Belgian MyCareNet Profiles
2.1.2 - STU Belgium flag

Belgian MyCareNet Profiles, published by eHealth Platform. This guide is not an authorized publication; it is the continuous build for version 2.1.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/mycarenet/ and changes regularly. See the Directory of published versions

Resource Profile: MyCareNet Coverage BE profile

Official URL: https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-mycarenet-coverage Version: 2.1.2
Standards status: Trial-use Maturity Level: 1 Computable Name: BeMyCareNetCoverage

Coverage profile for use in the different MyCareNet flows

Usages:

  • This Profile is not used by any profiles in this Implementation Guide

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.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage C 0..* Coverage Insurance or medical plan or a payment agreement
Constraints: BeInvCT1CT2
... id SΣ 1..1 id Logical id of this artifact
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... type SΣ 1..1 CodeableConcept Coverage category such as medical or accident
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.
.... coding SΣ 1..1 Coding Code defined by a terminology system
..... system SΣ 1..1 uri Identity of the terminology system
..... code SΣ 1..1 code Symbol in syntax defined by the system
... beneficiary SΣ 1..1 Reference(BePatient(2.1.2)) Plan beneficiary
... payor SΣ 1..1 Reference(BeOrganization(2.1.2)) Issuer of the policy
... class S 2..* BackboneElement Additional coverage classifications
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type SΣ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
..... coding SΣ 1..1 Coding Code defined by a terminology system
...... system SΣ 1..1 uri Identity of the terminology system
...... code SΣ 1..1 code Symbol in syntax defined by the system
.... value SΣ 1..1 string Value associated with the type
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:system S 0..1 uri Extension
URL: https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Coverage.status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
Coverage.type Base preferred Coverage Type and Self-Pay Codes 📍4.0.1 FHIR Std.
Coverage.class.type Base extensible Coverage Class Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
BeInvCT1CT2 error Coverage Coverage.class SHALL contain at least a CT1 and a CT2 value Coverage.class.value.extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value is Uri).where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1').empty().not() and Coverage.class.value.extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value is Uri).where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2').empty().not() and Coverage.class.value.where(extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1').exists()).memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-holder-code-1') and Coverage.class.value.where(extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2').exists()).memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-holder-code-2')
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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage C 0..* Coverage Insurance or medical plan or a payment agreement
Constraints: BeInvCT1CT2
... id S 1..1 id Logical id of this artifact
... status S 1..1 code active | cancelled | draft | entered-in-error
... type S 1..1 CodeableConcept Coverage category such as medical or accident
.... coding S 1..1 Coding Code defined by a terminology system
..... system S 1..1 uri Identity of the terminology system
..... code S 1..1 code Symbol in syntax defined by the system
... payor S 1..1 Reference(BeOrganization(2.1.2)) Issuer of the policy
... class S 2..* BackboneElement Additional coverage classifications
.... type S 1..1 CodeableConcept Type of class such as 'group' or 'plan'
..... coding S 1..1 Coding Code defined by a terminology system
...... system S 1..1 uri Identity of the terminology system
...... code S 1..1 code Symbol in syntax defined by the system
.... value S 1..1 string Value associated with the type
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:system S 0..1 uri Extension
URL: https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
BeInvCT1CT2 error Coverage Coverage.class SHALL contain at least a CT1 and a CT2 value Coverage.class.value.extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value is Uri).where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1').empty().not() and Coverage.class.value.extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value is Uri).where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2').empty().not() and Coverage.class.value.where(extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1').exists()).memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-holder-code-1') and Coverage.class.value.where(extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2').exists()).memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-holder-code-2')
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage C 0..* Coverage Insurance or medical plan or a payment agreement
Constraints: BeInvCT1CT2
... id SΣ 1..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
... 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
... 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 Coverage category such as medical or accident
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.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣ 1..1 Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system SΣ 1..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code SΣ 1..1 code Symbol in syntax defined by the system
..... display Σ 0..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... 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 SΣ 1..1 Reference(BePatient(2.1.2)) Plan beneficiary
... 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 SΣ 1..1 Reference(BeOrganization(2.1.2)) Issuer of the policy
... class S 2..* 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 SΣ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ 1..1 Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... value SΣ 1..1 string Value associated with the type
..... id 0..1 string xml:id (or equivalent in JSON)
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:system S 0..1 uri Extension
URL: https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system
..... 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Coverage.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Coverage.status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
Coverage.type Base preferred Coverage Type and Self-Pay Codes 📍4.0.1 FHIR Std.
Coverage.relationship Base extensible SubscriberPolicyholder Relationship Codes 📍4.0.1 FHIR Std.
Coverage.class.type Base extensible Coverage Class Codes 📍4.0.1 FHIR Std.
Coverage.costToBeneficiary.​type Base extensible Coverage Copay Type Codes 📍4.0.1 FHIR Std.
Coverage.costToBeneficiary.​exception.type Base example Example Coverage Financial Exception Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
BeInvCT1CT2 error Coverage Coverage.class SHALL contain at least a CT1 and a CT2 value Coverage.class.value.extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value is Uri).where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1').empty().not() and Coverage.class.value.extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value is Uri).where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2').empty().not() and Coverage.class.value.where(extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1').exists()).memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-holder-code-1') and Coverage.class.value.where(extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2').exists()).memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-holder-code-2')
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

