Núcleo de Interoperabilidad de Datos (NID) - MINSAL
0.4.0 - draft
Núcleo de Interoperabilidad de Datos (NID) - MINSAL
0.4.0 - draft
Núcleo de Interoperabilidad de Datos (NID) - MINSAL, published by Unidad de Interoperabilidad - MINSAL. This guide is not an authorized publication; it is the continuous build for version 0.4.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Minsal-CL/NID/ and changes regularly. See the Directory of published versions
| Official URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/MINSALCobertura | Version: 0.4.0 | |||
| Draft as of 2024-10-08 | Computable Name: MINSALCobertura | |||
Recurso para almacenar la cobertura del paciente
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Coverage
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Coverage |
C | 0..* | Coverage | Insurance or medical plan or a payment agreement cov-cls-01: En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA cov-cls-02: En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE |
  status |
S | 1..1 | code | active | cancelled | draft | entered-in-error |
| type |
S | 1..1 | CodeableConcept | Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) |
 policyHolder |
S | 1..1 | Reference(MINSAL Paciente) | Propietario de la póliza |
| beneficiary |
S | 1..1 | Reference(MINSAL Paciente) | Referencia al beneficiario del plan de salud |
| period |
S | 0..1 | Period | Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". |
| payor |
S | 1..1 | Reference(CL Organización) | Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) |
  Slices for class |
S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type |
   class:tramos |
S | 0..1 | BackboneElement | Tramos de FONASA, este valor es obligatorio en caso de ser FONASA |
  type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
  coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |
 display |
1..1 | string | Representation defined by the system Fixed Value: Tramos de FONASA | |
 value |
||||
 Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
 valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
 value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Tramos de FONASA (required) | |
| class:plan |
S | 0..1 | BackboneElement | Nombre del plan de isapre |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Plan de ISAPRE | |
| value |
S | 1..1 | string | Nombre del plan de isapre. |
| class:leyesPrev |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Otras Leyes Previsionales | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Previsionales (required) | |
| class:leyesRep |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 4 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Reparación | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Reparación (required) | |
| class:leyesPrio |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 5 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Priorización | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Grupo Marcas (required) | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI |
| Coverage.type | required | VSPrevision (a valid code from Previsión)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSPrevisionfrom this IG | |
| Coverage.class:tramos.type | extensible | Pattern: 1("Tramos de FONASA")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:tramos.value.extension:valorClase.value[x] | required | VSTramosFONASA (a valid code from Tramos de FONASA)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSTramosFONASAfrom this IG | |
| Coverage.class:plan.type | extensible | Pattern: 2("Plan de ISAPRE")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesPrev.type | extensible | Pattern: 3("Otras Leyes Previsionales")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesPrev.value.extension:valorClase.value[x] | required | VSLeyPrevisionales (a valid code from Leyes Previsionales)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSLeyPrevisionalesfrom this IG | |
| Coverage.class:leyesRep.type | extensible | Pattern: 4("Leyes de Reparación")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesRep.value.extension:valorClase.value[x] | required | VSLeyReparacion (a valid code from Leyes Reparación)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSLeyReparacionfrom this IG | |
| Coverage.class:leyesPrio.type | extensible | Pattern: 5("Leyes de Priorización")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesPrio.value.extension:valorClase.value[x] | required | VSGrupoMarcas (a valid code from Grupo Marcas)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSGrupoMarcasfrom this IG |
| Id | Grade | Path(s) | Details | Requirements |
| cov-cls-01 | error | Coverage | En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA : type.coding.where(code = 1).exists() implies class.type.coding.where(code = 1).exists() | |
| cov-cls-02 | error | Coverage | En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE : type.coding.where(code = 2).exists() implies class.type.coding.where(code = 2).exists() |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Coverage |
C | 0..* | Coverage | Insurance or medical plan or a payment agreement cov-cls-01: En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA cov-cls-02: En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE |
 implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
 modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored |
| status |
?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
 type |
SΣ | 1..1 | CodeableConcept | Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) |
| policyHolder |
SΣ | 1..1 | Reference(MINSAL Paciente) | Propietario de la póliza |
| beneficiary |
SΣ | 1..1 | Reference(MINSAL Paciente) | Referencia al beneficiario del plan de salud |
| period |
SΣ | 0..1 | Period | Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". |
| payor |
