Left: | C4BB Coverage (http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage) |
Right: | C4BB Coverage (http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage) |
Error | StructureDefinition.version | Values for version differ: '2.1.0-snapshot1' vs '2.1.0' |
Information | StructureDefinition.date | Values for date differ: '2024-07-27T20:09:37+08:00' vs '2024-12-18T23:56:31+00:00' |
Information | StructureDefinition.definition | Values for definition differ: 'A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.' vs 'A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](http://hl7.org/fhir/R4/provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.' |
Information | StructureDefinition.definition | Values for definition differ: 'A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).' vs 'A list of profiles (references to [StructureDefinition](http://hl7.org/fhir/R4/structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](http://hl7.org/fhir/R4/structuredefinition-definitions.html#StructureDefinition.url).' |
Name | Value | Comments | |
---|---|---|---|
abstract | false | ||
baseDefinition | http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage | ||
copyright | |||
date | 2024-07-27T20:09:37+08:00 | 2024-12-18T23:56:31+00:00 |
|
description | Data that reflect a payer’s coverage that was effective as of the date of service or the date of admission of the claim. | ||
experimental | |||
fhirVersion | 4.0.1 | ||
jurisdiction | |||
jurisdiction[0] | urn:iso:std:iso:3166#US | ||
kind | resource | ||
name | C4BBCoverage | ||
publisher | HL7 International / Financial Management | ||
purpose | |||
status | active | ||
title | C4BB Coverage | ||
type | Coverage | ||
url | http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage | ||
version | 2.1.0-snapshot1 | 2.1.0 |
|
Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Coverage | C | 0..* | USCoreCoverageProfile | Insurance or medical plan or a payment agreement us-core-15: Member Id in Coverage.identifier or Coverage.subscriberId SHALL be present | C | 0..* | USCoreCoverageProfile | Insurance or medical plan or a payment agreement us-core-15: Member Id in Coverage.identifier or Coverage.subscriberId SHALL be present | |||||||||
id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact | |||||||||
meta | SΣ | 1..1 | Meta | Metadata about the resource | SΣ | 1..1 | Meta | Metadata about the resource | |||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
versionId | Σ | 0..1 | id | Version specific identifier | Σ | 0..1 | id | Version specific identifier | |||||||||
lastUpdated | SΣ | 1..1 | instant | When the resource version last changed | SΣ | 1..1 | instant | When the resource version last changed | |||||||||
source | Σ | 0..1 | uri | Identifies where the resource comes from | Σ | 0..1 | uri | Identifies where the resource comes from | |||||||||
profile | Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | |||||||||
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | Σ | 0..* | Coding | Security Labels applied to this resource Binding: ?? (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | |||||||||
tag | Σ | 0..* | Coding | Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | Σ | 0..* | Coding | Tags applied to this resource Binding: ?? (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | |||||||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |||||||||
language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| |||||||||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
Slices for identifier | SΣ | 0..* | Identifier | Member ID and other identifiers Slice: Unordered, Open by pattern:type | SΣ | 0..* | Identifier | Member ID and other identifiers Slice: Unordered, Open by pattern:type | |||||||||
status | ?!SΣ | 1..1 | code | (USCDI) active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | ?!SΣ | 1..1 | code | (USCDI) active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | |||||||||
type | SΣ | 0..1 | CodeableConcept | (USCDI) Coverage category such as medical or accident Binding: ?? (extensible): US Public Health Data Consortium Source of Payment Codes | SΣ | 0..1 | CodeableConcept | (USCDI) Coverage category such as medical or accident Binding: ?? (extensible): US Public Health Data Consortium Source of Payment Codes | |||||||||
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | |||||||||
subscriber | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | |||||||||
subscriberId | SΣC | 1..1 | string | (USCDI) ID assigned to the subscriber | SΣC | 1..1 | string | (USCDI) ID assigned to the subscriber | |||||||||
beneficiary | SΣ | 1..1 | Reference(C4BB Patient) | (USCDI) Plan beneficiary | SΣ | 1..1 | Reference(C4BB Patient) | (USCDI) Plan beneficiary | |||||||||
dependent | Σ | 0..1 | string | Dependent number | Σ | 0..1 | string | Dependent number | |||||||||
relationship | S | 1..1 | CodeableConcept | (USCDI) Beneficiary relationship to the subscriber Binding: ?? (required) | S | 1..1 | CodeableConcept | (USCDI) Beneficiary relationship to the subscriber Binding: ?? (required) | |||||||||
period | SΣ | 0..1 | Period | (USCDI) Coverage start and end dates | SΣ | 0..1 | Period | (USCDI) Coverage start and end dates | |||||||||
payor | SΣ | 1..1 | Reference(C4BB Organization) | (USCDI) Issuer of the policy | SΣ | 1..1 | Reference(C4BB Organization) | (USCDI) Issuer of the policy | |||||||||
Slices for class | S | 0..* | BackboneElement | (USCDI) Additional coverage classifications Slice: Unordered, Open by pattern:type | S | 0..* | BackboneElement | (USCDI) Additional coverage classifications Slice: Unordered, Open by pattern:type | |||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc. | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc. | |||||||||
value | Σ | 1..1 | string | Value associated with the type | Σ | 1..1 | string | Value associated with the type | |||||||||
name | Σ | 0..1 | string | Human readable description of the type and value | Σ | 0..1 | string | Human readable description of the type and value | |||||||||
order | Σ | 0..1 | positiveInt | Relative order of the coverage | Σ | 0..1 | positiveInt | Relative order of the coverage | |||||||||
network | Σ | 0..1 | string | Insurer network | Σ | 0..1 | string | Insurer network | |||||||||
costToBeneficiary | 0..* | BackboneElement | Patient payments for services/products | 0..* | BackboneElement | Patient payments for services/products | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
type | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified. | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified. | |||||||||
value[x] | Σ | 1..1 | ??, Money | The amount or percentage due from the beneficiary | Σ | 1..1 | ??, Money | The amount or percentage due from the beneficiary | |||||||||
exception | 0..* | BackboneElement | Exceptions for patient payments | 0..* | BackboneElement | Exceptions for patient payments | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
type | Σ | 1..1 | CodeableConcept | Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays. | Σ | 1..1 | CodeableConcept | Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays. | |||||||||
period | Σ | 0..1 | Period | The effective period of the exception | Σ | 0..1 | Period | The effective period of the exception | |||||||||
subrogation | 0..1 | boolean | Reimbursement to insurer | 0..1 | boolean | Reimbursement to insurer | |||||||||||
contract | 0..* | Reference(Contract) | Contract details | 0..* | Reference(Contract) | Contract details | |||||||||||
Documentation for this format |