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 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="CoverageDental1"/>
<meta>
<lastUpdated value="2021-01-01T14:22:01.0314215+00:00"/>
<profile
value="http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage|2.1.0"/>
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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 CoverageDental1</b></p><a name="CoverageDental1"> </a><a name="hcCoverageDental1"> </a><a name="CoverageDental1-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: 2021-01-01 14:22:01+0000; Language: en-US</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-C4BB-Coverage.html">C4BB Coverageversion: null2.1.0)</a></p></div><p><b>identifier</b>: Member Number/210300002</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode DENTAL}">dental care 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.: 88800933501)</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.: 88800933501)</a></p><p><b>subscriberId</b>: 10300007</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.: 88800933501)</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>: 2021-01-01 --> 2021-12-31</p><p><b>payor</b>: <a href="Organization-DentalPayer1.html">Organization INSURANCE COMPANY XYZ</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>: 10300007</p><p><b>name</b>: Transcorp - dental</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>: 66783JJT</p><p><b>name</b>: INSURANCE COMPANY XYZ - PRIME</p></blockquote><p><b>network</b>: INSURANCE COMPANY XYZ - PRIME</p></div>
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<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MB"/>
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<system value="https://www.xxxhealthplan.com/fhir/memberidentifier"/>
<value value="210300002"/>
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<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="DENTAL"/>
</coding>
<text value="dental care policy"/>
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<policyHolder>🔗
<reference value="Patient/Patient2"/>
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<subscriber>🔗
<reference value="Patient/Patient2"/>
</subscriber>
<subscriberId value="10300007"/>
<beneficiary>🔗
<reference value="Patient/Patient2"/>
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<dependent value="01"/>
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value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
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<period>
<start value="2021-01-01"/>
<end value="2021-12-31"/>
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<payor>🔗
<reference value="Organization/DentalPayer1"/>
</payor>
<class>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="group"/>
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<text value="An employee group"/>
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<value value="10300007"/>
<name value="Transcorp - dental"/>
</class>
<class>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="plan"/>
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<text value="Plan"/>
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<value value="66783JJT"/>
<name value="INSURANCE COMPANY XYZ - PRIME"/>
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<network value="INSURANCE COMPANY XYZ - PRIME"/>
</Coverage>