SΣ | 1..1 | Reference(CL Organización) | Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) |
| Slices for class |
S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type |
| class:All Slices |
Content/Rules for all slices | |||
 modifierExtension |
?!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: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. |
 value |
Σ | 1..1 | string | Value associated with the type |
| class:tramos |
S | 0..1 | BackboneElement | Tramos de FONASA, este valor es obligatorio en caso de ser FONASA |
 modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Tramos de FONASA | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | |||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Tramos de FONASA (required) | |
| class:plan |
S | 0..1 | BackboneElement | Nombre del plan de isapre |
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Plan de ISAPRE | |
| value |
SΣ | 1..1 | string | Nombre del plan de isapre. |
| class:leyesPrev |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Otras Leyes Previsionales | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | |||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Previsionales (required) | |
| class:leyesRep |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 4 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Reparación | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | |||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Reparación (required) | |
| class:leyesPrio |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 5 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Priorización | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | |||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Grupo Marcas (required) | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI |
| Coverage.status | required | FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.0.1from the FHIR Standard | |
| Coverage.type | required | VSPrevision (a valid code from Previsión)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSPrevisionfrom this IG | |
| Coverage.class.type | extensible | CoverageClassCodeshttp://hl7.org/fhir/ValueSet/coverage-classfrom the FHIR Standard | |
| Coverage.class:tramos.type | extensible | Pattern: 1("Tramos de FONASA")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:tramos.value.extension:valorClase.value[x] | required | VSTramosFONASA (a valid code from Tramos de FONASA)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSTramosFONASAfrom this IG | |
| Coverage.class:plan.type | extensible | Pattern: 2("Plan de ISAPRE")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesPrev.type | extensible | Pattern: 3("Otras Leyes Previsionales")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesPrev.value.extension:valorClase.value[x] | required | VSLeyPrevisionales (a valid code from Leyes Previsionales)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSLeyPrevisionalesfrom this IG | |
| Coverage.class:leyesRep.type | extensible | Pattern: 4("Leyes de Reparación")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesRep.value.extension:valorClase.value[x] | required | VSLeyReparacion (a valid code from Leyes Reparación)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSLeyReparacionfrom this IG | |
| Coverage.class:leyesPrio.type | extensible | Pattern: 5("Leyes de Priorización")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesPrio.value.extension:valorClase.value[x] | required | VSGrupoMarcas (a valid code from Grupo Marcas)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSGrupoMarcasfrom this IG |
| Id | Grade | Path(s) | Details | Requirements |
| cov-cls-01 | error | Coverage | En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA : type.coding.where(code = 1).exists() implies class.type.coding.where(code = 1).exists() | |
| cov-cls-02 | error | Coverage | En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE : type.coding.where(code = 2).exists() implies class.type.coding.where(code = 2).exists() | |
| dom-2 | error | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Coverage | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | Coverage | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Coverage | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Coverage |
C | 0..* | Coverage | Insurance or medical plan or a payment agreement cov-cls-01: En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA cov-cls-02: En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE | ||||
| id |
Σ | 0..1 | id | Logical id of this artifact | ||||
| meta |
Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier |
Σ | 0..* | Identifier | Business Identifier for the coverage | ||||
| status |
?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
| type |
SΣ | 1..1 | CodeableConcept | Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) | ||||
| policyHolder |
SΣ | 1..1 | Reference(MINSAL Paciente) | Propietario de la póliza | ||||
| subscriber |
Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | ||||
| subscriberId |
Σ | 0..1 | string | ID assigned to the subscriber | ||||
| beneficiary |
SΣ | 1..1 | Reference(MINSAL Paciente) | Referencia al beneficiario del plan de salud | ||||
| dependent |
Σ | 0..1 | string | Dependent number | ||||
| relationship |
0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | |||||
| period |
SΣ | 0..1 | Period | Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". | ||||
| payor |
SΣ | 1..1 | Reference(CL Organización) | Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) | ||||
 Slices for class |
S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type | ||||
 class:All Slices |
Content/Rules for all slices | |||||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!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: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. | ||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:tramos |
