3.91 StructureDefinition: PrescribeIT® Coverage (NOT SUPPORTED)
The official URL for this profile is:
http://prescribeit.ca/fhir/StructureDefinition/profile-coverage
3.91.2 Formal Views of Profile Content
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Description of Profiles, Differentials, Snapshots and how the different presentations work.
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This structure is derived from Coverage
| Name | Card. | Type | Constraints and Usage |
|---|---|---|---|
 Coverage | 0..* | Coverage | Definition: Financial instrument which may be used to pay for or reimburse health care products and services. |
 id | 1..1 | id | Definition: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments: Usage Note: This will usually be a GUID and is assigned by the sending application. |
| issuer[x] (issuerReference) | 1..1 | Reference(Organization) {b} | Definition: The program or plan underwriter or payor. Comments: This is currently required in the spec. I've submitted a request to loosen it. |
  display | 1..1 | string | Max Length: 500 Definition: Plain text narrative that identifies the resource in addition to the resource reference. Comments: This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. |
| type | 0..1 | Coding | Binding: ActCoverageTypeCode (example): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.). Definition: The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health. |
| extension | 0..* | Extension | Slice: Unordered, Open by value:url Definition: An Extension |
| extension (description) | 0..1 | Coding Text | Definition: Allows the specification of a free-text description for a coded element that has a type of Coding rather than CodeableConcept. |
 url | 1..1 | uri | "http://sharedhealth.exchange/fhir/StructureDefinition/ext-coding-text" |
| value[x] | 1..1 | string | Max Length: 5000 Definition: Allows the specification of a free-text description for a coded element that has a type of Coding rather than CodeableConcept. |
| system | 0..1 | uri | Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. |
 code | 0..1 | code | Definition: A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
| planholder[x] (planholderIdentifier) | 1..1 | Identifier | Definition: The party who 'owns' the insurance contractual relationship to the policy or to whom the benefit of the policy is due. |
| value | 1..1 | string | Example' General': 123456 Max Length: 500 Definition: The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments: Conformance Rule: This element is required because of rules in the FHIR specification which may be relaxed in a future specification. If no useful value is known, this element may be populated 'Unknown'. |
| beneficiary[x] (beneficiaryReference) | 1..1 | Reference(Shared Health Patient) {b} | Definition: A reference from one resource to another. |
| relationship | 1..1 | Coding | Binding: Beneficiary Relationship Codes (example): The code for the relationship of the patient to the subscriber. Definition: The relationship of the patient to the planholdersubscriber). |
| system | 0..1 | uri | Fixed Value: http://hl7.org/fhir/v3/NullFlavor Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: Fixed value: http://hl7.org/fhir/v3/NullFlavor |
| code | 0..1 | code | Fixed Value: UNK Definition: A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Comments: Fixed value: UNK |
| identifier | 0..1 | Identifier | Definition: The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Subscriber Id, Certificate number or Personal Health Number or Case ID. |
| value | 1..1 | string | Example' General': 123456 Example' ???': 123456 Definition: The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments: If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. |
| group | 0..1 | string | Definition: Identifies a style or collective of coverage issues by the underwriter, for example may be used to identify a class of coverage or employer group. May also be referred to as a Policy or Group ID. |
This structure is derived from Coverage
Summary
Mandatory: 3 elements (1 nested mandatory element)
Must-Support: 18 elements
Fixed Value: 2 elements
Structures
This structure refers to these other structures:
- http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-reference
- http://sharedhealth.exchange/fhir/StructureDefinition/profile-patient
Extensions
This structure refers to these extensions:
This structure is derived from Coverage
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
 Coverage | S | 0..* | Coverage | Insurance or medical plan |
 id | S | 1..1 | id | Logical id of this artifact |
 issuerReference | S | 1..1 | Reference(Organization) {b} | Identifier for the plan issuer/carrier id |
| display | S | 1..1 | string | Name of payor Max Length: 500 |
| type | S | 0..1 | Coding | Type of coverage |
 extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
 ext-coding-text | S | 0..1 | string | Free text URL: http://sharedhealth.exchange/fhir/StructureDefinition/ext-coding-text |
| value[x] | S | 1..1 | string | Free text Max Length: 5000 |
| system | S | 0..1 | uri | Identity of the terminology system |
