FHIR CI-Build
AdministrationThis is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions
| Patient Administration Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: No defined compartments |
Raw Turtle (+ also see Turtle/RDF Format Specification)
StructureDefinition for insuranceplan
@prefix fhir: <http://hl7.org/fhir/> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
# - resource -------------------------------------------------------------------
[] a fhir:StructureDefinition ;
fhir:id [ fhir:v "InsurancePlan"] ;
fhir:meta [
fhir:lastUpdated [ fhir:v "2024-12-12T18:56:29.677+00:00" ]
] ;
fhir:text [
fhir:status [ fhir:v "generated" ]
] ;
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status" ] ;
fhir:value [ fhir:v "trial-use" ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg" ] ;
fhir:value [ fhir:v "pa" ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm" ] ;
fhir:value [ fhir:v "1" ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-security-category" ] ;
fhir:value [ fhir:v "business" ]
] ) ;
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/InsurancePlan"], [ fhir:v "http://hl7.org/fhir/StructureDefinition/InsurancePlan"] ;
fhir:version [ fhir:v "6.0.0-ballot2"], [ fhir:v "6.0.0-ballot2"] ;
fhir:name [ fhir:v "InsurancePlan"], [ fhir:v "InsurancePlan"] ;
fhir:status [ fhir:v "draft"], [ fhir:v "draft"] ;
fhir:experimental [ fhir:v "false"], [ fhir:v "false"] ;
fhir:date [ fhir:v "2024-12-12T18:56:29+00:00"], [ fhir:v "2024-12-12T18:56:29+00:00"] ;
fhir:publisher [ fhir:v "HL7 International / Patient Administration"], [ fhir:v "HL7 International / Patient Administration"] ;
fhir:contact ( [
fhir:telecom ( [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fiwg" ]
] )
] [
fhir:telecom ( [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/pafm" ]
] )
] [
fhir:telecom ( [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fiwg" ]
] )
] [
fhir:telecom ( [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/pafm" ]
] )
] ) ;
fhir:description [ fhir:v "Details of a Health Insurance plan provided by an organization under an InsuranceProduct."], [ fhir:v "Details of a Health Insurance plan provided by an organization under an InsuranceProduct."] ;
fhir:jurisdiction ( [
fhir:coding ( [
fhir:system [ fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm" ] ;
fhir:code [ fhir:v "001" ] ;
fhir:display [ fhir:v "World" ]
] )
] [
fhir:coding ( [
fhir:system [ fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm" ] ;
fhir:code [ fhir:v "001" ] ;
fhir:display [ fhir:v "World" ]
] )
] ) ;
fhir:fhirVersion [ fhir:v "6.0.0-ballot2"] ;
fhir:mapping ( [
fhir:identity [ fhir:v "w5" ] ;
fhir:uri [ fhir:v "http://hl7.org/fhir/fivews" ] ;
fhir:name [ fhir:v "FiveWs Pattern Mapping" ]
] [
fhir:identity [ fhir:v "rim" ] ;
fhir:uri [ fhir:v "http://hl7.org/v3" ] ;
fhir:name [ fhir:v "RIM Mapping" ]
] ) ;
fhir:kind [ fhir:v "resource"] ;
fhir:abstract [ fhir:v "false"] ;
fhir:type [ fhir:v "InsurancePlan"] ;
fhir:baseDefinition [ fhir:v "http://hl7.org/fhir/StructureDefinition/DomainResource"] ;
fhir:derivation [ fhir:v "specialization"] ;
fhir:snapshot [
fhir:element ( [
fhir:id [ fhir:v "InsurancePlan" ] ;
fhir:path [ fhir:v "InsurancePlan" ] ;
fhir:short [ fhir:v "Plan details" ] ;
fhir:definition [ fhir:v "InsurancePlan describes the costs to the subscriber or beneficiary associated with benefits, as well as additional information about the offering, such as who administers the plan, a coverage area, contact information, etc. The specific benefits covered by the plan are described in the `InsuranceProduct` referenced in `InsurancePlan.product`." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:constraint ( [
fhir:key [ fhir:v "dom-2" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "If the resource is contained in another resource, it SHALL NOT contain nested Resources" ] ;
fhir:expression [ fhir:v "contained.contained.empty()" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/DomainResource" ]
] [
fhir:key [ fhir:v "dom-3" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "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" ] ;
fhir:expression [ fhir:v "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()" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/DomainResource" ]
] [
fhir:key [ fhir:v "dom-4" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" ] ;
fhir:expression [ fhir:v "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/DomainResource" ]
] [
fhir:key [ fhir:v "dom-5" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "If a resource is contained in another resource, it SHALL NOT have a security label" ] ;
fhir:expression [ fhir:v "contained.meta.security.empty()" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/DomainResource" ]
] [
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice" ] ;
fhir:value [ fhir:v "true" ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation" ] ;
fhir:value [ fhir:v "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." ]
] ) ;
fhir:key [ fhir:v "dom-6" ] ;
fhir:severity [ fhir:v "warning" ] ;
fhir:human [ fhir:v "A resource should have narrative for robust management" ] ;
fhir:expression [ fhir:v "text.`div`.exists()" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/DomainResource" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "Entity, Role, or Act" ]
] [
fhir:identity [ fhir:v "w5" ] ;
