Coverage (29)

#NameSourceVerDescription
1Argonaut Coverage Profilefhir.argonaut.scheduling#1.0.0R3The Argonaut Coverage Profile profile is used to provide insurance information for scheduling an appointment and or registering a patient.
2AU Base Coveragehl7.fhir.au.base#currentR4This 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.
3AU Core Coveragehl7.fhir.au.core#currentR4This 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.
4BSeR Coveragehl7.fhir.us.bser#currentR4This Coverage profile represents identifiers and descriptors of an insurance plan underwriting some or all of the cost of the referral services provided.
5C4BB Coveragehl7.fhir.us.carin-bb#currentR4Data that reflect a payer’s coverage that was effective as of the date of service or the date of admission of the claim.
6C4DIC Coveragehl7.fhir.us.insurance-card#currentR4Data that reflect a payer’s coverage of the member.
7CH Core Coveragech.fhir.ig.ch-core#currentR4The Coverage referenced in the CH Core profiles.
8CH EMS Coverage Profilech.fhir.ig.ch-ems#1.9.0R4Definition of the coverage
9CH ORF Coveragech.fhir.ig.ch-orf#currentR4Profile to specify how the coverage is represented. This provides an organization or the individual, which will pay for services requested.
10Coverage - Principal Payer for Deliveryhl7.fhir.us.vrsandbox#currentR4This Coverage profile represents the principal payer for this delivery.
11Coverage - Principal Payer for Deliveryhl7.fhir.us.bfdr#currentR4This Coverage profile represents the principal payer for this delivery.
12Coverage Inicio LEfhir.minsal.ListaDeEspera#currentR4Coverage Inicio LE
13Coverage resource for use in NZ (Trial use)fhir.org.nz.ig.base#currentR4Coverage resource for use in NZ (Trial use)
14Coverage: EHIC hl7.fhir.eu.base#currentR4Coverage profile for the European Health Insurance Card
15Coverage: Encounter Payerhl7.eu.fhir.xpandh.hdr#currentR4Coverage used to represent the payer for this Encounter for the scope of the XpanDH project.
16CRD Coveragehl7.fhir.us.davinci-crd#currentR4This profile specifies constraints on the Coverage resource to support coverage requirements discovery.
17Da Vinci Admit/Discharge/Transfer Notification Coverage Profilehl7.fhir.us.davinci-alerts#currentR4The Da Vinci Admit/Discharge/Transfer Notification Coverage Profile is based on the [HRex Coverage Profile](http://build.fhir.org/ig/HL7/davinci-ehrx/StructureDefinition-hrex-coverage.html) and constrains the Patient resource referenced by the `Coverage.beneficiary` element to be found in the same message Bundle.
18Davinci ATR Coveragehl7.fhir.us.davinci-atr#currentR4This is the Coverage Resource profile for the IG.
19Diagnostic Coveragehl7.fhir.au.draft.diagnostic-orders#currentR4Diagnostic Coverage
20HRex Coverage Profilehl7.fhir.us.davinci-hrex#currentR4The HRex Coverage Profile defines the constraints for representing a member's healthcare insurance information to the Payer.  Coverage instances complying with this profile, sometimes together with the Patient which this profile references via `beneficiary`, allows a payer to identify a member in their system.
21MyCareNet Coverage BE profilehl7.fhir.be.mycarenet#currentR4Coverage profile for use in the different MyCareNet flows
22PAO Coveragehl7.fhir.us.dme-orders#currentR4PAO Coverage Resource Profile
23PAS Coveragehl7.fhir.us.davinci-pas#currentR4PAS constraints on Coverage resource mandating support for insurance elements relevant to the prior authorization request
24PCT Coveragehl7.fhir.us.davinci-pct#currentR4PCT Coverage is a profile for capturing data that reflect a payer’s coverage that was effective as of the proposed date of service or the date of admission of the GFE.
25PhCPCoveragehl7.fhir.us.phcp#1.0.0R4The Coverage profile groups the policy and authorization acts within a Payers Section to order the payment sources. The Coverage.identifier is the ID from the patient's insurance card.
26QICore Coveragehl7.fhir.us.qicore#currentR4Profile of Coverage for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.
