This page is part of the Australian Base IG (v4.2.2-ballot: AU Base R4.2 Ballot 5) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 4.1.0. For a full list of available versions, see the Directory of published versions

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Data Type Profile: AU Insurance Member Number

This identifier profile defines an insurance member number in an Australian context. An insurance member number is the unique member number assigned to an individual by an insurer and is typically displayed on their insurance card. An individual will not have more than one member number per insurer.

This definition supports the sending of an insurance member number that is relevant in a healthcare context and may be used to capture Australian and International health insurer issued member numbers. In Australia this will typically be a private health insurance member number. This identifier should not be confused with an insurance policy number.

Usage:

• Use this DataType Constraint: AU Base Coverage, AU Base Patient and AU Base Related Person

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Identifier

Name	Flags	Card.	Type	Description & Constraints
Identifier		0..*	Identifier	Insurance Member Number
type		1..1	CodeableConcept	Description of identifier Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
system		1..1	uri	System identifier namespace for the insurer that assigned the insurance member number
value		1..1	string	Insurance member number
assigner		1..1	Reference(Organization)	Insurer
display		1..1	string	Name of insurer
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Identifier		0..*	Identifier	Insurance Member Number
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..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. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
system	Σ	1..1	uri	System identifier namespace for the insurer that assigned the insurance member number Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	Insurance member number Example General: 123456
assigner	Σ	1..1	Reference(Organization)	Insurer
display	Σ	1..1	string	Name of insurer
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Identifier.type	extensible	Pattern: MB http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())

Name	Flags	Card.	Type	Description & Constraints
Identifier		0..*	Identifier	Insurance Member Number
id		0..1	string	Unique id for inter-element referencing
extension		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: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	System identifier namespace for the insurer that assigned the insurance member number Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	Insurance member number Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	1..1	Reference(Organization)	Insurer
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	1..1	string	Name of insurer
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Identifier.type	extensible	Pattern: MB http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Identifier.assigner.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Identifier

Summary

Mandatory: 5 elements

Maturity: 2

Differential View

This structure is derived from Identifier

Name	Flags	Card.	Type	Description & Constraints
Identifier		0..*	Identifier	Insurance Member Number
type		1..1	CodeableConcept	Description of identifier Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
system		1..1	uri	System identifier namespace for the insurer that assigned the insurance member number
value		1..1	string	Insurance member number
assigner		1..1	Reference(Organization)	Insurer
display		1..1	string	Name of insurer
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Identifier		0..*	Identifier	Insurance Member Number
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..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. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
system	Σ	1..1	uri	System identifier namespace for the insurer that assigned the insurance member number Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	Insurance member number Example General: 123456
assigner	Σ	1..1	Reference(Organization)	Insurer
display	Σ	1..1	string	Name of insurer
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Identifier.type	extensible	Pattern: MB http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Identifier		0..*	Identifier	Insurance Member Number
id		0..1	string	Unique id for inter-element referencing
extension		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: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..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. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	System identifier namespace for the insurer that assigned the insurance member number Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	Insurance member number Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	1..1	Reference(Organization)	Insurer
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	1..1	string	Name of insurer
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Identifier.type	extensible	Pattern: MB http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Identifier.assigner.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Identifier

Summary

Mandatory: 5 elements

Maturity: 2

Other representations of profile: CSV, Excel, Schematron