0.1.0 - ci-build
RuCoreIG, published by HL7 FHIR Россия. 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/fhir-ru/RuCoreIG/ and changes regularly. See the Directory of published versions
Official URL: https://fhir.ru/ig/core/StructureDefinition/core-coverage | Version: 0.1.0 | |||
Active as of 2024-12-10 | Computable Name: Core_Coverage |
Источник финансирования
Профиль Core Coverage ресурса Coverage отражает национальные требования к учету взаимоотношений между медицинской организацией и плательщиками при оплате медицинской помощи. • Использование справочников НСИ МЗ РФ для указания источника оплаты и документа-основания оплаты
Профиль может быть использован при передаче информации о медицинской помощи, которая предполагает оплату в рамках систем обязательного страхования, добровольного страхования, за счет средств пациента или иных физических или юридических лиц.
//пример требует исправления: у него идентификатор ОМСный, а плательщик – сам пациент
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Coverage
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
Slices for identifier | 0..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by value:system | |
identifier:OMS | 0..1 | Identifier | Полис ОМС- обязательного медицинского страхования | |
type | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |
system | 1..1 | uri | The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/OMS | |
identifier:DMS | 0..1 | Identifier | Полис ДМС - добровольного медицинского страхования | |
type | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |
system | 1..1 | uri | The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/DMS | |
identifier:Contract | 0..1 | Identifier | Договор на оказание платных медицинских услугя | |
type | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |
system | 1..1 | uri | The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/Contract | |
type | 0..1 | CodeableConcept | Тип страхового покрытия. Binding: Core_Vs_Nsi_Sources_Of_Paymente(required) Справочник НСИ Минздрава Источники оплаты медицинской помощи | |
beneficiary | 1..1 | Reference(Core Patient (Пациент)) | Ссылка на пациента | |
payor | 1..* | Reference(Core Organisation Payer (Организация-плательщик) | Core Patient Payer (Пациент - плательщик) | Core Related Person (Лицо, имеющее связь с пациентом) | Core Related Person Payer (Лицо-плательщик, имеющее связь с пациентом)) | Плательщик: пациент, родственник или организация | |
Documentation for this format |
Path | Conformance | ValueSet / Code | URI |
Coverage.identifier:OMS.type | required | Pattern: 1https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | |
Coverage.identifier:DMS.type | required | Pattern: 2https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | |
Coverage.identifier:Contract.type | required | Pattern: 3https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 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 | |
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 |
Slices for identifier | Σ | 0..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by value:system ele-1: All FHIR elements must have a @value or children |
identifier:OMS | Σ | 0..1 | Identifier | Полис ОМС- обязательного медицинского страхования ele-1: All FHIR elements must have a @value or children |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) ele-1: All FHIR elements must have a @value or children |
type | Σ | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |
system | Σ | 1..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Required Pattern: http://fhir.ru/core/systems/OMS |
identifier:DMS | Σ | 0..1 | Identifier | Полис ДМС - добровольного медицинского страхования ele-1: All FHIR elements must have a @value or children |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) ele-1: All FHIR elements must have a @value or children |
type | Σ | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |
system | Σ | 1..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Required Pattern: http://fhir.ru/core/systems/DMS |
identifier:Contract | Σ | 0..1 | Identifier | Договор на оказание платных медицинских услугя ele-1: All FHIR elements must have a @value or children |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) ele-1: All FHIR elements must have a @value or children |
type | Σ | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |
system | Σ | 1..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Required Pattern: http://fhir.ru/core/systems/Contract |
status | ?!Σ | 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 | Σ | 0..1 | CodeableConcept | Тип страхового покрытия. Binding: Core_Vs_Nsi_Sources_Of_Paymente(required) Справочник НСИ Минздрава Источники оплаты медицинской помощи Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. ele-1: All FHIR elements must have a @value or children |
beneficiary | Σ | 1..1 | Reference(Core Patient (Пациент)) | Ссылка на пациента ele-1: All FHIR elements must have a @value or children |
