HL7 Europe Laboratory Report
0.2.0-ci - ci-build 150

HL7 Europe Laboratory Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.2.0-ci built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/laboratory/ and changes regularly. See the Directory of published versions

: A.1.3 - Health insurance and payment information model to this guide - XML Representation

Page standards status: Informative Maturity Level: 2

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<ConceptMap xmlns="http://hl7.org/fhir">
  <id value="payer2FHIR-eu-lab"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ConceptMap payer2FHIR-eu-lab</b></p><a name="payer2FHIR-eu-lab"> </a><a name="hcpayer2FHIR-eu-lab"> </a><a name="payer2FHIR-eu-lab-en-US"> </a><p>Mapping from <a href="StructureDefinition-Payer.html">A.1.3 - Health insurance and payment information</a> to <a href="StructureDefinition-Bundle-eu-lab.html">Bundle: Laboratory Report</a></p><br/><p><b>Group 1 </b>Mapping from <a href="StructureDefinition-Payer.html">A.1.3 - Health insurance and payment information</a> to <a href="StructureDefinition-ServiceRequest-eu-lab.html">ServiceRequest: Laboratory Order</a></p><table class="grid"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td><td><b>Comment</b></td></tr><tr><td>Payer.insurance (A.1.3.1 Health insurance information)</td><td><a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-concept-map-equivalence.html#relatedto" title="relatedto">is related to</a></td><td>ServiceRequest.insurance</td><td>insurance.ofType(Coverage)</td></tr><tr><td>Payer.insurance.identifier (A.1.3.1.1 Health insurance code)</td><td><a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-concept-map-equivalence.html#relatedto" title="relatedto">is related to</a></td><td>ServiceRequest.insurance</td><td>details in Group 2</td></tr><tr><td>Payer.insurance.name (A.1.3.1.2 Health insurance name)</td><td><a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-concept-map-equivalence.html#relatedto" title="relatedto">is related to</a></td><td>ServiceRequest.insurance</td><td>details in Group 2</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-concept-map-equivalence.html#relatedto" title="relatedto">is related to</a></td><td>ServiceRequest.insurance</td><td>details in Group 2</td></tr></table><hr/><p><b>Group 2 </b>Mapping from <a href="StructureDefinition-Payer.html">A.1.3 - Health insurance and payment information</a> to <a href="http://hl7.org/fhir/R4/coverage.html">Coverage</a></p><table class="grid"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td><td><b>Comment</b></td></tr><tr><td>Payer.insurance (A.1.3.1 Health insurance information)</td><td><a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-concept-map-equivalence.html#relatedto" title="relatedto">is related to</a></td><td>Coverage</td><td/></tr><tr><td>Payer.insurance.identifier (A.1.3.1.1 Health insurance code)</td><td><a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-concept-map-equivalence.html#equivalent" title="equivalent">is equivalent to</a></td><td>Coverage.payor.identifier</td><td>payor.ofType(Organization)</td></tr><tr><td>Payer.insurance.name (A.1.3.1.2 Health insurance name)</td><td><a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-concept-map-equivalence.html#equivalent" title="equivalent">is equivalent to</a></td><td>Coverage.payor.name</td><td>payor.ofType(Organization)</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-concept-map-equivalence.html#equivalent" title="equivalent">is equivalent to</a></td><td>Coverage.policyHolder.identifier</td><td>If it refers to the owner of the policy</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-concept-map-equivalence.html#equivalent" title="equivalent">is equivalent to</a></td><td>Coverage.beneficiary.identifier</td><td>If it refers to the plan beneficiary</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-concept-map-equivalence.html#equivalent" title="equivalent">is equivalent to</a></td><td>Coverage.subscriberId</td><td>If it is the ID assigned to the subscriber</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-concept-map-equivalence.html#equivalent" title="equivalent">is equivalent to</a></td><td>Coverage.subscriber.identifier</td><td>If it refers to the subscriber to the policy and the Subscriber is of type Patient</td></tr></table><hr/><p><b>Group 3 </b>Mapping from <a href="StructureDefinition-Payer.html">A.1.3 - Health insurance and payment information</a> to <a href="StructureDefinition-Patient-eu-lab.html">Patient: Person</a></p><table class="grid"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td><td><b>Comment</b></td></tr><tr><td>Payer.insurance (A.1.3.1 Health insurance information)</td><td colspan="3" style="background-color: #efefef">(not mapped)</td></tr><tr><td>Payer.insurance.identifier (A.1.3.1.1 Health insurance code)</td><td colspan="3" style="background-color: #efefef">(not mapped)</td></tr><tr><td>Payer.insurance.name (A.1.3.1.2 Health insurance name)</td><td colspan="3" style="background-color: #efefef">(not mapped)</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/extensions/5.1.0/CodeSystem-concept-map-equivalence.html#relatedto" title="relatedto">is related to</a></td><td>Patient.identifier</td><td>Sometimes the identifier assigned by the payor (e.g. the SSN) is used as one of the Patient Identifiers</td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="2"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="informative"/>
  </extension>
  <url value="http://hl7.eu/fhir/laboratory/ConceptMap/payer2FHIR-eu-lab"/>
  <version value="0.2.0-ci"/>
  <name value="Payer2Fhir"/>
