LinuxForHealth FHIR Implementation Guide
8.0.0 - draft
LinuxForHealth FHIR Implementation Guide
8.0.0 - draft
LinuxForHealth FHIR Implementation Guide - Local Development build (v8.0.0). See the Directory of published versions
| Active as of 2022-11-10 |
Definitions for the cdm-coverage resource profile.
| 1. Coverage | |
| 2. Coverage.meta | |
| Type | Meta(ProcessMeta) |
| 3. Coverage.contained | |
| Control | 0..0* |
| 4. Coverage.extension | |
| Slicing | This element introduces a set of slices on Coverage.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 5. Coverage.extension:snapshotAgeInMonths | |
| SliceName | snapshotAgeInMonths |
| Definition | Age in months at the time of the coverage period |
| Control | 0..1 |
| Type | Extension(SnapshotAgeInMonths) (Extension Type: unsignedInt) |
| 6. Coverage.extension:snapshotAgeInYears | |
| SliceName | snapshotAgeInYears |
| Definition | The age of the person in years for the month of eligibility or service |
| Control | 0..1 |
| Type | Extension(SnapshotAgeInYears) (Extension Type: unsignedInt) |
| 7. Coverage.extension:employeeSnapshotAgeInYears | |
| SliceName | employeeSnapshotAgeInYears |
| Definition | The age of the employee in years for the month of eligibility or service |
| Control | 0..1 |
| Type | Extension(EmployeeSnapshotAgeInYears) (Extension Type: unsignedInt) |
| 8. Coverage.extension:ageGroup | |
| SliceName | ageGroup |
| Definition | Standard code for age groupings |
| Control | 0..1 |
| Type | Extension(AgeGroup) (Extension Type: CodeableConcept) |
| 9. Coverage.extension:ageGenderGroup | |
| SliceName | ageGenderGroup |
| Definition | Standard code for groupings that combine age and gender |
| Control | 0..1 |
| Type | Extension(AgeGenderGroup) (Extension Type: CodeableConcept) |
| 10. Coverage.extension:attributedProviderReferenceWithPeriod | |
| SliceName | attributedProviderReferenceWithPeriod |
| Definition | Attributed provider reference with period |
| Control | 0..1 |
| Type | Extension(AttributedProviderReferenceWithPeriod) (Extension Type: Reference(ReferenceWithPeriod)) |
| 11. Coverage.extension:benefitStatus | |
| SliceName | benefitStatus |
| Definition | HIPAA standard code for the benefit status |
| Control | 0..1 |
| Type | Extension(BenefitStatus) (Extension Type: CodeableConcept) |
| 12. Coverage.extension:benefitStatus.valueCodeableConcept | |
| Control | 0..1 |
| Binding | The codes SHALL be taken from HIPAA Benefit Status Value Set; other codes may be used where these codes are not suitable |
| 13. Coverage.extension:claimGroupIdentifier | |
| SliceName | claimGroupIdentifier |
| Definition | Group ID of the plan member. This ID associates the primary plan holder with any dependents. |
| Control | 0..1 |
| Type | Extension(ClaimGroupIdentifier) (Extension Type: string) |
| 14. Coverage.extension:cobraIndicator | |
| SliceName | cobraIndicator |
| Definition | Indicator of Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation for the person |
| Control | 0..1 |
| Type | Extension(CobraIndicator) (Extension Type: string) |
| 15. Coverage.extension:coverageDays | |
| SliceName | coverageDays |
| Definition | Number of covered days of eligibility |
| Control | 0..1 |
| Type | Extension(CoverageDays) (Extension Type: unsignedInt) |
| 16. Coverage.extension:coverageMonth | |
| SliceName | coverageMonth |
| Definition | Date which reflects the month of eligibility |
| Control | 0..1 |
| Type | Extension(CoverageMonth) (Extension Type: date) |
| 17. Coverage.extension:coverageInsurancePlan | |
| SliceName | coverageInsurancePlan |
| Definition | Reference to the insurance plan for this coverage |
| Control | 0..1 |
| Type | Extension(CoverageInsurancePlan) (Extension Type: Reference) |
| 18. Coverage.extension:dualEligibilityIndicator | |
| SliceName | dualEligibilityIndicator |
| Definition | Indicator of dual eligibility for the Medicaid market |
| Control | 0..1 |
| Type | Extension(DualEligibilityIndicator) (Extension Type: string) |
| 19. Coverage.extension:enrollmentPcp | |
| SliceName | enrollmentPcp |
| Definition | Provider identifier of the primary care physician for the plan member |
| Control | 0..1 |
| Type | Extension(EnrollmentPcp) (Extension Type: string) |
| 20. Coverage.extension:enrollmentPcpNameOnEnrollment | |
| SliceName | enrollmentPcpNameOnEnrollment |
| Definition | Original primary care physician (PCP) name as reporting on the eligibility record |
| Control | 0..1 |
| Type | Extension(EnrollmentPcpNameOnEnrollment) (Extension Type: string) |
| 21. Coverage.extension:enrollmentPcpZipOnEnrollment | |
| SliceName | enrollmentPcpZipOnEnrollment |
| Definition | Original primary care physician (PCP) zip as reporting on the eligibility record |
| Control | 0..1 |
| Type | Extension(EnrollmentPcpZipOnEnrollment) (Extension Type: string) |
| 22. Coverage.extension:employeeAverageScheduledHours | |
| SliceName | employeeAverageScheduledHours |
| Definition | Average number of hours the employee is scheduled to work per day |
| Control | 0..1 |
| Type | Extension(EmployeeAverageScheduledHours) (Extension Type: decimal) |
| 23. Coverage.extension:employeeBirthDate | |
| SliceName | employeeBirthDate |
| Definition | Birthdate of the employee or contract holder. For security, this field may be hidden or the value stored in this field should only contain the year. |
| Control | 0..1 |
| Type | Extension(EmployeeBirthDate) (Extension Type: date) |
| 24. Coverage.extension:employeeCompany | |
| SliceName | employeeCompany |
| Definition | Code for the company of the employee |
| Control | 0..1 |
| Type | Extension(EmployeeCompany) (Extension Type: CodeableConcept) |
| 25. Coverage.extension:employeeCostCenter | |
| SliceName | employeeCostCenter |
| Definition | Code for the cost center of the employee |
| Control | 0..1 |
| Type | Extension(EmployeeCostCenter) (Extension Type: CodeableConcept) |
| 26. Coverage.extension:employeeCount | |
| SliceName | employeeCount |
| Definition | Flag of the employees in the eligibility record. Each employee is identified with a value of 1. All others are given values of 0. |
| Control | 0..1 |
| Type | Extension(EmployeeCount) (Extension Type: unsignedInt) |
| 27. Coverage.extension:employeeBusinessUnit | |
| SliceName | employeeBusinessUnit |
| Definition | Code for the business unit of the employee |
| Control | 0..1 |
| Type | Extension(EmployeeBusinessUnit) (Extension Type: CodeableConcept) |
| 28. Coverage.extension:employeeDepartment | |
| SliceName | employeeDepartment |
| Definition | Code for the department of the employee |
| Control | 0..1 |
| Type | Extension(EmployeeDepartment) (Extension Type: CodeableConcept) |
| 29. Coverage.extension:employeeDivision | |
| SliceName | employeeDivision |
| Definition | Code for the division of the employee |
| Control | 0..1 |
| Type | Extension(EmployeeDivision) (Extension Type: CodeableConcept) |
| 30. Coverage.extension:employeeExemptIndicator | |
| SliceName | employeeExemptIndicator |
| Definition | Indicator of whether the employee status is exempt or non-exempt |
| Control | 0..1 |
| Type | Extension(EmployeeExemptIndicator) (Extension Type: string) |
| 31. Coverage.extension:employeeFamilySize | |
| SliceName | employeeFamilySize |
| Definition | Total family size of the employee, whether or not dependents are insured or participating in any programs |
| Control | 0..1 |
| Type | Extension(EmployeeFamilySize) (Extension Type: integer) |
| 32. Coverage.extension:employeeFTECount | |
| SliceName | employeeFTECount |
| Definition | Full Time Equivalent calculation for the employee. Example 1: A full-time employee would have a value of 1. Example 2: A 20-hour per week employee would have a value of 0.5. |
| Control | 0..1 |
| Type | Extension(EmployeeFTECount) (Extension Type: decimal) |
| 33. Coverage.extension:employeeId | |
| SliceName | employeeId |
| Definition | Identifier for the employee |
| Control | 0..* |
| Type | Extension(EmployeeId) (Extension Type: Identifier) |
| 34. Coverage.extension:employeeJobFamily | |
| SliceName | employeeJobFamily |
| Definition | Code for the job family of the employee |
| Control | 0..1 |
| Type | Extension(EmployeeJobFamily) (Extension Type: CodeableConcept) |
| 35. Coverage.extension:employeeJobGrade | |
| SliceName | employeeJobGrade |
| Definition | Code for the job grade of the employee |
| Control | 0..1 |
| Type | Extension(EmployeeJobGrade) (Extension Type: CodeableConcept) |
| 36. Coverage.extension:employeeJobLocation | |
| SliceName | employeeJobLocation |
| Definition | Code for the physical location where the employee works |
| Control | 0..* |
| Type | Extension(EmployeeJobLocation) (Extension Type: CodeableConcept) |
| 37. Coverage.extension:employeePayFrequency | |
| SliceName | employeePayFrequency |
| Definition | Code indicating the frequency with which the employee is paid (e.g., daily, weekly, monthly) |
| Control | 0..1 |
| Type | Extension(EmployeePayFrequency) (Extension Type: CodeableConcept) |
| 38. Coverage.extension:employeePerformanceRating | |
| SliceName | employeePerformanceRating |
| Definition | Code indicating the performance rating of the employee, assigned as of the last review period |
| Control | 0..1 |
| Type | Extension(EmployeePerformanceRating) (Extension Type: CodeableConcept) |
| 39. Coverage.extension:employeeShift | |
| SliceName | employeeShift |
| Definition | Code indicating the regular shift which the employee is scheduled to work (e.g., day, afternoon, midnight) |
| Control | 0..1 |
| Type | Extension(EmployeeShift) (Extension Type: CodeableConcept) |
| 40. Coverage.extension:employeeSubBusinessUnit | |
| SliceName | employeeSubBusinessUnit |
| Definition | Code of the sub business unit of the employee |
| Control | 0..1 |
| Type | Extension(EmployeeSubBusinessUnit) (Extension Type: CodeableConcept) |
| 41. Coverage.extension:salaryIndicator | |
| SliceName | salaryIndicator |
| Definition | Indicator of whether the employee status is salaried |
| Control | 0..1 |
| Type | Extension(SalaryIndicator) (Extension Type: string) |
| 42. Coverage.extension:unionWorkerIndicator | |
| SliceName | unionWorkerIndicator |
| Definition | Indicator that the contract holder (subscriber) belongs to a union |
| Control | 0..1 |
| Type | Extension(UnionWorkerIndicator) (Extension Type: string) |
| 43. Coverage.extension:employeeEducationLevel | |
| SliceName | employeeEducationLevel |