payor | Σ | 1..* | Reference(Core Organisation Payer (Организация-плательщик) | Core Patient Payer (Пациент - плательщик) | Core Related Person (Лицо, имеющее связь с пациентом) | Core Related Person Payer (Лицо-плательщик, имеющее связь с пациентом)) | Плательщик: пациент, родственник или организация ele-1: All FHIR elements must have a @value or children |
Documentation for this format |
Path | Conformance | ValueSet / Code | URI |
Coverage.identifier:OMS.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 from the FHIR Standard | |
Coverage.identifier:OMS.type | required | Pattern: 1https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | |
Coverage.identifier:DMS.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 from the FHIR Standard | |
Coverage.identifier:DMS.type | required | Pattern: 2https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | |
Coverage.identifier:Contract.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 from the FHIR Standard | |
Coverage.identifier:Contract.type | required | Pattern: 3https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | |
Coverage.status | required | FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.3.0 from the FHIR Standard | |
Coverage.type | preferred | CoverageTypeAndSelf-PayCodeshttp://hl7.org/fhir/ValueSet/coverage-type from the FHIR Standard |
Id | Grade | Path(s) | Details | Requirements |
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.exists() and ('#'+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(uri) = '#').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 | 0..* | Coverage | Insurance or medical plan or a payment agreement | |||||
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): IETF language tag
| |||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
contained | 0..* | Resource | Contained, inline Resources dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
Slices for identifier | Σ | 0..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by value:system | ||||
identifier:OMS | Σ | 0..1 | Identifier | Полис ОМС- обязательного медицинского страхования | ||||
id | 0..1 | id | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) | ||||
type | Σ | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |||||
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 | 0..1 | string | Representation defined by the system | |||||
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
text | 0..1 | string | Plain text representation of the concept | |||||
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/OMS | ||||
value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
identifier:DMS | Σ | 0..1 | Identifier | Полис ДМС - добровольного медицинского страхования | ||||
id | 0..1 | id | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) | ||||
type | Σ | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |||||
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 | 0..1 | string | Representation defined by the system | |||||
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
text | 0..1 | string | Plain text representation of the concept | |||||
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/DMS | ||||
value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
identifier:Contract | Σ | 0..1 | Identifier | Договор на оказание платных медицинских услугя | ||||
id | 0..1 | id | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) | ||||
type | Σ | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |||||
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 | 0..1 | string | Representation defined by the system | |||||
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
text | 0..1 | string | Plain text representation of the concept | |||||
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/Contract | ||||
value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
type | Σ | 0..1 | CodeableConcept | Тип страхового покрытия. Binding: Core_Vs_Nsi_Sources_Of_Paymente(required) Справочник НСИ Минздрава Источники оплаты медицинской помощи Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. | ||||
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | ||||
subscriber | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | ||||
subscriberId | Σ | 0..1 | string | ID assigned to the subscriber | ||||
beneficiary | Σ | 1..1 | Reference(Core Patient (Пациент)) | Ссылка на пациента | ||||
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 | Σ | 0..1 | Period | Coverage start and end dates | ||||
payor | Σ | 1..* | Reference(Core Organisation Payer (Организация-плательщик) | Core Patient Payer (Пациент - плательщик) | Core Related Person (Лицо, имеющее связь с пациентом) | Core Related Person Payer (Лицо-плательщик, имеющее связь с пациентом)) | Плательщик: пациент, родственник или организация | ||||
class | 0..* | BackboneElement | Additional coverage classifications | |||||
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 | ||||
order | Σ | 0..1 | positiveInt | Relative order of the coverage | ||||
network | Σ | 0..1 | string | Insurer network | ||||
costToBeneficiary | 0..* | BackboneElement | Patient payments for services/products | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
type | Σ | 0..1 | CodeableConcept | Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified. | ||||
