Intersection 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 both 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).

Structure

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage C0..*Insurance or medical plan or a payment agreement
Constraints: hrex-cov-1
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: ?? (preferred): A human language.
Additional BindingsPurpose
??Max Binding
... 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
... contained 0..*ResourceContained, inline Resources
... extension 1..*Extensionleft: Additional content defined by implementations; right: Extension
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier SΣ0..1Identifierleft: Also known as Member identifier; right: Member ID and other identifiers
... status ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
Binding: ?? (required): A code specifying the state of the resource instance.
... type SΣ0..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): US Public Health Data Consortium Source of Payment Codes
... policyHolder Σ0..1Reference(US Core Patient Profile | HRex Organization Profile | RelatedPerson)Owner of the policy
... subscriber Σ0..1Reference(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.
.... extension 0..*ExtensionAdditional content defined by implementations
.... reference Σ0..1stringLiteral reference, Relative, internal or absolute URL
.... type Σ0..1uriType the reference refers to (e.g. "Patient")
Binding: ?? (extensible): Aa resource (or, for logical models, the URI of the logical model).
.... identifier Σ0..1IdentifierLogical reference, when literal reference is not known
.... display Σ1..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.
... subscriberId SΣ1..1stringleft: Subscriber ID; right: ID assigned to the subscriber
... beneficiary SΣ1..1Reference(HRex Patient Demographics | #sd-hrex-patient-demographics-us-core-patient)left: Plan beneficiary; right: Patient or Plan Beneficiary
... dependent SΣ0..1stringDependent number
... relationship S1..1CodeableConceptBeneficiary relationship to the subscriber
Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
... period SΣ1..1PeriodCoverage start and end dates
... payor SΣ1..1left: 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
... class S1..*BackboneElementAdditional coverage classifications
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type Σ1..1CodeableConceptType of class such as 'group' or 'plan'
Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc.
.... value Σ1..1stringValue associated with the type
.... name Σ1..1stringHuman readable description of the type and value
... order Σ0..1positiveIntRelative order of the coverage
... network Σ0..1stringInsurer network
... costToBeneficiary 0..*BackboneElementPatient payments for services/products
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type Σ0..1CodeableConceptCost category
Binding: ?? (required)
.... value[x] Σ1..1The amount or percentage due from the beneficiary
..... valueQuantityQuantity(SimpleQuantity | ?gen-e2?)
..... valueMoneyMoney(SimpleQuantity)
.... exception 0..*BackboneElementExceptions for patient payments
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type Σ1..1CodeableConceptException category
Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays.
..... period Σ0..1PeriodThe effective period of the exception
... subrogation 0..1booleanReimbursement to insurer
... contract 0..*Reference(Contract)Contract details

doco Documentation for this format