27RTPBC Coveragehl7.fhir.us.carin-rtpbc#1.0.0R4This profile constrains the Coverage resource for carrying the pharmacy benefit information required in the consumer real-time pharmacy benefit check process
28Specialty Rx Coveragehl7.fhir.us.specialty-rx#currentR4This profile constrains the Coverage resource for carrying insurance coverage information in the specialty medication enrollment process
29US Core Coverage Profilehl7.fhir.us.core#currentR4The US Core Coverage Profile is based upon the core FHIR Coverage Resource and implements the US Core Data for Interoperability (USCDI) v3 Health Insurance Information requirements. To promote interoperability and adoption through common implementation, this profile sets minimum expectations for the Coverage resource to record, search, and fetch the "data related to an individual's insurance coverage for health care". It identifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains the way the elements are used when using this profile. It provides the floor for standards development for specific use cases.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
Coverage D I I D D I D D I D I C I
Coverage.grouping C
Coverage.grouping.planDisplay C
Coverage.grouping.plan C
Coverage.payor C C C D C D C S C D (2) C C C D C C C C C D
Coverage.payor.identifier D
Coverage.payor.identifier.value C C
Coverage.payor.identifier.system F
Coverage.payor.identifier.type F
Coverage.payor.identifier.type.text F
Coverage.payor.type
Coverage.payor.display C D C
Coverage.payor.extension S C S C (2)
Coverage.payor.reference C
Coverage.id D C
Coverage.meta C C
Coverage.meta.profile C D S C F D (2)
Coverage.meta.lastUpdated C D C D
Coverage.implicitRules
Coverage.language
Coverage.text
Coverage.contained
Coverage.extension S C (10) S C
Coverage.modifierExtension
Coverage.identifier D S C (4) S C (2) S C (2) S C F D (2) S C (2) C D S C (2) S C (2) S C (2) C D S C (2) S C (2)
Coverage.identifier.assigner C
Coverage.identifier.value C C C C C
Coverage.identifier.system C F C
Coverage.identifier.type C F C F B M (2) C B M C F C C F C F
Coverage.identifier.type.text
Coverage.identifier.type.coding C C
Coverage.identifier.type.coding.code C C F
Coverage.identifier.type.coding.system C C F
Coverage.status C D D D F C F B M F D
Coverage.kind
Coverage.paymentBy
Coverage.paymentBy.extension
Coverage.paymentBy.modifierExtension
Coverage.paymentBy.party
Coverage.paymentBy.responsibility
Coverage.type B M B M B M B M D C D B M C B M C B M C F B M C F B M C B M C B M D B M
Coverage.type.text C
Coverage.type.coding C
Coverage.type.coding.system C
Coverage.type.coding.display
Coverage.type.coding.code C
Coverage.policyHolder C
Coverage.subscriber C D C C
Coverage.subscriber.display C
Coverage.subscriber.reference C
Coverage.subscriberId C D C D C D C C C C D D
Coverage.beneficiary D D D C D
Coverage.beneficiary.reference C C C
Coverage.dependent C
Coverage.relationship C B M C D B M C D B M C D B M C C C D B M
Coverage.relationship.coding S C B M (2)
Coverage.period D D D C C C D
Coverage.period.end C D
Coverage.insurer
Coverage.class S C (3) S C (3) S C (10) S C (3) S C (2) C S C (2) C S C (3) S C D (5) S C D (5) S C (3)
Coverage.class.extension
Coverage.class.modifierExtension
Coverage.class.type F (2) F (2) F B M (10) B M B M F (2) C F F F C F B M (5) C F B M (5) F (2)
Coverage.class.type.coding C C C
Coverage.class.type.coding.code C C F C
Coverage.class.type.coding.system C F C
Coverage.class.value D (2) D (2) D (2) (2) C D (2)
Coverage.class.value.extension S C (2)
Coverage.class.name D (2) D (2) D (2) (2) C (2) D (2)
Coverage.order
Coverage.network
Coverage.costToBeneficiary C
Coverage.costToBeneficiary.extension
Coverage.costToBeneficiary.modifierExtension
Coverage.costToBeneficiary.type C B M B M
Coverage.costToBeneficiary.category
Coverage.costToBeneficiary.network
Coverage.costToBeneficiary.unit
Coverage.costToBeneficiary.term
Coverage.costToBeneficiary.value[x] I
Coverage.costToBeneficiary.value[x].currency D
Coverage.costToBeneficiary.value[x].value D
Coverage.costToBeneficiary.value[x].extension S C D
Coverage.costToBeneficiary.exception
Coverage.costToBeneficiary.exception.extension
Coverage.costToBeneficiary.exception.modifierExtension
Coverage.costToBeneficiary.exception.type
Coverage.costToBeneficiary.exception.period
Coverage.subrogation
Coverage.contract
Coverage.insurancePlan
S: There is slicing defined in the element(s)
C: There is cardinality erstrictions defined in the element(s)
I: There is invariants defined in the element(s)
F: There is a fixed or pattern value defined in the element(s)
D: There is document provided in the element(s)
B: There is terminology bindings defined in the element(s)
M: At least one of the element(s) has must-support = true
(N): The number of elements if > 1

Produced 08 Sep 2023