value[x] | Σ | 1..1 | The amount or percentage due from the beneficiary | |||||
valueQuantity | Quantity(SimpleQuantity) | |||||||
valueMoney | Money | |||||||
exception | 0..* | BackboneElement | Exceptions for patient payments | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
type | Σ | 1..1 | CodeableConcept | Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays. | ||||
period | Σ | 0..1 | Period | The effective period of the exception | ||||
subrogation | 0..1 | boolean | Reimbursement to insurer | |||||
contract | 0..* | Reference(Contract) | Contract details | |||||
Documentation for this format |
Path | Conformance | ValueSet / Code | URI | |||
Coverage.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languages from the FHIR Standard
| ||||
Coverage.identifier:OMS.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 from the FHIR Standard | ||||
Coverage.identifier:OMS.type | required | Pattern: 1https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | ||||
Coverage.identifier:DMS.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 from the FHIR Standard | ||||
Coverage.identifier:DMS.type | required | Pattern: 2https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | ||||
Coverage.identifier:Contract.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 from the FHIR Standard | ||||
Coverage.identifier:Contract.type | required | Pattern: 3https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | ||||
Coverage.status | required | FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.3.0 from the FHIR Standard | ||||
Coverage.type | preferred | CoverageTypeAndSelf-PayCodeshttp://hl7.org/fhir/ValueSet/coverage-type from the FHIR Standard | ||||
Coverage.relationship | extensible | SubscriberRelationshipCodeshttp://hl7.org/fhir/ValueSet/subscriber-relationship from the FHIR Standard | ||||
Coverage.class.type | extensible | CoverageClassCodeshttp://hl7.org/fhir/ValueSet/coverage-class from the FHIR Standard | ||||
Coverage.costToBeneficiary.type | extensible | CoverageCopayTypeCodeshttp://hl7.org/fhir/ValueSet/coverage-copay-type from the FHIR Standard | ||||
Coverage.costToBeneficiary.exception.type | example | ExampleCoverageFinancialExceptionCodeshttp://hl7.org/fhir/ValueSet/coverage-financial-exception from the FHIR Standard |
Id | Grade | Path(s) | Details | Requirements |
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.exists() and ('#'+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(uri) = '#').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() | |
dom-r4b | warning | Coverage.contained | Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems : ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic) | |
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: 0 element(6 nested mandatory elements)
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Coverage
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
Slices for identifier | 0..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by value:system | |
identifier:OMS | 0..1 | Identifier | Полис ОМС- обязательного медицинского страхования | |
type | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |
system | 1..1 | uri | The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/OMS | |
identifier:DMS | 0..1 | Identifier | Полис ДМС - добровольного медицинского страхования | |
type | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |
system | 1..1 | uri | The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/DMS | |
identifier:Contract | 0..1 | Identifier | Договор на оказание платных медицинских услугя | |
type | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |
system | 1..1 | uri | The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/Contract | |
type | 0..1 | CodeableConcept | Тип страхового покрытия. Binding: Core_Vs_Nsi_Sources_Of_Paymente(required) Справочник НСИ Минздрава Источники оплаты медицинской помощи | |
beneficiary | 1..1 | Reference(Core Patient (Пациент)) | Ссылка на пациента | |
payor | 1..* | Reference(Core Organisation Payer (Организация-плательщик) | Core Patient Payer (Пациент - плательщик) | Core Related Person (Лицо, имеющее связь с пациентом) | Core Related Person Payer (Лицо-плательщик, имеющее связь с пациентом)) | Плательщик: пациент, родственник или организация | |
Documentation for this format |
Path | Conformance | ValueSet / Code | URI |
Coverage.identifier:OMS.type | required | Pattern: 1https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | |
Coverage.identifier:DMS.type | required | Pattern: 2https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | |
Coverage.identifier:Contract.type | required | Pattern: 3https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG |
Key Elements View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 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 | |
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 |
Slices for identifier | Σ | 0..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by value:system ele-1: All FHIR elements must have a @value or children |