| Definition | Code indicating the highest level of education that the employee has completed (e.g., not a high school graduate, high school graduate, some college, associates degree, bachelors degree, graduate degree) |
| Control | 0..1 |
| Type | Extension(EmployeeEducationLevel) (Extension Type: CodeableConcept) |
| 44. Coverage.extension:employeeEducationLevel.valueCodeableConcept | |
| Control | 0..1 |
| Binding | The codes SHALL be taken from Payer Education Level Value Set; other codes may be used where these codes are not suitable |
| 45. Coverage.extension:employeeGender | |
| SliceName | employeeGender |
| Definition | Employee gender code |
| Control | 0..1 |
| Type | Extension(EmployeeGender) (Extension Type: CodeableConcept) |
| 46. Coverage.extension:employeeGender.valueCodeableConcept | |
| Control | 0..1 |
| Binding | The codes SHALL be taken from Payer Gender Value Set; other codes may be used where these codes are not suitable |
| 47. Coverage.extension:employeeHireDate | |
| SliceName | employeeHireDate |
| Definition | First date of employment for the employee |
| Control | 0..* |
| Type | Extension(EmployeeHireDate) (Extension Type: date) |
| 48. Coverage.extension:employeeTerminationDate | |
| SliceName | employeeTerminationDate |
| Definition | Last date of employment for the employee |
| Control | 0..* |
| Type | Extension(EmployeeTerminationDate) (Extension Type: date) |
| 49. Coverage.extension:employeeTerminationReason | |
| SliceName | employeeTerminationReason |
| Definition | Code indicating the reason for employee termination, if the employee was terminated (e.g., discharged, resigned) |
| Control | 0..* |
| Type | Extension(EmployeeTerminationReason) (Extension Type: CodeableConcept) |
| 50. Coverage.extension:employeeJobTitle | |
| SliceName | employeeJobTitle |
| Definition | Job title of the employee |
| Control | 0..1 |
| Type | Extension(EmployeeJobTitle) (Extension Type: CodeableConcept) |
| 51. Coverage.extension:employeeJobTitle.valueCodeableConcept | |
| Control | 0..1 |
| Binding | The codes SHALL be taken from Payer Job Title Value Set; other codes may be used where these codes are not suitable |
| 52. Coverage.extension:employeeLaborUnion | |
| SliceName | employeeLaborUnion |
| Definition | Code for the labor union of the employee |
| Control | 0..1 |
| Type | Extension(EmployeeLaborUnion) (Extension Type: CodeableConcept) |
| 53. Coverage.extension:employeeRetirementDate | |
| SliceName | employeeRetirementDate |
| Definition | Date of retirement for the employee or contract holder |
| Control | 0..1 |
| Type | Extension(EmployeeRetirementDate) (Extension Type: date) |
| 54. Coverage.extension:employeeStatus | |
| SliceName | employeeStatus |
| Definition | Status of the employee based on one or more code systems. Example codes include HIPAA (HipaaEmployeeStatusCodeSystem), Payer (PayerEmployeeStatusCodeSystem) or customer-specific codes. |
| Control | 0..1 |
| Type | Extension(EmployeeStatus) (Extension Type: CodeableConcept) |
| 55. Coverage.extension:employeeUnionId | |
| SliceName | employeeUnionId |
| Definition | Identification for the labor union member |
| Control | 0..1 |
| Type | Extension(EmployeeUnionId) (Extension Type: string) |
| 56. Coverage.extension:employeeWageAmount | |
| SliceName | employeeWageAmount |
| Definition | Wage amount of the employee for the time period represented by the Wage Basis field |
| Control | 0..1 |
| Type | Extension(EmployeeWageAmount) (Extension Type: decimal) |
| 57. Coverage.extension:employeeWageBasis | |
| SliceName | employeeWageBasis |
| Definition | Code indicating the basis on which the wages of the employee are calculated (e.g., hourly, daily, weekly, bimonthly, monthly, annually) |
| Control | 0..1 |
| Type | Extension(EmployeeWageBasis) (Extension Type: CodeableConcept) |
| 58. Coverage.extension:employeeYearOfService | |
| SliceName | employeeYearOfService |
| Definition | Net credited service in years for the employee |
| Control | 0..1 |
| Type | Extension(EmployeeYearOfService) (Extension Type: unsignedInt) |
| 59. Coverage.extension:employer | |
| SliceName | employer |
| Definition | Code for the employer |
| Control | 0..1 |
| Type | Extension(Employer) (Extension Type: CodeableConcept) |
| 60. Coverage.extension:familyIncomeLevel | |
| SliceName | familyIncomeLevel |
| Definition | Code for the family income level of the person based on the Federal Poverty Level (FPL) |
| Control | 0..1 |
| Type | Extension(FamilyIncomeLevel) (Extension Type: CodeableConcept) |
| 61. Coverage.extension:jobClassCode | |
| SliceName | jobClassCode |
| Definition | Classifcation group of the job role of the employee, for example, Top Executives, Post-secondary teachers, and Engineers |
| Control | 0..1 |
| Type | Extension(JobClassCode) (Extension Type: CodeableConcept) |
| 62. Coverage.extension:jobLocationZipcode | |
| SliceName | jobLocationZipcode |
| Definition | 5-digit zip code of the facility where the employee works |
| Control | 0..1 |
| Type | Extension(JobLocationZipcode) (Extension Type: string) |
| 63. Coverage.extension:longTermDisabilityBenefitRate | |
| SliceName | longTermDisabilityBenefitRate |
| Definition | Long term disability (LTD) benefit rate, expressed as a percentage of base wages (for example, 50.00%, 60.00%, 70.00%) |
| Control | 0..1 |
| Type | Extension(LongTermDisabilityBenefitRate) (Extension Type: decimal) |
| 64. Coverage.extension:medicareCoverage | |
| SliceName | medicareCoverage |
| Definition | Standard code for the type of Medicare coverage, if any, for the person |
| Control | 0..1 |
| Type | Extension(MedicareCoverage) (Extension Type: CodeableConcept) |
| 65. Coverage.extension:medicareCoverage.valueCodeableConcept | |
| Control | 0..1 |
| Binding | The codes SHALL be taken from Payer Medicare Coverage Value Set; other codes may be used where these codes are not suitable |
| 66. Coverage.extension:medicareIndicator | |
| SliceName | medicareIndicator |
| Definition | Indicator of Medicare coverage for the member |
| Control | 0..1 |
| Type | Extension(MedicareIndicator) (Extension Type: string) |
| 67. Coverage.extension:memberEmployeeIndicator | |
| SliceName | memberEmployeeIndicator |
| Definition | Code indicates whether the member is either an employee of the health plan, or the dependent of an employee of the health plan |
| Control | 0..1 |
| Type | Extension(MemberEmployeeIndicator) (Extension Type: CodeableConcept) |
| 68. Coverage.extension:planEmployeeCode | |
| SliceName | planEmployeeCode |
| Definition | Code indicating whether the member is an employee of the health plan or the dependent of an employee of the health plan |
| Control | 0..1 |
| Type | Extension(PlanEmployeeCode) (Extension Type: string) |
| 69. Coverage.extension:regionCode | |
| SliceName | regionCode |
| Definition | Customer-specific code for the geographic region of the employee |
| Control | 0..1 |
| Type | Extension(RegionCode) (Extension Type: CodeableConcept) |
| 70. Coverage.extension:restrictedBenefits | |
| SliceName | restrictedBenefits |
| Definition | Code of the scope of Medicaid or CHIP benefits for a person |
| Control | 0..1 |
| Type | Extension(RestrictedBenefits) (Extension Type: CodeableConcept) |
| 71. Coverage.extension:shortTermDisabilityBenefitRate | |
| SliceName | shortTermDisabilityBenefitRate |
| Definition | Short term disability (STD) benefit rate, expressed as a percentage of base wages or benefit amount (for example, 50.00%, 60.00%, 70.00%) |
| Control | 0..1 |
| Type | Extension(ShortTermDisabilityBenefitRate) (Extension Type: decimal) |
| 72. Coverage.extension:ssiIndicator | |
| SliceName | ssiIndicator |
| Definition | Indicates if the person receives Supplemental Security Income (SSI) administered via the Social Security Administration (SSA), at the time of coverage |
| Control | 0..1 |
| Type | Extension(SsiIndicator) (Extension Type: string) |
| 73. Coverage.extension:ssiStatus | |
| SliceName | ssiStatus |
| Definition | Standard code of the Supplemental Security Income (SSI) status for the person, at the time of coverage |
| Control | 0..1 |
| Type | Extension(SsiStatus) (Extension Type: CodeableConcept) |
| 74. Coverage.extension:ssiStatus.valueCodeableConcept | |
| Control | 0..1 |
| Binding | The codes SHALL be taken from Payer SSI Status Value Set; other codes may be used where these codes are not suitable |
| 75. Coverage.extension:tanfBenefits | |
| SliceName | tanfBenefits |
| Definition | Standard code of the Temporary Assistance for Needy Families (TANF) benefits for the person |
| Control | 0..1 |
| Type | Extension(TanfBenefits) (Extension Type: CodeableConcept) |
| 76. Coverage.extension:tanfBenefits.valueCodeableConcept | |
| Control | 0..1 |
| Binding | The codes SHALL be taken from Payer TANF Benefit Value Set; other codes may be used where these codes are not suitable |
| 77. Coverage.extension:totalDependentCount | |
| SliceName | totalDependentCount |
| Definition | Number of dependents covered by the group health medical plan |
| Control | 0..1 |
| Type | Extension(TotalDependentCount) (Extension Type: integer) |
| 78. Coverage.extension:subscriberIdEncrypted | |
| SliceName | subscriberIdEncrypted |
| Definition | Encrypted identifier of the subscriber or family |
| Control | 0..1 |
| Type | Extension(SubscriberIdEncrypted) (Extension Type: string) |
| 79. Coverage.extension:payerRecordPopulationCount | |
| SliceName | payerRecordPopulationCount |
| Definition | Specifies whether the member should be counted as eligible for the coverage period. A value of 1 is used to count the member as eligible for the coverage period. Else the value should be 0. |
| Control | 0..1 |
| Type | Extension(PayerRecordPopulationCount) (Extension Type: integer) |
| 80. Coverage.identifier | |
| Note | This is a business identifier, not a resource identifier (see discussion) |
| Type | Identifier(CDMIdentifier) |
| 81. Coverage.period | |
| Control | 10..1 |
| 82. Coverage.payor | |
| Control | 1..1* |
| 83. Coverage.class | |
| Control | 0..? |
| 84. Coverage.class.type | |
| Binding | The codes SHALL be taken from Payer Coverage Class Value Set; other codes may be used where these codes are not suitableThe codes SHALL be taken from CoverageClassCodes; other codes may be used where these codes are not suitable |
| 1. Coverage | |
| Definition | Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment. |