| code | S | 0..1 | code | Symbol in syntax defined by the system |
 planholderIdentifier | S | 1..1 | Identifier | Plan holder |
| value | S | 1..1 | string | The value that is unique Max Length: 500 |
| beneficiaryReference | S | 1..1 | Reference(Shared Health Patient) {b} | A reference from one resource to another |
| relationship | S | 1..1 | Coding | Patient relationship to planholder |
| system | S | 0..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/v3/NullFlavor |
| code | S | 0..1 | code | Symbol in syntax defined by the system Fixed Value: UNK |
| identifier | S | 0..1 | Identifier | The primary coverage ID |
| value | S | 1..1 | string | The value that is unique Example ???: 123456 |
| group | S | 0..1 | string | An identifier for the group |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Coverage | S | 0..* | Coverage | Insurance or medical plan |
 id | SΣ | 1..1 | id | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: http://tools.ietf.org/html/bcp47 (required): A human language. | |
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
| contained | 0..* | Resource | Contained, inline Resources | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
 issuer[x] | Σ | 1..1 | (Slice Definition) | Identifier for the plan issuer Slice: Unordered, Closed by type:$this |
 issuer[x]:issuerReference | SΣ | 1..1 | Reference(Organization) {b} | Identifier for the plan issuer/carrier id |
 id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| reference | ΣI | 0..1 | string | Relative, internal or absolute URL reference |
| display | SΣ | 1..1 | string | Name of payor Max Length: 500 |
| bin | 0..1 | string | BIN Number | |
| period | Σ | 0..1 | Period | Coverage start and end dates |
| type | SΣ | 0..1 | Coding | Type of coverage Binding: ActCoverageTypeCode (example): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.). |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
| ext-coding-text | S | 0..1 | string | Free text URL: http://sharedhealth.exchange/fhir/StructureDefinition/ext-coding-text |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| url | S | 1..1 | uri | "http://sharedhealth.exchange/fhir/StructureDefinition/ext-coding-text" |
| value[x] | S | 1..1 | string | Free text Max Length: 5000 |
| system | SΣ | 0..1 | uri | Identity of the terminology system |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | SΣ | 0..1 | code | Symbol in syntax defined by the system |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| planholder[x] | ?! | 1..1 | (Slice Definition) | Plan holder Slice: Unordered, Closed by type:$this |
| planholder[x]:planholderIdentifier | ?!S | 1..1 | Identifier | Plan holder |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 0..1 | uri | The namespace for the identifier Example General: http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri |
| value | SΣ | 1..1 | string | The value that is unique Example General: 123456 Max Length: 500 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| beneficiary[x] | ?! | 1..1 | (Slice Definition) | Plan Beneficiary Slice: Unordered, Closed by type:$this |
| beneficiary[x]:beneficiaryReference | ?!S | 1..1 | Reference(Shared Health Patient) {b} | A reference from one resource to another |
| relationship | S | 1..1 | Coding | Patient relationship to planholder Binding: Beneficiary Relationship Codes (example): The code for the relationship of the patient to the subscriber. |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| system | SΣ | 0..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/v3/NullFlavor |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | SΣ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: UNK |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| identifier | SΣ | 0..1 | Identifier | The primary coverage ID |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 0..1 | uri | The namespace for the identifier Example General: http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri |
| value | SΣ | 1..1 | string | The value that is unique Example General: 123456 Example ???: 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| group | SΣ | 0..1 | string | An identifier for the group |
| plan | Σ | 0..1 | string | An identifier for the plan |
| subPlan | Σ | 0..1 | string | An identifier for the subsection of the plan |
| dependent | Σ | 0..1 | positiveInt | Dependent number |
| sequence | Σ | 0..1 | positiveInt | The plan instance or sequence counter |
| exception | 0..* | Coding | Eligibility exceptions Binding: Exception Codes (example): The eligibility exception codes. | |
| school | 0..1 | string | Name of School | |
| network | Σ | 0..1 | string | Insurer network |
| contract | 0..* | Reference(Contract) | Contract details | |
| Documentation for this format | ||||
Grid View
This structure is derived from Coverage
| Name | Card. | Type | Constraints and Usage |
|---|---|---|---|
| Coverage | 0..* | Coverage | Definition: Financial instrument which may be used to pay for or reimburse health care products and services. |
| id | 1..1 | id | Definition: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments: Usage Note: This will usually be a GUID and is assigned by the sending application. |