identifier:OMS | Σ | 0..1 | Identifier | Полис ОМС- обязательного медицинского страхования ele-1: All FHIR elements must have a @value or children |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) ele-1: All FHIR elements must have a @value or children |
type | Σ | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |
system | Σ | 1..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Required Pattern: http://fhir.ru/core/systems/OMS |
identifier:DMS | Σ | 0..1 | Identifier | Полис ДМС - добровольного медицинского страхования ele-1: All FHIR elements must have a @value or children |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) ele-1: All FHIR elements must have a @value or children |
type | Σ | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |
system | Σ | 1..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Required Pattern: http://fhir.ru/core/systems/DMS |
identifier:Contract | Σ | 0..1 | Identifier | Договор на оказание платных медицинских услугя ele-1: All FHIR elements must have a @value or children |
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) ele-1: All FHIR elements must have a @value or children |
type | Σ | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |
code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |
system | Σ | 1..1 | uri | The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Required Pattern: http://fhir.ru/core/systems/Contract |
status | ?!Σ | 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 | Σ | 0..1 | CodeableConcept | Тип страхового покрытия. Binding: Core_Vs_Nsi_Sources_Of_Paymente(required) Справочник НСИ Минздрава Источники оплаты медицинской помощи Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. ele-1: All FHIR elements must have a @value or children |
beneficiary | Σ | 1..1 | Reference(Core Patient (Пациент)) | Ссылка на пациента ele-1: All FHIR elements must have a @value or children |
payor | Σ | 1..* | Reference(Core Organisation Payer (Организация-плательщик) | Core Patient Payer (Пациент - плательщик) | Core Related Person (Лицо, имеющее связь с пациентом) | Core Related Person Payer (Лицо-плательщик, имеющее связь с пациентом)) | Плательщик: пациент, родственник или организация ele-1: All FHIR elements must have a @value or children |
Documentation for this format |
Path | Conformance | ValueSet / Code | URI |
Coverage.identifier:OMS.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 from the FHIR Standard | |
Coverage.identifier:OMS.type | required | Pattern: 1https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | |
Coverage.identifier:DMS.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 from the FHIR Standard | |
Coverage.identifier:DMS.type | required | Pattern: 2https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | |
Coverage.identifier:Contract.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 from the FHIR Standard | |
Coverage.identifier:Contract.type | required | Pattern: 3https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | |
Coverage.status | required | FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.3.0 from the FHIR Standard | |
Coverage.type | preferred | CoverageTypeAndSelf-PayCodeshttp://hl7.org/fhir/ValueSet/coverage-type from the FHIR Standard |
Id | Grade | Path(s) | Details | Requirements |
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.exists() and ('#'+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(uri) = '#').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 | 0..* | Coverage | Insurance or medical plan or a payment agreement | |||||
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): IETF language tag
| |||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
contained | 0..* | Resource | Contained, inline Resources dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
Slices for identifier | Σ | 0..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by value:system | ||||
identifier:OMS | Σ | 0..1 | Identifier | Полис ОМС- обязательного медицинского страхования | ||||
id | 0..1 | id | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) | ||||
type | Σ | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |||||
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 | 0..1 | string | Representation defined by the system | |||||
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
text | 0..1 | string | Plain text representation of the concept | |||||
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/OMS | ||||
value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
identifier:DMS | Σ | 0..1 | Identifier | Полис ДМС - добровольного медицинского страхования | ||||
id | 0..1 | id | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) | ||||
type | Σ | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |||||
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 | 0..1 | string | Representation defined by the system | |||||
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
text | 0..1 | string | Plain text representation of the concept | |||||
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/DMS | ||||
value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
identifier:Contract | Σ | 0..1 | Identifier | Договор на оказание платных медицинских услугя | ||||
id | 0..1 | id | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required) | ||||
