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 0.4.4 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

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Resource Profile: MINSAL Cobertura de Salud del Paciente

Recurso para almacenar la cobertura del paciente

Usage:

• Examples for this Resource Profile: Coverage/CoberturaFONASAEjemplo

Formal Views of Profile Content

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

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

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

Terminology Bindings (Differential)

Path	Conformance	ValueSet / Code	URI
Coverage.type	required	VSPrevision (a valid code from Previsión) https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSPrevision from this IG
Coverage.class:tramos.type	extensible	Pattern: 1("Tramos de FONASA") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSTramosFONASA from this IG
Coverage.class:plan.type	extensible	Pattern: 2("Plan de ISAPRE") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from this IG
Coverage.class:leyesPrev.type	extensible	Pattern: 3("Otras Leyes Previsionales") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSLeyPrevisionales from this IG
Coverage.class:leyesRep.type	extensible	Pattern: 4("Leyes de Reparación") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSLeyReparacion from this IG
Coverage.class:leyesPrio.type	extensible	Pattern: 5("Leyes de Priorización") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSGrupoMarcas from this IG

Constraints

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 dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management 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 ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. ele-1: All FHIR elements must have a @value or children
type	SΣ	1..1	CodeableConcept	Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) ele-1: All FHIR elements must have a @value or children
policyHolder	SΣ	1..1	Reference(MINSAL Paciente)	Propietario de la póliza ele-1: All FHIR elements must have a @value or children
beneficiary	SΣ	1..1	Reference(MINSAL Paciente)	Referencia al beneficiario del plan de salud ele-1: All FHIR elements must have a @value or children
period	SΣ	0..1	Period	Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". ele-1: All FHIR elements must have a @value or children
payor	SΣ	1..1	Reference(CL Organización)	Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) ele-1: All FHIR elements must have a @value or children
Slices for class	S	0..*	BackboneElement	Additional coverage classifications Slice: Unordered, Open by value:type ele-1: All FHIR elements must have a @value or children
class:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. ele-1: All FHIR elements must have a @value or children
value	Σ	1..1	string	Value associated with the type ele-1: All FHIR elements must have a @value or children
class:tramos	S	0..1	BackboneElement	Tramos de FONASA, este valor es obligatorio en caso de ser FONASA ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) ele-1: All FHIR elements must have a @value or children 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 ele-1: All FHIR elements must have a @value or children
Slices for extension		1..1	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
valorClase	S	1..1	(Complex)	Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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) ele-1: All FHIR elements must have a @value or children
class:plan	S	0..1	BackboneElement	Nombre del plan de isapre ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) ele-1: All FHIR elements must have a @value or children 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. ele-1: All FHIR elements must have a @value or children
class:leyesPrev	S	0..*	BackboneElement	Nombre de la ley previsional ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) ele-1: All FHIR elements must have a @value or children 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 ele-1: All FHIR elements must have a @value or children
Slices for extension		1..1	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
valorClase	S	1..1	(Complex)	Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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) ele-1: All FHIR elements must have a @value or children
class:leyesRep	S	0..*	BackboneElement	Nombre de la ley previsional ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) ele-1: All FHIR elements must have a @value or children 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 ele-1: All FHIR elements must have a @value or children
Slices for extension		1..1	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
valorClase	S	1..1	(Complex)	Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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) ele-1: All FHIR elements must have a @value or children
class:leyesPrio	S	0..*	BackboneElement	Nombre de la ley previsional ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) ele-1: All FHIR elements must have a @value or children 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 ele-1: All FHIR elements must have a @value or children
Slices for extension		1..1	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
valorClase	S	1..1	(Complex)	Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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) ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard
Coverage.type	required	VSPrevision (a valid code from Previsión) https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSPrevision from this IG
Coverage.class.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class from the FHIR Standard
Coverage.class:tramos.type	extensible	Pattern: 1("Tramos de FONASA") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSTramosFONASA from this IG
Coverage.class:plan.type	extensible	Pattern: 2("Plan de ISAPRE") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from this IG
Coverage.class:leyesPrev.type	extensible	Pattern: 3("Otras Leyes Previsionales") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSLeyPrevisionales from this IG
Coverage.class:leyesRep.type	extensible	Pattern: 4("Leyes de Reparación") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSLeyReparacion from this IG
Coverage.class:leyesPrio.type	extensible	Pattern: 5("Leyes de Priorización") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSGrupoMarcas from this IG