S | 0..1 | BackboneElement | Tramos de FONASA, este valor es obligatorio en caso de ser FONASA | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Tramos de FONASA | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | |||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Tramos de FONASA (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length: 1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:plan |
S | 0..1 | BackboneElement | Nombre del plan de isapre | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Plan de ISAPRE | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
SΣ | 1..1 | string | Nombre del plan de isapre. | ||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:leyesPrev |
S | 0..* | BackboneElement | Nombre de la ley previsional | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Otras Leyes Previsionales | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | |||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Previsionales (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length: 1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:leyesRep |
S | 0..* | BackboneElement | Nombre de la ley previsional | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 4 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Reparación | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | |||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Reparación (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length: 1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:leyesPrio |
S | 0..* | BackboneElement | Nombre de la ley previsional | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 5 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Priorización | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | |||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Grupo Marcas (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length: 1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| order |
Σ | 0..1 | positiveInt | Relative order of the coverage | ||||
| network |
Σ | 0..1 | string | Insurer network | ||||
| costToBeneficiary |
0..* | BackboneElement | Patient payments for services/products | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| type |
Σ | 0..1 | CodeableConcept | Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified. | ||||
 value[x] |
Σ | 1..1 | The amount or percentage due from the beneficiary | |||||
| valueQuantity |
Quantity(SimpleQuantity) | |||||||
| valueMoney |
Money | |||||||
| exception |
0..* | BackboneElement | Exceptions for patient payments | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| type |
Σ | 1..1 | CodeableConcept | Exception category Binding: ExampleCoverageFinancialExceptionCodes (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 | ||||
| subrogation |
0..1 | boolean | Reimbursement to insurer | |||||
| contract |
0..* | Reference(Contract) | Contract details | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | URI | |||
| Coverage.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard | ||||
| Coverage.status | required | FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.0.1from the FHIR Standard | ||||
| Coverage.type | required | VSPrevision (a valid code from Previsión)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSPrevisionfrom this IG | ||||
| Coverage.relationship | extensible | SubscriberRelationshipCodeshttp://hl7.org/fhir/ValueSet/subscriber-relationshipfrom the FHIR Standard | ||||
| Coverage.class.type | extensible | CoverageClassCodeshttp://hl7.org/fhir/ValueSet/coverage-classfrom the FHIR Standard | ||||
| Coverage.class:tramos.type | extensible | Pattern: 1("Tramos de FONASA")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | ||||
| Coverage.class:tramos.value.extension:valorClase.value[x] | required | VSTramosFONASA (a valid code from Tramos de FONASA)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSTramosFONASAfrom this IG | ||||
| Coverage.class:plan.type | extensible | Pattern: 2("Plan de ISAPRE")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | ||||
| Coverage.class:leyesPrev.type | extensible | Pattern: 3("Otras Leyes Previsionales")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | ||||
| Coverage.class:leyesPrev.value.extension:valorClase.value[x] | required | VSLeyPrevisionales (a valid code from Leyes Previsionales)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSLeyPrevisionalesfrom this IG | ||||
| Coverage.class:leyesRep.type | extensible | Pattern: 4("Leyes de Reparación")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | ||||
| Coverage.class:leyesRep.value.extension:valorClase.value[x] | required | VSLeyReparacion (a valid code from Leyes Reparación)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSLeyReparacionfrom this IG | ||||
| Coverage.class:leyesPrio.type | extensible | Pattern: 5("Leyes de Priorización")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | ||||
| Coverage.class:leyesPrio.value.extension:valorClase.value[x] | required | VSGrupoMarcas (a valid code from Grupo Marcas)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSGrupoMarcasfrom this IG | ||||
| Coverage.costToBeneficiary.type | extensible | CoverageCopayTypeCodeshttp://hl7.org/fhir/ValueSet/coverage-copay-typefrom the FHIR Standard | ||||
| Coverage.costToBeneficiary.exception.type | example | ExampleCoverageFinancialExceptionCodeshttp://hl7.org/fhir/ValueSet/coverage-financial-exceptionfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| cov-cls-01 | error | Coverage | En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA : type.coding.where(code = 1).exists() implies class.type.coding.where(code = 1).exists() | |
| cov-cls-02 | error | Coverage | En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE : type.coding.where(code = 2).exists() implies class.type.coding.where(code = 2).exists() | |
