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

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: Coverage Example - Secondary Payer - XML Representation

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<Coverage xmlns="http://hl7.org/fhir">
  <id value="SecondaryPayerExample"/>
  <meta>
    <extension
               url="http://linuxforhealth.org/fhir/cdm/StructureDefinition/tenant-id">
      <valueString value="99999"/>
    </extension>
    <extension
               url="http://linuxforhealth.org/fhir/cdm/StructureDefinition/ingestion-batch-id">
      <valueString value="b069a545-9506-40c6-8498-23de2e189143"/>
    </extension>
    <source value="http://acme-health.com/emr1"/>
    <profile
             value="http://linuxforhealth.org/fhir/cdm/StructureDefinition/cdm-coverage"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Coverage</b><a name="SecondaryPayerExample"> </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 "SecondaryPayerExample" </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: d3f8b14e-039f-4e2b-abd5-0b59cffe2756(use: OFFICIAL)</p><p><b>status</b>: active</p><p><b>type</b>: retiree health program <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>#RETIRE)</span></p><p><b>policyHolder</b>: <a href="Patient-CDMPatientInstance.html">Patient/CDMPatientInstance</a> " MCLASTNAME"</p><p><b>subscriber</b>: <a href="Patient-CDMPatientInstance.html">Patient/CDMPatientInstance</a> " MCLASTNAME"</p><p><b>beneficiary</b>: <a href="Patient-CDMPatientInstance.html">Patient/CDMPatientInstance</a> " MCLASTNAME"</p><p><b>relationship</b>: Self <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>#self)</span></p><p><b>period</b>: 2020-01-01 12:00:00+0000 --&gt; (ongoing)</p><p><b>payor</b>: <span></span></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>: RET-VHA</p><p><b>name</b>: RETIREE</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>: VHA</p></blockquote><p><b>order</b>: 2</p><p><b>network</b>: VHA</p></div>
  </text>
  <identifier>
    <use value="official"/>
    <type>
      <coding>
        <system
                value="http://linuxforhealth.org/fhir/cdm/CodeSystem/identifier-type"/>
        <code value="SSRI"/>
      </coding>
    </type>
    <system value="http://acme-health.com/emr1/coverage"/>
    <value value="d3f8b14e-039f-4e2b-abd5-0b59cffe2756"/>
    <assigner>
      <display value="Acme Health - EMR1"/>
    </assigner>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <code value="RETIRE"/>
    </coding>
  </type>
  <policyHolder>
    <reference value="Patient/CDMPatientInstance"/>
  </policyHolder>
  <subscriber>
    <reference value="Patient/CDMPatientInstance"/>
  </subscriber>
  <beneficiary>
    <reference value="Patient/CDMPatientInstance"/>
  </beneficiary>
  <relationship>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
      <code value="self"/>
    </coding>
  </relationship>
  <period>
    <start value="2020-01-01T00:00:00Z"/>
  </period>
  <payor>
    <type value="Organization"/>
    <identifier>
      <system value="http://acme-health.com/organization/payer"/>
      <value value="VA"/>
    </identifier>
  </payor>
  <class>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
        <code value="group"/>
      </coding>
    </type>
    <value value="RET-VHA"/>
    <name value="RETIREE"/>
  </class>
  <class>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
        <code value="plan"/>
      </coding>
    </type>
    <value value="VHA"/>
  </class>
  <order value="2"/>
  <network value="VHA"/>
</Coverage>