Left: | Specialty Rx Coverage (http://hl7.org/fhir/us/specialty-rx/StructureDefinition/specialty-rx-coverage) |
Right: | Specialty Rx Coverage (http://hl7.org/fhir/us/specialty-rx/StructureDefinition/specialty-rx-coverage) |
Error | StructureDefinition.version | Values for version differ: '2.0.0' vs '2.1.0' |
Name | Value | Comments | |
---|---|---|---|
abstract | false | ||
baseDefinition | http://hl7.org/fhir/StructureDefinition/Coverage | ||
copyright | |||
date | 2023-04-30T00:00:00-05:00 | ||
description | This profile constrains the Coverage resource for carrying insurance coverage information in the specialty medication enrollment process | ||
experimental | false | ||
fhirVersion | 4.0.1 | ||
jurisdiction | |||
jurisdiction[0] | urn:iso:std:iso:3166#US | ||
kind | resource | ||
name | SpecialtyRxCoverage | ||
publisher | HL7 International - Pharmacy | ||
purpose | |||
status | active | ||
title | Specialty Rx Coverage | ||
type | Coverage | ||
url | http://hl7.org/fhir/us/specialty-rx/StructureDefinition/specialty-rx-coverage | ||
version | 2.0.0 | 2.1.0 |
|
Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | L Type | L Description & Constraints | Comments | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | 0..* | Coverage | Insurance or medical plan or a payment agreement | |||||||||||
id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact | |||||||||
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.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| |||||||||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
contained | 0..* | Resource | Contained, inline Resources | 0..* | Resource | Contained, inline Resources | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
Slices for identifier | SΣ | 0..* | Identifier | Member ID and other identifiers Slice: Unordered, Open by pattern:type | SΣ | 0..* | Identifier | Member ID and other identifiers Slice: Unordered, Open by pattern:type | |||||||||
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | |||||||||
type | 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 | 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. | |||||||||
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 | SΣ | 0..1 | string | ID assigned to the subscriber by the health plan | SΣ | 0..1 | string | ID assigned to the subscriber by the health plan | |||||||||
beneficiary | Σ | 1..1 | Reference(Patient) | Plan beneficiary | Σ | 1..1 | Reference(Patient) | Plan beneficiary | |||||||||
dependent | Σ | 0..1 | string | Dependent number | Σ | 0..1 | string | Dependent number | |||||||||
relationship | 0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | 0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | |||||||||||
period | Σ | 0..1 | Period | Coverage start and end dates | Σ | 0..1 | Period | Coverage start and end dates | |||||||||
payor | SΣ | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy | SΣ | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy | |||||||||
Slices for class | S | 0..* | BackboneElement | Pharmacy coverage identifiers Slice: Unordered, Open by value:type | S | 0..* | BackboneElement | Pharmacy coverage identifiers Slice: Unordered, Open by value:type | |||||||||
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): Coverage Class Codes | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible): Coverage Class Codes | |||||||||
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 |