VJL - Vähiandmete juhtimislaud, published by TEHIK. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TEHIK-EE/ig-ee-vjl/ and changes regularly. See the Directory of published versions

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Resource Profile: EE VJL Coverage

Coverage profile for vjl.

Usages:

• This Profile is not used by any profiles in this Specification

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
Coverage.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Coverage.contained		0..*	Resource	Contained, inline Resources
Coverage.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored
Coverage.status	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
Coverage.kind	Σ This element is included in summaries.	1..1	code	insurance | self-pay | other Binding: Kind (required)
Coverage.type	Σ This element is included in summaries.	0..1	CodeableConcept	Coverage category such as medical or accident Binding: https://fhir.ee/ValueSet/rahastamise-allikas (required)
Coverage.beneficiary	Σ This element is included in summaries.	1..1	Reference(EE VJL Patient)	Plan beneficiary
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.status	Base	required	Financial Resource Status Codes	📍5.0.0	FHIR Std.
Coverage.kind	Base	required	Kind	📍5.0.0	FHIR Std.
Coverage.type	Base	required	https://fhir.ee/ValueSet/rahastamise-allikas	Not State	Unknown
Coverage.class.type	Base	extensible	Coverage Class Codes	📍5.0.0	FHIR Std.

Constraints

Id

Grade

Path(s)

Description

Expression

This structure is derived from Coverage

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
Coverage.paymentBy		0..0		Self-pay parties and responsibility
Coverage.type		0..1	CodeableConcept	Coverage category such as medical or accident Binding: https://fhir.ee/ValueSet/rahastamise-allikas (required)
Coverage.policyHolder		0..0		Owner of the policy
Coverage.subscriber		0..0		Subscriber to the policy
Coverage.subscriberId		0..0		ID assigned to the subscriber
Coverage.beneficiary		1..1	Reference(EE VJL Patient)	Plan beneficiary
Coverage.dependent		0..0		Dependent number
Coverage.relationship		0..0		Beneficiary relationship to the subscriber
Coverage.insurer		0..0		Issuer of the policy
Coverage.class		0..0		Additional coverage classifications
Coverage.order		0..0		Relative order of the coverage
Coverage.network		0..0		Insurer network
Coverage.costToBeneficiary		0..0		Patient payments for services/products
Coverage.subrogation		0..0		Reimbursement to insurer
Coverage.contract		0..0		Contract details
Coverage.insurancePlan		0..0		Insurance plan details
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Coverage.type	Base	required	https://fhir.ee/ValueSet/rahastamise-allikas	Not State	Unknown

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
Coverage.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Coverage.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Coverage.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Coverage.language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
Coverage.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Coverage.contained		0..*	Resource	Contained, inline Resources
Coverage.extension		0..*	Extension	Additional content defined by implementations
Coverage.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored
Coverage.identifier	Σ This element is included in summaries.	0..*	Identifier	Business identifier(s) for this coverage
Coverage.status	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
Coverage.kind	Σ This element is included in summaries.	1..1	code	insurance | self-pay | other Binding: Kind (required)
Coverage.type	Σ This element is included in summaries.	0..1	CodeableConcept	Coverage category such as medical or accident Binding: https://fhir.ee/ValueSet/rahastamise-allikas (required)
Coverage.beneficiary	Σ This element is included in summaries.	1..1	Reference(EE VJL Patient)	Plan beneficiary
Coverage.period	Σ This element is included in summaries.	0..1	Period	Coverage start and end dates
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.language	Base	required	All Languages	📍5.0.0	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍5.0.0	FHIR Std.
Coverage.kind	Base	required	Kind	📍5.0.0	FHIR Std.
Coverage.type	Base	required	https://fhir.ee/ValueSet/rahastamise-allikas	Not State	Unknown
Coverage.class.type	Base	extensible	Coverage Class Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​category	Base	example	Benefit Category Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​network	Base	example	Network Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​unit	Base	example	Unit Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​term	Base	example	Benefit Term Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📍5.0.0	FHIR Std.