| Control | 0..* |
| Comments | The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers. |
| Invariants | Defined on this element dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (: text.`div`.exists()) |
| 2. Coverage.meta | |
| Definition | The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Meta(ProcessMeta) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 3. Coverage.implicitRules | |
| Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
| Control | 0..1 |
| Type | uri |
| Is Modifier | true |
| Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 4. Coverage.contained | |
| Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. |
| Control | 0..0* |
| Type | Resource |
| Alternate Names | inline resources, anonymous resources, contained resources |
| Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. |
| 5. Coverage.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Control | 0..* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Coverage.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 6. Coverage.extension:snapshotAgeInMonths | |
| SliceName | snapshotAgeInMonths |
| Definition | Age in months at the time of the coverage period |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(SnapshotAgeInMonths) (Extension Type: unsignedInt) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 7. Coverage.extension:snapshotAgeInYears | |
| SliceName | snapshotAgeInYears |
| Definition | The age of the person in years for the month of eligibility or service |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(SnapshotAgeInYears) (Extension Type: unsignedInt) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 8. Coverage.extension:employeeSnapshotAgeInYears | |
| SliceName | employeeSnapshotAgeInYears |
| Definition | The age of the employee in years for the month of eligibility or service |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeSnapshotAgeInYears) (Extension Type: unsignedInt) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 9. Coverage.extension:ageGroup | |
| SliceName | ageGroup |
| Definition | Standard code for age groupings |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(AgeGroup) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 10. Coverage.extension:ageGenderGroup | |
| SliceName | ageGenderGroup |
| Definition | Standard code for groupings that combine age and gender |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(AgeGenderGroup) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 11. Coverage.extension:attributedProviderReferenceWithPeriod | |
| SliceName | attributedProviderReferenceWithPeriod |
| Definition | Attributed provider reference with period |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(AttributedProviderReferenceWithPeriod) (Extension Type: Reference(ReferenceWithPeriod)) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 12. Coverage.extension:benefitStatus | |
| SliceName | benefitStatus |
| Definition | HIPAA standard code for the benefit status |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(BenefitStatus) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 13. Coverage.extension:benefitStatus.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Control | 0..0* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 14. Coverage.extension:benefitStatus.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| XML Representation | In the XML format, this property is represented as an attribute. |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/benefit-status |
| 15. Coverage.extension:benefitStatus.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 16. Coverage.extension:benefitStatus.value[x]:valueCodeableConcept | |
| SliceName | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Binding | The codes SHALL be taken from HIPAA Benefit Status Value Set; other codes may be used where these codes are not suitableFor codes, see (unbound) |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 17. Coverage.extension:claimGroupIdentifier | |
| SliceName | claimGroupIdentifier |
| Definition | Group ID of the plan member. This ID associates the primary plan holder with any dependents. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(ClaimGroupIdentifier) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 18. Coverage.extension:cobraIndicator | |
| SliceName | cobraIndicator |
| Definition | Indicator of Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation for the person |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(CobraIndicator) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 19. Coverage.extension:coverageDays | |
| SliceName | coverageDays |
| Definition | Number of covered days of eligibility |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(CoverageDays) (Extension Type: unsignedInt) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 20. Coverage.extension:coverageMonth | |
| SliceName | coverageMonth |
| Definition | Date which reflects the month of eligibility |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(CoverageMonth) (Extension Type: date) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 21. Coverage.extension:coverageInsurancePlan | |
| SliceName | coverageInsurancePlan |
| Definition | Reference to the insurance plan for this coverage |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(CoverageInsurancePlan) (Extension Type: Reference) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 22. Coverage.extension:dualEligibilityIndicator | |
| SliceName | dualEligibilityIndicator |
| Definition | Indicator of dual eligibility for the Medicaid market |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(DualEligibilityIndicator) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 23. Coverage.extension:enrollmentPcp | |
| SliceName | enrollmentPcp |
| Definition | Provider identifier of the primary care physician for the plan member |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EnrollmentPcp) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 24. Coverage.extension:enrollmentPcpNameOnEnrollment | |
| SliceName | enrollmentPcpNameOnEnrollment |
| Definition | Original primary care physician (PCP) name as reporting on the eligibility record |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EnrollmentPcpNameOnEnrollment) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 25. Coverage.extension:enrollmentPcpZipOnEnrollment | |
| SliceName | enrollmentPcpZipOnEnrollment |
| Definition | Original primary care physician (PCP) zip as reporting on the eligibility record |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EnrollmentPcpZipOnEnrollment) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 26. Coverage.extension:employeeAverageScheduledHours | |
| SliceName | employeeAverageScheduledHours |
| Definition | Average number of hours the employee is scheduled to work per day |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeAverageScheduledHours) (Extension Type: decimal) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 27. Coverage.extension:employeeBirthDate | |
| SliceName | employeeBirthDate |
| Definition | Birthdate of the employee or contract holder. For security, this field may be hidden or the value stored in this field should only contain the year. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeBirthDate) (Extension Type: date) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 28. Coverage.extension:employeeCompany | |
| SliceName | employeeCompany |
| Definition | Code for the company of the employee |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeCompany) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 29. Coverage.extension:employeeCostCenter | |
| SliceName | employeeCostCenter |
| Definition | Code for the cost center of the employee |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeCostCenter) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 30. Coverage.extension:employeeCount | |
| SliceName | employeeCount |
| Definition | Flag of the employees in the eligibility record. Each employee is identified with a value of 1. All others are given values of 0. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeCount) (Extension Type: unsignedInt) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 31. Coverage.extension:employeeBusinessUnit | |
| SliceName | employeeBusinessUnit |
| Definition | Code for the business unit of the employee |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeBusinessUnit) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 32. Coverage.extension:employeeDepartment | |
| SliceName | employeeDepartment |
| Definition | Code for the department of the employee |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeDepartment) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 33. Coverage.extension:employeeDivision | |
| SliceName | employeeDivision |
| Definition | Code for the division of the employee |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeDivision) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 34. Coverage.extension:employeeExemptIndicator | |
| SliceName | employeeExemptIndicator |
| Definition | Indicator of whether the employee status is exempt or non-exempt |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeExemptIndicator) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 35. Coverage.extension:employeeFamilySize | |
| SliceName | employeeFamilySize |
| Definition | Total family size of the employee, whether or not dependents are insured or participating in any programs |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeFamilySize) (Extension Type: integer) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 36. Coverage.extension:employeeFTECount | |
| SliceName | employeeFTECount |
| Definition | Full Time Equivalent calculation for the employee. Example 1: A full-time employee would have a value of 1. Example 2: A 20-hour per week employee would have a value of 0.5. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeFTECount) (Extension Type: decimal) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 37. Coverage.extension:employeeId | |
| SliceName | employeeId |
| Definition | Identifier for the employee |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeId) (Extension Type: Identifier) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 38. Coverage.extension:employeeJobFamily | |
| SliceName | employeeJobFamily |
