StructureDefinition-ndhEx-InsurancePlan

Sourcehl7.fhir.us.ndh#current:National Directory of Healthcare Providers & Services (NDH) Implementation Guide (v4.0.1)
resourceTypeStructureDefinition
idndhEx-InsurancePlan
canonicalhttp://hl7.org/fhir/us/ndh/StructureDefinition/ndhEx-InsurancePlan
version1.0.0-ballot
statusactive
publisherHL7 International - Patient Administration Work Group
nameNdhExInsurancePlan
titleNDH Exchange InsurancePlan Profile
date2023-07-29T19:27:44+00:00
descriptionAn InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits). InsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.
jurisdictionsus
fhirVersion4.0.1
kindresource
abstractfalse
sdTtypeInsurancePlan
derivationconstraint
basehttp://hl7.org/fhir/us/ndh/StructureDefinition/ndh-InsurancePlan
Usages
Name Flags Card. Type Description & Constraints doco
. . InsurancePlan C NdhInsurancePlan plan-type-is-distinct: Each InsurancePlan.plan should have a distinct plan.type.
. . . meta
. . . . profile 1..1
. . . extension 1..
. . . extension:verification-status S 1..
. . . identifier
. . . . extension 1..
. . . . extension:identifier-status S 1..
. . . . use S
. . . . type S
. . . . system S
. . . . value S
. . . . assigner S Reference (NDH Exchange Organization Profile)
. . . alias S
. . . period S
. . . ownedBy Reference (NDH Exchange Organization Profile)
. . . administeredBy Reference (NDH Exchange Organization Profile)
. . . coverageArea Reference (NDH Exchange Location Profile)
. . . contact S
. . . . purpose S
. . . . name S
. . . . . use S
. . . . . text S
. . . . . family S
. . . . . given S
. . . . . prefix S
. . . . . suffix S
. . . . . period S
. . . . telecom S
. . . . . extension:contactpoint-availabletime S
. . . . . extension:via-intermediary S
. . . . . system S
. . . . . value S
. . . . . use S
. . . . . rank S
. . . endpoint S Reference (NDH Exchange Endpoint Profile)
. . . network Reference (NDH Exchange Network Profile)
. . . coverage S
. . . . type S
. . . . network Reference (NDH Exchange Network Profile)
. . . . benefit S
. . . . . type S
. . . . . requirement S
. . . . . limit S
. . . . . . value S
. . . . . . code S
. . . plan S
. . . . identifier S
. . . . . extension:identifier-status S
. . . . . use S
. . . . . type S
. . . . . system S
. . . . . value S
. . . . . period S
. . . . . assigner S Reference (NDH Exchange Organization Profile)
. . . . type S
. . . . coverageArea S Reference (NDH Exchange Location Profile)
. . . . network S Reference (NDH Exchange Network Profile)
. . . . generalCost S
. . . . . type S
. . . . . groupSize S
. . . . . cost S
. . . . . comment S
. . . . specificCost S
. . . . . category S
. . . . . benefit S
. . . . . . type S
. . . . . . cost S
. . . . . . . type S
. . . . . . . applicability S
. . . . . . . qualifiers S
. . . . . . . value S

doco Documentation for this format

Produced 08 Sep 2023