HL7 Europe Base Profiles
0.0.1-ci - ci-build 150

HL7 Europe Base Profiles, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.0.1-ci built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/base/ and changes regularly. See the Directory of published versions

Resource Profile: Coverage: EHIC

Official URL: http://hl7.eu/fhir/base/StructureDefinition/Coverage-eu-ehic Version: 0.0.1-ci
Draft as of 2024-12-18 Computable Name: CoverageEhic

Copyright/Legal: Used by permission of HL7 Europe, all rights reserved Creative Commons License

Coverage profile for the European Health Insurance Card

Usage:

Formal Views of Profile Content

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

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... identifier 1..1 Identifier EHIC#8 - Identification number of the card
... type 1..1 CodeableConcept Coverage category such as medical or accident
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: http://terminology.hl7.eu/CodeSystem/v3-ActCode
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: EHIC
..... display 1..1 string Representation defined by the system
Fixed Value: European Health Insurance Card
... beneficiary 1..1 Reference(Patient (EHIC)) EHIC fields #3 to #6 (Name, Id, birthDate)
.... end 1..1 dateTime EHIC#9 - Expiry date
... insurer 1..1 Reference(Organization) Issuer of the policy
.... display 1..1 string EHIC#7 - Identification number of the institution

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... status ?!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
... kind Σ 1..1 code insurance | self-pay | other
Binding: Kind (required)
ele-1: All FHIR elements must have a @value or children
... type Σ 1..1 CodeableConcept Coverage category such as medical or accident
Binding: CoverageTypeAndSelfPayCodes (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
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: http://terminology.hl7.eu/CodeSystem/v3-ActCode
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: EHIC
..... display 1..1 string Representation defined by the system
Fixed Value: European Health Insurance Card
... beneficiary Σ 1..1 Reference(Patient (EHIC)) EHIC fields #3 to #6 (Name, Id, birthDate)
ele-1: All FHIR elements must have a @value or children
... period Σ 1..1 Period Coverage start and end dates
ele-1: All FHIR elements must have a @value or children
.... end ΣC 1..1 dateTime EHIC#9 - Expiry date
ele-1: All FHIR elements must have a @value or children
... insurer Σ 1..1 Reference(Organization) Issuer of the policy
ele-1: All FHIR elements must have a @value or children
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
ele-1: All FHIR elements must have a @value or children
.... display ΣC 1..1 string EHIC#7 - Identification number of the institution
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Coverage.statusrequiredFinancialResourceStatusCodes
http://hl7.org/fhir/ValueSet/fm-status|5.0.0
from the FHIR Standard
Coverage.kindrequiredKind
http://hl7.org/fhir/ValueSet/coverage-kind|5.0.0
from the FHIR Standard
Coverage.typepreferredPattern: EHIC("European Health Insurance Card")
http://hl7.org/fhir/ValueSet/coverage-type
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorCoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageIf 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCoverageIf 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-5errorCoverageIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCoverageA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. 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: AllLanguages (required): IETF language tag for a human language

Additional BindingsPurpose
CommonLanguages Starter Set
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... identifier Σ 1..1 Identifier EHIC#8 - Identification number of the card
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.

... kind Σ 1..1 code insurance | self-pay | other
Binding: Kind (required)
... paymentBy 0..* BackboneElement Self-pay parties and responsibility
.... 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
.... party Σ 1..1 Reference(Patient | RelatedPerson | Organization) Parties performing self-payment
.... responsibility Σ 0..1 string Party's responsibility
... type Σ 1..1 CodeableConcept Coverage category such as medical or accident
Binding: CoverageTypeAndSelfPayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.


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: http://terminology.hl7.eu/CodeSystem/v3-ActCode
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: EHIC
..... display 1..1 string Representation defined by the system
Fixed Value: European Health Insurance Card
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 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..* Identifier ID assigned to the subscriber
... beneficiary Σ 1..1 Reference(Patient (EHIC)) EHIC fields #3 to #6 (Name, Id, birthDate)
... 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 1..1 Period Coverage start and end dates
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... start ΣC 0..1 dateTime Starting time with inclusive boundary
.... end ΣC 1..1 dateTime EHIC#9 - Expiry date
... insurer Σ 1..1 Reference(Organization) Issuer of the policy
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient") - must be a resource in resources
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier ΣC 0..1 Identifier Logical reference, when literal reference is not known
.... display ΣC 1..1 string EHIC#7 - Identification number of the institution
... 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, e.g. Group, Plan, Class, etc.

.... value Σ 1..1 Identifier 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.