  <title value="eHN Payer to this guide Map"/>
  <status value="draft"/>
  <experimental value="true"/>
  <date value="2024-10-14T12:48:35+00:00"/>
  <publisher value="HL7 Europe"/>
  <contact>
    <name value="HL7 Europe"/>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.eu"/>
    </telecom>
  </contact>
  <description value="eHN Payer Model to this guide Map"/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="150"/>
      <display value="Europe"/>
    </coding>
  </jurisdiction>
  <purpose
           value="It shows how the Laboratory Report Payer data set defined by the EU eHN guidelines is mapped into this guide"/>
  <copyright
             value="Used by permission of HL7 Europe, all rights reserved Creative Commons License"/>
  <sourceUri value="http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"/>
  <targetUri
             value="http://hl7.eu/fhir/laboratory/StructureDefinition/Bundle-eu-lab"/>
  <group>
    <source value="http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"/>
    <target
            value="http://hl7.eu/fhir/laboratory/StructureDefinition/ServiceRequest-eu-lab"/>
    <element>
      <code value="Payer.insurance"/>
      <display value="A.1.3.1 Health insurance information"/>
      <target>
        <code value="ServiceRequest.insurance"/>
        <equivalence value="relatedto"/>
        <comment value="insurance.ofType(Coverage)"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.identifier"/>
      <display value="A.1.3.1.1 Health insurance code"/>
      <target>
        <code value="ServiceRequest.insurance"/>
        <equivalence value="relatedto"/>
        <comment value="details in Group 2"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.name"/>
      <display value="A.1.3.1.2 Health insurance name"/>
      <target>
        <code value="ServiceRequest.insurance"/>
        <equivalence value="relatedto"/>
        <comment value="details in Group 2"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.subjectIdentifier"/>
      <display value="A.1.3.1.3 Health insurance number"/>
      <target>
        <code value="ServiceRequest.insurance"/>
        <equivalence value="relatedto"/>
        <comment value="details in Group 2"/>
      </target>
    </element>
  </group>
  <group>
    <source value="http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"/>
    <target value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
    <element>
      <code value="Payer.insurance"/>
      <display value="A.1.3.1 Health insurance information"/>
      <target>
        <code value="Coverage"/>
        <equivalence value="relatedto"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.identifier"/>
      <display value="A.1.3.1.1 Health insurance code"/>
      <target>
        <code value="Coverage.payor.identifier"/>
        <equivalence value="equivalent"/>
        <comment value="payor.ofType(Organization)"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.name"/>
      <display value="A.1.3.1.2 Health insurance name"/>
      <target>
        <code value="Coverage.payor.name"/>
        <equivalence value="equivalent"/>
        <comment value="payor.ofType(Organization)"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.subjectIdentifier"/>
      <display value="A.1.3.1.3 Health insurance number"/>
      <target>
        <code value="Coverage.policyHolder.identifier"/>
        <equivalence value="equivalent"/>
        <comment value="If it refers to the owner of the policy"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.subjectIdentifier"/>
      <display value="A.1.3.1.3 Health insurance number"/>
      <target>
        <code value="Coverage.beneficiary.identifier"/>
        <equivalence value="equivalent"/>
        <comment value="If it refers to the plan beneficiary"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.subjectIdentifier"/>
      <display value="A.1.3.1.3 Health insurance number"/>
      <target>
        <code value="Coverage.subscriberId"/>
        <equivalence value="equivalent"/>
        <comment value="If it is the ID assigned to the subscriber"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.subjectIdentifier"/>
      <display value="A.1.3.1.3 Health insurance number"/>
      <target>
        <code value="Coverage.subscriber.identifier"/>
        <equivalence value="equivalent"/>
        <comment
                 value="If it refers to the subscriber to the policy and the Subscriber is of type Patient"/>
      </target>
    </element>
  </group>
  <group>
    <source value="http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"/>
    <target
            value="http://hl7.eu/fhir/laboratory/StructureDefinition/Patient-eu-lab"/>
    <element>
      <code value="Payer.insurance"/>
      <display value="A.1.3.1 Health insurance information"/>
      <target>
        <equivalence value="unmatched"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.identifier"/>
      <display value="A.1.3.1.1 Health insurance code"/>
      <target>
        <equivalence value="unmatched"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.name"/>
      <display value="A.1.3.1.2 Health insurance name"/>
      <target>
        <equivalence value="unmatched"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.subjectIdentifier"/>
      <display value="A.1.3.1.3 Health insurance number"/>
      <target>
        <code value="Patient.identifier"/>
        <equivalence value="relatedto"/>
        <comment
                 value="Sometimes the identifier assigned by the payor (e.g. the SSN) is used as one of the Patient Identifiers"/>
      </target>
    </element>
  </group>
</ConceptMap>