## Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage vs http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-coverage

Left: | US Core Coverage Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage)
Right: | DeIdentified UDS Plus Coverage (http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-coverage)

### Messages

Error | StructureDefinition.url | Values for url differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage' vs 'http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-coverage'
Error | StructureDefinition.version | Values for version differ: '9.0.0-ballot' vs '0.1.0'
Information | StructureDefinition.name | Values for name differ: 'USCoreCoverageProfile' vs 'DeIdentifiedUDSPlusCoverage'
Information | StructureDefinition.title | Values for title differ: 'US Core Coverage Profile' vs 'DeIdentified UDS Plus Coverage'
Information | StructureDefinition.date | Values for date differ: '2023-10-17' vs '2026-03-16T10:54:28+00:00'
Information | StructureDefinition.publisher | Values for publisher differ: 'HL7 International / Cross-Group Projects' vs 'HL7 International / Cross Group Projects'
Information | StructureDefinition.short | Values for short differ: 'Insurance or medical plan or a payment agreement' vs 'UDS Plus Coverage'
Information | StructureDefinition.definition | Values for definition differ: 'Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.' vs 'The UDS+ profile is based on the **QI Core Coverage profile and establishes the core elements, extensions, vocabularies and value sets for representing Coverage for UDS+ program.'
Information | StructureDefinition.short | Values for short differ: 'Logical id of this artifact' vs 'The de-identified Coverage identifier created by the health center to send data to HRSA.'
Information | StructureDefinition.definition | Values for definition differ: 'The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.' vs 'De-dentified Coverage identifier.'
Warning | Coverage.id | Elements differ in definition for mustSupport: 'false' vs 'true'
Information | StructureDefinition.short | Values for short differ: 'Text summary of the resource, for human interpretation' vs 'Cannot include any text in the resource as part of the de-identified data.'
Information | Coverage.text | Element maximum cardinalities differ: '1' vs '0'
Information | StructureDefinition.short | Values for short differ: 'Contained, inline Resources' vs 'Cannot include any contained resources in the resource as part of the de-identified data.'
Information | Coverage.contained | Element maximum cardinalities differ: '2147483647' vs '0'
Information | StructureDefinition.short | Values for short differ: 'Additional content defined by implementations' vs 'Extension'
Information | StructureDefinition.definition | Values for definition differ: 'May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'An Extension'
Information | Coverage.extension | Element minimum cardinalities differ: '0' vs '2'
Information | StructureDefinition.short | Values for short differ: 'Member ID and other identifiers' vs 'Business Identifier for the coverage'
Warning | Coverage.identifier | Elements differ in definition for mustSupport: 'true' vs 'false'
Information | StructureDefinition.comment | Values for comment differ: 'The `Coverage.status` alone does not indicate whether an individual's coverage is terminated or that the individual is not covered. The `Coverage.period` needs to be considered as well.' vs 'This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid.'
Information | Coverage.type | Element minimum cardinalities differ: '0' vs '1'
Warning | Coverage.subscriberId | Elements differ in definition for mustSupport: 'true' vs 'false'
Information | StructureDefinition.comment | Values for comment differ: 'Relationship of the member to the person insured (subscriber)' vs 'Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others.'
Warning | Coverage.relationship | Elements differ in definition for mustSupport: 'true' vs 'false'
Information | Coverage.relationship | Element minimum cardinalities differ: '1' vs '0'
Information | StructureDefinition.comment | Values for comment differ: 'Issuer of the Policy' vs 'May provide multiple identifiers such as insurance company identifier or business identifier (BIN number). For selfpay it may provide multiple paying persons and/or organizations.'
Information | Coverage.payor | Element maximum cardinalities differ: '1' vs '2147483647'
Error | Coverage.payor | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/uds-plus/StructureDefinition/de-identified-uds-plus-patient], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization], CanonicalType[http://hl7.org/fhir/us/uds-plus/StructureDefinition/de-identified-uds-plus-relatedperson]])
Warning | Coverage.class | Elements differ in definition for mustSupport: 'true' vs 'false'