| Definition | Code for the job family of the employee |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeJobFamily) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 39. Coverage.extension:employeeJobGrade | |
| SliceName | employeeJobGrade |
| Definition | Code for the job grade of the employee |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeJobGrade) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 40. Coverage.extension:employeeJobLocation | |
| SliceName | employeeJobLocation |
| Definition | Code for the physical location where the employee works |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeJobLocation) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 41. Coverage.extension:employeePayFrequency | |
| SliceName | employeePayFrequency |
| Definition | Code indicating the frequency with which the employee is paid (e.g., daily, weekly, monthly) |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeePayFrequency) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 42. Coverage.extension:employeePerformanceRating | |
| SliceName | employeePerformanceRating |
| Definition | Code indicating the performance rating of the employee, assigned as of the last review period |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeePerformanceRating) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 43. Coverage.extension:employeeShift | |
| SliceName | employeeShift |
| Definition | Code indicating the regular shift which the employee is scheduled to work (e.g., day, afternoon, midnight) |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeShift) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 44. Coverage.extension:employeeSubBusinessUnit | |
| SliceName | employeeSubBusinessUnit |
| Definition | Code of the sub business unit of the employee |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeSubBusinessUnit) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 45. Coverage.extension:salaryIndicator | |
| SliceName | salaryIndicator |
| Definition | Indicator of whether the employee status is salaried |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(SalaryIndicator) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 46. Coverage.extension:unionWorkerIndicator | |
| SliceName | unionWorkerIndicator |
| Definition | Indicator that the contract holder (subscriber) belongs to a union |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(UnionWorkerIndicator) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 47. Coverage.extension:employeeEducationLevel | |
| SliceName | employeeEducationLevel |
| Definition | Code indicating the highest level of education that the employee has completed (e.g., not a high school graduate, high school graduate, some college, associates degree, bachelors degree, graduate degree) |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeEducationLevel) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 48. Coverage.extension:employeeEducationLevel.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Control | 0..0* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 49. Coverage.extension:employeeEducationLevel.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| XML Representation | In the XML format, this property is represented as an attribute. |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/employee-education-level |
| 50. Coverage.extension:employeeEducationLevel.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 51. Coverage.extension:employeeEducationLevel.value[x]:valueCodeableConcept | |
| SliceName | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Binding | The codes SHALL be taken from Payer Education Level Value Set; other codes may be used where these codes are not suitableFor codes, see (unbound) |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 52. Coverage.extension:employeeGender | |
| SliceName | employeeGender |
| Definition | Employee gender code |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeGender) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 53. Coverage.extension:employeeGender.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Control | 0..0* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 54. Coverage.extension:employeeGender.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| XML Representation | In the XML format, this property is represented as an attribute. |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/employee-gender |
| 55. Coverage.extension:employeeGender.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 56. Coverage.extension:employeeGender.value[x]:valueCodeableConcept | |
| SliceName | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Binding | The codes SHALL be taken from Payer Gender Value Set; other codes may be used where these codes are not suitableFor codes, see (unbound) |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 57. Coverage.extension:employeeHireDate | |
| SliceName | employeeHireDate |
| Definition | First date of employment for the employee |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeHireDate) (Extension Type: date) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 58. Coverage.extension:employeeTerminationDate | |
| SliceName | employeeTerminationDate |
| Definition | Last date of employment for the employee |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeTerminationDate) (Extension Type: date) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 59. Coverage.extension:employeeTerminationReason | |
| SliceName | employeeTerminationReason |
| Definition | Code indicating the reason for employee termination, if the employee was terminated (e.g., discharged, resigned) |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeTerminationReason) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 60. Coverage.extension:employeeJobTitle | |
| SliceName | employeeJobTitle |
| Definition | Job title of the employee |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeJobTitle) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 61. Coverage.extension:employeeJobTitle.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Control | 0..0* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 62. Coverage.extension:employeeJobTitle.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| XML Representation | In the XML format, this property is represented as an attribute. |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/employee-job-title |
| 63. Coverage.extension:employeeJobTitle.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 64. Coverage.extension:employeeJobTitle.value[x]:valueCodeableConcept | |
| SliceName | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Binding | The codes SHALL be taken from Payer Job Title Value Set; other codes may be used where these codes are not suitableFor codes, see (unbound) |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 65. Coverage.extension:employeeLaborUnion | |
| SliceName | employeeLaborUnion |
| Definition | Code for the labor union of the employee |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeLaborUnion) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 66. Coverage.extension:employeeRetirementDate | |
| SliceName | employeeRetirementDate |
| Definition | Date of retirement for the employee or contract holder |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeRetirementDate) (Extension Type: date) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 67. Coverage.extension:employeeStatus | |
| SliceName | employeeStatus |
| Definition | Status of the employee based on one or more code systems. Example codes include HIPAA (HipaaEmployeeStatusCodeSystem), Payer (PayerEmployeeStatusCodeSystem) or customer-specific codes. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeStatus) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 68. Coverage.extension:employeeUnionId | |
| SliceName | employeeUnionId |
| Definition | Identification for the labor union member |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeUnionId) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 69. Coverage.extension:employeeWageAmount | |
| SliceName | employeeWageAmount |
| Definition | Wage amount of the employee for the time period represented by the Wage Basis field |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeWageAmount) (Extension Type: decimal) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 70. Coverage.extension:employeeWageBasis | |
| SliceName | employeeWageBasis |
| Definition | Code indicating the basis on which the wages of the employee are calculated (e.g., hourly, daily, weekly, bimonthly, monthly, annually) |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeWageBasis) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 71. Coverage.extension:employeeYearOfService | |
| SliceName | employeeYearOfService |
| Definition | Net credited service in years for the employee |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(EmployeeYearOfService) (Extension Type: unsignedInt) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 72. Coverage.extension:employer | |
| SliceName | employer |
| Definition | Code for the employer |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(Employer) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 73. Coverage.extension:familyIncomeLevel | |
| SliceName | familyIncomeLevel |
| Definition | Code for the family income level of the person based on the Federal Poverty Level (FPL) |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(FamilyIncomeLevel) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 74. Coverage.extension:jobClassCode | |
| SliceName | jobClassCode |
| Definition | Classifcation group of the job role of the employee, for example, Top Executives, Post-secondary teachers, and Engineers |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(JobClassCode) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 75. Coverage.extension:jobLocationZipcode | |
| SliceName | jobLocationZipcode |
| Definition | 5-digit zip code of the facility where the employee works |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(JobLocationZipcode) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 76. Coverage.extension:longTermDisabilityBenefitRate | |
| SliceName | longTermDisabilityBenefitRate |
