Union of http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage and http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage

This is the set of resources that conform to either of the profiles PCT Coverage (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage) and PCT Coverage (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage). E.g. what you have to deal with if you get resources conforming to one of them

Structure

NameFlagsCard.TypeDescription & Constraints    Filter: doco
Coverage C0..*Insurance or medical plan or a payment agreement
Constraints: hrex-cov-1
Coverage.meta This element is included in summaries. 0..1MetaMetadata about the resource
Coverage.implicitRules This element is a modifier element. This element is included in summaries. 0..1uriA set of rules under which this content was created
Coverage.language 0..1codeLanguage of the resource content
Binding: ?? (preferred): A human language.
Coverage.text 0..1NarrativeText summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Coverage.contained 0..*ResourceContained, inline Resources
Coverage.extension 0..*Extensionleft: Additional content defined by implementations; right: Extension
Coverage.modifierExtension This element is a modifier element. 0..*ExtensionExtensions that cannot be ignored
Coverage.identifier This element must be supported. This element is included in summaries. 0..*Identifierleft: Also known as Member identifier; right: Member ID and other identifiers
Coverage.identifier.extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
Coverage.identifier.use This element is a modifier element. This element is included in summaries. 0..1codeusual | official | temp | secondary | old (If known)
Binding: ?? (required): Identifies the purpose for this identifier, if known .
Coverage.identifier.type This element is included in summaries. 0..1CodeableConceptDescription of identifier
Binding: ?? (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Coverage.identifier.system This element is included in summaries. 0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
Coverage.identifier.value This element must be supported. This element is included in summaries. 1..1stringThe value that is unique within the system.
Example General: 123456
Coverage.identifier.period This element is included in summaries. 0..1PeriodTime period when id is/was valid for use
Coverage.identifier.assigner This element is included in summaries. 0..1Reference(Organization)Organization that issued id (may be just text)
Coverage.status This element is a modifier element. This element must be supported. This element is included in summaries. 1..1codeactive | cancelled | draft | entered-in-error
Binding: ?? (required): A code specifying the state of the resource instance.
Coverage.type This element must be supported. This element is included in summaries. 0..1CodeableConceptleft: Coverage category such as medical or accident; right: Coverage category such as medical or accident. A coverage.type of `81` (Self-pay) MAY be used to imply that the patient has no coverage or that an individual or organization other than an insurer is taking responsibility for payment for a portion of the health care costs.
Binding: ?? (extensible): left: The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.; right: US Public Health Data Consortium Source of Payment Codes
Coverage.policyHolder This element is included in summaries. 0..1Reference(Patient | RelatedPerson | Organization)Owner of the policy
Coverage.subscriber This element is included in summaries. 0..1Reference(Patient | RelatedPerson)Required if subscriber is a person that is not the beneficiary. When date of birth or gender are not known, omit Patient.birthDate and set Patient.gender to unknown.
Coverage.subscriber.extension 0..*ExtensionAdditional content defined by implementations
Coverage.subscriber.reference This element is included in summaries. 0..1stringLiteral reference, Relative, internal or absolute URL
Coverage.subscriber.type This element is included in summaries. 0..1uriType the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).
Coverage.subscriber.identifier This element is included in summaries. 0..1IdentifierLogical reference, when literal reference is not known
Coverage.subscriber.display This element is included in summaries. 0..1stringleft: Provide the name of the subscriber in Coverage.subscriber.display concatenating the subscriber’s prefix, given name, family name and suffix (in this order), each separated by a single space. If discrete name parts are required, a Patient resource SHALL be pointed to in Coverage.subscriber.reference.; right: Provide the name of the subscriber in Coverage.subscriber.display concatenating the subscriber's prefix, given name, family name and suffix (in this order), each separated by a single space. If discrete name parts are required, a Patient resource SHALL be pointed to in Coverage.subscriber.reference.
Coverage.subscriberId This element must be supported. This element is included in summaries. 1..1stringleft: Subscriber ID; right: ID assigned to the subscriber
Coverage.subscriberId.extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
Coverage.subscriberId.value 0..1stringPrimitive value for string
Max Length:1048576
Coverage.beneficiary This element must be supported. This element is included in summaries. 1..1Reference(HRex Patient Demographics | #sd-202-hrex-patient-demographics-us-core-patient)left: Plan beneficiary; right: Patient or Plan Beneficiary
Coverage.dependent This element must be supported. This element is included in summaries. 0..1stringDependent number
Coverage.relationship This element must be supported. 1..1CodeableConceptBeneficiary relationship to the subscriber
Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
Coverage.period This element must be supported. This element is included in summaries. 0..1PeriodCoverage start and end dates
Coverage.payor This element must be supported. This element is included in summaries. 1..1Reference(PCT Organization), Reference(PCT Organization | http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0 | http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson|7.0.0)left: Issuer of the policy; right: Issuer of the policy. For Self-pay or uninsured this should be a reference to a patient or related person resource
Coverage.class This element must be supported. 0..*BackboneElementAdditional coverage classifications
Coverage.class.extension 0..*ExtensionAdditional content defined by implementations
Coverage.class.modifierExtension This element is a modifier element. This element is included in summaries. 0..*ExtensionExtensions that cannot be ignored even if unrecognized
Coverage.class.type This element is included in summaries. 1..1CodeableConceptType of class such as 'group' or 'plan'
Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc.
Coverage.class.value This element is included in summaries. 1..1stringValue associated with the type
Coverage.class.name This element is included in summaries. 1..1stringHuman readable description of the type and value
Coverage.order This element is included in summaries. 0..1positiveIntRelative order of the coverage
Coverage.network This element is included in summaries. 0..1stringInsurer network
Coverage.costToBeneficiary 0..*BackboneElementPatient payments for services/products
Coverage.costToBeneficiary.extension 0..*ExtensionAdditional content defined by implementations
Coverage.costToBeneficiary.modifierExtension This element is a modifier element. This element is included in summaries. 0..*ExtensionExtensions that cannot be ignored even if unrecognized
Coverage.costToBeneficiary.type This element is included in summaries. 0..1CodeableConceptCost category
Binding: ?? (required)
Coverage.costToBeneficiary.value[x] This element is included in summaries. 1..1The amount or percentage due from the beneficiary
Coverage.costToBeneficiary.value[x].valueQuantityQuantity(SimpleQuantity)
Coverage.costToBeneficiary.value[x].valueMoneyMoney
Coverage.costToBeneficiary.exception 0..*BackboneElementExceptions for patient payments
Coverage.costToBeneficiary.exception.extension 0..*ExtensionAdditional content defined by implementations
Coverage.costToBeneficiary.exception.modifierExtension This element is a modifier element. This element is included in summaries. 0..*ExtensionExtensions that cannot be ignored even if unrecognized
Coverage.costToBeneficiary.exception.type This element is included in summaries. 1..1CodeableConceptException category
Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays.
Coverage.costToBeneficiary.exception.period This element is included in summaries. 0..1PeriodThe effective period of the exception
Coverage.subrogation 0..1booleanReimbursement to insurer
Coverage.contract 0..*Reference(Contract)Contract details

doco Documentation for this format