fhir:map [ fhir:v "administrative.entity" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.id" ] ;
fhir:path [ fhir:v "InsurancePlan.id" ] ;
fhir:short [ fhir:v "Logical id of this artifact" ] ;
fhir:definition [ fhir:v "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." ] ;
fhir:comment [ fhir:v "Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "Resource.id" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ] ;
fhir:value [ fhir:v "id" ]
] ) ;
fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "true" ]
] [
fhir:id [ fhir:v "InsurancePlan.meta" ] ;
fhir:path [ fhir:v "InsurancePlan.meta" ] ;
fhir:short [ fhir:v "Metadata about the resource" ] ;
fhir:definition [ fhir:v "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "Resource.meta" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Meta" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "true" ]
] [
fhir:id [ fhir:v "InsurancePlan.implicitRules" ] ;
fhir:path [ fhir:v "InsurancePlan.implicitRules" ] ;
fhir:short [ fhir:v "A set of rules under which this content was created" ] ;
fhir:definition [ fhir:v "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." ] ;
fhir:comment [ fhir:v "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "Resource.implicitRules" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "uri" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "true" ] ;
fhir:isModifierReason [ fhir:v "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation" ] ;
fhir:isSummary [ fhir:v "true" ]
] [
fhir:id [ fhir:v "InsurancePlan.language" ] ;
fhir:path [ fhir:v "InsurancePlan.language" ] ;
fhir:short [ fhir:v "Language of the resource content" ] ;
fhir:definition [ fhir:v "The base language in which the resource is written." ] ;
fhir:comment [ fhir:v "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "Resource.language" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "code" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:binding [
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ] ;
fhir:value [ fhir:v "Language" ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding" ] ;
fhir:value [ fhir:v "true" ]
] ) ;
fhir:strength [ fhir:v "required" ] ;
fhir:description [ fhir:v "IETF language tag for a human language" ] ;
fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot2" ] ;
fhir:additional ( [
fhir:purpose [ fhir:v "starter" ] ;
fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/languages" ]
] )
]
] [
fhir:id [ fhir:v "InsurancePlan.text" ] ;
fhir:path [ fhir:v "InsurancePlan.text" ] ;
fhir:short [ fhir:v "Text summary of the resource, for human interpretation" ] ;
fhir:definition [ fhir:v "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." ] ;
fhir:comment [ fhir:v "Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later." ] ;
fhir:alias ( [ fhir:v "narrative" ] [ fhir:v "html" ] [ fhir:v "xhtml" ] [ fhir:v "display" ] ) ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "DomainResource.text" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Narrative" ]
] ) ;
fhir:condition ( [ fhir:v "dom-6" ] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "Act.text?" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.contained" ] ;
fhir:path [ fhir:v "InsurancePlan.contained" ] ;
fhir:short [ fhir:v "Contained, inline Resources" ] ;
fhir:definition [ fhir:v "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning." ] ;
fhir:comment [ fhir:v "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels." ] ;
fhir:alias ( [ fhir:v "inline resources" ] [ fhir:v "anonymous resources" ] [ fhir:v "contained resources" ] ) ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "DomainResource.contained" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Resource" ]
] ) ;
fhir:condition ( [ fhir:v "dom-2" ] [ fhir:v "dom-4" ] [ fhir:v "dom-3" ] [ fhir:v "dom-5" ] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "N/A" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.extension" ] ;
fhir:path [ fhir:v "InsurancePlan.extension" ] ;
fhir:short [ fhir:v "Additional content defined by implementations" ] ;
fhir:definition [ fhir:v "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ] ;
fhir:comment [ fhir:v "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." ] ;
fhir:alias ( [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "DomainResource.extension" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Extension" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "N/A" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.modifierExtension" ] ;
fhir:path [ fhir:v "InsurancePlan.modifierExtension" ] ;
fhir:short [ fhir:v "Extensions that cannot be ignored" ] ;
fhir:definition [ fhir:v "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ;
fhir:comment [ fhir:v "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." ] ;
fhir:requirements [ fhir:v "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ] ;
fhir:alias ( [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "DomainResource.modifierExtension" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Extension" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "true" ] ;
fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" ] ;
fhir:isSummary [ fhir:v "true" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "N/A" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.identifier" ] ;
fhir:path [ fhir:v "InsurancePlan.identifier" ] ;
