HL7 PT FHIR Implementation Guide: Example IG Release 1 | STU1
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HL7 PT FHIR Implementation Guide: Example IG Release 1 | STU1, publicado por HL7 Portugal. Este guia não é uma publicação autorizada; é a compilação contínua para a versão 1.0.0 construída pela FHIR (HL7® FHIR® Standard) CI Build. Esta versão é baseada no conteúdo atual de https://github.com/hl7-pt/patient-admin-ig/ e muda regularmente. Veja o Diretório de versões publicadas

Resource Profile: PTCoverage

Official URL: http://example.com/fhir/hl7pt/StructureDefinition/Coverage-Pt Version: 1.0.0
Active as of 2025-12-18 Computable Name: PTCoverage

Perfil de Coverage para contexto PT, com tipos de coberturas/isenções, beneficiários (numero de beneficiários, apólices) e entidades responsáveis associadas.

Usos:

  • Este Perfil não é utilizado por nenhum perfil neste guia de implementação

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.

NomeBandeirasCard.TipoDescrição e condicionalismos    Filter: Filtersdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... id Σ 1..1 id Logical id of this artifact
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Fatias para extension 0..* Extension Extension
Fatia: Não ordenado, Aberto por value:url
.... extension:coverage-reason S 0..1 CodeableConcept motivo de isenção
URL: http://example.com/fhir/hl7pt/StructureDefinition/coverage-reason-pt
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Vínculo: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... type SΣ 0..1 CodeableConcept Coverage category such as medical or accident
Vínculo: 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.
... beneficiary SΣ 1..1 Reference(Patient) Plan beneficiary
... period SΣ 0..1 Period Coverage start and end dates
... payor SΣ 1..1 Reference(Organization) Issuer of the policy

doco Documentação para este formato

Terminologia Ligações

Caminho Estado Utilização Conjunto de valores Versão Fonte
Coverage.status Base required Financial Resource Status Codes 📍4.0.1 a norma FHIR
Coverage.type Base preferred Coverage Type and Self-Pay Codes 📍4.0.1 a norma FHIR

Restrições

Id Grau Caminho(s) Descrição Expressão
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

NomeBandeirasCard.TipoDescrição e condicionalismos    Filter: Filtersdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... id 1..1 id Logical id of this artifact
... Fatias para extension 0..* Extension Extension
Fatia: Não ordenado, Aberto por value:url
.... extension:coverage-reason S 0..1 CodeableConcept motivo de isenção
URL: http://example.com/fhir/hl7pt/StructureDefinition/coverage-reason-pt
... type S 0..1 CodeableConcept Coverage category such as medical or accident
... period S 0..1 Period Coverage start and end dates
... payor S 1..1 Reference(Organization) Issuer of the policy

doco Documentação para este formato
NomeBandeirasCard.TipoDescrição e condicionalismos    Filter: Filtersdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... id Σ 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
... Fatias para extension 0..* Extension Extension
Fatia: Não ordenado, Aberto por value:url
.... extension:coverage-reason S 0..1 CodeableConcept motivo de isenção
URL: http://example.com/fhir/hl7pt/StructureDefinition/coverage-reason-pt
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for the coverage
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Vínculo: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... type SΣ 0..1 CodeableConcept Coverage category such as medical or accident
Vínculo: 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 SΣ 1..1 Reference(Patient) Plan beneficiary
... dependent Σ 0..1 string Dependent number
... relationship 0..1 CodeableConcept Beneficiary relationship to the subscriber
Vínculo: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
... period SΣ 0..1 Period Coverage start and end dates
... payor SΣ 1..1 Reference(Organization) Issuer of the policy
... 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'
Vínculo: 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
Vínculo: 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
Vínculo: 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 Documentação para este formato

Terminologia Ligações

Caminho Estado Utilização Conjunto de valores Versão Fonte
Coverage.language Base preferred Common Languages 📍4.0.1 a norma FHIR
Coverage.status Base required Financial Resource Status Codes 📍4.0.1 a norma FHIR
Coverage.type Base preferred Coverage Type and Self-Pay Codes 📍4.0.1 a norma FHIR
Coverage.relationship Base extensible SubscriberPolicyholder Relationship Codes 📍4.0.1 a norma FHIR
Coverage.class.type Base extensible Coverage Class Codes 📍4.0.1 a norma FHIR
Coverage.costToBeneficiary.​type Base extensible Coverage Copay Type Codes 📍4.0.1 a norma FHIR
Coverage.costToBeneficiary.​exception.type Base example Example Coverage Financial Exception Codes 📍4.0.1 a norma FHIR

