This is the set of resources that conform to both RTPBC Coverage (http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-coverage) and RTPBC Coverage (http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-coverage).
Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||
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![]() ![]() | 0..* | Insurance or medical plan or a payment agreement | ||||||
![]() ![]() ![]() | Σ | 0..1 | Meta | Metadata about the resource | ||||
![]() ![]() ![]() | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() ![]() | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
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![]() ![]() ![]() | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
![]() ![]() ![]() | 0..* | Resource | Contained, inline Resources | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]() ![]() | Σ | 0..* | Identifier | Business Identifier for the coverage | ||||
![]() ![]() ![]() | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | ||||
![]() ![]() ![]() | Σ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. | ||||
![]() ![]() ![]() | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | ||||
![]() ![]() ![]() | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | ||||
![]() ![]() ![]() | SΣ | 0..1 | string | Health Plan Cardholder ID | ||||
![]() ![]() ![]() | SΣ | 1..1 | Reference(Patient) | Plan beneficiary | ||||
![]() ![]() ![]() | Σ | 0..1 | string | Dependent number | ||||
![]() ![]() ![]() | 0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | |||||
![]() ![]() ![]() | Σ | 0..1 | Period | Coverage start and end dates | ||||
![]() ![]() ![]() | SΣ | 1..1 | Reference(Organization | Patient | RelatedPerson) | Payer ID | ||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() | Σ | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||
![]() ![]() ![]() ![]() | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model). | ||||
![]() ![]() ![]() ![]() | SΣ | 0..1 | Identifier | Payer ID | ||||
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: ?? (required): Identifies the purpose for this identifier, if known . | ||||
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | CodeableConcept | Description of identifier Binding: ?? (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | ||||
![]() ![]() ![]() ![]() ![]() | SΣ | 1..1 | string | Payer ID Value Example General: 123456 | ||||
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
![]() ![]() ![]() ![]() ![]() | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
![]() ![]() ![]() ![]() | Σ | 0..1 | string | Text alternative for the resource | ||||
![]() ![]() ![]() | S | 0..* | BackboneElement | Pharmacy coverage identifiers | ||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible): Coverage Class Codes | ||||
![]() ![]() ![]() ![]() | Σ | 1..1 | string | Value associated with the type | ||||
![]() ![]() ![]() ![]() | Σ | 0..1 | string | Human readable description of the type and value | ||||
![]() ![]() ![]() | Σ | 0..1 | positiveInt | Relative order of the coverage | ||||
![]() ![]() ![]() | Σ | 0..1 | string | Insurer network | ||||
![]() ![]() ![]() | 0..* | BackboneElement | Patient payments for services/products | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified. | ||||
![]() ![]() ![]() ![]() | Σ | 1..1 | The amount or percentage due from the beneficiary | |||||
![]() ![]() ![]() ![]() ![]() | Quantity(SimpleQuantity | ?gen-e2?) | |||||||
![]() ![]() ![]() ![]() ![]() | Money(SimpleQuantity) | |||||||
![]() ![]() ![]() ![]() | 0..* | BackboneElement | Exceptions for patient payments | |||||
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() | 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 | 0..1 | Period | The effective period of the exception | ||||
![]() ![]() ![]() | 0..1 | boolean | Reimbursement to insurer | |||||
![]() ![]() ![]() | 0..* | Reference(Contract) | Contract details | |||||
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