fhir:short [ fhir:v "Business Identifier for Plan" ] ;
fhir:definition [ fhir:v "Identifiers, such as the plan ID and/or group ID associated with the insurance plan." ] ;
fhir:comment [ fhir:v "In some markets, the combination of a plan ID and a group ID are needed to uniquely identify an InsurancePlan. For example, if a single plan (Bronze) is offered to two employer groups (Boilermakers and Aviation), you would represent that using two InsurancePlan resources, as shown below:\r```\rInsurancePlan.identifier 0..* (Boilermakers) InsurancePlan/bm\r [0].value = 1234 (bronze plan)\r [0].type = Plan\r [0].system = https://insurance-payer.com/plan-numbers\r\r [1].value = Boilermakers\r [1].type = Group\r [1].system = https:// insurance-payer.com /group-numbers\r```\r```\rInsurancePlan.identifier 0..* (Aviation) InsurancePlan/av\r [0].value = 1234 (bronze plan)\r [0].type = Plan\r [0].system = https:// insurance-payer.com /plan-numbers\r\r [1].value = Aviation\r [1].type = Group\r [1].system = https:// insurance-payer.com /group-numbers\r```" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.identifier" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Identifier" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "true" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "w5" ] ;
fhir:map [ fhir:v "FiveWs.identifier" ]
] [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v ".scopes[Role](classCode=IDENT)" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.type" ] ;
fhir:path [ fhir:v "InsurancePlan.type" ] ;
fhir:short [ fhir:v "Classification of Plan" ] ;
fhir:definition [ fhir:v "Type of plan. For example, \"Platinum\" or \"High Deductable\"." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.type" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.product" ] ;
fhir:path [ fhir:v "InsurancePlan.product" ] ;
fhir:short [ fhir:v "The product that this plan is available under" ] ;
fhir:definition [ fhir:v "The product that this plan is available under." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.product" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Reference" ] ;
fhir:targetProfile ( [ fhir:v "http://hl7.org/fhir/StructureDefinition/InsuranceProduct" ] )
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "true" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "N/A" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.coverageArea" ] ;
fhir:path [ fhir:v "InsurancePlan.coverageArea" ] ;
fhir:short [ fhir:v "Where product-plan applies" ] ;
fhir:definition [ fhir:v "The geographic region in which a health insurance plan's benefits apply." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.coverageArea" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Reference" ] ;
fhir:targetProfile ( [ fhir:v "http://hl7.org/fhir/StructureDefinition/Location" ] )
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "true" ]
] [
fhir:id [ fhir:v "InsurancePlan.network" ] ;
fhir:path [ fhir:v "InsurancePlan.network" ] ;
fhir:short [ fhir:v "What networks provide coverage" ] ;
fhir:definition [ fhir:v "Reference to the network that providing the type of coverage." ] ;
fhir:comment [ fhir:v "Networks are represented as a hierarchy of organization resources." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.network" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Reference" ] ;
fhir:targetProfile ( [ fhir:v "http://hl7.org/fhir/StructureDefinition/Organization" ] )
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.generalCost" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost" ] ;
fhir:short [ fhir:v "Overall costs" ] ;
fhir:definition [ fhir:v "Overall costs associated with the plan." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.generalCost" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "BackboneElement" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.generalCost.id" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost.id" ] ;
fhir:representation ( [ fhir:v "xmlAttr" ] ) ;
fhir:short [ fhir:v "Unique id for inter-element referencing" ] ;
fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "Element.id" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ] ;
fhir:value [ fhir:v "string" ]
] ) ;
fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String" ]
] ) ;
fhir:condition ( [ fhir:v "ele-1" ] ) ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "n/a" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.generalCost.extension" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost.extension" ] ;
fhir:short [ fhir:v "Additional content defined by implementations" ] ;
fhir:definition [ fhir:v "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ] ;
fhir:comment [ fhir:v "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." ] ;
fhir:alias ( [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "Element.extension" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Extension" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "n/a" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.generalCost.modifierExtension" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost.modifierExtension" ] ;
fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ;
fhir:definition [ fhir:v "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ;
fhir:comment [ fhir:v "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." ] ;
fhir:requirements [ fhir:v "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ] ;
