Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions
Mappings for the davinci-pct-coverage resource profile.
| Name | Workflow Pattern | RIM Mapping | FiveWs Pattern Mapping | Canadian Dental Association eclaims standard | HL7 v2 Mapping | Canadian Pharmacy Associaiton eclaims standard |
 Coverage |
Event |
Coverage |
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  Coverage / id |
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  Coverage / meta |
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  Coverage / implicitRules |
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  Coverage / language |
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  Coverage / text |
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Act.text? |
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  Coverage / contained |
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N/A |
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  Coverage / Slices for extension |
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   Coverage / Slices for extension / extension:coverage-kind |
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    Coverage / Slices for extension / extension:coverage-kind / id |
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n/a |
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    Coverage / Slices for extension / extension:coverage-kind / extension |
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    Coverage / Slices for extension / extension:coverage-kind / url |
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N/A |
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    Coverage / Slices for extension / extension:coverage-kind / value[x] |
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N/A |
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   Coverage / Slices for extension / extension:self-pay-declared |
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  Coverage / modifierExtension |
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N/A |
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  Coverage / Slices for identifier |
Event.identifier |
.id |
FiveWs.identifier |
C02 |
IN1-2 |
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   Coverage / Slices for identifier / identifier:memberid |
Event.identifier |
.id |
FiveWs.identifier |
C02 |
IN1-2 |
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    Coverage / Slices for identifier / identifier:memberid / id |
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n/a |
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    Coverage / Slices for identifier / identifier:memberid / extension |
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n/a |
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    Coverage / Slices for identifier / identifier:memberid / use |
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Role.code or implied by context |
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N/A |
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    Coverage / Slices for identifier / identifier:memberid / type |
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Role.code or implied by context |
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CX.5 |
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    Coverage / Slices for identifier / identifier:memberid / system |
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II.root or Role.id.root |
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CX.4 / EI-2-4 |
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    Coverage / Slices for identifier / identifier:memberid / value |
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II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root) |
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CX.1 / EI.1 |
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    Coverage / Slices for identifier / identifier:memberid / period |
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Role.effectiveTime or implied by context |
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CX.7 + CX.8 |
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    Coverage / Slices for identifier / identifier:memberid / assigner |
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II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper |
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  Coverage / status |
Event.status |
Act.status |
FiveWs.status |
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  Coverage / type |
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FiveWs.class |
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IN1-15 |
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  Coverage / policyHolder |
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FiveWs.subject |
D01 through D09 |
- IN1-16
- 18
- 19-name of insured
- address
- date of birth
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C.35 |
  Coverage / subscriber |
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FiveWs.subject |
D01 through D09 |
- IN1-16
- 18
- 19-name of insured
- address
- date of birth
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C.35 |
   Coverage / subscriber / id |
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n/a |
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   Coverage / subscriber / extension |
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n/a |
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   Coverage / subscriber / reference |
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N/A |
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   Coverage / subscriber / type |
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N/A |
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   Coverage / subscriber / identifier |
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.identifier |
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   Coverage / subscriber / display |
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N/A |
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  Coverage / subscriberId |
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FiveWs.subject |
D01 through D09 |
- IN1-16
- 18
- 19-name of insured
- address
- date of birth
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C.35 |
   Coverage / subscriberId / id |
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   Coverage / subscriberId / Slices for extension |
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    Coverage / subscriberId / Slices for extension / extension:dataAbsentReason |
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ANY.nullFlavor |
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     Coverage / subscriberId / Slices for extension / extension:dataAbsentReason / id |
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n/a |
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     Coverage / subscriberId / Slices for extension / extension:dataAbsentReason / extension |
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     Coverage / subscriberId / Slices for extension / extension:dataAbsentReason / url |
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N/A |
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     Coverage / subscriberId / Slices for extension / extension:dataAbsentReason / value[x] |
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N/A |
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   Coverage / subscriberId / value |
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  Coverage / beneficiary |
Event.subject |
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FiveWs.subject |
D01 through D09 |
- IN1-16
- 18
- 19-name of insured
- address
- date of birth
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C.35 |
  Coverage / dependent |
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C17 |
- No exact HL7 v2 equivalent concept seems to exist; |
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  Coverage / relationship |
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C03 |
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  Coverage / period |
Event.occurrence[x] |
Act.effectiveTime |
FiveWs.done[x] |
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IN1-12 / IN1-13 |
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  Coverage / payor |
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FiveWs.author |
A05 |
IN1-3 |
C.30 |
  Coverage / Slices for class |
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   Coverage / Slices for class / class:All Slices |
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    Coverage / Slices for class / class:All Slices / id |
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n/a |
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    Coverage / Slices for class / class:All Slices / extension |
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n/a |
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    Coverage / Slices for class / class:All Slices / modifierExtension |
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N/A |
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    Coverage / Slices for class / class:All Slices / type |
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    Coverage / Slices for class / class:All Slices / value |
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IN1-8 |
C.31 |
    Coverage / Slices for class / class:All Slices / name |
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IN1-8 |
C.31 |
   Coverage / Slices for class / class:group |
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    Coverage / Slices for class / class:group / id |
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n/a |
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    Coverage / Slices for class / class:group / extension |
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n/a |
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    Coverage / Slices for class / class:group / modifierExtension |
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N/A |
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    Coverage / Slices for class / class:group / type |
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    Coverage / Slices for class / class:group / value |
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IN1-8 |
C.31 |
    Coverage / Slices for class / class:group / name |
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IN1-8 |
C.31 |
   Coverage / Slices for class / class:plan |
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    Coverage / Slices for class / class:plan / id |
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n/a |
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    Coverage / Slices for class / class:plan / extension |
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n/a |
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    Coverage / Slices for class / class:plan / modifierExtension |
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N/A |
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    Coverage / Slices for class / class:plan / type |
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    Coverage / Slices for class / class:plan / value |
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IN1-8 |
C.31 |
    Coverage / Slices for class / class:plan / name |
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IN1-8 |
C.31 |
  Coverage / order |
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- No exact HL7 v2 equivalent concept seems to exist; |
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  Coverage / network |
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D10 |
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  Coverage / costToBeneficiary |
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   Coverage / costToBeneficiary / id |
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n/a |
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   Coverage / costToBeneficiary / extension |
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n/a |
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   Coverage / costToBeneficiary / modifierExtension |
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N/A |
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   Coverage / costToBeneficiary / type |
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   Coverage / costToBeneficiary / value[x] |
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IN1-8 |
C.31 |
   Coverage / costToBeneficiary / exception |
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    Coverage / costToBeneficiary / exception / id |
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n/a |
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    Coverage / costToBeneficiary / exception / extension |
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n/a |
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    Coverage / costToBeneficiary / exception / modifierExtension |
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N/A |
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    Coverage / costToBeneficiary / exception / type |
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    Coverage / costToBeneficiary / exception / period |
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  Coverage / subrogation |
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  Coverage / contract |
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n/a |
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D01 through D09 |
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C.35 |
Documentation for this format |