type | Σ | 1..1 | CodeableConcept | Тип идентификатора, кодируется по НСИ Binding: Core ValueSet NSI coverage document (документы-основания для оплаты медицинских услуг) (required) 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://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document | |||||
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 | 0..1 | string | Representation defined by the system | |||||
userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
text | 0..1 | string | Plain text representation of the concept | |||||
system | Σ | 1..1 | uri | The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/Contract | ||||
value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
type | Σ | 0..1 | CodeableConcept | Тип страхового покрытия. Binding: Core_Vs_Nsi_Sources_Of_Paymente(required) Справочник НСИ Минздрава Источники оплаты медицинской помощи Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. | ||||
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | ||||
subscriber | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | ||||
subscriberId | Σ | 0..1 | string | ID assigned to the subscriber | ||||
beneficiary | Σ | 1..1 | Reference(Core Patient (Пациент)) | Ссылка на пациента | ||||
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 | Σ | 0..1 | Period | Coverage start and end dates | ||||
payor | Σ | 1..* | Reference(Core Organisation Payer (Организация-плательщик) | Core Patient Payer (Пациент - плательщик) | Core Related Person (Лицо, имеющее связь с пациентом) | Core Related Person Payer (Лицо-плательщик, имеющее связь с пациентом)) | Плательщик: пациент, родственник или организация | ||||
class | 0..* | BackboneElement | Additional coverage classifications | |||||
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 | ||||
order | Σ | 0..1 | positiveInt | Relative order of the coverage | ||||
network | Σ | 0..1 | string | Insurer network | ||||
costToBeneficiary | 0..* | BackboneElement | Patient payments for services/products | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
type | Σ | 0..1 | CodeableConcept | Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified. | ||||
value[x] | Σ | 1..1 | The amount or percentage due from the beneficiary | |||||
valueQuantity | Quantity(SimpleQuantity) | |||||||
valueMoney | Money | |||||||
exception | 0..* | BackboneElement | Exceptions for patient payments | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
type | Σ | 1..1 | CodeableConcept | Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays. | ||||
period | Σ | 0..1 | Period | The effective period of the exception | ||||
subrogation | 0..1 | boolean | Reimbursement to insurer | |||||
contract | 0..* | Reference(Contract) | Contract details | |||||
Documentation for this format |
Path | Conformance | ValueSet / Code | URI | |||
Coverage.language | preferred | CommonLanguageshttp://hl7.org/fhir/ValueSet/languages from the FHIR Standard
| ||||
Coverage.identifier:OMS.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 from the FHIR Standard | ||||
Coverage.identifier:OMS.type | required | Pattern: 1https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | ||||
Coverage.identifier:DMS.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 from the FHIR Standard | ||||
Coverage.identifier:DMS.type | required | Pattern: 2https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | ||||
Coverage.identifier:Contract.use | required | IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.3.0 from the FHIR Standard | ||||
Coverage.identifier:Contract.type | required | Pattern: 3https://fhir.ru/ig/core/ValueSet/core-vs-nsi-coverage-document from this IG | ||||
Coverage.status | required | FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.3.0 from the FHIR Standard | ||||
Coverage.type | preferred | CoverageTypeAndSelf-PayCodeshttp://hl7.org/fhir/ValueSet/coverage-type from the FHIR Standard | ||||
Coverage.relationship | extensible | SubscriberRelationshipCodeshttp://hl7.org/fhir/ValueSet/subscriber-relationship from the FHIR Standard | ||||
Coverage.class.type | extensible | CoverageClassCodeshttp://hl7.org/fhir/ValueSet/coverage-class from the FHIR Standard | ||||
Coverage.costToBeneficiary.type | extensible | CoverageCopayTypeCodeshttp://hl7.org/fhir/ValueSet/coverage-copay-type from the FHIR Standard | ||||
Coverage.costToBeneficiary.exception.type | example | ExampleCoverageFinancialExceptionCodeshttp://hl7.org/fhir/ValueSet/coverage-financial-exception from the FHIR Standard |
Id | Grade | Path(s) | Details | Requirements |
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.exists() and ('#'+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(uri) = '#').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() | |
dom-r4b | warning | Coverage.contained | Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems : ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic) | |
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: 0 element(6 nested mandatory elements)
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
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