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage C 0..* Coverage Insurance or medical plan or a payment agreement
Constraints: BeInvCT1CT2
... id SΣ 1..1 id Logical id of this artifact
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... type SΣ 1..1 CodeableConcept Coverage category such as medical or accident
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.
.... coding SΣ 1..1 Coding Code defined by a terminology system
..... system SΣ 1..1 uri Identity of the terminology system
..... code SΣ 1..1 code Symbol in syntax defined by the system
... beneficiary SΣ 1..1 Reference(BePatient(2.1.2)) Plan beneficiary
... payor SΣ 1..1 Reference(BeOrganization(2.1.2)) Issuer of the policy
... class S 2..* BackboneElement Additional coverage classifications
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type SΣ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
..... coding SΣ 1..1 Coding Code defined by a terminology system
...... system SΣ 1..1 uri Identity of the terminology system
...... code SΣ 1..1 code Symbol in syntax defined by the system
.... value SΣ 1..1 string Value associated with the type
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:system S 0..1 uri Extension
URL: https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Coverage.status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
Coverage.type Base preferred Coverage Type and Self-Pay Codes 📍4.0.1 FHIR Std.
Coverage.class.type Base extensible Coverage Class Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
BeInvCT1CT2 error Coverage Coverage.class SHALL contain at least a CT1 and a CT2 value Coverage.class.value.extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value is Uri).where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1').empty().not() and Coverage.class.value.extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value is Uri).where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2').empty().not() and Coverage.class.value.where(extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1').exists()).memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-holder-code-1') and Coverage.class.value.where(extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2').exists()).memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-holder-code-2')
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()

Differential View

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage C 0..* Coverage Insurance or medical plan or a payment agreement
Constraints: BeInvCT1CT2
... id S 1..1 id Logical id of this artifact
... status S 1..1 code active | cancelled | draft | entered-in-error
... type S 1..1 CodeableConcept Coverage category such as medical or accident
.... coding S 1..1 Coding Code defined by a terminology system
..... system S 1..1 uri Identity of the terminology system
..... code S 1..1 code Symbol in syntax defined by the system
... payor S 1..1 Reference(BeOrganization(2.1.2)) Issuer of the policy
... class S 2..* BackboneElement Additional coverage classifications
.... type S 1..1 CodeableConcept Type of class such as 'group' or 'plan'
..... coding S 1..1 Coding Code defined by a terminology system
...... system S 1..1 uri Identity of the terminology system
...... code S 1..1 code Symbol in syntax defined by the system
.... value S 1..1 string Value associated with the type
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:system S 0..1 uri Extension
URL: https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
BeInvCT1CT2 error Coverage Coverage.class SHALL contain at least a CT1 and a CT2 value Coverage.class.value.extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value is Uri).where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1').empty().not() and Coverage.class.value.extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value is Uri).where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2').empty().not() and Coverage.class.value.where(extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1').exists()).memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-holder-code-1') and Coverage.class.value.where(extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2').exists()).memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-holder-code-2')

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Coverage C 0..* Coverage Insurance or medical plan or a payment agreement
Constraints: BeInvCT1CT2
... id SΣ 1..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
... 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
... 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 Coverage category such as medical or accident
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.
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... coding SΣ 1..1 Coding Code defined by a terminology system
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... system SΣ 1..1 uri Identity of the terminology system
..... version Σ 0..1 string Version of the system - if relevant
..... code SΣ 1..1 code Symbol in syntax defined by the system
..... display Σ 0..1 string Representation defined by the system
..... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
.... text Σ 0..1 string Plain text representation of the concept
... 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 SΣ 1..1 Reference(BePatient(2.1.2)) Plan beneficiary
... 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 SΣ 1..1 Reference(BeOrganization(2.1.2)) Issuer of the policy
... class S 2..* 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 SΣ 1..1 CodeableConcept Type of class such as 'group' or 'plan'
Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ 1..1 Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code SΣ 1..1 code Symbol in syntax defined by the system
...... display Σ 0..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... value SΣ 1..1 string Value associated with the type
..... id 0..1 string xml:id (or equivalent in JSON)
..... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:system S 0..1 uri Extension
URL: https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system
..... 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Coverage.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Coverage.status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
Coverage.type Base preferred Coverage Type and Self-Pay Codes 📍4.0.1 FHIR Std.
Coverage.relationship Base extensible SubscriberPolicyholder Relationship Codes 📍4.0.1 FHIR Std.
Coverage.class.type Base extensible Coverage Class Codes 📍4.0.1 FHIR Std.
Coverage.costToBeneficiary.​type Base extensible Coverage Copay Type Codes 📍4.0.1 FHIR Std.
Coverage.costToBeneficiary.​exception.type Base example Example Coverage Financial Exception Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
BeInvCT1CT2 error Coverage Coverage.class SHALL contain at least a CT1 and a CT2 value Coverage.class.value.extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value is Uri).where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1').empty().not() and Coverage.class.value.extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value is Uri).where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2').empty().not() and Coverage.class.value.where(extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1').exists()).memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-holder-code-1') and Coverage.class.value.where(extension('https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system').where(value = 'https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2').exists()).memberOf('https://www.ehealth.fgov.be/standards/fhir/mycarenet/ValueSet/be-vs-holder-code-2')
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

 

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