fhir:alias ( [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Extension" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:isModifier [ fhir:v "true" ] ;
fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ;
fhir:isSummary [ fhir:v "true" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "N/A" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.generalCost.type" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost.type" ] ;
fhir:short [ fhir:v "Classification of specific cost" ] ;
fhir:definition [ fhir:v "Type of cost." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.generalCost.type" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.generalCost.groupSize" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost.groupSize" ] ;
fhir:short [ fhir:v "Number of enrollees" ] ;
fhir:definition [ fhir:v "Number of participants enrolled in the plan." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.generalCost.groupSize" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "positiveInt" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.generalCost.cost" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost.cost" ] ;
fhir:short [ fhir:v "Cost value" ] ;
fhir:definition [ fhir:v "Value of the cost." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.generalCost.cost" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Money" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.generalCost.comment" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost.comment" ] ;
fhir:short [ fhir:v "Additional cost information" ] ;
fhir:definition [ fhir:v "Additional information about the general costs associated with this plan." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.generalCost.comment" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "string" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost" ] ;
fhir:short [ fhir:v "Individual cost elements" ] ;
fhir:definition [ fhir:v "Costs associated with the coverage provided by the product-plan." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.specificCost" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "BackboneElement" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.id" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.id" ] ;
fhir:representation ( [ fhir:v "xmlAttr" ] ) ;
fhir:short [ fhir:v "Unique id for inter-element referencing" ] ;
fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "Element.id" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ] ;
fhir:value [ fhir:v "string" ]
] ) ;
fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String" ]
] ) ;
fhir:condition ( [ fhir:v "ele-1" ] ) ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "n/a" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.extension" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.extension" ] ;
fhir:short [ fhir:v "Additional content defined by implementations" ] ;
fhir:definition [ fhir:v "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ] ;
fhir:comment [ fhir:v "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." ] ;
fhir:alias ( [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "Element.extension" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Extension" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "n/a" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.modifierExtension" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.modifierExtension" ] ;
fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ;
fhir:definition [ fhir:v "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ;
fhir:comment [ fhir:v "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." ] ;
fhir:requirements [ fhir:v "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ] ;
fhir:alias ( [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Extension" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:isModifier [ fhir:v "true" ] ;
fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ;
fhir:isSummary [ fhir:v "true" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "N/A" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.category" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.category" ] ;
fhir:short [ fhir:v "General category of benefit" ] ;
fhir:definition [ fhir:v "General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health)." ] ;
fhir:min [ fhir:v "1" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.specificCost.category" ] ;
fhir:min [ fhir:v "1" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit" ] ;
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ] ;
fhir:value [ fhir:v "PlanBenefit" ]
] ) ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit" ] ;
fhir:short [ fhir:v "Benefits list" ] ;
fhir:definition [ fhir:v "List of the specific benefits under this category of benefit." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "BackboneElement" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.id" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.id" ] ;
fhir:representation ( [ fhir:v "xmlAttr" ] ) ;
fhir:short [ fhir:v "Unique id for inter-element referencing" ] ;
fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "Element.id" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ] ;
fhir:value [ fhir:v "string" ]
] ) ;
fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String" ]
] ) ;
