Profile Comparison between http://hl7.org.au/fhir/core/StructureDefinition/au-core-coverage vs http://hl7.org.au/fhir/core/StructureDefinition/au-core-coverage

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org.au/fhir/StructureDefinition/au-coverage
copyright	Used by permission of HL7 International, all rights reserved Creative Commons License. HL7 Australia© 2022+; Licensed Under Creative Commons No Rights Reserved.
date	2023-08-22T20:24:06+10:00	2023-11-16T10:32:02+11:00	Values Differ
description	This profile sets minimum expectations for a Coverage resource to record, search, and fetch information about a patient's public or private insurance coverage. It is based on the [AU Base Coverage](http://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-coverage.html) resource and identifies the *additional* mandatory core elements, extensions, vocabularies and value sets that **SHALL** be present in the Coverage when conforming to this profile. It provides the floor for standards development for specific uses cases in an Australian context.
experimental
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#AU
kind	resource
name	AUCoreCoverage
publisher	HL7 Australia
purpose
status	draft
title	AU Core Coverage
type	Coverage
url	http://hl7.org.au/fhir/core/StructureDefinition/au-core-coverage
version	0.2.1-preview	0.2.2-preview	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	L Type	L Description & Constraints	Comments
Coverage	C	0..*	AUBaseCoverage	Insurance or medical plan or a payment agreement au-core-cov-01: The coverage shall at least have a valid identifier or type	C	0..*	AUBaseCoverage	Insurance or medical plan or a payment agreement au-core-cov-01: The coverage shall at least have a valid identifier or type
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. Additional Bindings Purpose ?? Max Binding		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding
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
Slices for identifier	SC	0..*	??, ??, ??, ??	An identifier intended for computation Slice: Unordered, Open by pattern:type	SC	0..*	??, ??, ??, ??	An identifier intended for computation Slice: Unordered, Open by pattern:type	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]])
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	SΣC	0..1	CodeableConcept	Coverage category such as medical or accident Binding: ?? (extensible)	SΣC	0..1	CodeableConcept	Coverage category such as medical or accident Binding: ?? (extensible)
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	SΣ	1..1	Reference(AU Core Patient)	Plan beneficiary	SΣ	1..1	Reference(AU Core Patient)	Plan beneficiary
dependent	Σ	0..1	string	Dependent number	Σ	0..1	string	Dependent number
relationship	S	0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).	S	0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: ?? (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
period	SΣ	0..1	Period	Coverage start and end dates	SΣ	0..1	Period	Coverage start and end dates
payor	SΣ	1..*	Reference(AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Issuer of the policy	SΣ	1..*	Reference(AU Core Organization | AU Core Patient | AU Core RelatedPerson)	Issuer of the policy
class	S	0..*	BackboneElement	Additional coverage classifications	S	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	SΣ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc.	SΣ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: ?? (extensible): The policy classifications, eg. Group, Plan, Class, etc.
value	SΣ	1..1	string	Value associated with the type	SΣ	1..1	string	Value associated with the type
name	SΣ	0..1	string	Human readable description of the type and value	SΣ	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