.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example)
.... network 0..1 CodeableConcept In or out of network
Binding: NetworkTypeCodes (example)
.... unit 0..1 CodeableConcept Individual or family
Binding: UnitTypeCodes (example)
.... term 0..1 CodeableConcept Annual or lifetime
Binding: BenefitTermCodes (example)
.... value[x] Σ 0..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
... insurancePlan 0..1 Reference(InsurancePlan) Insurance plan details

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Coverage.languagerequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages|5.0.0
from the FHIR Standard
Coverage.statusrequiredFinancialResourceStatusCodes
http://hl7.org/fhir/ValueSet/fm-status|5.0.0
from the FHIR Standard
Coverage.kindrequiredKind
http://hl7.org/fhir/ValueSet/coverage-kind|5.0.0
from the FHIR Standard
Coverage.typepreferredPattern: EHIC("European Health Insurance Card")
http://hl7.org/fhir/ValueSet/coverage-type
from the FHIR Standard
Coverage.relationshipextensibleSubscriberRelationshipCodes
http://hl7.org/fhir/ValueSet/subscriber-relationship
from the FHIR Standard
Coverage.insurer.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Coverage.class.typeextensibleCoverageClassCodes
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.costToBeneficiary.typeextensibleCoverageCopayTypeCodes
http://hl7.org/fhir/ValueSet/coverage-copay-type
from the FHIR Standard
Coverage.costToBeneficiary.categoryexampleBenefitCategoryCodes
http://hl7.org/fhir/ValueSet/ex-benefitcategory
from the FHIR Standard
Coverage.costToBeneficiary.networkexampleNetworkTypeCodes
http://hl7.org/fhir/ValueSet/benefit-network
from the FHIR Standard
Coverage.costToBeneficiary.unitexampleUnitTypeCodes
http://hl7.org/fhir/ValueSet/benefit-unit
from the FHIR Standard
Coverage.costToBeneficiary.termexampleBenefitTermCodes
http://hl7.org/fhir/ValueSet/benefit-term
from the FHIR Standard
Coverage.costToBeneficiary.exception.typeexampleExampleCoverageFinancialExceptionCodes
http://hl7.org/fhir/ValueSet/coverage-financial-exception
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorCoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageIf 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCoverageIf 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-5errorCoverageIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCoverageA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from Coverage

Summary

Mandatory: 6 elements

Structures

This structure refers to these other structures:

Differential View

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... identifier 1..1 Identifier EHIC#8 - Identification number of the card
... type 1..1 CodeableConcept Coverage category such as medical or accident
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: http://terminology.hl7.eu/CodeSystem/v3-ActCode
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: EHIC
..... display 1..1 string Representation defined by the system
Fixed Value: European Health Insurance Card
... beneficiary 1..1 Reference(Patient (EHIC)) EHIC fields #3 to #6 (Name, Id, birthDate)
.... end 1..1 dateTime EHIC#9 - Expiry date
... insurer 1..1 Reference(Organization) Issuer of the policy
.... display 1..1 string EHIC#7 - Identification number of the institution

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... status ?!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
... kind Σ 1..1 code insurance | self-pay | other
Binding: Kind (required)
ele-1: All FHIR elements must have a @value or children
... type Σ 1..1 CodeableConcept Coverage category such as medical or accident
Binding: CoverageTypeAndSelfPayCodes (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
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: http://terminology.hl7.eu/CodeSystem/v3-ActCode
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: EHIC
..... display 1..1 string Representation defined by the system
Fixed Value: European Health Insurance Card
... beneficiary Σ 1..1 Reference(Patient (EHIC)) EHIC fields #3 to #6 (Name, Id, birthDate)
ele-1: All FHIR elements must have a @value or children
... period Σ 1..1 Period Coverage start and end dates
ele-1: All FHIR elements must have a @value or children
.... end ΣC 1..1 dateTime EHIC#9 - Expiry date
ele-1: All FHIR elements must have a @value or children
... insurer Σ 1..1 Reference(Organization) Issuer of the policy
ele-1: All FHIR elements must have a @value or children
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
ele-1: All FHIR elements must have a @value or children
.... display ΣC 1..1 string EHIC#7 - Identification number of the institution
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Coverage.statusrequiredFinancialResourceStatusCodes
http://hl7.org/fhir/ValueSet/fm-status|5.0.0
from the FHIR Standard
Coverage.kindrequiredKind
http://hl7.org/fhir/ValueSet/coverage-kind|5.0.0
from the FHIR Standard
Coverage.typepreferredPattern: EHIC("European Health Insurance Card")
http://hl7.org/fhir/ValueSet/coverage-type
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorCoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageIf 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCoverageIf 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-5errorCoverageIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCoverageA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. 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: AllLanguages (required): IETF language tag for a human language

Additional BindingsPurpose
CommonLanguages Starter Set
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... identifier Σ 1..1 Identifier EHIC#8 - Identification number of the card
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.