| dom-2 | error | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Coverage | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | Coverage | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Coverage | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from Coverage
Summary
Mandatory: 2 elements(8 nested mandatory elements)
Must-Support: 17 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Coverage
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Coverage |
C | 0..* | Coverage | Insurance or medical plan or a payment agreement cov-cls-01: En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA cov-cls-02: En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE |
| status |
S | 1..1 | code | active | cancelled | draft | entered-in-error |
| type |
S | 1..1 | CodeableConcept | Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) |
| policyHolder |
S | 1..1 | Reference(MINSAL Paciente) | Propietario de la póliza |
| beneficiary |
S | 1..1 | Reference(MINSAL Paciente) | Referencia al beneficiario del plan de salud |
| period |
S | 0..1 | Period | Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". |
| payor |
S | 1..1 | Reference(CL Organización) | Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) |
| Slices for class |
S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type |
| class:tramos |
S | 0..1 | BackboneElement | Tramos de FONASA, este valor es obligatorio en caso de ser FONASA |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Tramos de FONASA | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Tramos de FONASA (required) | |
| class:plan |
S | 0..1 | BackboneElement | Nombre del plan de isapre |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Plan de ISAPRE | |
| value |
S | 1..1 | string | Nombre del plan de isapre. |
| class:leyesPrev |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Otras Leyes Previsionales | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Previsionales (required) | |
| class:leyesRep |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 4 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Reparación | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Reparación (required) | |
| class:leyesPrio |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 5 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Priorización | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Grupo Marcas (required) | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI |
| Coverage.type | required | VSPrevision (a valid code from Previsión)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSPrevisionfrom this IG | |
| Coverage.class:tramos.type | extensible | Pattern: 1("Tramos de FONASA")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:tramos.value.extension:valorClase.value[x] | required | VSTramosFONASA (a valid code from Tramos de FONASA)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSTramosFONASAfrom this IG | |
| Coverage.class:plan.type | extensible | Pattern: 2("Plan de ISAPRE")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesPrev.type | extensible | Pattern: 3("Otras Leyes Previsionales")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesPrev.value.extension:valorClase.value[x] | required | VSLeyPrevisionales (a valid code from Leyes Previsionales)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSLeyPrevisionalesfrom this IG | |
| Coverage.class:leyesRep.type | extensible | Pattern: 4("Leyes de Reparación")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesRep.value.extension:valorClase.value[x] | required | VSLeyReparacion (a valid code from Leyes Reparación)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSLeyReparacionfrom this IG | |
| Coverage.class:leyesPrio.type | extensible | Pattern: 5("Leyes de Priorización")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesPrio.value.extension:valorClase.value[x] | required | VSGrupoMarcas (a valid code from Grupo Marcas)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSGrupoMarcasfrom this IG |
| Id | Grade | Path(s) | Details | Requirements |
| cov-cls-01 | error | Coverage | En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA : type.coding.where(code = 1).exists() implies class.type.coding.where(code = 1).exists() | |
| cov-cls-02 | error | Coverage | En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE : type.coding.where(code = 2).exists() implies class.type.coding.where(code = 2).exists() |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Coverage |
C | 0..* | Coverage | Insurance or medical plan or a payment agreement cov-cls-01: En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA cov-cls-02: En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE |
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored |
| status |
?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
| type |
SΣ | 1..1 | CodeableConcept | Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) |
| policyHolder |
SΣ | 1..1 | Reference(MINSAL Paciente) | Propietario de la póliza |
| beneficiary |
SΣ | 1..1 | Reference(MINSAL Paciente) | Referencia al beneficiario del plan de salud |
| period |
SΣ | 0..1 | Period | Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". |
| payor |
SΣ | 1..1 | Reference(CL Organización) | Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) |
| Slices for class |
S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type |
| class:All Slices |
Content/Rules for all slices | |||
| modifierExtension |
?!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: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. |
| value |
Σ | 1..1 | string | Value associated with the type |
| class:tramos |
S | 0..1 | BackboneElement | Tramos de FONASA, este valor es obligatorio en caso de ser FONASA |
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Tramos de FONASA | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | |||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Tramos de FONASA (required) | |
