LinuxForHealth FHIR Implementation Guide - Local Development build (v8.0.0). See the Directory of published versions

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: Coverage Example - Primary Payer - JSON Representation

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{
  "resourceType" : "Coverage",
  "id" : "PrimaryPayerExample",
  "meta" : {
    "extension" : [
      {
        "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/tenant-id",
        "valueString" : "99999"
      },
      {
        "url" : "http://linuxforhealth.org/fhir/cdm/StructureDefinition/ingestion-batch-id",
        "valueString" : "b069a545-9506-40c6-8498-23de2e189143"
      }
    ],
    "source" : "http://acme-health.com/emr1",
    "profile" : [
      "http://linuxforhealth.org/fhir/cdm/StructureDefinition/cdm-coverage"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b><a name=\"PrimaryPayerExample\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Coverage \"PrimaryPayerExample\" </p><p style=\"margin-bottom: 0px\">Information Source: http://acme-health.com/emr1!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-cdm-coverage.html\">CDM Coverage</a></p></div><p><b>identifier</b>: Source System Row Identifier: c35466d6-0d2b-4efa-8265-b9ac3f887e08(use: OFFICIAL)</p><p><b>status</b>: active</p><p><b>type</b>: preferred provider organization policy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-ActCode.html\">ActCode</a>#PPO)</span></p><p><b>policyHolder</b>: <a href=\"Organization-Employer1.html\">Organization/Employer1</a> \"Employer 1\"</p><p><b>subscriber</b>: <span></span></p><p><b>beneficiary</b>: <a href=\"Patient-CDMPatientInstance.html\">Patient/CDMPatientInstance</a> \" MCLASTNAME\"</p><p><b>relationship</b>: Spouse <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#spouse)</span></p><p><b>period</b>: 2020-01-01 12:00:00+0000 --&gt; (ongoing)</p><p><b>payor</b>: <a href=\"Organization-Payer1.html\">Organization/Payer1</a> \"Payer 1\"</p><blockquote><p><b>class</b></p><p><b>type</b>: Group <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#group)</span></p><p><b>value</b>: 10985-PAYER1</p><p><b>name</b>: PPO with HSA</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: Plan <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-coverage-class.html\">Coverage Class Codes</a>#plan)</span></p><p><b>value</b>: 282</p></blockquote><p><b>order</b>: 1</p><p><b>network</b>: Choice POS II</p></div>"
  },
  "identifier" : [
    {
      "use" : "official",
      "type" : {
        "coding" : [
          {
            "system" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/identifier-type",
            "code" : "SSRI"
          }
        ]
      },
      "system" : "http://acme-health.com/emr1/coverage",
      "value" : "c35466d6-0d2b-4efa-8265-b9ac3f887e08",
      "assigner" : {
        "display" : "Acme Health - EMR1"
      }
    }
  ],
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code" : "PPO"
      }
    ]
  },
  "policyHolder" : {
    "reference" : "Organization/Employer1"
  },
  "subscriber" : {
    "type" : "RelatedPerson",
    "identifier" : {
      "system" : "http://acme-health.com/emr1/related-person",
      "value" : "Spouse1"
    }
  },
  "beneficiary" : {
    "reference" : "Patient/CDMPatientInstance"
  },
  "relationship" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code" : "spouse"
      }
    ]
  },
  "period" : {
    "start" : "2020-01-01T00:00:00Z"
  },
  "payor" : [
    {
      "reference" : "Organization/Payer1"
    }
  ],
  "class" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "group"
          }
        ]
      },
      "value" : "10985-PAYER1",
      "name" : "PPO with HSA"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "plan"
          }
        ]
      },
      "value" : "282"
    }
  ],
  "order" : 1,
  "network" : "Choice POS II"
}