Name | Flags | Card. | Type | Description & Constraints![]() |
---|---|---|---|---|
TU | DomainResource | Insurance or medical plan or a payment agreement Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension | ||
Σ | 0..* | Identifier | Business Identifier for the coverage | |
?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Financial Resource Status Codes (Required) | |
Σ | 0..1 | CodeableConcept | Coverage category such as medical or accident Coverage Type and Self-Pay Codes (Preferred) | |
Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy | |
Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | |
Σ | 0..1 | string | ID assigned to the subscriber | |
Σ | 1..1 | Reference(Patient) | Plan beneficiary | |
Σ | 0..1 | string | Dependent number | |
0..1 | CodeableConcept | Beneficiary relationship to the subscriber SubscriberPolicyholder Relationship Codes (Extensible) | ||
Σ | 0..1 | Period | Coverage start and end dates | |
Σ | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy | |
0..* | BackboneElement | Additional coverage classifications | ||
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Coverage Class Codes (Extensible) | |
Σ | 1..1 | string | Value associated with the type | |
Σ | 0..1 | string | Human readable description of the type and value | |
Σ | 0..1 | positiveInt | Relative order of the coverage | |
Σ | 0..1 | string | Insurer network | |
0..* | BackboneElement | Patient payments for services/products | ||
Σ | 0..1 | CodeableConcept | Cost category Coverage Copay Type Codes (Extensible) | |
Σ | 1..1 | The amount or percentage due from the beneficiary | ||
SimpleQuantity | ||||
Money | ||||
0..* | BackboneElement | Exceptions for patient payments | ||
Σ | 1..1 | CodeableConcept | Exception category Example Coverage Financial Exception Codes (Example) | |
Σ | 0..1 | Period | The effective period of the exception | |
0..1 | boolean | Reimbursement to insurer | ||
0..* | Reference(Contract) | Contract details | ||
![]() |