Profile Comparison between http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-coverage vs http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-coverage

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org.au/fhir/StructureDefinition/au-coverage
copyright	Used by permission of HL7 International, all rights reserved Creative Commons License. HL7 Australia© 2024+; Licensed Under Creative Commons No Rights Reserved.
description	This profile sets minimum expectations for a Coverage resource that is used to record, search, and fetch information about insurance or medical plan or a payment agreement for a patient. It is based on the [AU Base Coverage](https://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-coverage.html) and identifies the additional constraints, extensions, vocabularies and value sets that **SHALL** be present in the Coverage when conforming to this profile.	This profile sets minimum expectations for a Coverage resource that is used to record, search, and fetch information about insurance or medical plan or a payment agreement for a patient. It is based on the [AU Base Coverage](https://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-coverage.html) profile and identifies the additional constraints, extensions, vocabularies and value sets that **SHALL** be present in the Coverage when conforming to this profile.	Values Differ
experimental
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#AU
kind	resource
name	AUeRequestingCoverage
publisher	HL7 Australia
purpose
status	active
title	AU eRequesting Coverage
type	Coverage
url	http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-coverage

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	R Type	R Description & Constraints	Comments
Coverage		0..*	AUBaseCoverage	Insurance or medical plan or a payment agreement		0..*	AUBaseCoverage	Insurance or medical plan or a payment agreement
id	Σ	0..1	id	Logical id of this artifact	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding	Example/preferred bindings differ at Coverage.language using binding from AUeRequestingCoverage
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		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		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	??, ??, ??, ??, ??, ??, ??	Business Identifier for the coverage	SOΣ	0..*	??, ??, ??, ??, ??, ??, ??	Business Identifier for the coverage Obligations Actor SHALL:populate-if-known AU eRequesting Placer SHALL:handle AU eRequesting Filler SHALL:handle AU eRequesting Server SHALL:able-to-populate AU eRequesting Server SHALL:no-error AU eRequesting Patient	Elements differ in definition for mustSupport: 'false' vs 'true' Type Mismatch: Identifier([CanonicalType[http://hl7.org/fhir/StructureDefinition/Identifier], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-medicarecardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-dvanumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-insurancemembernumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-pensionerconcessioncardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-cwlthseniorshealthcardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-healthcarecardnumber]]) vs Identifier([CanonicalType[http://hl7.org/fhir/StructureDefinition/Identifier], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-medicarecardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-dvanumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-insurancemembernumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-pensionerconcessioncardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-cwlthseniorshealthcardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-healthcarecardnumber]])
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance.	?!SOΣ	1..1	code	Status of the coverage Binding: ?? (required): A code specifying the state of the resource instance. Fixed Value: active Obligations Actor SHALL:populate AU eRequesting Placer SHALL:handle AU eRequesting Filler SHALL:handle AU eRequesting Server SHALL:able-to-populate AU eRequesting Server SHALL:no-error AU eRequesting Patient	Elements differ in definition for mustSupport: 'false' vs 'true'
type	SOΣ	1..1	CodeableConcept	Coverage category such as medical or accident Binding: ?? (preferred) Additional Bindings Purpose ?? Min Binding Obligations Actor SHALL:populate AU eRequesting Placer SHALL:handle AU eRequesting Filler SHALL:handle AU eRequesting Server SHALL:able-to-populate AU eRequesting Server SHALL:no-error AU eRequesting Patient	SOΣ	1..1	CodeableConcept	Coverage category such as medical or accident Binding: ?? (preferred) Additional Bindings Purpose ?? Min Binding Obligations Actor SHALL:populate AU eRequesting Placer SHALL:handle AU eRequesting Filler SHALL:handle AU eRequesting Server SHALL:able-to-populate AU eRequesting Server SHALL:no-error AU eRequesting Patient
policyHolder	Σ	0..1	Reference(Patient | RelatedPerson | Organization)	Owner of the policy	Σ	0..1	Reference(Patient | RelatedPerson | Organization)	Owner of the policy
subscriber	Σ	0..1	Reference(Patient | RelatedPerson)	Subscriber to the policy	Σ	0..1	Reference(Patient | RelatedPerson)	Subscriber to the policy
subscriberId	Σ	0..1	string	ID assigned to the subscriber	Σ	0..1	string	ID assigned to the subscriber
beneficiary	Σ	1..1	Reference(Patient)	Plan beneficiary	SOΣ	1..1	Reference(AU eRequesting Patient)	Plan beneficiary Obligations Actor SHALL:populate AU eRequesting Placer SHALL:handle AU eRequesting Filler SHALL:handle AU eRequesting Server SHALL:able-to-populate AU eRequesting Server SHALL:no-error AU eRequesting Patient	Elements differ in definition for mustSupport: 'false' vs 'true'
dependent	Σ	0..1	string	Dependent number	Σ	0..1	string	Dependent number
relationship		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
period	Σ	0..1	Period	Coverage start and end dates	Σ	0..1	Period	Coverage start and end dates
payor	Σ	1..*	Reference(Organization | Patient | RelatedPerson)	Issuer of the policy	SOΣ	1..*	Reference(AU eRequesting Patient | AU eRequesting Organization | AU Core RelatedPerson)	Issuer of the policy Obligations Actor SHALL:populate AU eRequesting Placer SHALL:handle AU eRequesting Filler SHALL:handle AU eRequesting Server SHALL:able-to-populate AU eRequesting Server SHALL:no-error AU eRequesting Patient	Elements differ in definition for mustSupport: 'false' vs 'true' Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/Organization], CanonicalType[http://hl7.org/fhir/StructureDefinition/Patient], CanonicalType[http://hl7.org/fhir/StructureDefinition/RelatedPerson]]) vs Reference([CanonicalType[http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-patient], CanonicalType[http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-organization], CanonicalType[http://hl7.org.au/fhir/core/StructureDefinition/au-core-relatedperson]])
class		0..*	BackboneElement	Additional coverage classifications		0..*	BackboneElement	Additional coverage classifications
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!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: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc.	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc.
value	Σ	1..1	string	Value associated with the type	Σ	1..1	string	Value associated with the type
name	Σ	0..1	string	Human readable description of the type and value	Σ	0..1	string	Human readable description of the type and value
order	Σ	0..1	positiveInt	Relative order of the coverage	Σ	0..1	positiveInt	Relative order of the coverage
network	Σ	0..1	string	Insurer network	Σ	0..1	string	Insurer network
costToBeneficiary		0..*	BackboneElement	Patient payments for services/products		0..*	BackboneElement	Patient payments for services/products
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	CodeableConcept	Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified.	Σ	0..1	CodeableConcept	Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified.
value[x]	Σ	1..1	??, Money	The amount or percentage due from the beneficiary	Σ	1..1	??, Money	The amount or percentage due from the beneficiary
exception		0..*	BackboneElement	Exceptions for patient payments		0..*	BackboneElement	Exceptions for patient payments
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays.	Σ	1..1	CodeableConcept	Exception category Binding: ?? (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	Σ	0..1	Period	The effective period of the exception
subrogation		0..1	boolean	Reimbursement to insurer		0..1	boolean	Reimbursement to insurer
contract		0..*	Reference(Contract)	Contract details		0..*	Reference(Contract)	Contract details
Documentation for this format