## Profile Comparison between http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-coverage vs http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-coverage

Left: | AU eRequesting Coverage (http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-coverage)
Right: | AU eRequesting Coverage (http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-coverage)

### Messages

Information | Coverage.language | Example/preferred bindings differ at Coverage.language using binding from AUeRequestingCoverage
Warning | Coverage.identifier | Elements differ in definition for mustSupport: 'false' vs 'true'
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], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-pensionerconcessioncardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-cwlthseniorshealthcardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-healthcarecardnumber]]) 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], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-pensionerconcessioncardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-cwlthseniorshealthcardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-healthcarecardnumber]])
Warning | Coverage.status | Elements differ in definition for mustSupport: 'false' vs 'true'
Warning | Coverage.beneficiary | Elements differ in definition for mustSupport: 'false' vs 'true'
Warning | Coverage.payor | Elements differ in definition for mustSupport: 'false' vs 'true'
Error | Coverage.payor | Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/Organization], CanonicalType[http://hl7.org/fhir/StructureDefinition/Patient], CanonicalType[http://hl7.org/fhir/StructureDefinition/RelatedPerson]]) vs Reference([CanonicalType[http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-patient], CanonicalType[http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-organization], CanonicalType[http://hl7.org.au/fhir/core/StructureDefinition/au-core-relatedperson]])

### 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© 2024+; Licensed Under Creative Commons No Rights Reserved. |
description | This profile sets minimum expectations for a Coverage resource that is used to record, search, and fetch information about insurance or medical plan or a payment agreement for a patient. It is based on the [AU Base Coverage](https://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-coverage.html) and identifies the additional constraints, extensions, vocabularies and value sets that **SHALL** be present in the Coverage when conforming to this profile. | This profile sets minimum expectations for a Coverage resource that is used to record, search, and fetch information about insurance or medical plan or a payment agreement for a patient. It is based on the [AU Base Coverage](https://build.fhir.org/ig/hl7au/au-fhir-base/StructureDefinition-au-coverage.html) profile and identifies the additional constraints, extensions, vocabularies and value sets that **SHALL** be present in the Coverage when conforming to this profile. | Values Differ
experimental |  |
fhirVersion | 4.0.1 |
jurisdiction |  |
jurisdiction[0] | urn:iso:std:iso:3166#AU |
kind | resource |
name | AUeRequestingCoverage |
publisher | HL7 Australia |
purpose |  |
status | active |
title | AU eRequesting Coverage |
type | Coverage |
url | http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-coverage |

### Structure

Name | L Flags | L Card. | L Type | L Description & Constraints | R Flags | R Card. | R Type | R Description & Constraints | Comments
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
Coverage |  | 0..* | AUBaseCoverage | Insurance or medical plan or a payment agreement |  | 0..* | AUBaseCoverage | 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.
Additional Bindings | Purpose
?? | Max Binding
|  | 0..1 | code | Language of the resource content Binding: ?? (preferred): A human language.
Additional Bindings | Purpose
?? | Max Binding
| Example/preferred bindings differ at Coverage.language using binding from AUeRequestingCoverage
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements |
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 | Σ | 0..* | ??, ??, ??, ??, ??, ??, ?? | Business Identifier for the coverage | SO Σ | 0..* | ??, ??, ??, ??, ??, ??, ?? | Business Identifier for the coverage
Obligations | Actor
SHALL:populate-if-known | AU eRequesting Placer
SHALL:handle | AU eRequesting Filler
SHALL:handle | AU eRequesting Server
SHALL:able-to-populate | AU eRequesting Server
SHALL:no-error | AU eRequesting Patient
| Elements differ in definition for mustSupport: 'false' vs 'true' 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], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-pensionerconcessioncardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-cwlthseniorshealthcardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-healthcarecardnumber]]) 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], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-pensionerconcessioncardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-cwlthseniorshealthcardnumber], CanonicalType[http://hl7.org.au/fhir/StructureDefinition/au-healthcarecardnumber]])
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. | ?!SO Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: ?? (required): A code specifying the state of the resource instance. Fixed Value: active
Obligations | Actor
SHALL:populate | AU eRequesting Placer
SHALL:handle | AU eRequesting Filler
SHALL:handle | AU eRequesting Server
SHALL:able-to-populate | AU eRequesting Server
SHALL:no-error | AU eRequesting Patient
| Elements differ in definition for mustSupport: 'false' vs 'true'
type | SO Σ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (preferred)
Additional Bindings | Purpose
?? | Min Binding
Obligations | Actor
SHALL:populate | AU eRequesting Placer
SHALL:handle | AU eRequesting Filler
SHALL:handle | AU eRequesting Server
SHALL:able-to-populate | AU eRequesting Server
SHALL:no-error | AU eRequesting Patient
| SO Σ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: ?? (preferred)
Additional Bindings | Purpose
?? | Min Binding
Obligations | Actor
SHALL:populate | AU eRequesting Placer
SHALL:handle | AU eRequesting Filler
SHALL:handle | AU eRequesting Server
SHALL:able-to-populate | AU eRequesting Server
SHALL:no-error | AU eRequesting Patient
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 | SO Σ | 1..1 | Reference(AU eRequesting Patient) | Plan beneficiary
Obligations | Actor
SHALL:populate | AU eRequesting Placer
SHALL:handle | AU eRequesting Filler
SHALL:handle | AU eRequesting Server
SHALL:able-to-populate | AU eRequesting Server
SHALL:no-error | AU eRequesting Patient
| Elements differ in definition for mustSupport: 'false' vs 'true'
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 | SO Σ | 1..* | Reference(AU eRequesting Patient | AU eRequesting Organization | AU Core RelatedPerson) | Issuer of the policy
Obligations | Actor
SHALL:populate | AU eRequesting Placer
SHALL:handle | AU eRequesting Filler
SHALL:handle | AU eRequesting Server
SHALL:able-to-populate | AU eRequesting Server
SHALL:no-error | AU eRequesting Patient
| Elements differ in definition for mustSupport: 'false' vs 'true' Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/Organization], CanonicalType[http://hl7.org/fhir/StructureDefinition/Patient], CanonicalType[http://hl7.org/fhir/StructureDefinition/RelatedPerson]]) vs Reference([CanonicalType[http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-patient], CanonicalType[http://hl7.org.au/fhir/ereq/StructureDefinition/au-erequesting-organization], CanonicalType[http://hl7.org.au/fhir/core/StructureDefinition/au-core-relatedperson]])
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