... kind Σ 1..1 code insurance | self-pay | other
Binding: Kind (required)
... paymentBy 0..* BackboneElement Self-pay parties and responsibility
.... 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
.... party Σ 1..1 Reference(Patient | RelatedPerson | Organization) Parties performing self-payment
.... responsibility Σ 0..1 string Party's responsibility
... type Σ 1..1 CodeableConcept Coverage category such as medical or accident
Binding: CoverageTypeAndSelfPayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.


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: http://terminology.hl7.eu/CodeSystem/v3-ActCode
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: EHIC
..... display 1..1 string Representation defined by the system
Fixed Value: European Health Insurance Card
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 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..* Identifier ID assigned to the subscriber
... beneficiary Σ 1..1 Reference(Patient (EHIC)) EHIC fields #3 to #6 (Name, Id, birthDate)
... 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 1..1 Period Coverage start and end dates
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... start ΣC 0..1 dateTime Starting time with inclusive boundary
.... end ΣC 1..1 dateTime EHIC#9 - Expiry date
... insurer Σ 1..1 Reference(Organization) Issuer of the policy
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... type Σ 0..1 uri Type the reference refers to (e.g. "Patient") - must be a resource in resources
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).

.... identifier ΣC 0..1 Identifier Logical reference, when literal reference is not known
.... display ΣC 1..1 string EHIC#7 - Identification number of the institution
... 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, e.g. Group, Plan, Class, etc.

.... value Σ 1..1 Identifier 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.

.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example)
.... network 0..1 CodeableConcept In or out of network
Binding: NetworkTypeCodes (example)
.... unit 0..1 CodeableConcept Individual or family
Binding: UnitTypeCodes (example)
.... term 0..1 CodeableConcept Annual or lifetime
Binding: BenefitTermCodes (example)
.... value[x] Σ 0..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
... insurancePlan 0..1 Reference(InsurancePlan) Insurance plan details

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Coverage.languagerequiredAllLanguages
http://hl7.org/fhir/ValueSet/all-languages|5.0.0
from the FHIR Standard
Coverage.statusrequiredFinancialResourceStatusCodes
http://hl7.org/fhir/ValueSet/fm-status|5.0.0
from the FHIR Standard
Coverage.kindrequiredKind
http://hl7.org/fhir/ValueSet/coverage-kind|5.0.0
from the FHIR Standard
Coverage.typepreferredPattern: EHIC("European Health Insurance Card")
http://hl7.org/fhir/ValueSet/coverage-type
from the FHIR Standard
Coverage.relationshipextensibleSubscriberRelationshipCodes
http://hl7.org/fhir/ValueSet/subscriber-relationship
from the FHIR Standard
Coverage.insurer.typeextensibleResourceType
http://hl7.org/fhir/ValueSet/resource-types
from the FHIR Standard
Coverage.class.typeextensibleCoverageClassCodes
http://hl7.org/fhir/ValueSet/coverage-class
from the FHIR Standard
Coverage.costToBeneficiary.typeextensibleCoverageCopayTypeCodes
http://hl7.org/fhir/ValueSet/coverage-copay-type
from the FHIR Standard
Coverage.costToBeneficiary.categoryexampleBenefitCategoryCodes
http://hl7.org/fhir/ValueSet/ex-benefitcategory
from the FHIR Standard
Coverage.costToBeneficiary.networkexampleNetworkTypeCodes
http://hl7.org/fhir/ValueSet/benefit-network
from the FHIR Standard
Coverage.costToBeneficiary.unitexampleUnitTypeCodes
http://hl7.org/fhir/ValueSet/benefit-unit
from the FHIR Standard
Coverage.costToBeneficiary.termexampleBenefitTermCodes
http://hl7.org/fhir/ValueSet/benefit-term
from the FHIR Standard
Coverage.costToBeneficiary.exception.typeexampleExampleCoverageFinancialExceptionCodes
http://hl7.org/fhir/ValueSet/coverage-financial-exception
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorCoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageIf 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorCoverageIf 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-5errorCoverageIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCoverageA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from Coverage

Summary

Mandatory: 6 elements

Structures

This structure refers to these other structures:

 

Other representations of profile: CSV, Excel, Schematron