This is the set of resources that conform to either of the profiles US Core Coverage Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage) and DAPL Coverage (http://hl7.org/fhir/us/dapl/StructureDefinition/dapl-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..* | left: Insurance or medical plan or a payment agreement; right: DAPL Coverage Constraints: us-core-15 | |
![]() ![]() | 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 | left: Text summary of the resource, for human interpretation; right: Cannot include any text in the resource as part of the deidentified or anonymized data. This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |
![]() ![]() | 0..* | Resource | left: Contained, inline Resources; right: Cannot include any contained resources in the resource as part of the deidentified or anonymized data. | |
![]() ![]() | 0..* | Extension | Additional content defined by implementations | |
![]() ![]() | ?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() | SΣ | 0..* | Identifier | left: Member ID and other identifiers; right: Business Identifier for the coverage |
![]() ![]() | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. |
![]() ![]() | SΣ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (extensible): left: Centers for Disease Control and Prevention National Center for Health Statistics Source of Payment Codes; right: 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(Patient | RelatedPerson | Organization) | Owner of the policy |
![]() ![]() | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy |
![]() ![]() | SΣ | 0..1 | string | ID assigned to the subscriber |
![]() ![]() | SΣ | 1..1 | Reference(US Core Patient Profile | #sd+2-us-core-patient-dapl-deidentified-patient) | Plan beneficiary |
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
![]() ![]() ![]() | ΣC | 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 | 0..1 | string | Dependent number |
![]() ![]() | S | 0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). |
![]() ![]() | SΣ | 0..1 | Period | Coverage start and end dates |
![]() ![]() | SΣ | 1..* | Reference(US Core Organization Profile S | US Core Patient Profile | US Core RelatedPerson Profile), Reference(DAPL Deidentified Patient | US Core Organization Profile | DAPL Deidentified RelatedPerson) | Issuer of the policy |
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
![]() ![]() ![]() | ΣC | 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 |
![]() ![]() | S | 0..* | 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 | 0..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: ?? (extensible): The types of services to which patient copayments are specified. |
![]() ![]() ![]() | 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 | |
Documentation for this format | ||||