Constraints

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. Additional Bindings Purpose AllLanguages Max Binding
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

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Coverage.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard
Coverage.type	required	VSPrevision (a valid code from Previsión) https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSPrevision from this IG
Coverage.relationship	extensible	SubscriberRelationshipCodes http://hl7.org/fhir/ValueSet/subscriber-relationship from the FHIR Standard
Coverage.class.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class from the FHIR Standard
Coverage.class:tramos.type	extensible	Pattern: 1("Tramos de FONASA") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSTramosFONASA from this IG
Coverage.class:plan.type	extensible	Pattern: 2("Plan de ISAPRE") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from this IG
Coverage.class:leyesPrev.type	extensible	Pattern: 3("Otras Leyes Previsionales") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSLeyPrevisionales from this IG
Coverage.class:leyesRep.type	extensible	Pattern: 4("Leyes de Reparación") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSLeyReparacion from this IG
Coverage.class:leyesPrio.type	extensible	Pattern: 5("Leyes de Priorización") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSGrupoMarcas from this IG
Coverage.costToBeneficiary.type	extensible	CoverageCopayTypeCodes http://hl7.org/fhir/ValueSet/coverage-copay-type from the FHIR Standard
Coverage.costToBeneficiary.exception.type	example	ExampleCoverageFinancialExceptionCodes http://hl7.org/fhir/ValueSet/coverage-financial-exception from the FHIR Standard

Constraints

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:

• MINSAL Paciente (https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/MINSALPaciente)
• CL Organización (https://hl7chile.cl/fhir/ig/clcore/StructureDefinition/CoreOrganizacionCl)

Extensions

This structure refers to these extensions:

• https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Coverage.class

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

Terminology Bindings (Differential)

Path	Conformance	ValueSet / Code	URI
Coverage.type	required	VSPrevision (a valid code from Previsión) https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSPrevision from this IG
Coverage.class:tramos.type	extensible	Pattern: 1("Tramos de FONASA") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSTramosFONASA from this IG
Coverage.class:plan.type	extensible	Pattern: 2("Plan de ISAPRE") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from this IG
Coverage.class:leyesPrev.type	extensible	Pattern: 3("Otras Leyes Previsionales") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSLeyPrevisionales from this IG
Coverage.class:leyesRep.type	extensible	Pattern: 4("Leyes de Reparación") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSLeyReparacion from this IG
Coverage.class:leyesPrio.type	extensible	Pattern: 5("Leyes de Priorización") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSGrupoMarcas from this IG