| issuer[x] (issuerReference) | 1..1 | Reference(Organization) {b} | Definition: The program or plan underwriter or payor. Comments: This is currently required in the spec. I've submitted a request to loosen it. |
| display | 1..1 | string | Max Length: 500 Definition: Plain text narrative that identifies the resource in addition to the resource reference. Comments: This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. |
| type | 0..1 | Coding | Binding: ActCoverageTypeCode (example): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.). Definition: The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health. |
| extension | 0..* | Extension | Slice: Unordered, Open by value:url Definition: An Extension |
| extension (description) | 0..1 | Coding Text | Definition: Allows the specification of a free-text description for a coded element that has a type of Coding rather than CodeableConcept. |
| url | 1..1 | uri | "http://sharedhealth.exchange/fhir/StructureDefinition/ext-coding-text" |
| value[x] | 1..1 | string | Max Length: 5000 Definition: Allows the specification of a free-text description for a coded element that has a type of Coding rather than CodeableConcept. |
| system | 0..1 | uri | Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously. |
| code | 0..1 | code | Definition: A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
| planholder[x] (planholderIdentifier) | 1..1 | Identifier | Definition: The party who 'owns' the insurance contractual relationship to the policy or to whom the benefit of the policy is due. |
| value | 1..1 | string | Example' General': 123456 Max Length: 500 Definition: The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments: Conformance Rule: This element is required because of rules in the FHIR specification which may be relaxed in a future specification. If no useful value is known, this element may be populated 'Unknown'. |
| beneficiary[x] (beneficiaryReference) | 1..1 | Reference(Shared Health Patient) {b} | Definition: A reference from one resource to another. |
| relationship | 1..1 | Coding | Binding: Beneficiary Relationship Codes (example): The code for the relationship of the patient to the subscriber. Definition: The relationship of the patient to the planholdersubscriber). |
| system | 0..1 | uri | Fixed Value: http://hl7.org/fhir/v3/NullFlavor Definition: The identification of the code system that defines the meaning of the symbol in the code. Comments: Fixed value: http://hl7.org/fhir/v3/NullFlavor |
| code | 0..1 | code | Fixed Value: UNK Definition: A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Comments: Fixed value: UNK |
| identifier | 0..1 | Identifier | Definition: The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Subscriber Id, Certificate number or Personal Health Number or Case ID. |
| value | 1..1 | string | Example' General': 123456 Example' ???': 123456 Definition: The portion of the identifier typically relevant to the user and which is unique within the context of the system. Comments: If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. |
| group | 0..1 | string | Definition: Identifies a style or collective of coverage issues by the underwriter, for example may be used to identify a class of coverage or employer group. May also be referred to as a Policy or Group ID. |
This structure is derived from Coverage
Summary
Mandatory: 3 elements (1 nested mandatory element)
Must-Support: 18 elements
Fixed Value: 2 elements
Structures
This structure refers to these other structures:
- http://sharedhealth.exchange/fhir/StructureDefinition/dtprofile-reference
- http://sharedhealth.exchange/fhir/StructureDefinition/profile-patient
Extensions
This structure refers to these extensions:
Differential View
This structure is derived from Coverage
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Coverage | S | 0..* | Coverage | Insurance or medical plan |
| id | S | 1..1 | id | Logical id of this artifact |
| issuerReference | S | 1..1 | Reference(Organization) {b} | Identifier for the plan issuer/carrier id |
| display | S | 1..1 | string | Name of payor Max Length: 500 |
| type | S | 0..1 | Coding | Type of coverage |
| extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
| ext-coding-text | S | 0..1 | string | Free text URL: http://sharedhealth.exchange/fhir/StructureDefinition/ext-coding-text |
| value[x] | S | 1..1 | string | Free text Max Length: 5000 |
| system | S | 0..1 | uri | Identity of the terminology system |
| code | S | 0..1 | code | Symbol in syntax defined by the system |
| planholderIdentifier | S | 1..1 | Identifier | Plan holder |
| value | S | 1..1 | string | The value that is unique Max Length: 500 |
| beneficiaryReference | S | 1..1 | Reference(Shared Health Patient) {b} | A reference from one resource to another |
| relationship | S | 1..1 | Coding | Patient relationship to planholder |
| system | S | 0..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/v3/NullFlavor |
| code | S | 0..1 | code | Symbol in syntax defined by the system Fixed Value: UNK |
| identifier | S | 0..1 | Identifier | The primary coverage ID |