| class:plan |
S | 0..1 | BackboneElement | Nombre del plan de isapre |
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Plan de ISAPRE | |
| value |
SΣ | 1..1 | string | Nombre del plan de isapre. |
| class:leyesPrev |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Otras Leyes Previsionales | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | |||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Previsionales (required) | |
| class:leyesRep |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 4 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Reparación | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | |||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Reparación (required) | |
| class:leyesPrio |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 5 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Priorización | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | |||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Grupo Marcas (required) | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code | URI |
| Coverage.status | required | FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.0.1from the FHIR Standard | |
| Coverage.type | required | VSPrevision (a valid code from Previsión)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSPrevisionfrom this IG | |
| Coverage.class.type | extensible | CoverageClassCodeshttp://hl7.org/fhir/ValueSet/coverage-classfrom the FHIR Standard | |
| Coverage.class:tramos.type | extensible | Pattern: 1("Tramos de FONASA")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:tramos.value.extension:valorClase.value[x] | required | VSTramosFONASA (a valid code from Tramos de FONASA)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSTramosFONASAfrom this IG | |
| Coverage.class:plan.type | extensible | Pattern: 2("Plan de ISAPRE")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesPrev.type | extensible | Pattern: 3("Otras Leyes Previsionales")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesPrev.value.extension:valorClase.value[x] | required | VSLeyPrevisionales (a valid code from Leyes Previsionales)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSLeyPrevisionalesfrom this IG | |
| Coverage.class:leyesRep.type | extensible | Pattern: 4("Leyes de Reparación")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesRep.value.extension:valorClase.value[x] | required | VSLeyReparacion (a valid code from Leyes Reparación)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSLeyReparacionfrom this IG | |
| Coverage.class:leyesPrio.type | extensible | Pattern: 5("Leyes de Priorización")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | |
| Coverage.class:leyesPrio.value.extension:valorClase.value[x] | required | VSGrupoMarcas (a valid code from Grupo Marcas)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSGrupoMarcasfrom this IG |
| Id | Grade | Path(s) | Details | Requirements |
| cov-cls-01 | error | Coverage | En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA : type.coding.where(code = 1).exists() implies class.type.coding.where(code = 1).exists() | |
| cov-cls-02 | error | Coverage | En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE : type.coding.where(code = 2).exists() implies class.type.coding.where(code = 2).exists() | |
| dom-2 | error | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Coverage | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | Coverage | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Coverage | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Coverage |
C | 0..* | Coverage | Insurance or medical plan or a payment agreement cov-cls-01: En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA cov-cls-02: En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE | ||||
| id |
Σ | 0..1 | id | Logical id of this artifact | ||||
| meta |
Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier |
Σ | 0..* | Identifier | Business Identifier for the coverage | ||||
| status |
?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
| type |
SΣ | 1..1 | CodeableConcept | Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) | ||||
| policyHolder |
SΣ | 1..1 | Reference(MINSAL Paciente) | Propietario de la póliza | ||||
| subscriber |
Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | ||||
| subscriberId |
Σ | 0..1 | string | ID assigned to the subscriber | ||||
| beneficiary |
SΣ | 1..1 | Reference(MINSAL Paciente) | Referencia al beneficiario del plan de salud | ||||
| dependent |
Σ | 0..1 | string | Dependent number | ||||
| relationship |
0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | |||||
| period |
SΣ | 0..1 | Period | Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". | ||||
| payor |
SΣ | 1..1 | Reference(CL Organización) | Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) | ||||
| Slices for class |
S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type | ||||
| class:All Slices |
Content/Rules for all slices | |||||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!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: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. | ||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:tramos |
S | 0..1 | BackboneElement | Tramos de FONASA, este valor es obligatorio en caso de ser FONASA | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Tramos de FONASA | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | |||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Tramos de FONASA (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length: 1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:plan |
S | 0..1 | BackboneElement | Nombre del plan de isapre | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Plan de ISAPRE | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
