Left: | CH ORF Coverage (http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage) |
Right: | CH ORF Coverage (http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage) |
Error | StructureDefinition.version | Values for version differ: '2.0.1' vs '3.0.0-ballot' |
Information | StructureDefinition.date | Values for date differ: '2023-12-28T11:36:57+01:00' vs '2024-05-17T06:31:46+00:00' |
Error | StructureDefinition.baseDefinition | Values for baseDefinition differ: 'http://hl7.org/fhir/StructureDefinition/Coverage' vs 'http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-coverage' |
Information | StructureDefinition.definition | Values for definition differ: 'Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.' vs 'This is basic constraint on Coverage for use in CH Core resources.' |
Information | StructureDefinition.short | Values for short differ: 'Issuer of the policy' vs 'Issuer of the policy (if it is not the patient him/herself, represent the payor as a contained resource)' |
Name | Value | Comments | |
---|---|---|---|
abstract | false | ||
baseDefinition | http://hl7.org/fhir/StructureDefinition/Coverage | http://fhir.ch/ig/ch-core/StructureDefinition/ch-core-coverage |
|
copyright | CC0-1.0 | ||
date | 2023-12-28T11:36:57+01:00 | 2024-05-17T06:31:46+00:00 |
|
description | Profile to specify how the coverage is represented. This provides an organization or the individual, which will pay for services requested. | ||
experimental | |||
fhirVersion | 4.0.1 | ||
jurisdiction | |||
jurisdiction[0] | urn:iso:std:iso:3166#CH | ||
kind | resource | ||
name | ChOrfCoverage | ||
publisher | HL7 Switzerland | ||
purpose | |||
status | active | ||
title | CH ORF Coverage | ||
type | Coverage | ||
url | http://fhir.ch/ig/ch-orf/StructureDefinition/ch-orf-coverage | ||
version | 2.0.1 | 3.0.0-ballot |
|
Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Coverage | 0..* | Coverage | CH ORF Coverage | 0..* | CHCoreCoverage | CH ORF Coverage | |||||||||||
id | Σ | 0..1 | id | Logical id of this artifact | Σ | 0..1 | id | Logical id of this artifact | |||||||||
meta | Σ | 0..1 | Meta | Metadata about the resource | Σ | 0..1 | Meta | Metadata about the resource | |||||||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ?!Σ | 0..1 | uri | A set of rules under which this content was created | |||||||||
language | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
| |||||||||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||||||||
contained | S | 0..* | Resource | Contained, inline Resources | S | 0..* | Resource | Contained, inline Resources | |||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ?! | 0..* | Extension | Extensions that cannot be ignored | |||||||||
identifier | SΣ | 0..* | Identifier | Business Identifier for the coverage | SΣ | 0..* | Identifier | Business Identifier for the coverage Slice: Unordered, Open by pattern:$this | |||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: ?? (required): Identifies the purpose for this identifier, if known . | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: ?? (required): Identifies the purpose for this identifier, if known . | |||||||||
type | SΣ | 1..1 | CodeableConcept | Description of identifier Binding: ?? (required) | SΣ | 1..1 | CodeableConcept | Description of identifier Binding: ?? (required) | |||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
coding | SΣ | 1..* | Coding | Code defined by a terminology system | SΣ | 1..* | Coding | Code defined by a terminology system | |||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
Slices for extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||||||
system | SΣ | 1..1 | uri | Identity of the terminology system | SΣ | 1..1 | uri | Identity of the terminology system | |||||||||
version | Σ | 0..1 | string | Version of the system - if relevant | Σ | 0..1 | string | Version of the system - if relevant | |||||||||
code | SΣ | 1..1 | code | Symbol in syntax defined by the system | SΣ | 1..1 | code | Symbol in syntax defined by the system | |||||||||
display | Σ | 0..1 | string | Representation defined by the system | Σ | 0..1 | string | Representation defined by the system | |||||||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | Σ | 0..1 | boolean | If this coding was chosen directly by the user | |||||||||
text | SΣ | 0..1 | string | Plain text representation of the concept | SΣ | 0..1 | string | Plain text representation of the concept | |||||||||