| Definition | Long term disability (LTD) benefit rate, expressed as a percentage of base wages (for example, 50.00%, 60.00%, 70.00%) |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(LongTermDisabilityBenefitRate) (Extension Type: decimal) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 77. Coverage.extension:medicareCoverage | |
| SliceName | medicareCoverage |
| Definition | Standard code for the type of Medicare coverage, if any, for the person |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(MedicareCoverage) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 78. Coverage.extension:medicareCoverage.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Control | 0..0* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 79. Coverage.extension:medicareCoverage.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| XML Representation | In the XML format, this property is represented as an attribute. |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/medicare-coverage |
| 80. Coverage.extension:medicareCoverage.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 81. Coverage.extension:medicareCoverage.value[x]:valueCodeableConcept | |
| SliceName | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Binding | The codes SHALL be taken from Payer Medicare Coverage Value Set; other codes may be used where these codes are not suitableFor codes, see (unbound) |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 82. Coverage.extension:medicareIndicator | |
| SliceName | medicareIndicator |
| Definition | Indicator of Medicare coverage for the member |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(MedicareIndicator) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 83. Coverage.extension:memberEmployeeIndicator | |
| SliceName | memberEmployeeIndicator |
| Definition | Code indicates whether the member is either an employee of the health plan, or the dependent of an employee of the health plan |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(MemberEmployeeIndicator) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 84. Coverage.extension:planEmployeeCode | |
| SliceName | planEmployeeCode |
| Definition | Code indicating whether the member is an employee of the health plan or the dependent of an employee of the health plan |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(PlanEmployeeCode) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 85. Coverage.extension:regionCode | |
| SliceName | regionCode |
| Definition | Customer-specific code for the geographic region of the employee |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(RegionCode) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 86. Coverage.extension:restrictedBenefits | |
| SliceName | restrictedBenefits |
| Definition | Code of the scope of Medicaid or CHIP benefits for a person |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(RestrictedBenefits) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 87. Coverage.extension:shortTermDisabilityBenefitRate | |
| SliceName | shortTermDisabilityBenefitRate |
| Definition | Short term disability (STD) benefit rate, expressed as a percentage of base wages or benefit amount (for example, 50.00%, 60.00%, 70.00%) |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(ShortTermDisabilityBenefitRate) (Extension Type: decimal) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 88. Coverage.extension:ssiIndicator | |
| SliceName | ssiIndicator |
| Definition | Indicates if the person receives Supplemental Security Income (SSI) administered via the Social Security Administration (SSA), at the time of coverage |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(SsiIndicator) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 89. Coverage.extension:ssiStatus | |
| SliceName | ssiStatus |
| Definition | Standard code of the Supplemental Security Income (SSI) status for the person, at the time of coverage |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(SsiStatus) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 90. Coverage.extension:ssiStatus.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Control | 0..0* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 91. Coverage.extension:ssiStatus.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| XML Representation | In the XML format, this property is represented as an attribute. |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/ssi-status |
| 92. Coverage.extension:ssiStatus.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 93. Coverage.extension:ssiStatus.value[x]:valueCodeableConcept | |
| SliceName | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Binding | The codes SHALL be taken from Payer SSI Status Value Set; other codes may be used where these codes are not suitableFor codes, see (unbound) |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 94. Coverage.extension:tanfBenefits | |
| SliceName | tanfBenefits |
| Definition | Standard code of the Temporary Assistance for Needy Families (TANF) benefits for the person |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(TanfBenefits) (Extension Type: CodeableConcept) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 95. Coverage.extension:tanfBenefits.extension | |
| Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Control | 0..0* |
| Type | Extension |
| Alternate Names | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 96. Coverage.extension:tanfBenefits.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| XML Representation | In the XML format, this property is represented as an attribute. |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/tanf-benefits |
| 97. Coverage.extension:tanfBenefits.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 98. Coverage.extension:tanfBenefits.value[x]:valueCodeableConcept | |
| SliceName | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..1 |
| Binding | The codes SHALL be taken from Payer TANF Benefit Value Set; other codes may be used where these codes are not suitableFor codes, see (unbound) |
| Type | Choice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 99. Coverage.extension:totalDependentCount | |
| SliceName | totalDependentCount |
| Definition | Number of dependents covered by the group health medical plan |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(TotalDependentCount) (Extension Type: integer) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 100. Coverage.extension:subscriberIdEncrypted | |
| SliceName | subscriberIdEncrypted |
| Definition | Encrypted identifier of the subscriber or family |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(SubscriberIdEncrypted) (Extension Type: string) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 101. Coverage.extension:payerRecordPopulationCount | |
| SliceName | payerRecordPopulationCount |
| Definition | Specifies whether the member should be counted as eligible for the coverage period. A value of 1 is used to count the member as eligible for the coverage period. Else the value should be 0. |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | Extension(PayerRecordPopulationCount) (Extension Type: integer) |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 102. Coverage.modifierExtension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 103. Coverage.identifier | |
| Definition | An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. A unique identifier assigned to this coverage. |
| Note | This is a business identifier, not a resource identifier (see discussion) |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Type | Identifier(CDMIdentifier) |
| Requirements | Allows coverages to be distinguished and referenced. |
| Comments | The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependant. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 104. Coverage.status | |
| Definition | The status of the resource instance. |
| Control | 1..1 |
| Binding | The codes SHALL be taken from FinancialResourceStatusCodes A code specifying the state of the resource instance. |
| Type | code |
| Is Modifier | true |
| Requirements | Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'. |
| Comments | This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 105. Coverage.beneficiary | |
| Definition | The party who benefits from the insurance coverage; the patient when products and/or services are provided. |
| Control | 1..1 |
| Type | Reference(Patient)) |
| Requirements | This is the party who receives treatment for which the costs are reimbursed under the coverage. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 106. Coverage.period | |
| Definition | Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force. |
| Control | 10..1 |
| Type | Period |
| Requirements | Some insurers require the submission of the coverage term. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 107. Coverage.payor | |
| Definition | The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. |
| Control | 1..1* |
| Type | Reference(Organization|Patient|RelatedPerson)) |
| Requirements | Need to identify the issuer to target for claim processing and for coordination of benefit processing. |
| Comments | May provide multiple identifiers such as insurance company identifier or business identifier (BIN number). For selfpay it may provide multiple paying persons and/or organizations. |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 1. Coverage | |||||
| Definition | Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment. | ||||
| Control | 0..* | ||||
| Comments | The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers. | ||||
| 2. Coverage.id | |||||
| Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | ||||
| Control | 0..1 | ||||
| Type | id | ||||
| Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||||
| 3. Coverage.meta | |||||
| Definition | The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Meta(ProcessMeta) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 4. Coverage.implicitRules | |||||
| Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. | ||||
| Control | 0..1 | ||||
| Type | uri | ||||
| Is Modifier | true | ||||
| Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 5. Coverage.language | |||||
| Definition | The base language in which the resource is written. | ||||
| Control | 0..1 | ||||
| Binding | The codes SHOULD be taken from CommonLanguages
A human language
| ||||
| Type | code | ||||
| Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 6. Coverage.text | |||||
| Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. | ||||
| Control | 0..1 | ||||
| Type | Narrative | ||||
| Alternate Names | narrativehtmlxhtmldisplay | ||||
| Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 7. Coverage.contained | |||||
| Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. | ||||
| Control | 0..0 | ||||
| Type | Resource | ||||
| Alternate Names | inline resourcesanonymous resourcescontained resources | ||||
| Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. | ||||
| 8. Coverage.extension | |||||
| Definition | An Extension | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
| 9. Coverage.extension:snapshotAgeInMonths | |||||
| SliceName | snapshotAgeInMonths | ||||
| Definition | Age in months at the time of the coverage period | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(SnapshotAgeInMonths) (Extension Type: unsignedInt) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 10. Coverage.extension:snapshotAgeInYears | |||||
| SliceName | snapshotAgeInYears | ||||
| Definition | The age of the person in years for the month of eligibility or service | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(SnapshotAgeInYears) (Extension Type: unsignedInt) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 11. Coverage.extension:employeeSnapshotAgeInYears | |||||
| SliceName | employeeSnapshotAgeInYears | ||||
| Definition | The age of the employee in years for the month of eligibility or service | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeSnapshotAgeInYears) (Extension Type: unsignedInt) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 12. Coverage.extension:ageGroup | |||||
| SliceName | ageGroup | ||||
| Definition | Standard code for age groupings | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(AgeGroup) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 13. Coverage.extension:ageGenderGroup | |||||
| SliceName | ageGenderGroup | ||||
| Definition | Standard code for groupings that combine age and gender | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(AgeGenderGroup) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 14. Coverage.extension:attributedProviderReferenceWithPeriod | |||||
| SliceName | attributedProviderReferenceWithPeriod | ||||
| Definition | Attributed provider reference with period | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(AttributedProviderReferenceWithPeriod) (Extension Type: Reference(ReferenceWithPeriod)) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 15. Coverage.extension:benefitStatus | |||||
| SliceName | benefitStatus | ||||
| Definition | HIPAA standard code for the benefit status | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(BenefitStatus) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 16. Coverage.extension:benefitStatus.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| 17. Coverage.extension:benefitStatus.extension | |||||
| Definition | An Extension | ||||
| Control | 0..0 | ||||
| Type | Extension | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
| 18. Coverage.extension:benefitStatus.url | |||||
| Definition | Source of the definition for the extension code - a logical name or a URL. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/benefit-status | ||||
| 19. Coverage.extension:benefitStatus.value[x] | |||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
| ||||
| 20. Coverage.extension:benefitStatus.value[x]:valueCodeableConcept | |||||
| SliceName | valueCodeableConcept | ||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Binding | The codes SHALL be taken from HIPAA Benefit Status Value Set; other codes may be used where these codes are not suitable | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 21. Coverage.extension:claimGroupIdentifier | |||||
| SliceName | claimGroupIdentifier | ||||
| Definition | Group ID of the plan member. This ID associates the primary plan holder with any dependents. | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(ClaimGroupIdentifier) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 22. Coverage.extension:cobraIndicator | |||||
| SliceName | cobraIndicator | ||||
| Definition | Indicator of Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation for the person | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(CobraIndicator) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 23. Coverage.extension:coverageDays | |||||
| SliceName | coverageDays | ||||
| Definition | Number of covered days of eligibility | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(CoverageDays) (Extension Type: unsignedInt) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 24. Coverage.extension:coverageMonth | |||||
| SliceName | coverageMonth | ||||
| Definition | Date which reflects the month of eligibility | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(CoverageMonth) (Extension Type: date) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 25. Coverage.extension:coverageInsurancePlan | |||||
| SliceName | coverageInsurancePlan | ||||
| Definition | Reference to the insurance plan for this coverage | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(CoverageInsurancePlan) (Extension Type: Reference) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 26. Coverage.extension:dualEligibilityIndicator | |||||
| SliceName | dualEligibilityIndicator | ||||
| Definition | Indicator of dual eligibility for the Medicaid market | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(DualEligibilityIndicator) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 27. Coverage.extension:enrollmentPcp | |||||
| SliceName | enrollmentPcp | ||||
| Definition | Provider identifier of the primary care physician for the plan member | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EnrollmentPcp) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 28. Coverage.extension:enrollmentPcpNameOnEnrollment | |||||
| SliceName | enrollmentPcpNameOnEnrollment | ||||
| Definition | Original primary care physician (PCP) name as reporting on the eligibility record | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EnrollmentPcpNameOnEnrollment) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 29. Coverage.extension:enrollmentPcpZipOnEnrollment | |||||
| SliceName | enrollmentPcpZipOnEnrollment | ||||
| Definition | Original primary care physician (PCP) zip as reporting on the eligibility record | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EnrollmentPcpZipOnEnrollment) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 30. Coverage.extension:employeeAverageScheduledHours | |||||
| SliceName | employeeAverageScheduledHours | ||||
| Definition | Average number of hours the employee is scheduled to work per day | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeAverageScheduledHours) (Extension Type: decimal) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 31. Coverage.extension:employeeBirthDate | |||||
| SliceName | employeeBirthDate | ||||
| Definition | Birthdate of the employee or contract holder. For security, this field may be hidden or the value stored in this field should only contain the year. | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeBirthDate) (Extension Type: date) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 32. Coverage.extension:employeeCompany | |||||
| SliceName | employeeCompany | ||||
| Definition | Code for the company of the employee | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeCompany) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 33. Coverage.extension:employeeCostCenter | |||||
| SliceName | employeeCostCenter | ||||
| Definition | Code for the cost center of the employee | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeCostCenter) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 34. Coverage.extension:employeeCount | |||||
| SliceName | employeeCount | ||||
| Definition | Flag of the employees in the eligibility record. Each employee is identified with a value of 1. All others are given values of 0. | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeCount) (Extension Type: unsignedInt) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 35. Coverage.extension:employeeBusinessUnit | |||||
| SliceName | employeeBusinessUnit | ||||
| Definition | Code for the business unit of the employee | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeBusinessUnit) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 36. Coverage.extension:employeeDepartment | |||||
| SliceName | employeeDepartment | ||||
| Definition | Code for the department of the employee | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeDepartment) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 37. Coverage.extension:employeeDivision | |||||
| SliceName | employeeDivision | ||||
| Definition | Code for the division of the employee | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeDivision) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 38. Coverage.extension:employeeExemptIndicator | |||||
| SliceName | employeeExemptIndicator | ||||
| Definition | Indicator of whether the employee status is exempt or non-exempt | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeExemptIndicator) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 39. Coverage.extension:employeeFamilySize | |||||
| SliceName | employeeFamilySize | ||||
| Definition | Total family size of the employee, whether or not dependents are insured or participating in any programs | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeFamilySize) (Extension Type: integer) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 40. Coverage.extension:employeeFTECount | |||||
| SliceName | employeeFTECount | ||||
| Definition | Full Time Equivalent calculation for the employee. Example 1: A full-time employee would have a value of 1. Example 2: A 20-hour per week employee would have a value of 0.5. | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeFTECount) (Extension Type: decimal) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 41. Coverage.extension:employeeId | |||||
| SliceName | employeeId | ||||
| Definition | Identifier for the employee | ||||
| Control | 0..* This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeId) (Extension Type: Identifier) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 42. Coverage.extension:employeeJobFamily | |||||
| SliceName | employeeJobFamily | ||||