### Metadata

Name | Value | Comments
--- | --- | ---
abstract | false |
baseDefinition | http://hl7.org/fhir/StructureDefinition/Coverage |
copyright | Used by permission of HL7 International, all rights reserved Creative Commons License |  | Removed the item 'Used by permission of HL7 International, all rights reserved Creative Commons License'
date | 2023-10-17 | 2026-03-16T10:54:28+00:00 | Values Differ
description | The US Core Coverage Profile inherits from the FHIR [Coverage](https://hl7.org/fhir/R4/coverage.html) resource; refer to it for scope and usage definitions. This profile meets the requirements of the US Core Data for Interoperability (USCDI) *Health Insurance Information* Data Class. It sets minimum expectations for the Coverage resource to record, search, and fetch data related to an individual's insurance coverage for health care. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. | The UDS+ profile establishes the core elements, extensions, vocabularies and value sets for representing Coverage for UDS+ program. | Values Differ
experimental | false |
fhirVersion | 4.0.1 |
jurisdiction |  |
jurisdiction[0] | urn:iso:std:iso:3166#US |
kind | resource |
name | USCoreCoverageProfile | DeIdentifiedUDSPlusCoverage | Values Differ
publisher | HL7 International / Cross-Group Projects | HL7 International / Cross Group Projects | Values Differ
purpose |  |
status | active |
title | US Core Coverage Profile | DeIdentified UDS Plus Coverage | Values Differ
type | Coverage |
url | http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage | http://hl7.org/fhir/us/uds-plus/StructureDefinition/uds-plus-coverage | Values Differ
version | 9.0.0-ballot | 0.1.0 | Values Differ