Constraints

Id

Grade

Path(s)

Description

Expression

This structure is derived from Coverage

Summary

Prohibited: 14 elements

Structures

This structure refers to these other structures:

• EE VJL Patient (https://fhir.ee/vjl/StructureDefinition/ee-vjl-patient)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
Coverage.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Coverage.contained		0..*	Resource	Contained, inline Resources
Coverage.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored
Coverage.status	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
Coverage.kind	Σ This element is included in summaries.	1..1	code	insurance | self-pay | other Binding: Kind (required)
Coverage.type	Σ This element is included in summaries.	0..1	CodeableConcept	Coverage category such as medical or accident Binding: https://fhir.ee/ValueSet/rahastamise-allikas (required)
Coverage.beneficiary	Σ This element is included in summaries.	1..1	Reference(EE VJL Patient)	Plan beneficiary
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.status	Base	required	Financial Resource Status Codes	📍5.0.0	FHIR Std.
Coverage.kind	Base	required	Kind	📍5.0.0	FHIR Std.
Coverage.type	Base	required	https://fhir.ee/ValueSet/rahastamise-allikas	Not State	Unknown
Coverage.class.type	Base	extensible	Coverage Class Codes	📍5.0.0	FHIR Std.

Constraints

Id

Grade

Path(s)

Description

Expression

Differential View

This structure is derived from Coverage

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
Coverage.paymentBy		0..0		Self-pay parties and responsibility
Coverage.type		0..1	CodeableConcept	Coverage category such as medical or accident Binding: https://fhir.ee/ValueSet/rahastamise-allikas (required)
Coverage.policyHolder		0..0		Owner of the policy
Coverage.subscriber		0..0		Subscriber to the policy
Coverage.subscriberId		0..0		ID assigned to the subscriber
Coverage.beneficiary		1..1	Reference(EE VJL Patient)	Plan beneficiary
Coverage.dependent		0..0		Dependent number
Coverage.relationship		0..0		Beneficiary relationship to the subscriber
Coverage.insurer		0..0		Issuer of the policy
Coverage.class		0..0		Additional coverage classifications
Coverage.order		0..0		Relative order of the coverage
Coverage.network		0..0		Insurer network
Coverage.costToBeneficiary		0..0		Patient payments for services/products
Coverage.subrogation		0..0		Reimbursement to insurer
Coverage.contract		0..0		Contract details
Coverage.insurancePlan		0..0		Insurance plan details
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Coverage.type	Base	required	https://fhir.ee/ValueSet/rahastamise-allikas	Not State	Unknown

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
Coverage.id	Σ This element is included in summaries.	0..1	id	Logical id of this artifact
Coverage.meta	Σ This element is included in summaries.	0..1	Meta	Metadata about the resource
Coverage.implicitRules	?! This element is a modifier element. Σ This element is included in summaries.	0..1	uri	A set of rules under which this content was created
Coverage.language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
Coverage.text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Coverage.contained		0..*	Resource	Contained, inline Resources
Coverage.extension		0..*	Extension	Additional content defined by implementations
Coverage.modifierExtension	?! This element is a modifier element. Σ This element is included in summaries.	0..*	Extension	Extensions that cannot be ignored
Coverage.identifier	Σ This element is included in summaries.	0..*	Identifier	Business identifier(s) for this coverage
Coverage.status	?! This element is a modifier element. Σ This element is included in summaries.	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
Coverage.kind	Σ This element is included in summaries.	1..1	code	insurance | self-pay | other Binding: Kind (required)
Coverage.type	Σ This element is included in summaries.	0..1	CodeableConcept	Coverage category such as medical or accident Binding: https://fhir.ee/ValueSet/rahastamise-allikas (required)
Coverage.beneficiary	Σ This element is included in summaries.	1..1	Reference(EE VJL Patient)	Plan beneficiary
Coverage.period	Σ This element is included in summaries.	0..1	Period	Coverage start and end dates
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.language	Base	required	All Languages	📍5.0.0	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍5.0.0	FHIR Std.
Coverage.kind	Base	required	Kind	📍5.0.0	FHIR Std.
Coverage.type	Base	required	https://fhir.ee/ValueSet/rahastamise-allikas	Not State	Unknown
Coverage.class.type	Base	extensible	Coverage Class Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​category	Base	example	Benefit Category Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​network	Base	example	Network Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​unit	Base	example	Unit Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​term	Base	example	Benefit Term Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📍5.0.0	FHIR Std.

Constraints

Id

Grade

Path(s)

Description

Expression

This structure is derived from Coverage

Summary

Prohibited: 14 elements

Structures

This structure refers to these other structures:

• EE VJL Patient (https://fhir.ee/vjl/StructureDefinition/ee-vjl-patient)

Other representations of profile: CSV, Excel, Schematron