fhir:condition ( [ fhir:v "ele-1" ] ) ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "n/a" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.extension" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.extension" ] ;
fhir:short [ fhir:v "Additional content defined by implementations" ] ;
fhir:definition [ fhir:v "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ] ;
fhir:comment [ fhir:v "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." ] ;
fhir:alias ( [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "Element.extension" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Extension" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "n/a" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.modifierExtension" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.modifierExtension" ] ;
fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ;
fhir:definition [ fhir:v "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ;
fhir:comment [ fhir:v "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." ] ;
fhir:requirements [ fhir:v "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ] ;
fhir:alias ( [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Extension" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:isModifier [ fhir:v "true" ] ;
fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ;
fhir:isSummary [ fhir:v "true" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "N/A" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.type" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.type" ] ;
fhir:short [ fhir:v "Classification of benefit provided" ] ;
fhir:definition [ fhir:v "Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care)." ] ;
fhir:min [ fhir:v "1" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.type" ] ;
fhir:min [ fhir:v "1" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost" ] ;
fhir:short [ fhir:v "List of the costs" ] ;
fhir:definition [ fhir:v "List of the costs associated with a specific benefit." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "BackboneElement" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost.id" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.id" ] ;
fhir:representation ( [ fhir:v "xmlAttr" ] ) ;
fhir:short [ fhir:v "Unique id for inter-element referencing" ] ;
fhir:definition [ fhir:v "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "Element.id" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type" ] ;
fhir:value [ fhir:v "string" ]
] ) ;
fhir:code [ fhir:v "http://hl7.org/fhirpath/System.String" ]
] ) ;
fhir:condition ( [ fhir:v "ele-1" ] ) ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "n/a" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost.extension" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.extension" ] ;
fhir:short [ fhir:v "Additional content defined by implementations" ] ;
fhir:definition [ fhir:v "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." ] ;
fhir:comment [ fhir:v "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." ] ;
fhir:alias ( [ fhir:v "extensions" ] [ fhir:v "user content" ] ) ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "Element.extension" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Extension" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "n/a" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost.modifierExtension" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.modifierExtension" ] ;
fhir:short [ fhir:v "Extensions that cannot be ignored even if unrecognized" ] ;
fhir:definition [ fhir:v "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." ] ;
fhir:comment [ fhir:v "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." ] ;
fhir:requirements [ fhir:v "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." ] ;
fhir:alias ( [ fhir:v "extensions" ] [ fhir:v "user content" ] [ fhir:v "modifiers" ] ) ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "BackboneElement.modifierExtension" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Extension" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:isModifier [ fhir:v "true" ] ;
fhir:isModifierReason [ fhir:v "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" ] ;
fhir:isSummary [ fhir:v "true" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "N/A" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost.type" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.type" ] ;
fhir:short [ fhir:v "Classification of specific cost" ] ;
fhir:definition [ fhir:v "Type of cost (copay; individual cap; family cap; coinsurance; deductible)." ] ;
fhir:min [ fhir:v "1" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.type" ] ;
fhir:min [ fhir:v "1" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost.applicability" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.applicability" ] ;
fhir:short [ fhir:v "in-network | out-of-network | other" ] ;
fhir:definition [ fhir:v "Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other)." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.applicability" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:binding [
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ] ;
fhir:value [ fhir:v "BenefitCostApplicability" ]
] ) ;
fhir:strength [ fhir:v "required" ] ;
fhir:description [ fhir:v "Whether the cost applies to in-network or out-of-network providers." ] ;
fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/insuranceplan-applicability|6.0.0-ballot2" ]