SΣ | 1..1 | string | Nombre del plan de isapre. | ||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:leyesPrev |
S | 0..* | BackboneElement | Nombre de la ley previsional | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Otras Leyes Previsionales | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | |||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Previsionales (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length: 1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:leyesRep |
S | 0..* | BackboneElement | Nombre de la ley previsional | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 4 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Reparación | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | |||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Reparación (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length: 1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:leyesPrio |
S | 0..* | BackboneElement | Nombre de la ley previsional | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!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: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 5 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Priorización | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | |||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Grupo Marcas (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length: 1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| order |
Σ | 0..1 | positiveInt | Relative order of the coverage | ||||
| network |
Σ | 0..1 | string | Insurer network | ||||
| costToBeneficiary |
0..* | BackboneElement | Patient payments for services/products | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| type |
Σ | 0..1 | CodeableConcept | Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified. | ||||
| value[x] |
Σ | 1..1 | The amount or percentage due from the beneficiary | |||||
| valueQuantity |
Quantity(SimpleQuantity) | |||||||
| valueMoney |
Money | |||||||
| exception |
0..* | BackboneElement | Exceptions for patient payments | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| type |
Σ | 1..1 | CodeableConcept | Exception category Binding: ExampleCoverageFinancialExceptionCodes (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 | ||||
| subrogation |
0..1 | boolean | Reimbursement to insurer | |||||
| contract |
0..* | Reference(Contract) | Contract details | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | URI | |||
| Coverage.language | preferred | CommonLanguages
http://hl7.org/fhir/ValueSet/languagesfrom the FHIR Standard | ||||
| Coverage.status | required | FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.0.1from the FHIR Standard | ||||
| Coverage.type | required | VSPrevision (a valid code from Previsión)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSPrevisionfrom this IG | ||||
| Coverage.relationship | extensible | SubscriberRelationshipCodeshttp://hl7.org/fhir/ValueSet/subscriber-relationshipfrom the FHIR Standard | ||||
| Coverage.class.type | extensible | CoverageClassCodeshttp://hl7.org/fhir/ValueSet/coverage-classfrom the FHIR Standard | ||||
| Coverage.class:tramos.type | extensible | Pattern: 1("Tramos de FONASA")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | ||||
| Coverage.class:tramos.value.extension:valorClase.value[x] | required | VSTramosFONASA (a valid code from Tramos de FONASA)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSTramosFONASAfrom this IG | ||||
| Coverage.class:plan.type | extensible | Pattern: 2("Plan de ISAPRE")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | ||||
| Coverage.class:leyesPrev.type | extensible | Pattern: 3("Otras Leyes Previsionales")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | ||||
| Coverage.class:leyesPrev.value.extension:valorClase.value[x] | required | VSLeyPrevisionales (a valid code from Leyes Previsionales)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSLeyPrevisionalesfrom this IG | ||||
| Coverage.class:leyesRep.type | extensible | Pattern: 4("Leyes de Reparación")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | ||||
| Coverage.class:leyesRep.value.extension:valorClase.value[x] | required | VSLeyReparacion (a valid code from Leyes Reparación)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSLeyReparacionfrom this IG | ||||
| Coverage.class:leyesPrio.type | extensible | Pattern: 5("Leyes de Priorización")https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCoberturafrom this IG | ||||
| Coverage.class:leyesPrio.value.extension:valorClase.value[x] | required | VSGrupoMarcas (a valid code from Grupo Marcas)https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSGrupoMarcasfrom this IG | ||||
| Coverage.costToBeneficiary.type | extensible | CoverageCopayTypeCodeshttp://hl7.org/fhir/ValueSet/coverage-copay-typefrom the FHIR Standard | ||||
| Coverage.costToBeneficiary.exception.type | example | ExampleCoverageFinancialExceptionCodeshttp://hl7.org/fhir/ValueSet/coverage-financial-exceptionfrom the FHIR Standard |
| Id | Grade | Path(s) | Details | Requirements |
| cov-cls-01 | error | Coverage | En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA : type.coding.where(code = 1).exists() implies class.type.coding.where(code = 1).exists() | |
| cov-cls-02 | error | Coverage | En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE : type.coding.where(code = 2).exists() implies class.type.coding.where(code = 2).exists() | |
| dom-2 | error | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Coverage | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | Coverage | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Coverage | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from Coverage
Summary
Mandatory: 2 elements(8 nested mandatory elements)
Must-Support: 17 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Other representations of profile: CSV, Excel, Schematron