Left: | AU Base Coverage (http://hl7.org.au/fhir/StructureDefinition/au-coverage) |
Right: | AU Base Coverage (http://hl7.org.au/fhir/StructureDefinition/au-coverage) |
Error | StructureDefinition.version | Values for version differ: '4.2.1-preview' vs '4.2.2-ballot' |
Information | StructureDefinition.date | Values for date differ: '2024-06-20T16:58:33+10:00' vs '2024-08-04T06:52:39+00:00' |
Error | Coverage.identifier | Type Mismatch: Identifier([CanonicalType[http://hl7.org/fhir/StructureDefinition/Identifier], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-medicarecardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-dvanumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-insurancemembernumber]]) vs Identifier([CanonicalType[http://hl7.org/fhir/StructureDefinition/Identifier], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-medicarecardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-dvanumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-insurancemembernumber]]) |
Information | Coverage.type | Example/preferred bindings differ at Coverage.type using binding from AUBaseCoverage |
Name | Value | Comments | |
---|---|---|---|
abstract | false | ||
baseDefinition | http://hl7.org/fhir/StructureDefinition/Coverage | ||
copyright | HL7 Australia© 2018+; Licensed Under Creative Commons No Rights Reserved. | ||
date | 2024-06-20T16:58:33+10:00 | 2024-08-04T06:52:39+00:00 |
|
description | This profile defines a coverage structure that localises core concepts, including terminology, for use in an Australian context. The purpose of this profile is to provide national level agreement on core localised concepts. This profile does not force conformance to core localised concepts. It enables implementers and modellers to make their own rules, i.e. [profiling](http://hl7.org/fhir/profiling.html), about how to support these concepts for specific implementation needs. | ||
experimental | |||
fhirVersion | 4.0.1 | ||
jurisdiction | |||
jurisdiction[0] | urn:iso:std:iso:3166#AU | ||
kind | resource | ||
name | AUBaseCoverage | ||
publisher | HL7 Australia | ||
purpose | |||
status | draft | ||
title | AU Base Coverage | ||
type | Coverage | ||
url | http://hl7.org.au/fhir/StructureDefinition/au-coverage | ||
version | 4.2.1-preview | 4.2.2-ballot |
|
Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | 0..* | Coverage | Insurance or medical plan or a payment agreement | |||||||||||
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 | 0..* | Resource | Contained, inline Resources | 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 | 0..* | ??, ??, ??, ?? | An identifier intended for computation | 0..* | ??, ??, ??, ?? | An identifier intended for computation |
| ||||||||||
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | |||||||||
type | Σ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (preferred) | Σ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. |
| ||||||||
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | |||||||||
subscriber | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | Σ | 0..1 | Reference(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 | Σ | 1..1 | Reference(Patient) | Plan beneficiary | Σ | 1..1 | Reference(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 | Σ | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy | Σ | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy | |||||||||
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): The policy classifications, eg. Group, Plan, Class, etc. | |||||||||
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 |