DaVinci PDEX Plan Net
0.3.0 - STU1

DaVinci PDEX Plan Net, published by HL7 Financial Management Working Group. This is not an authorized publication; it is the continuous build for version 0.3.0). This version is based on the current content of https://github.com/HL7/davinci-pdex-plan-net/ and changes regularly. See the Directory of published versions

Resource Profile: PlannetNetwork

A Network refers to a healthcare provider insurance network. A healthcare provider insurance network is an aggregation of organizations and individuals that deliver a set of services across a geography through health insurance products/plans. A network is typically owned by a payer.

In the PlanNet IG, individuals and organizations are represented as participants in a PLan-Net Network through the practitionerRole and Plan-Net-organizationAffiliation resources, respectively.

Guidance: When the contact is a department name, rather than a human (e.g., patient help line), include a blank family and given name, and provide the department name in contact.nae.text

The official URL for this profile is:

http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Network

Implementation Guidance

  • When the contact is a department name, rather than a human (e.g., patient help line), include a blank family and given name, and provide the department name in contact.name.text.
  • Note that the relationship between InsurancePlans and Networks is many-to-many. A plan may be associated with multiple networks, and a network may be associated with many plans. In this IG, this i s modeled by having InsurancePlans reference networks (directionality of relationship supports this).

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Organization

NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization 0..*OrganizationA grouping of people or organizations with a common purpose
... meta
.... lastUpdated 1..1instantWhen the resource version last changed
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... location-reference S0..*Reference()Location Reference
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/location-reference
.... id S0..1stringUnique id for inter-element referencing
.... use S0..1codeusual | official | temp | secondary | old (If known)
.... type S0..1CodeableConceptDescription of identifier
.... system S0..1uriThe namespace for the identifier value
.... value S0..1stringThe value that is unique
.... period S0..1PeriodTime period when id is/was valid for use
.... assigner S0..1Reference(Organization)Organization that issued id (may be just text)
... active S1..1booleanWhether the organization's record is still in active use
Fixed Value: true
... type S0..*CodeableConceptKind of organization
Binding: Organization Type (required)
Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/OrgTypeCS
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: payer
... name S0..1stringName used for the organization
... alias S0..*stringA list of alternate names that the organization is known as, or was known as in the past
... telecom 0..0
... address S0..1AddressAn address for the organization
... partOf S1..1Reference(Plan-net Organization)The organization of which this organization forms a part
... contact S0..*BackboneElementContact for the organization for a certain purpose
.... name S0..1HumanNameA name associated with the contact
..... use S0..1codeusual | official | temp | nickname | anonymous | old | maiden
..... text S0..1stringText representation of the full name
..... family S0..1stringFamily name (often called 'Surname')
..... given S0..*stringGiven names (not always 'first'). Includes middle names
..... prefix S0..*stringParts that come before the name
..... suffix S0..*stringParts that come after the name
..... period S0..1PeriodTime period when name was/is in use
.... telecom S0..*ContactPointContact details (telephone, email, etc.) for a contact
..... contactpoint-availabletime S0..*(Complex)Extension
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/contactpoint-availabletime
..... via-intermediary S0..*Reference(Plan-net PractitionerRole | Plan-net OrganizationAffiliation | Plan-net Location | Plan-net Organization)Via Intermediary
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/via-intermediary
..... system S0..1codephone | fax | email | pager | url | sms | other
..... value S0..1stringThe actual contact point details
..... use S0..1codehome | work | temp | old | mobile - purpose of this contact point
..... period S0..1PeriodTime period when the contact point was/is in use
... endpoint S0..*Reference(Plan-net Endpoint)Technical endpoints providing access to services operated for the organization

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization I0..*OrganizationA grouping of people or organizations with a common purpose
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId ΣI0..1idVersion specific identifier
.... lastUpdated ΣI1..1instantWhen the resource version last changed
.... source ΣI0..1uriIdentifies where the resource comes from
.... profile ΣI0..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security ΣI0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible)
.... tag ΣI0..*CodingTags applied to this resource
Binding: CommonTags (example)
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
... location-reference SI0..*Reference()Location Reference
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/location-reference
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierIdentifies this organization across multiple systems
.... id S0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!SΣI0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
.... type SΣI0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
.... system SΣI0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣI0..1stringThe value that is unique
Example General: 123456
.... period SΣI0..1PeriodTime period when id is/was valid for use
.... assigner SΣI0..1Reference(Organization)Organization that issued id (may be just text)
... active ?!SΣI1..1booleanWhether the organization's record is still in active use
Fixed Value: true
... type SΣI0..*CodeableConceptKind of organization
Binding: Organization Type (required)

Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/OrgTypeCS
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: payer
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... name SΣI0..1stringName used for the organization
... alias SI0..*stringA list of alternate names that the organization is known as, or was known as in the past
... address SI0..1AddressAn address for the organization
... partOf SΣI1..1Reference(Plan-net Organization)The organization of which this organization forms a part
... contact SI0..*BackboneElementContact for the organization for a certain purpose
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... purpose I0..1CodeableConceptThe type of contact
Binding: ContactEntityType (extensible)
.... name SI0..1HumanNameA name associated with the contact
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣI0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required)
..... text SΣI0..1stringText representation of the full name
..... family SΣI0..1stringFamily name (often called 'Surname')
..... given SΣI0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
..... prefix SΣI0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
..... suffix SΣI0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
..... period SΣI0..1PeriodTime period when name was/is in use
.... telecom SI0..*ContactPointContact details (telephone, email, etc.) for a contact
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... contactpoint-availabletime SI0..*(Complex)Optional Extensions Element
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/contactpoint-availabletime
..... via-intermediary SI0..*Reference(Plan-net PractitionerRole | Plan-net OrganizationAffiliation | Plan-net Location | Plan-net Organization)Via Intermediary
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/via-intermediary
..... system SΣI0..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required)
..... value SΣI0..1stringThe actual contact point details
..... use ?!SΣI0..1codehome | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required)
..... rank ΣI0..1positiveIntSpecify preferred order of use (1 = highest)
..... period SΣI0..1PeriodTime period when the contact point was/is in use
.... address I0..1AddressVisiting or postal addresses for the contact
... endpoint SI0..*Reference(Plan-net Endpoint)Technical endpoints providing access to services operated for the organization

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization I0..*OrganizationA grouping of people or organizations with a common purpose
... location-reference I0..*Reference()Location Reference
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/location-reference
... identifier ΣI0..*IdentifierIdentifies this organization across multiple systems
.... id 0..1stringUnique id for inter-element referencing
.... use ?!ΣI0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
.... type ΣI0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
.... system ΣI0..1uriThe namespace for the identifier value
.... value ΣI0..1stringThe value that is unique
.... period ΣI0..1PeriodTime period when id is/was valid for use
.... assigner ΣI0..1Reference(Organization)Organization that issued id (may be just text)
... active ?!ΣI1..1booleanWhether the organization's record is still in active use
Fixed Value: true
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/OrgTypeCS
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: payer
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... name ΣI0..1stringName used for the organization
... alias I0..*stringA list of alternate names that the organization is known as, or was known as in the past
... address I0..1AddressAn address for the organization
... partOf ΣI1..1Reference(Plan-net Organization)The organization of which this organization forms a part
... contact I0..*BackboneElementContact for the organization for a certain purpose
.... name I0..1HumanNameA name associated with the contact
..... use ?!ΣI0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required)
..... text ΣI0..1stringText representation of the full name
..... family ΣI0..1stringFamily name (often called 'Surname')
..... given ΣI0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
..... prefix ΣI0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
..... suffix ΣI0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
..... period ΣI0..1PeriodTime period when name was/is in use
.... telecom I0..*ContactPointContact details (telephone, email, etc.) for a contact
..... contactpoint-availabletime I0..*(Complex)Optional Extensions Element
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/contactpoint-availabletime
..... via-intermediary I0..*Reference(Plan-net PractitionerRole | Plan-net OrganizationAffiliation | Plan-net Location | Plan-net Organization)Via Intermediary
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/via-intermediary
..... system ΣI0..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required)
..... value ΣI0..1stringThe actual contact point details
..... use ?!ΣI0..1codehome | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required)
..... period ΣI0..1PeriodTime period when the contact point was/is in use
... endpoint I0..*Reference(Plan-net Endpoint)Technical endpoints providing access to services operated for the organization

doco Documentation for this format

Differential View

This structure is derived from Organization

NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization 0..*OrganizationA grouping of people or organizations with a common purpose
... meta
.... lastUpdated 1..1instantWhen the resource version last changed
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... location-reference S0..*Reference()Location Reference
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/location-reference
.... id S0..1stringUnique id for inter-element referencing
.... use S0..1codeusual | official | temp | secondary | old (If known)
.... type S0..1CodeableConceptDescription of identifier
.... system S0..1uriThe namespace for the identifier value
.... value S0..1stringThe value that is unique
.... period S0..1PeriodTime period when id is/was valid for use
.... assigner S0..1Reference(Organization)Organization that issued id (may be just text)
... active S1..1booleanWhether the organization's record is still in active use
Fixed Value: true
... type S0..*CodeableConceptKind of organization
Binding: Organization Type (required)
Required Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/OrgTypeCS
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: payer
... name S0..1stringName used for the organization
... alias S0..*stringA list of alternate names that the organization is known as, or was known as in the past
... telecom 0..0
... address S0..1AddressAn address for the organization
... partOf S1..1Reference(Plan-net Organization)The organization of which this organization forms a part
... contact S0..*BackboneElementContact for the organization for a certain purpose
.... name S0..1HumanNameA name associated with the contact
..... use S0..1codeusual | official | temp | nickname | anonymous | old | maiden
..... text S0..1stringText representation of the full name
..... family S0..1stringFamily name (often called 'Surname')
..... given S0..*stringGiven names (not always 'first'). Includes middle names
..... prefix S0..*stringParts that come before the name
..... suffix S0..*stringParts that come after the name
..... period S0..1PeriodTime period when name was/is in use
.... telecom S0..*ContactPointContact details (telephone, email, etc.) for a contact
..... contactpoint-availabletime S0..*(Complex)Extension
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/contactpoint-availabletime
..... via-intermediary S0..*Reference(Plan-net PractitionerRole | Plan-net OrganizationAffiliation | Plan-net Location | Plan-net Organization)Via Intermediary
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/via-intermediary
..... system S0..1codephone | fax | email | pager | url | sms | other
..... value S0..1stringThe actual contact point details
..... use S0..1codehome | work | temp | old | mobile - purpose of this contact point
..... period S0..1PeriodTime period when the contact point was/is in use
... endpoint S0..*Reference(Plan-net Endpoint)Technical endpoints providing access to services operated for the organization