| Definition | Code for the job family of the employee | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeJobFamily) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 43. Coverage.extension:employeeJobGrade | |||||
| SliceName | employeeJobGrade | ||||
| Definition | Code for the job grade of the employee | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeJobGrade) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 44. Coverage.extension:employeeJobLocation | |||||
| SliceName | employeeJobLocation | ||||
| Definition | Code for the physical location where the employee works | ||||
| Control | 0..* This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeJobLocation) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 45. Coverage.extension:employeePayFrequency | |||||
| SliceName | employeePayFrequency | ||||
| Definition | Code indicating the frequency with which the employee is paid (e.g., daily, weekly, monthly) | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeePayFrequency) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 46. Coverage.extension:employeePerformanceRating | |||||
| SliceName | employeePerformanceRating | ||||
| Definition | Code indicating the performance rating of the employee, assigned as of the last review period | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeePerformanceRating) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 47. Coverage.extension:employeeShift | |||||
| SliceName | employeeShift | ||||
| Definition | Code indicating the regular shift which the employee is scheduled to work (e.g., day, afternoon, midnight) | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeShift) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 48. Coverage.extension:employeeSubBusinessUnit | |||||
| SliceName | employeeSubBusinessUnit | ||||
| Definition | Code of the sub business unit of the employee | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeSubBusinessUnit) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 49. Coverage.extension:salaryIndicator | |||||
| SliceName | salaryIndicator | ||||
| Definition | Indicator of whether the employee status is salaried | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(SalaryIndicator) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 50. Coverage.extension:unionWorkerIndicator | |||||
| SliceName | unionWorkerIndicator | ||||
| Definition | Indicator that the contract holder (subscriber) belongs to a union | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(UnionWorkerIndicator) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 51. Coverage.extension:employeeEducationLevel | |||||
| SliceName | employeeEducationLevel | ||||
| Definition | Code indicating the highest level of education that the employee has completed (e.g., not a high school graduate, high school graduate, some college, associates degree, bachelors degree, graduate degree) | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeEducationLevel) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 52. Coverage.extension:employeeEducationLevel.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| 53. Coverage.extension:employeeEducationLevel.extension | |||||
| Definition | An Extension | ||||
| Control | 0..0 | ||||
| Type | Extension | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
| 54. Coverage.extension:employeeEducationLevel.url | |||||
| Definition | Source of the definition for the extension code - a logical name or a URL. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/employee-education-level | ||||
| 55. Coverage.extension:employeeEducationLevel.value[x] | |||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
| ||||
| 56. Coverage.extension:employeeEducationLevel.value[x]:valueCodeableConcept | |||||
| SliceName | valueCodeableConcept | ||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Binding | The codes SHALL be taken from Payer Education Level Value Set; other codes may be used where these codes are not suitable | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 57. Coverage.extension:employeeGender | |||||
| SliceName | employeeGender | ||||
| Definition | Employee gender code | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeGender) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 58. Coverage.extension:employeeGender.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| 59. Coverage.extension:employeeGender.extension | |||||
| Definition | An Extension | ||||
| Control | 0..0 | ||||
| Type | Extension | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
| 60. Coverage.extension:employeeGender.url | |||||
| Definition | Source of the definition for the extension code - a logical name or a URL. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/employee-gender | ||||
| 61. Coverage.extension:employeeGender.value[x] | |||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
| ||||
| 62. Coverage.extension:employeeGender.value[x]:valueCodeableConcept | |||||
| SliceName | valueCodeableConcept | ||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Binding | The codes SHALL be taken from Payer Gender Value Set; other codes may be used where these codes are not suitable | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 63. Coverage.extension:employeeHireDate | |||||
| SliceName | employeeHireDate | ||||
| Definition | First date of employment for the employee | ||||
| Control | 0..* This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeHireDate) (Extension Type: date) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 64. Coverage.extension:employeeTerminationDate | |||||
| SliceName | employeeTerminationDate | ||||
| Definition | Last date of employment for the employee | ||||
| Control | 0..* This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeTerminationDate) (Extension Type: date) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 65. Coverage.extension:employeeTerminationReason | |||||
| SliceName | employeeTerminationReason | ||||
| Definition | Code indicating the reason for employee termination, if the employee was terminated (e.g., discharged, resigned) | ||||
| Control | 0..* This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeTerminationReason) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 66. Coverage.extension:employeeJobTitle | |||||
| SliceName | employeeJobTitle | ||||
| Definition | Job title of the employee | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeJobTitle) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 67. Coverage.extension:employeeJobTitle.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| 68. Coverage.extension:employeeJobTitle.extension | |||||
| Definition | An Extension | ||||
| Control | 0..0 | ||||
| Type | Extension | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
| 69. Coverage.extension:employeeJobTitle.url | |||||
| Definition | Source of the definition for the extension code - a logical name or a URL. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/employee-job-title | ||||
| 70. Coverage.extension:employeeJobTitle.value[x] | |||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
| ||||
| 71. Coverage.extension:employeeJobTitle.value[x]:valueCodeableConcept | |||||
| SliceName | valueCodeableConcept | ||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Binding | The codes SHALL be taken from Payer Job Title Value Set; other codes may be used where these codes are not suitable | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 72. Coverage.extension:employeeLaborUnion | |||||
| SliceName | employeeLaborUnion | ||||
| Definition | Code for the labor union of the employee | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeLaborUnion) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 73. Coverage.extension:employeeRetirementDate | |||||
| SliceName | employeeRetirementDate | ||||
| Definition | Date of retirement for the employee or contract holder | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeRetirementDate) (Extension Type: date) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 74. Coverage.extension:employeeStatus | |||||
| SliceName | employeeStatus | ||||
| Definition | Status of the employee based on one or more code systems. Example codes include HIPAA (HipaaEmployeeStatusCodeSystem), Payer (PayerEmployeeStatusCodeSystem) or customer-specific codes. | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeStatus) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 75. Coverage.extension:employeeUnionId | |||||
| SliceName | employeeUnionId | ||||
| Definition | Identification for the labor union member | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeUnionId) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 76. Coverage.extension:employeeWageAmount | |||||
| SliceName | employeeWageAmount | ||||
| Definition | Wage amount of the employee for the time period represented by the Wage Basis field | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeWageAmount) (Extension Type: decimal) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 77. Coverage.extension:employeeWageBasis | |||||
| SliceName | employeeWageBasis | ||||
| Definition | Code indicating the basis on which the wages of the employee are calculated (e.g., hourly, daily, weekly, bimonthly, monthly, annually) | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeWageBasis) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 78. Coverage.extension:employeeYearOfService | |||||
| SliceName | employeeYearOfService | ||||
| Definition | Net credited service in years for the employee | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(EmployeeYearOfService) (Extension Type: unsignedInt) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 79. Coverage.extension:employer | |||||
| SliceName | employer | ||||
| Definition | Code for the employer | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(Employer) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 80. Coverage.extension:familyIncomeLevel | |||||
| SliceName | familyIncomeLevel | ||||
| Definition | Code for the family income level of the person based on the Federal Poverty Level (FPL) | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(FamilyIncomeLevel) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 81. Coverage.extension:jobClassCode | |||||
| SliceName | jobClassCode | ||||