| value | S | 1..1 | string | The value that is unique Example ???: 123456 |
| group | S | 0..1 | string | An identifier for the group |
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Coverage | S | 0..* | Coverage | Insurance or medical plan |
| id | SΣ | 1..1 | id | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| language | 0..1 | code | Language of the resource content Binding: http://tools.ietf.org/html/bcp47 (required): A human language. | |
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
| contained | 0..* | Resource | Contained, inline Resources | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| issuer[x] | Σ | 1..1 | (Slice Definition) | Identifier for the plan issuer Slice: Unordered, Closed by type:$this |
| issuer[x]:issuerReference | SΣ | 1..1 | Reference(Organization) {b} | Identifier for the plan issuer/carrier id |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| reference | ΣI | 0..1 | string | Relative, internal or absolute URL reference |
| display | SΣ | 1..1 | string | Name of payor Max Length: 500 |
| bin | 0..1 | string | BIN Number | |
| period | Σ | 0..1 | Period | Coverage start and end dates |
| type | SΣ | 0..1 | Coding | Type of coverage Binding: ActCoverageTypeCode (example): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.). |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | S | 0..* | Extension | Extension Slice: Unordered, Open by value:url |
| ext-coding-text | S | 0..1 | string | Free text URL: http://sharedhealth.exchange/fhir/StructureDefinition/ext-coding-text |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| url | S | 1..1 | uri | "http://sharedhealth.exchange/fhir/StructureDefinition/ext-coding-text" |
| value[x] | S | 1..1 | string | Free text Max Length: 5000 |
| system | SΣ | 0..1 | uri | Identity of the terminology system |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | SΣ | 0..1 | code | Symbol in syntax defined by the system |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| planholder[x] | ?! | 1..1 | (Slice Definition) | Plan holder Slice: Unordered, Closed by type:$this |
| planholder[x]:planholderIdentifier | ?!S | 1..1 | Identifier | Plan holder |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 0..1 | uri | The namespace for the identifier Example General: http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri |
| value | SΣ | 1..1 | string | The value that is unique Example General: 123456 Max Length: 500 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| beneficiary[x] | ?! | 1..1 | (Slice Definition) | Plan Beneficiary Slice: Unordered, Closed by type:$this |
| beneficiary[x]:beneficiaryReference | ?!S | 1..1 | Reference(Shared Health Patient) {b} | A reference from one resource to another |
| relationship | S | 1..1 | Coding | Patient relationship to planholder Binding: Beneficiary Relationship Codes (example): The code for the relationship of the patient to the subscriber. |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| system | SΣ | 0..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/v3/NullFlavor |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | SΣ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: UNK |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| identifier | SΣ | 0..1 | Identifier | The primary coverage ID |
| id | 0..1 | id | xml:id (or equivalent in JSON) | |
| extension | 0..* | Extension | Additional Content defined by implementations | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 0..1 | uri | The namespace for the identifier Example General: http://www.acme.com/identifiers/patient or urn:ietf:rfc:3986 if the Identifier.value itself is a full uri |
| value | SΣ | 1..1 | string | The value that is unique Example General: 123456 Example ???: 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| group | SΣ | 0..1 | string | An identifier for the group |
| plan | Σ | 0..1 | string | An identifier for the plan |
| subPlan | Σ | 0..1 | string | An identifier for the subsection of the plan |
| dependent | Σ | 0..1 | positiveInt | Dependent number |
| sequence | Σ | 0..1 | positiveInt | The plan instance or sequence counter |
| exception | 0..* | Coding | Eligibility exceptions Binding: Exception Codes (example): The eligibility exception codes. | |
| school | 0..1 | string | Name of School | |
| network | Σ | 0..1 | string | Insurer network |
| contract | 0..* | Reference(Contract) | Contract details | |
| Documentation for this format | ||||
Other representations of profile: Schematron
3.91.3 Terminology Bindings
Terminology Bindings
| Path | Conformance | ValueSet |
| Coverage.language | required | http://tools.ietf.org/html/bcp47 |
| Coverage.type | example | ActCoverageTypeCode |
| Coverage.planholder[x]:planholderIdentifier.use | required | IdentifierUse |
| Coverage.planholder[x]:planholderIdentifier.type | extensible | Identifier Type Codes |
| Coverage.relationship | example | Fixed Value: UNK |
| Coverage.identifier.use | required | IdentifierUse |
| Coverage.identifier.type | extensible | Identifier Type Codes |
| Coverage.exception | example | Exception Codes |
3.91.4 Constraints
Constraints
| Id | Path | Details | Requirements |