Restrições

Id Grau Caminho(s) Descrição Expressão
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

Resumo

Obrigatório: 1 elemento
Deve ser suportado: 5 elementos

Extensões

Esta estrutura refere-se a estas extensões:

Key Elements View

NomeBandeirasCard.TipoDescrição e condicionalismos    Filter: Filtersdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... id Σ 1..1 id Logical id of this artifact
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Fatias para extension 0..* Extension Extension
Fatia: Não ordenado, Aberto por value:url
.... extension:coverage-reason S 0..1 CodeableConcept motivo de isenção
URL: http://example.com/fhir/hl7pt/StructureDefinition/coverage-reason-pt
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Vínculo: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... type SΣ 0..1 CodeableConcept Coverage category such as medical or accident
Vínculo: 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.
... beneficiary SΣ 1..1 Reference(Patient) Plan beneficiary
... period SΣ 0..1 Period Coverage start and end dates
... payor SΣ 1..1 Reference(Organization) Issuer of the policy

doco Documentação para este formato

Terminologia Ligações

Caminho Estado Utilização Conjunto de valores Versão Fonte
Coverage.status Base required Financial Resource Status Codes 📍4.0.1 a norma FHIR
Coverage.type Base preferred Coverage Type and Self-Pay Codes 📍4.0.1 a norma FHIR

Restrições

Id Grau Caminho(s) Descrição Expressão
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

NomeBandeirasCard.TipoDescrição e condicionalismos    Filter: Filtersdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... id 1..1 id Logical id of this artifact
... Fatias para extension 0..* Extension Extension
Fatia: Não ordenado, Aberto por value:url
.... extension:coverage-reason S 0..1 CodeableConcept motivo de isenção
URL: http://example.com/fhir/hl7pt/StructureDefinition/coverage-reason-pt
... type S 0..1 CodeableConcept Coverage category such as medical or accident
... period S 0..1 Period Coverage start and end dates
... payor S 1..1 Reference(Organization) Issuer of the policy

doco Documentação para este formato

Snapshot View

NomeBandeirasCard.TipoDescrição e condicionalismos    Filter: Filtersdoco
.. Coverage 0..* Coverage Insurance or medical plan or a payment agreement
... id Σ 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
... Fatias para extension 0..* Extension Extension
Fatia: Não ordenado, Aberto por value:url
.... extension:coverage-reason S 0..1 CodeableConcept motivo de isenção
URL: http://example.com/fhir/hl7pt/StructureDefinition/coverage-reason-pt
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for the coverage
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Vínculo: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... type SΣ 0..1 CodeableConcept Coverage category such as medical or accident
Vínculo: 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 SΣ 1..1 Reference(Patient) Plan beneficiary
... dependent Σ 0..1 string Dependent number
... relationship 0..1 CodeableConcept Beneficiary relationship to the subscriber
Vínculo: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
... period SΣ 0..1 Period Coverage start and end dates
... payor SΣ 1..1 Reference(Organization) Issuer of the policy
... 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'
Vínculo: 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
Vínculo: 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
Vínculo: 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 Documentação para este formato

Terminologia Ligações

Caminho Estado Utilização Conjunto de valores Versão Fonte
Coverage.language Base preferred Common Languages 📍4.0.1 a norma FHIR
Coverage.status Base required Financial Resource Status Codes 📍4.0.1 a norma FHIR
Coverage.type Base preferred Coverage Type and Self-Pay Codes 📍4.0.1 a norma FHIR
Coverage.relationship Base extensible SubscriberPolicyholder Relationship Codes 📍4.0.1 a norma FHIR
Coverage.class.type Base extensible Coverage Class Codes 📍4.0.1 a norma FHIR
Coverage.costToBeneficiary.​type Base extensible Coverage Copay Type Codes 📍4.0.1 a norma FHIR
Coverage.costToBeneficiary.​exception.type Base example Example Coverage Financial Exception Codes 📍4.0.1 a norma FHIR

Restrições

Id Grau Caminho(s) Descrição Expressão
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

Resumo

Obrigatório: 1 elemento
Deve ser suportado: 5 elementos

Extensões

Esta estrutura refere-se a estas extensões:

 

Other representations of profile: CSV, Excel, Schematron