Constraints

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 dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management 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 ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. ele-1: All FHIR elements must have a @value or children
type	SΣ	1..1	CodeableConcept	Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) ele-1: All FHIR elements must have a @value or children
policyHolder	SΣ	1..1	Reference(MINSAL Paciente)	Propietario de la póliza ele-1: All FHIR elements must have a @value or children
beneficiary	SΣ	1..1	Reference(MINSAL Paciente)	Referencia al beneficiario del plan de salud ele-1: All FHIR elements must have a @value or children
period	SΣ	0..1	Period	Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". ele-1: All FHIR elements must have a @value or children
payor	SΣ	1..1	Reference(CL Organización)	Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) ele-1: All FHIR elements must have a @value or children
Slices for class	S	0..*	BackboneElement	Additional coverage classifications Slice: Unordered, Open by value:type ele-1: All FHIR elements must have a @value or children
class:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. ele-1: All FHIR elements must have a @value or children
value	Σ	1..1	string	Value associated with the type ele-1: All FHIR elements must have a @value or children
class:tramos	S	0..1	BackboneElement	Tramos de FONASA, este valor es obligatorio en caso de ser FONASA ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) ele-1: All FHIR elements must have a @value or children 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 ele-1: All FHIR elements must have a @value or children
Slices for extension		1..1	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
valorClase	S	1..1	(Complex)	Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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) ele-1: All FHIR elements must have a @value or children
class:plan	S	0..1	BackboneElement	Nombre del plan de isapre ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) ele-1: All FHIR elements must have a @value or children 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. ele-1: All FHIR elements must have a @value or children
class:leyesPrev	S	0..*	BackboneElement	Nombre de la ley previsional ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) ele-1: All FHIR elements must have a @value or children 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 ele-1: All FHIR elements must have a @value or children
Slices for extension		1..1	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
valorClase	S	1..1	(Complex)	Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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) ele-1: All FHIR elements must have a @value or children
class:leyesRep	S	0..*	BackboneElement	Nombre de la ley previsional ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) ele-1: All FHIR elements must have a @value or children 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 ele-1: All FHIR elements must have a @value or children
Slices for extension		1..1	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
valorClase	S	1..1	(Complex)	Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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) ele-1: All FHIR elements must have a @value or children
class:leyesPrio	S	0..*	BackboneElement	Nombre de la ley previsional ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) ele-1: All FHIR elements must have a @value or children 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 ele-1: All FHIR elements must have a @value or children
Slices for extension		1..1	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
valorClase	S	1..1	(Complex)	Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
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) ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard
Coverage.type	required	VSPrevision (a valid code from Previsión) https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSPrevision from this IG
Coverage.class.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class from the FHIR Standard
Coverage.class:tramos.type	extensible	Pattern: 1("Tramos de FONASA") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSTramosFONASA from this IG
Coverage.class:plan.type	extensible	Pattern: 2("Plan de ISAPRE") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from this IG
Coverage.class:leyesPrev.type	extensible	Pattern: 3("Otras Leyes Previsionales") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSLeyPrevisionales from this IG
Coverage.class:leyesRep.type	extensible	Pattern: 4("Leyes de Reparación") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSLeyReparacion from this IG
Coverage.class:leyesPrio.type	extensible	Pattern: 5("Leyes de Priorización") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSGrupoMarcas from this IG

Constraints

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. Additional Bindings Purpose AllLanguages Max Binding
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

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Coverage.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard
Coverage.type	required	VSPrevision (a valid code from Previsión) https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSPrevision from this IG
Coverage.relationship	extensible	SubscriberRelationshipCodes http://hl7.org/fhir/ValueSet/subscriber-relationship from the FHIR Standard
Coverage.class.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class from the FHIR Standard
Coverage.class:tramos.type	extensible	Pattern: 1("Tramos de FONASA") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSTramosFONASA from this IG
Coverage.class:plan.type	extensible	Pattern: 2("Plan de ISAPRE") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from this IG
Coverage.class:leyesPrev.type	extensible	Pattern: 3("Otras Leyes Previsionales") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSLeyPrevisionales from this IG
Coverage.class:leyesRep.type	extensible	Pattern: 4("Leyes de Reparación") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSLeyReparacion from this IG
Coverage.class:leyesPrio.type	extensible	Pattern: 5("Leyes de Priorización") https://interoperabilidad.minsal.cl/fhir/ig/nid/ValueSet/VSClasesDeCobertura from 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/VSGrupoMarcas from this IG
Coverage.costToBeneficiary.type	extensible	CoverageCopayTypeCodes http://hl7.org/fhir/ValueSet/coverage-copay-type from the FHIR Standard
Coverage.costToBeneficiary.exception.type	example	ExampleCoverageFinancialExceptionCodes http://hl7.org/fhir/ValueSet/coverage-financial-exception from the FHIR Standard

Constraints

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:

• MINSAL Paciente (https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/MINSALPaciente)
• CL Organización (https://hl7chile.cl/fhir/ig/clcore/StructureDefinition/CoreOrganizacionCl)

Extensions

This structure refers to these extensions:

• https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Coverage.class