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | |||||||||
value | SΣ | 1..1 | string | The value that is unique Example General: 123456 | SΣ | 1..1 | string | The value that is unique Example General: 123456 | |||||||||
period | Σ | 0..1 | Period | Time period when id is/was valid for use | 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) | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | |||||||||
status | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | |||||||||
type | SΣ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (required) | SΣ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (required) | |||||||||
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | Σ | 0..1 | Reference(CH Core Patient | RelatedPerson | CH Core Organization) | Owner of the policy | |||||||||
subscriber | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | Σ | 0..1 | Reference(CH Core Patient | RelatedPerson) | Subscriber to the policy | |||||||||
subscriberId | Σ | 0..1 | string | ID assigned to the subscriber | Σ | 0..1 | string | ID assigned to the subscriber | |||||||||
beneficiary | SΣ | 1..1 | Reference(CH Core Patient) | Plan beneficiary | SΣ | 1..1 | Reference(CH Core Patient) | Plan beneficiary | |||||||||
dependent | Σ | 0..1 | string | Dependent number | Σ | 0..1 | string | Dependent number | |||||||||
relationship | 0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | 0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | |||||||||||
period | Σ | 0..1 | Period | Coverage start and end dates | Σ | 0..1 | Period | Coverage start and end dates | |||||||||
payor | SΣ | 1..* | Reference(CH Core Organization | CH Core Patient | RelatedPerson) | Issuer of the policy | SΣ | 1..* | Reference(CH Core Organization | CH Core Patient | RelatedPerson) {c, r} | Issuer of the policy (if it is not the patient him/herself, represent the payor as a contained resource) | |||||||||
class | 0..* | BackboneElement | Additional coverage classifications | 0..* | BackboneElement | Additional coverage classifications | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc. | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: ?? (extensible) | |||||||||
value | Σ | 1..1 | string | Value associated with the type | Σ | 1..1 | string | Value associated with the type | |||||||||
name | Σ | 0..1 | string | Human readable description of the type and value | Σ | 0..1 | string | Human readable description of the type and value | |||||||||
order | Σ | 0..1 | positiveInt | Relative order of the coverage | Σ | 0..1 | positiveInt | Relative order of the coverage | |||||||||
network | Σ | 0..1 | string | Insurer network | Σ | 0..1 | string | Insurer network | |||||||||
costToBeneficiary | 0..* | BackboneElement | Patient payments for services/products | 0..* | BackboneElement | Patient payments for services/products | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
type | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified. | Σ | 0..1 | CodeableConcept | Cost category Binding: ?? (extensible): The types of services to which patient copayments are specified. | |||||||||
value[x] | Σ | 1..1 | ??, Money | The amount or percentage due from the beneficiary | Σ | 1..1 | ??, Money | The amount or percentage due from the beneficiary | |||||||||
exception | 0..* | BackboneElement | Exceptions for patient payments | 0..* | BackboneElement | Exceptions for patient payments | |||||||||||
id | 0..1 | string | Unique id for inter-element referencing | 0..1 | string | Unique id for inter-element referencing | |||||||||||
extension | 0..* | Extension | Additional content defined by implementations | 0..* | Extension | Additional content defined by implementations | |||||||||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||||||
type | Σ | 1..1 | CodeableConcept | Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays. | Σ | 1..1 | CodeableConcept | Exception category Binding: ?? (example): The types of exceptions from the part or full value of financial obligations such as copays. | |||||||||
period | Σ | 0..1 | Period | The effective period of the exception | Σ | 0..1 | Period | The effective period of the exception | |||||||||
subrogation | 0..1 | boolean | Reimbursement to insurer | 0..1 | boolean | Reimbursement to insurer | |||||||||||
contract | 0..* | Reference(Contract) | Contract details | 0..* | Reference(Contract) | Contract details | |||||||||||
Documentation for this format |