### Structure

Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
Coverage | C | 0..* | Coverage | Insurance or medical plan or a payment agreement Constraints: us-core-15 |  | 0..* | Coverage | UDS Plus Coverage |
id | Σ | 0..1 | id | Logical id of this artifact | S Σ | 0..1 | id | The de-identified Coverage identifier created by the health center to send data to HRSA. | Elements differ in definition for mustSupport: 'false' vs 'true'
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
language |  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
|  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |  | 0..0 |  | Cannot include any text in the resource as part of the de-identified data. This profile does not constrain the narrative in regard to content, language, or traceability to data elements | Element maximum cardinalities differ: '1' vs '0'
contained |  | 0..* | Resource | Contained, inline Resources |  | 0..0 |  | Cannot include any contained resources in the resource as part of the de-identified data. | Element maximum cardinalities differ: '2147483647' vs '0'
extension |  | 0..* | Extension | Additional content defined by implementations |  | 2..* | Extension | Extension Slice: Unordered, Open by value:url | Element minimum cardinalities differ: '0' vs '2'
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored |
Slices for identifier | S Σ | 0..* | Identifier | Member ID and other identifiers Slice: Unordered, Open by value:type | Σ | 0..* | Identifier | Business Identifier for the coverage | Elements differ in definition for mustSupport: 'true' vs 'false'
status | ?!S Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | ?!S Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. Fixed Value: active |
type | S Σ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (extensible): Centers for Disease Control and Prevention National Center for Health Statistics Source of Payment Codes | S Σ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (extensible): The set of codes to be used for UDS+ reporting. | Element minimum cardinalities differ: '0' vs '1'
id |  |  |  |  |  | 0..1 | string | Unique id for inter-element referencing | Added this element
Slices for extension |  |  |  |  |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | Added this element
coding |  |  |  |  | Σ | 0..* | Coding | Code defined by a terminology system | Added this element
text |  |  |  |  | Σ | 0..0 |  | Plain text representation of the concept | Added this element
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy |
subscriber | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy |
subscriberId | S Σ C | 0..1 | string | ID assigned to the subscriber | Σ | 0..1 | string | ID assigned to the subscriber | Elements differ in definition for mustSupport: 'true' vs 'false'
beneficiary | S Σ | 1..1 | Reference(US Core Patient Profile) | Plan beneficiary | S Σ | 1..1 | Reference(De-Identified UDS Plus Patient) | Plan beneficiary |
id |  |  |  |  |  | 0..1 | string | Unique id for inter-element referencing | Added this element
Slices for extension |  |  |  |  |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | Added this element
reference |  |  |  |  | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL | Added this element
type |  |  |  |  | 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). | Added this element
identifier |  |  |  |  | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | Added this element
display |  |  |  |  | Σ | 0..0 |  | Text alternative for the resource | Added this element
dependent | Σ | 0..1 | string | Dependent number | Σ | 0..1 | string | Dependent number |
relationship | S | 1..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible) |  | 0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | Elements differ in definition for mustSupport: 'true' vs 'false' Element minimum cardinalities differ: '1' vs '0'
period | S Σ | 0..1 | Period | Coverage start and end dates | S Σ | 0..1 | Period | Coverage start and end dates |
payor | S Σ | 1..1 | Reference(US Core Organization Profile S | US Core Patient Profile | US Core RelatedPerson Profile) | Issuer of the policy | S Σ | 1..* | Reference(De-Identified UDS Plus Patient | US Core Organization Profile | De-Identified UDS Plus RelatedPerson) | Issuer of the policy | Element maximum cardinalities differ: '1' vs '2147483647' Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson]]) vs Reference([CanonicalType[http://hl7.org/fhir/us/uds-plus/StructureDefinition/de-identified-uds-plus-patient], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization], CanonicalType[http://hl7.org/fhir/us/uds-plus/StructureDefinition/de-identified-uds-plus-relatedperson]])
id |  |  |  |  |  | 0..1 | string | Unique id for inter-element referencing | Added this element
Slices for extension |  |  |  |  |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | Added this element
reference |  |  |  |  | Σ C | 0..1 | string | Literal reference, Relative, internal or absolute URL | Added this element
type |  |  |  |  | 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). | Added this element
identifier |  |  |  |  | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | Added this element
display |  |  |  |  | Σ | 0..0 |  | Text alternative for the resource | Added this element
Slices for class | S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type |  | 0..* | BackboneElement | Additional coverage classifications | Elements differ in definition for mustSupport: 'true' vs 'false'
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | 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 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc. |
value | Σ | 1..1 | string | Value associated with the type | Σ | 1..1 | string | Value associated with the type |
name | Σ | 0..1 | string | Human readable description of the type and value | Σ | 0..1 | string | Human readable description of the type and value |
order | Σ | 0..1 | positiveInt | Relative order of the coverage | Σ | 0..1 | positiveInt | Relative order of the coverage |
network | Σ | 0..1 | string | Insurer network | Σ | 0..1 | string | Insurer network |
costToBeneficiary |  | 0..* | BackboneElement | Patient payments for services/products |  | 0..* | BackboneElement | Patient payments for services/products |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified. | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified. |
value[x] | Σ | 1..1 | ??, Money | The amount or percentage due from the beneficiary | Σ | 1..1 | ??, Money | The amount or percentage due from the beneficiary |
exception |  | 0..* | BackboneElement | Exceptions for patient payments |  | 0..* | BackboneElement | Exceptions for patient payments |
id |  | 0..1 | string | Unique id for inter-element referencing |  | 0..1 | string | Unique id for inter-element referencing |
extension |  | 0..* | Extension | Additional content defined by implementations |  | 0..* | Extension | Additional content defined by implementations |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | 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 | 1..1 | CodeableConcept | Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays. |
period | Σ | 0..1 | Period | The effective period of the exception | Σ | 0..1 | Period | The effective period of the exception |
subrogation |  | 0..1 | boolean | Reimbursement to insurer |  | 0..1 | boolean | Reimbursement to insurer |
contract |  | 0..* | Reference(Contract) | Contract details |  | 0..* | Reference(Contract) | Contract details |
Documentation for this format