      "system" : "https://www.xxxhealthplan.com/fhir/memberidentifier",
      "value" : "1234-234-1243-12345678901"
    }
  ],
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code" : "HIP"
      }
    ],
    "text" : "health insurance plan policy"
  },
  "policyHolder" : {
    🔗 "reference" : "Patient/Patient2"
  },
  "subscriber" : {
    🔗 "reference" : "Patient/Patient2"
  },
  "subscriberId" : "12345678901",
  "beneficiary" : {
    🔗 "reference" : "Patient/Patient2"
  },
  "dependent" : "01",
  "relationship" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code" : "self"
      }
    ]
  },
  "period" : {
    "start" : "2019-01-01",
    "end" : "2019-10-31"
  },
  "payor" : [
    {
      🔗 "reference" : "Organization/Payer1"
    }
  ],
  "class" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "group"
          }
        ],
        "text" : "An employee group"
      },
      "value" : "021890",
      "name" : "Acme Corporation"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "plan"
          }
        ],
        "text" : "Plan"
      },
      "value" : "XYZ123",
      "name" : "XYZ123-UPMC CONSUMER ADVA"
    }
  ],
  "network" : "XYZ123-UPMC CONSUMER ADVA"
}