FHIR CI-Build
AdministrationThis is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
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| Patient Administration Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: No defined compartments |
This is a representation of the json schema for InsurancePlan, which is just a part of the full JSON Schema.
{
"$schema": "http://json-schema.org/draft-06/schema#",
"id": "http://hl7.org/fhir/json-schema/InsurancePlan",
"$ref": "#/definitions/InsurancePlan",
"description": "see http://hl7.org/fhir/json.html#schema for information about the FHIR Json Schemas",
"definitions": {
"InsurancePlan": {
"description": "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`.",
"properties": {
"resourceType": {
"description": "This is a InsurancePlan resource",
"const": "InsurancePlan"
},
"id": {
"description": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"$ref": "id.schema.json#/definitions/id"
},
"meta": {
"description": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"$ref": "Meta.schema.json#/definitions/Meta"
},
"implicitRules": {
"description": "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.",
"$ref": "#/definitions/uri"
},
"_implicitRules": {
"description": "Extensions for implicitRules",
"$ref": "Element.schema.json#/definitions/Element"
},
"language": {
"description": "The base language in which the resource is written.",
"$ref": "#/definitions/code"
},
"_language": {
"description": "Extensions for language",
"$ref": "Element.schema.json#/definitions/Element"
},
"text": {
"description": "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.",
"$ref": "Narrative.schema.json#/definitions/Narrative"
},
"contained": {
"description": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.",
"items": {
"$ref": "ResourceList.schema.json#/definitions/ResourceList"
},
"type": "array"
},
"extension": {
"description": "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.",
"items": {
"$ref": "Extension.schema.json#/definitions/Extension"
},
"type": "array"
},
"modifierExtension": {
"description": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element\u0027s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"items": {
"$ref": "Extension.schema.json#/definitions/Extension"
},
"type": "array"
},
"identifier": {
"description": "Identifiers, such as the plan ID and/or group ID associated with the insurance plan.",
"items": {
"$ref": "Identifier.schema.json#/definitions/Identifier"
},
"type": "array"
},
"type": {
"description": "Type of plan. For example, \"Platinum\" or \"High Deductable\".",
"$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
},
"product": {
"description": "The product that this plan is available under.",
"$ref": "Reference.schema.json#/definitions/Reference"
},
"coverageArea": {
"description": "The geographic region in which a health insurance plan\u0027s benefits apply.",
"items": {
"$ref": "Reference.schema.json#/definitions/Reference"
},
"type": "array"
},
"network": {
"description": "Reference to the network that providing the type of coverage.",
"items": {
"$ref": "Reference.schema.json#/definitions/Reference"
},
"type": "array"
},
"generalCost": {
"description": "Overall costs associated with the plan.",
"items": {
"$ref": "#/definitions/InsurancePlan_GeneralCost"
},
"type": "array"
},
"specificCost": {
"description": "Costs associated with the coverage provided by the product-plan.",
"items": {
"$ref": "#/definitions/InsurancePlan_SpecificCost"
},
"type": "array"
}
},
"type": "object",
"additionalProperties": false,
"required": [
"resourceType"
]
},
"InsurancePlan_GeneralCost": {
"description": "InsurancePlan describes the costs to the subscriber or beneficiary associated with benefits, as well as additional information about the offering, such as who administers the plan, a coverage area, contact information, etc. The specific benefits covered by the plan are described in the `InsuranceProduct` referenced in `InsurancePlan.product`.",
"properties": {
"id": {
"description": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"$ref": "string.schema.json#/definitions/string"
},
"extension": {
"description": "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.",
"items": {
"$ref": "Extension.schema.json#/definitions/Extension"
},
"type": "array"
},
"modifierExtension": {
"description": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element\u0027s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"items": {
"$ref": "Extension.schema.json#/definitions/Extension"
},
"type": "array"
},
"type": {
"description": "Type of cost.",
"$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
},
"groupSize": {
"description": "Number of participants enrolled in the plan.",
"$ref": "#/definitions/positiveInt"
},
"_groupSize": {
"description": "Extensions for groupSize",
"$ref": "Element.schema.json#/definitions/Element"
},
"cost": {
"description": "Value of the cost.",
"$ref": "Money.schema.json#/definitions/Money"
},
"comment": {
"description": "Additional information about the general costs associated with this plan.",
"$ref": "#/definitions/string"
},
"_comment": {
"description": "Extensions for comment",
"$ref": "Element.schema.json#/definitions/Element"
}
},
"type": "object",
"additionalProperties": false
},
"InsurancePlan_SpecificCost": {
"description": "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`.",
"properties": {
"id": {
"description": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"$ref": "string.schema.json#/definitions/string"
},
"extension": {
"description": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"items": {
"$ref": "Extension.schema.json#/definitions/Extension"
},
"type": "array"
},
"modifierExtension": {
"description": "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\u0027s 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).",
"items": {
"$ref": "Extension.schema.json#/definitions/Extension"
},
"type": "array"
},
"category": {
"description": "General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health).",
"$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
},
"benefit": {
"description": "List of the specific benefits under this category of benefit.",
"items": {
"$ref": "#/definitions/InsurancePlan_Benefit"
},
"type": "array"
}
},
"type": "object",
"additionalProperties": false,
"required": [
"category"
]
},
"InsurancePlan_Benefit": {
"description": "InsurancePlan describes the costs to the subscriber or beneficiary associated with benefits, as well as additional information about the offering, such as who administers the plan, a coverage area, contact information, etc. The specific benefits covered by the plan are described in the `InsuranceProduct` referenced in `InsurancePlan.product`.",
"properties": {
"id": {
"description": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"$ref": "string.schema.json#/definitions/string"
},
"extension": {
"description": "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.",
"items": {
"$ref": "Extension.schema.json#/definitions/Extension"
},
"type": "array"
},
"modifierExtension": {
"description": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element\u0027s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"items": {
"$ref": "Extension.schema.json#/definitions/Extension"
},
"type": "array"
},
"type": {
"description": "Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care).",
"$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
},
"cost": {
"description": "List of the costs associated with a specific benefit.",
"items": {
"$ref": "#/definitions/InsurancePlan_Cost"
},
"type": "array"
}
},
"type": "object",
"additionalProperties": false,
"required": [
"type"
]
},
"InsurancePlan_Cost": {
"description": "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`.",
"properties": {
"id": {
"description": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"$ref": "string.schema.json#/definitions/string"
},
"extension": {
"description": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"items": {
"$ref": "Extension.schema.json#/definitions/Extension"
},
"type": "array"
},
"modifierExtension": {
"description": "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\u0027s 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).",
"items": {
"$ref": "Extension.schema.json#/definitions/Extension"
},
"type": "array"
},
"type": {
"description": "Type of cost (copay; individual cap; family cap; coinsurance; deductible).",
"$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
},
"applicability": {
"description": "Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other).",
"$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
},
"qualifier": {
"description": "Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA).",
"items": {
"$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
},
"type": "array"
},
"value": {
"description": "The actual cost value. (some of the costs may be represented as percentages rather than currency, e.g. 10% coinsurance).",
"$ref": "Quantity.schema.json#/definitions/Quantity"
}
},
"type": "object",
"additionalProperties": false,
"required": [
"type"
]
}
}
}
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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