Supporting Image Extension

The Supporting Image extension enables payers to provide images associated with a member's physical insurance card as part of the Coverage resource. A common use case is providing images of the front and back of the insurance card so that members can access a digital copy of their card through consuming applications.

Structure

Each instance of the Supporting Image extension contains three sub-extensions:

Recording Front and Back of Card Images

To provide images of the front and back of a physical insurance card, include two instances of the Supporting Image extension on the Coverage resource. Use the label sub-extension to identify which side of the card the image represents and the description sub-extension to provide accessible text describing the image content.

Example: Front and back card images using inline Attachments

{
  "resourceType": "Coverage",
  "extension": [
    {
      "extension": [
        {
          "url": "label",
          "valueString": "Front of insurance card"
        },
        {
          "url": "description",
          "valueString": "Image of the front of the member's physical insurance card showing plan name, member ID, and group number"
        },
        {
          "url": "image",
          "valueAttachment": {
            "contentType": "image/jpeg",
            "data": "<base64-encoded image data>"
          }
        }
      ],
      "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
    },
    {
      "extension": [
        {
          "url": "label",
          "valueString": "Back of insurance card"
        },
        {
          "url": "description",
          "valueString": "Image of the back of the member's physical insurance card showing claims address, customer service numbers, and pharmacy information"
        },
        {
          "url": "image",
          "valueAttachment": {
            "contentType": "image/jpeg",
            "data": "<base64-encoded image data>"
          }
        }
      ],
      "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
    }
  ]
}

Guidance

• The extension is repeatable (0..*) on the Coverage resource, allowing multiple images to be attached.
• When providing card images, use descriptive label values such as "Front of insurance card" and "Back of insurance card" so that consuming applications can display them appropriately.
• The description sub-extension SHOULD contain sufficient detail for accessibility purposes (e.g., screen readers). Describe the key information visible on the card image.
• When providing inline image data, the contentType and data elements of the Attachment are required. Common content types include image/jpeg and image/png.
• Alternatively, the image may be provided as a reference to a DocumentReference resource if the payer prefers not to embed the image data inline.
• This extension may also be used for other supporting images beyond card front/back, such as images that communicate the type of coverage provided or partner logos.

• Text Summary
• Differential Table
• Snapshot Table
• All

This structure is derived from Extension

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..*	Extension	Supporting image
extension		3..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:description		1..1	Extension	Extension
extension		0..0		Extension
url		1..1	uri	"description"
value[x]		0..1	string	Value of extension
extension:image		1..1	Extension	Extension
extension		0..0		Extension
url		1..1	uri	"image"
Slices for value[x]		0..1		Value of extension Slice: Unordered, Open by type:$this
valueAttachment			Attachment
valueReference			Reference(DocumentReference)
value[x]:valueAttachment		0..1	Attachment	Value of extension
contentType		1..1	code	Mime type of the content, with charset etc.
data		1..1	base64Binary	Data inline, base64ed
value[x]:valueReference		0..1	Reference(DocumentReference)	Value of extension
reference		1..1	string	Literal reference, Relative, internal or absolute URL
extension:label		1..1	Extension	Extension
extension		0..0		Extension
url		1..1	uri	"label"
value[x]		0..1	string	Value of extension
url		1..1	uri	"http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
value[x]		0..0		Value of extension
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..*	Extension	Supporting image
id		0..1	string	Unique id for inter-element referencing
Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
extension:description		1..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"description"
value[x]		0..1	string	Value of extension
extension:image		1..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"image"
Slices for value[x]		0..1		Value of extension Slice: Unordered, Closed by type:$this
valueAttachment			Attachment
valueReference			Reference(DocumentReference)
value[x]:valueAttachment		0..1	Attachment	Value of extension
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	Σ	1..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding Example General: en-AU
data		1..1	base64Binary	Data inline, base64ed
url	Σ	0..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size	Σ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	Σ	0..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	Σ	0..1	dateTime	Date attachment was first created
value[x]:valueReference		0..1	Reference(DocumentReference)	Value of extension
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
extension:label		1..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"label"
value[x]		0..1	string	Value of extension
url		1..1	uri	"http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: This extension enables payers to provide other supporting images found on a member's physicial insurance card. A supporting image may be displayed by consuming applications when rendering the coverage information for use by the health plan member. These images may communicate additional information to the member such as the type of coverage provided or partner logos. The extension also allows for the health plan to provide a Label for the image which can be displayed in the consuming application as well as a Description of the content in the image file. Detailed descriptions are encouraged to assist with accessibility.

• description: string: An Extension
• image: Attachment, Reference: An Extension
• label: string: An Extension

Maturity: 2

Differential View

This structure is derived from Extension

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..*	Extension	Supporting image
extension		3..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:description		1..1	Extension	Extension
extension		0..0		Extension
url		1..1	uri	"description"
value[x]		0..1	string	Value of extension
extension:image		1..1	Extension	Extension
extension		0..0		Extension
url		1..1	uri	"image"
Slices for value[x]		0..1		Value of extension Slice: Unordered, Open by type:$this
valueAttachment			Attachment
valueReference			Reference(DocumentReference)
value[x]:valueAttachment		0..1	Attachment	Value of extension
contentType		1..1	code	Mime type of the content, with charset etc.
data		1..1	base64Binary	Data inline, base64ed
value[x]:valueReference		0..1	Reference(DocumentReference)	Value of extension
reference		1..1	string	Literal reference, Relative, internal or absolute URL
extension:label		1..1	Extension	Extension
extension		0..0		Extension
url		1..1	uri	"label"
value[x]		0..1	string	Value of extension
url		1..1	uri	"http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
value[x]		0..0		Value of extension
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..*	Extension	Supporting image
id		0..1	string	Unique id for inter-element referencing
Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
extension:description		1..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"description"
value[x]		0..1	string	Value of extension
extension:image		1..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"image"
Slices for value[x]		0..1		Value of extension Slice: Unordered, Closed by type:$this
valueAttachment			Attachment
valueReference			Reference(DocumentReference)
value[x]:valueAttachment		0..1	Attachment	Value of extension
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	Σ	1..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding Example General: en-AU
data		1..1	base64Binary	Data inline, base64ed
url	Σ	0..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size	Σ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	Σ	0..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	Σ	0..1	dateTime	Date attachment was first created
value[x]:valueReference		0..1	Reference(DocumentReference)	Value of extension
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
extension:label		1..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"label"
value[x]		0..1	string	Value of extension
url		1..1	uri	"http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-SupportingImage-extension"
Documentation for this format