]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost.qualifier" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.qualifier" ] ;
fhir:short [ fhir:v "Additional information about the cost" ] ;
fhir:definition [ fhir:v "Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA)." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.qualifier" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost.value" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.value" ] ;
fhir:short [ fhir:v "The actual cost value" ] ;
fhir:definition [ fhir:v "The actual cost value. (some of the costs may be represented as percentages rather than currency, e.g. 10% coinsurance)." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:base [
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.value" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ]
] ;
fhir:type ( [
fhir:code [ fhir:v "Quantity" ]
] ) ;
fhir:constraint ( [
fhir:key [ fhir:v "ele-1" ] ;
fhir:severity [ fhir:v "error" ] ;
fhir:human [ fhir:v "All FHIR elements must have a @value or children" ] ;
fhir:expression [ fhir:v "hasValue() or (children().count() > id.count())" ] ;
fhir:source [ fhir:v "http://hl7.org/fhir/StructureDefinition/Element" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] )
] ;
fhir:differential [
fhir:element ( [
fhir:id [ fhir:v "InsurancePlan" ] ;
fhir:path [ fhir:v "InsurancePlan" ] ;
fhir:short [ fhir:v "Plan details" ] ;
fhir:definition [ fhir:v "InsurancePlan describes the costs to the subscriber or beneficiary associated with benefits, as well as additional information about the offering, such as who administers the plan, a coverage area, contact information, etc. The specific benefits covered by the plan are described in the `InsuranceProduct` referenced in `InsurancePlan.product`." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "w5" ] ;
fhir:map [ fhir:v "administrative.entity" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.identifier" ] ;
fhir:path [ fhir:v "InsurancePlan.identifier" ] ;
fhir:short [ fhir:v "Business Identifier for Plan" ] ;
fhir:definition [ fhir:v "Identifiers, such as the plan ID and/or group ID associated with the insurance plan." ] ;
fhir:comment [ fhir:v "In some markets, the combination of a plan ID and a group ID are needed to uniquely identify an InsurancePlan. For example, if a single plan (Bronze) is offered to two employer groups (Boilermakers and Aviation), you would represent that using two InsurancePlan resources, as shown below:\r```\rInsurancePlan.identifier 0..* (Boilermakers) InsurancePlan/bm\r [0].value = 1234 (bronze plan)\r [0].type = Plan\r [0].system = https://insurance-payer.com/plan-numbers\r\r [1].value = Boilermakers\r [1].type = Group\r [1].system = https:// insurance-payer.com /group-numbers\r```\r```\rInsurancePlan.identifier 0..* (Aviation) InsurancePlan/av\r [0].value = 1234 (bronze plan)\r [0].type = Plan\r [0].system = https:// insurance-payer.com /plan-numbers\r\r [1].value = Aviation\r [1].type = Group\r [1].system = https:// insurance-payer.com /group-numbers\r```" ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type ( [
fhir:code [ fhir:v "Identifier" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "true" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "w5" ] ;
fhir:map [ fhir:v "FiveWs.identifier" ]
] [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v ".scopes[Role](classCode=IDENT)" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.type" ] ;
fhir:path [ fhir:v "InsurancePlan.type" ] ;
fhir:short [ fhir:v "Classification of Plan" ] ;
fhir:definition [ fhir:v "Type of plan. For example, \"Platinum\" or \"High Deductable\"." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.product" ] ;
fhir:path [ fhir:v "InsurancePlan.product" ] ;
fhir:short [ fhir:v "The product that this plan is available under" ] ;
fhir:definition [ fhir:v "The product that this plan is available under." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type ( [
fhir:code [ fhir:v "Reference" ] ;
fhir:targetProfile ( [ fhir:v "http://hl7.org/fhir/StructureDefinition/InsuranceProduct" ] )
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "true" ] ;
fhir:mapping ( [
fhir:identity [ fhir:v "rim" ] ;
fhir:map [ fhir:v "N/A" ]
] )
] [
fhir:id [ fhir:v "InsurancePlan.coverageArea" ] ;
fhir:path [ fhir:v "InsurancePlan.coverageArea" ] ;
fhir:short [ fhir:v "Where product-plan applies" ] ;
fhir:definition [ fhir:v "The geographic region in which a health insurance plan's benefits apply." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type ( [
fhir:code [ fhir:v "Reference" ] ;
fhir:targetProfile ( [ fhir:v "http://hl7.org/fhir/StructureDefinition/Location" ] )
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "true" ]
] [
fhir:id [ fhir:v "InsurancePlan.network" ] ;
fhir:path [ fhir:v "InsurancePlan.network" ] ;
fhir:short [ fhir:v "What networks provide coverage" ] ;
fhir:definition [ fhir:v "Reference to the network that providing the type of coverage." ] ;
fhir:comment [ fhir:v "Networks are represented as a hierarchy of organization resources." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type ( [
fhir:code [ fhir:v "Reference" ] ;
fhir:targetProfile ( [ fhir:v "http://hl7.org/fhir/StructureDefinition/Organization" ] )
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.generalCost" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost" ] ;
fhir:short [ fhir:v "Overall costs" ] ;
