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| Patient Administration Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: No defined compartments |
ShEx statement for insuranceproduct
PREFIX fhir: <http://hl7.org/fhir/>
PREFIX fhirvs: <http://hl7.org/fhir/ValueSet/>
PREFIX xsd: <http://www.w3.org/2001/XMLSchema#>
PREFIX rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#>
IMPORT <code.shex>
IMPORT <string.shex>
IMPORT <Period.shex>
IMPORT <Quantity.shex>
IMPORT <Location.shex>
IMPORT <Endpoint.shex>
IMPORT <Reference.shex>
IMPORT <Identifier.shex>
IMPORT <Organization.shex>
IMPORT <DomainResource.shex>
IMPORT <CodeableConcept.shex>
IMPORT <BackboneElement.shex>
IMPORT <ExtendedContactDetail.shex>
start=@<InsuranceProduct> AND {fhir:nodeRole [fhir:treeRoot]}
# Details of a Health Insurance product provided by an organization
<InsuranceProduct> EXTENDS @<DomainResource> CLOSED {
a [fhir:InsuranceProduct]?;fhir:nodeRole [fhir:treeRoot]?;
fhir:identifier @<OneOrMore_Identifier>?; # Business Identifier for Product
fhir:status @<code> AND
{fhir:v @fhirvs:publication-status}?; # draft | active | retired | unknown
fhir:type @<OneOrMore_CodeableConcept>?; # Kind of product
fhir:name @<string>?; # Official name
fhir:alias @<OneOrMore_string>?; # Alternate names
fhir:period @<Period>?; # When the product is available
fhir:ownedBy @<Reference> AND {fhir:link
@<Organization> ? }?; # Product issuer
fhir:administeredBy @<Reference> AND {fhir:link
@<Organization> ? }?; # Product administrator
fhir:coverageArea @<OneOrMore_Reference_Location>?; # Where product applies
fhir:contact @<OneOrMore_ExtendedContactDetail>?; # Official contact details relevant
# to the health insurance product
fhir:endpoint @<OneOrMore_Reference_Endpoint>?; # Technical endpoint
fhir:network @<OneOrMore_Reference_Organization>?; # What networks are Included
fhir:coverage @<OneOrMore_InsuranceProduct.coverage>?; # Coverage details
fhir:related @<OneOrMore_InsuranceProduct.related>?; # Associated insurance product
}
# Associated insurance product
<InsuranceProduct.related> EXTENDS @<BackboneElement> CLOSED {
fhir:product @<Reference> AND {fhir:link
@<InsuranceProduct> ? }?; # Related Product reference
fhir:relationship @<CodeableConcept>?; # Relationship of this product to
# the related product
fhir:period @<Period>?; # Period that this Relationship is
# valid
}
# List of benefits
<InsuranceProduct.coverage.benefit> EXTENDS @<BackboneElement> CLOSED {
fhir:type @<CodeableConcept>; # Classification of benefit provided
fhir:requirement @<string>?; # Referral requirements
fhir:limit @<OneOrMore_InsuranceProduct.coverage.benefit.limit>?; # Limits on the provided benefits
}
# Coverage details
<InsuranceProduct.coverage> EXTENDS @<BackboneElement> CLOSED {
fhir:type @<CodeableConcept>; # Classification of Coverage
fhir:network @<OneOrMore_Reference_Organization>?; # What networks provide coverage
fhir:benefit @<OneOrMore_InsuranceProduct.coverage.benefit>; # List of benefits
}
# Limits on the provided benefits
<InsuranceProduct.coverage.benefit.limit> EXTENDS @<BackboneElement> CLOSED {
fhir:value @<Quantity>?; # Maximum value allowed
fhir:code @<CodeableConcept>?; # Benefit limit details
}
#---------------------- Cardinality Types (OneOrMore) -------------------
<OneOrMore_Identifier> CLOSED {
rdf:first @<Identifier> ;
rdf:rest [rdf:nil] OR @<OneOrMore_Identifier>
}
<OneOrMore_CodeableConcept> CLOSED {
rdf:first @<CodeableConcept> ;
rdf:rest [rdf:nil] OR @<OneOrMore_CodeableConcept>
}
<OneOrMore_string> CLOSED {
rdf:first @<string> ;
rdf:rest [rdf:nil] OR @<OneOrMore_string>
}
<OneOrMore_Reference_Location> CLOSED {
rdf:first @<Reference> AND {fhir:link
@<Location> } ;
rdf:rest [rdf:nil] OR @<OneOrMore_Reference_Location>
}
<OneOrMore_ExtendedContactDetail> CLOSED {
rdf:first @<ExtendedContactDetail> ;
rdf:rest [rdf:nil] OR @<OneOrMore_ExtendedContactDetail>
}
<OneOrMore_Reference_Endpoint> CLOSED {
rdf:first @<Reference> AND {fhir:link
@<Endpoint> } ;
rdf:rest [rdf:nil] OR @<OneOrMore_Reference_Endpoint>
}
<OneOrMore_Reference_Organization> CLOSED {
rdf:first @<Reference> AND {fhir:link
@<Organization> } ;
rdf:rest [rdf:nil] OR @<OneOrMore_Reference_Organization>
}
<OneOrMore_InsuranceProduct.coverage> CLOSED {
rdf:first @<InsuranceProduct.coverage> ;
rdf:rest [rdf:nil] OR @<OneOrMore_InsuranceProduct.coverage>
}
<OneOrMore_InsuranceProduct.related> CLOSED {
rdf:first @<InsuranceProduct.related> ;
rdf:rest [rdf:nil] OR @<OneOrMore_InsuranceProduct.related>
}
<OneOrMore_InsuranceProduct.coverage.benefit.limit> CLOSED {
rdf:first @<InsuranceProduct.coverage.benefit.limit> ;
rdf:rest [rdf:nil] OR @<OneOrMore_InsuranceProduct.coverage.benefit.limit>
}
<OneOrMore_InsuranceProduct.coverage.benefit> CLOSED {
rdf:first @<InsuranceProduct.coverage.benefit> ;
rdf:rest [rdf:nil] OR @<OneOrMore_InsuranceProduct.coverage.benefit>
}
#---------------------- Value Sets ------------------------
# The lifecycle status of an artifact.
fhirvs:publication-status ["draft" "active" "retired" "unknown"]
Usage note: every effort has been made to ensure that the ShEx files 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-ballot3 generated on Sat, Oct 25, 2025 19:06+0000.
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