Da Vinci Payer Data Exchange
2.1.1 - STU 2.1 United States of America flag

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

: Coverage to Match Example 2 - XML Representation

Page standards status: Informative

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<Coverage xmlns="http://hl7.org/fhir">
  <id value="CoverageMatchExample2"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-coverage"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Coverage CoverageMatchExample2</b></p><a name="CoverageMatchExample2"> </a><a name="hcCoverageMatchExample2"> </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"/><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/davinci-hrex/STU1.1/StructureDefinition-hrex-coverage.html">HRex Member Match Coverage Profile</a></p></div><p><b>status</b>: Draft</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode EHPLANS}">EHPLANS</span></p><p><b>subscriber</b>: <a href="https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=http://hl7.org/fhir/us/core/Patient/patient-prov-002">Patient/patient-prov-002</a></p><p><b>subscriberId</b>: 87654321</p><p><b>beneficiary</b>: <a href="https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=http://hl7.org/fhir/us/core/Patient/patient-prov-002">Patient/patient-prov-002</a></p><p><b>relationship</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}">Self</span></p><p><b>period</b>: 2023-06-01 --&gt; 2024-05-31</p><p><b>payor</b>: Another Health Plan (Identifier: <a href="http://terminology.hl7.org/3.1.0/NamingSystem-npi.html" title="National Provider Identifier">NPI</a>/1111111111)</p><blockquote><p><b>class</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/coverage-class group}">Group</span></p><p><b>value</b>: EMPLOY-67890</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>: HMO-BASIC</p></blockquote></div>
  </text>
  <status value="draft"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <code value="EHPLANS"/>
    </coding>
  </type>
  <subscriber>
    <reference value="Patient/patient-prov-002"/>
  </subscriber>
  <subscriberId value="87654321"/>
  <beneficiary>
    <reference value="Patient/patient-prov-002"/>
  </beneficiary>
  <relationship>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
      <code value="self"/>
    </coding>
  </relationship>
  <period>
    <start value="2023-06-01"/>
    <end value="2024-05-31"/>
  </period>
  <payor>
    <identifier>
      <system value="http://hl7.org/fhir/sid/us-npi"/>
      <value value="1111111111"/>
    </identifier>
    <display value="Another Health Plan"/>
  </payor>
  <class>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
        <code value="group"/>
      </coding>
    </type>
    <value value="EMPLOY-67890"/>
  </class>
  <class>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
        <code value="plan"/>
      </coding>
    </type>
    <value value="HMO-BASIC"/>
  </class>
</Coverage>