fhir:definition [ fhir:v "Overall costs associated with the plan." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type ( [
fhir:code [ fhir:v "BackboneElement" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.generalCost.type" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost.type" ] ;
fhir:short [ fhir:v "Classification of specific cost" ] ;
fhir:definition [ fhir:v "Type of cost." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.generalCost.groupSize" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost.groupSize" ] ;
fhir:short [ fhir:v "Number of enrollees" ] ;
fhir:definition [ fhir:v "Number of participants enrolled in the plan." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type ( [
fhir:code [ fhir:v "positiveInt" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.generalCost.cost" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost.cost" ] ;
fhir:short [ fhir:v "Cost value" ] ;
fhir:definition [ fhir:v "Value of the cost." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type ( [
fhir:code [ fhir:v "Money" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.generalCost.comment" ] ;
fhir:path [ fhir:v "InsurancePlan.generalCost.comment" ] ;
fhir:short [ fhir:v "Additional cost information" ] ;
fhir:definition [ fhir:v "Additional information about the general costs associated with this plan." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type ( [
fhir:code [ fhir:v "string" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost" ] ;
fhir:short [ fhir:v "Individual cost elements" ] ;
fhir:definition [ fhir:v "Costs associated with the coverage provided by the product-plan." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type ( [
fhir:code [ fhir:v "BackboneElement" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.category" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.category" ] ;
fhir:short [ fhir:v "General category of benefit" ] ;
fhir:definition [ fhir:v "General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health)." ] ;
fhir:min [ fhir:v "1" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit" ] ;
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name" ] ;
fhir:value [ fhir:v "PlanBenefit" ]
] ) ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit" ] ;
fhir:short [ fhir:v "Benefits list" ] ;
fhir:definition [ fhir:v "List of the specific benefits under this category of benefit." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type ( [
fhir:code [ fhir:v "BackboneElement" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.type" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.type" ] ;
fhir:short [ fhir:v "Classification of benefit provided" ] ;
fhir:definition [ fhir:v "Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care)." ] ;
fhir:min [ fhir:v "1" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost" ] ;
fhir:short [ fhir:v "List of the costs" ] ;
fhir:definition [ fhir:v "List of the costs associated with a specific benefit." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type ( [
fhir:code [ fhir:v "BackboneElement" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost.type" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.type" ] ;
fhir:short [ fhir:v "Classification of specific cost" ] ;
fhir:definition [ fhir:v "Type of cost (copay; individual cap; family cap; coinsurance; deductible)." ] ;
fhir:min [ fhir:v "1" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost.applicability" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.applicability" ] ;
fhir:short [ fhir:v "in-network | out-of-network | other" ] ;
fhir:definition [ fhir:v "Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other)." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ] ;
fhir:binding [
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName" ] ;
fhir:value [ fhir:v "BenefitCostApplicability" ]
] ) ;
fhir:strength [ fhir:v "required" ] ;
fhir:description [ fhir:v "Whether the cost applies to in-network or out-of-network providers." ] ;
fhir:valueSet [ fhir:v "http://hl7.org/fhir/ValueSet/insuranceplan-applicability|6.0.0-ballot2" ]
]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost.qualifier" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.qualifier" ] ;
fhir:short [ fhir:v "Additional information about the cost" ] ;
fhir:definition [ fhir:v "Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA)." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "*" ] ;
fhir:type ( [
fhir:code [ fhir:v "CodeableConcept" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] [
fhir:id [ fhir:v "InsurancePlan.specificCost.benefit.cost.value" ] ;
fhir:path [ fhir:v "InsurancePlan.specificCost.benefit.cost.value" ] ;
fhir:short [ fhir:v "The actual cost value" ] ;
fhir:definition [ fhir:v "The actual cost value. (some of the costs may be represented as percentages rather than currency, e.g. 10% coinsurance)." ] ;
fhir:min [ fhir:v "0" ] ;
fhir:max [ fhir:v "1" ] ;
fhir:type ( [
fhir:code [ fhir:v "Quantity" ]
] ) ;
fhir:mustSupport [ fhir:v "false" ] ;
fhir:isModifier [ fhir:v "false" ] ;
fhir:isSummary [ fhir:v "false" ]
] )
] .
# -------------------------------------------------------------------------------------
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.
FHIR ®© HL7.org 2011+. FHIR R6 hl7.fhir.core#6.0.0-ballot2 generated on Thu, Dec 12, 2024 19:29+0000.
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