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
Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() |
---|---|---|---|---|
![]() ![]() | C | 0..* | Insurance or medical plan or a payment agreement Constraints: hrex-cov-1 | |
![]() ![]() ![]() | 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. | |
![]() ![]() ![]() | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
![]() ![]() ![]() | 0..* | Resource | Contained, inline Resources | |
![]() ![]() ![]() | 0..* | Extension | left: Additional content defined by implementations; right: Extension | |
![]() ![]() ![]() | ?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() ![]() | SΣ | 0..1 | Identifier | Also known as Member identifier |
![]() ![]() ![]() ![]() | 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 | The value that is unique within the system. 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 | 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(US Core Patient Profile | HRex Organization Profile | RelatedPerson) | Owner of the policy |
![]() ![]() ![]() | Σ | 0..1 | Reference(US Core Patient Profile) | 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. |
![]() ![]() ![]() ![]() | 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). |
![]() ![]() ![]() ![]() | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known |
![]() ![]() ![]() ![]() | Σ | 1..1 | string | 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. |
![]() ![]() ![]() | SΣ | 1..1 | string | Subscriber ID |
![]() ![]() ![]() | SΣ | 1..1 | Reference(HRex Patient Demographics) | Plan beneficiary |
![]() ![]() ![]() | SΣ | 0..1 | string | Dependent number |
![]() ![]() ![]() | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | |
![]() ![]() ![]() | Σ | 1..1 | Period | Coverage start and end dates |
![]() ![]() ![]() | SΣ | 1..1 | Reference(PCT Organization | #sd-davinci-pct-organization-davinci-pct-organization) | Issuer of the policy |
![]() ![]() ![]() | 1..* | BackboneElement | Additional coverage classifications | |
![]() ![]() ![]() ![]() | 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): The policy classifications, eg. Group, Plan, Class, etc. |
![]() ![]() ![]() ![]() | Σ | 1..1 | string | Value associated with the type |
![]() ![]() ![]() ![]() | Σ | 1..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: ?? (required) |
![]() ![]() ![]() ![]() | Σ | 1..1 | The amount or percentage due from the beneficiary | |
![]() ![]() ![]() ![]() ![]() | Quantity(SimpleQuantity) | |||
![]() ![]() ![]() ![]() ![]() | Money | |||
![]() ![]() ![]() ![]() | 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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