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization I0..*OrganizationA grouping of people or organizations with a common purpose
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId ΣI0..1idVersion specific identifier
.... lastUpdated ΣI1..1instantWhen the resource version last changed
.... source ΣI0..1uriIdentifies where the resource comes from
.... profile ΣI0..*canonical(StructureDefinition)Profiles this resource claims to conform to
.... security ΣI0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible)
.... tag ΣI0..*CodingTags applied to this resource
Binding: CommonTags (example)
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
... location-reference SI0..*Reference()Location Reference
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/location-reference
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierIdentifies this organization across multiple systems
.... id S0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!SΣI0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
.... type SΣI0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
.... system SΣI0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value SΣI0..1stringThe value that is unique
Example General: 123456
.... period SΣI0..1PeriodTime period when id is/was valid for use
.... assigner SΣI0..1Reference(Organization)Organization that issued id (may be just text)
... active ?!SΣI1..1booleanWhether the organization's record is still in active use
Fixed Value: true
... type SΣI0..*CodeableConceptKind of organization
Binding: Organization Type (required)

Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/OrgTypeCS
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: payer
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... name SΣI0..1stringName used for the organization
... alias SI0..*stringA list of alternate names that the organization is known as, or was known as in the past
... address SI0..1AddressAn address for the organization
... partOf SΣI1..1Reference(Plan-net Organization)The organization of which this organization forms a part
... contact SI0..*BackboneElementContact for the organization for a certain purpose
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... purpose I0..1CodeableConceptThe type of contact
Binding: ContactEntityType (extensible)
.... name SI0..1HumanNameA name associated with the contact
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!SΣI0..1codeusual | official | temp | nickname | anonymous | old | maiden
Binding: NameUse (required)
..... text SΣI0..1stringText representation of the full name
..... family SΣI0..1stringFamily name (often called 'Surname')
..... given SΣI0..*stringGiven names (not always 'first'). Includes middle names
This repeating element order: Given Names appear in the correct order for presenting the name
..... prefix SΣI0..*stringParts that come before the name
This repeating element order: Prefixes appear in the correct order for presenting the name
..... suffix SΣI0..*stringParts that come after the name
This repeating element order: Suffixes appear in the correct order for presenting the name
..... period SΣI0..1PeriodTime period when name was/is in use
.... telecom SI0..*ContactPointContact details (telephone, email, etc.) for a contact
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... contactpoint-availabletime SI0..*(Complex)Optional Extensions Element
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/contactpoint-availabletime
..... via-intermediary SI0..*Reference(Plan-net PractitionerRole | Plan-net OrganizationAffiliation | Plan-net Location | Plan-net Organization)Via Intermediary
URL: http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/via-intermediary
..... system SΣI0..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required)
..... value SΣI0..1stringThe actual contact point details
..... use ?!SΣI0..1codehome | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required)
..... rank ΣI0..1positiveIntSpecify preferred order of use (1 = highest)
..... period SΣI0..1PeriodTime period when the contact point was/is in use
.... address I0..1AddressVisiting or postal addresses for the contact
... endpoint SI0..*Reference(Plan-net Endpoint)Technical endpoints providing access to services operated for the organization

doco Documentation for this format

 

Other representations of profile: Schematron

Terminology Bindings

PathConformanceValueSet / Code
Organization.meta.securityextensibleAll Security Labels
Organization.meta.tagexampleCommonTags
Organization.languagepreferredCommonLanguages
Max Binding: AllLanguages
Organization.identifier.userequiredIdentifierUse
Organization.identifier.typeextensibleIdentifier Type Codes
Organization.typerequiredPattern: payer
Organization.contact.purposeextensibleContactEntityType
Organization.contact.name.userequiredNameUse
Organization.contact.telecom.systemrequiredContactPointSystem
Organization.contact.telecom.userequiredContactPointUse