| Definition | Classifcation group of the job role of the employee, for example, Top Executives, Post-secondary teachers, and Engineers | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(JobClassCode) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 82. Coverage.extension:jobLocationZipcode | |||||
| SliceName | jobLocationZipcode | ||||
| Definition | 5-digit zip code of the facility where the employee works | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(JobLocationZipcode) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 83. Coverage.extension:longTermDisabilityBenefitRate | |||||
| SliceName | longTermDisabilityBenefitRate | ||||
| Definition | Long term disability (LTD) benefit rate, expressed as a percentage of base wages (for example, 50.00%, 60.00%, 70.00%) | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(LongTermDisabilityBenefitRate) (Extension Type: decimal) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 84. Coverage.extension:medicareCoverage | |||||
| SliceName | medicareCoverage | ||||
| Definition | Standard code for the type of Medicare coverage, if any, for the person | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(MedicareCoverage) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 85. Coverage.extension:medicareCoverage.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| 86. Coverage.extension:medicareCoverage.extension | |||||
| Definition | An Extension | ||||
| Control | 0..0 | ||||
| Type | Extension | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
| 87. Coverage.extension:medicareCoverage.url | |||||
| Definition | Source of the definition for the extension code - a logical name or a URL. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/medicare-coverage | ||||
| 88. Coverage.extension:medicareCoverage.value[x] | |||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
| ||||
| 89. Coverage.extension:medicareCoverage.value[x]:valueCodeableConcept | |||||
| SliceName | valueCodeableConcept | ||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Binding | The codes SHALL be taken from Payer Medicare Coverage Value Set; other codes may be used where these codes are not suitable | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 90. Coverage.extension:medicareIndicator | |||||
| SliceName | medicareIndicator | ||||
| Definition | Indicator of Medicare coverage for the member | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(MedicareIndicator) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 91. Coverage.extension:memberEmployeeIndicator | |||||
| SliceName | memberEmployeeIndicator | ||||
| Definition | Code indicates whether the member is either an employee of the health plan, or the dependent of an employee of the health plan | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(MemberEmployeeIndicator) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 92. Coverage.extension:planEmployeeCode | |||||
| SliceName | planEmployeeCode | ||||
| Definition | Code indicating whether the member is an employee of the health plan or the dependent of an employee of the health plan | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(PlanEmployeeCode) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 93. Coverage.extension:regionCode | |||||
| SliceName | regionCode | ||||
| Definition | Customer-specific code for the geographic region of the employee | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(RegionCode) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 94. Coverage.extension:restrictedBenefits | |||||
| SliceName | restrictedBenefits | ||||
| Definition | Code of the scope of Medicaid or CHIP benefits for a person | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(RestrictedBenefits) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 95. Coverage.extension:shortTermDisabilityBenefitRate | |||||
| SliceName | shortTermDisabilityBenefitRate | ||||
| Definition | Short term disability (STD) benefit rate, expressed as a percentage of base wages or benefit amount (for example, 50.00%, 60.00%, 70.00%) | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(ShortTermDisabilityBenefitRate) (Extension Type: decimal) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 96. Coverage.extension:ssiIndicator | |||||
| SliceName | ssiIndicator | ||||
| Definition | Indicates if the person receives Supplemental Security Income (SSI) administered via the Social Security Administration (SSA), at the time of coverage | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(SsiIndicator) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 97. Coverage.extension:ssiStatus | |||||
| SliceName | ssiStatus | ||||
| Definition | Standard code of the Supplemental Security Income (SSI) status for the person, at the time of coverage | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(SsiStatus) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 98. Coverage.extension:ssiStatus.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| 99. Coverage.extension:ssiStatus.extension | |||||
| Definition | An Extension | ||||
| Control | 0..0 | ||||
| Type | Extension | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
| 100. Coverage.extension:ssiStatus.url | |||||
| Definition | Source of the definition for the extension code - a logical name or a URL. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/ssi-status | ||||
| 101. Coverage.extension:ssiStatus.value[x] | |||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
| ||||
| 102. Coverage.extension:ssiStatus.value[x]:valueCodeableConcept | |||||
| SliceName | valueCodeableConcept | ||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Binding | The codes SHALL be taken from Payer SSI Status Value Set; other codes may be used where these codes are not suitable | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 103. Coverage.extension:tanfBenefits | |||||
| SliceName | tanfBenefits | ||||
| Definition | Standard code of the Temporary Assistance for Needy Families (TANF) benefits for the person | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(TanfBenefits) (Extension Type: CodeableConcept) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 104. Coverage.extension:tanfBenefits.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| 105. Coverage.extension:tanfBenefits.extension | |||||
| Definition | An Extension | ||||
| Control | 0..0 | ||||
| Type | Extension | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
| 106. Coverage.extension:tanfBenefits.url | |||||
| Definition | Source of the definition for the extension code - a logical name or a URL. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||
| Fixed Value | http://linuxforhealth.org/fhir/cdm/StructureDefinition/tanf-benefits | ||||
| 107. Coverage.extension:tanfBenefits.value[x] | |||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
| ||||
| 108. Coverage.extension:tanfBenefits.value[x]:valueCodeableConcept | |||||
| SliceName | valueCodeableConcept | ||||
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). | ||||
| Control | 0..1 | ||||
| Binding | The codes SHALL be taken from Payer TANF Benefit Value Set; other codes may be used where these codes are not suitable | ||||
| Type | CodeableConcept | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 109. Coverage.extension:totalDependentCount | |||||
| SliceName | totalDependentCount | ||||
| Definition | Number of dependents covered by the group health medical plan | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(TotalDependentCount) (Extension Type: integer) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 110. Coverage.extension:subscriberIdEncrypted | |||||
| SliceName | subscriberIdEncrypted | ||||
| Definition | Encrypted identifier of the subscriber or family | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(SubscriberIdEncrypted) (Extension Type: string) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 111. Coverage.extension:payerRecordPopulationCount | |||||
| SliceName | payerRecordPopulationCount | ||||
| Definition | Specifies whether the member should be counted as eligible for the coverage period. A value of 1 is used to count the member as eligible for the coverage period. Else the value should be 0. | ||||
| Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
| Type | Extension(PayerRecordPopulationCount) (Extension Type: integer) | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 112. Coverage.modifierExtension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensionsuser content | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 113. Coverage.identifier | |||||
| Definition | An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. | ||||
| Note | This is a business identifier, not a resource identifier (see discussion) | ||||
| Control | 0..* This element is affected by the following invariants: ele-1 | ||||
| Type | Identifier(CDMIdentifier) | ||||
| Requirements | Allows coverages to be distinguished and referenced. | ||||
| Comments | The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependant. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 114. Coverage.status | |||||
| Definition | The status of the resource instance. | ||||
| Control | 1..1 | ||||
| Binding | The codes SHALL be taken from FinancialResourceStatusCodes A code specifying the state of the resource instance | ||||
| Type | code | ||||
| Is Modifier | true | ||||
| Requirements | Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'. | ||||
| Comments | This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 115. Coverage.type | |||||
| Definition | The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization. | ||||
| Control | 0..1 | ||||
| Binding | The codes SHOULD be taken from CoverageTypeAndSelf-PayCodes The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization | ||||
| Type | CodeableConcept | ||||
| Requirements | The order of application of coverages is dependent on the types of coverage. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 116. Coverage.policyHolder | |||||
| Definition | The party who 'owns' the insurance policy. | ||||
| Control | 0..1 | ||||
| Type | Reference(PatientRelatedPersonOrganization)) | ||||
| Requirements | This provides employer information in the case of Worker's Compensation and other policies. | ||||
| Comments | For example: may be an individual, corporation or the subscriber's employer. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 117. Coverage.subscriber | |||||
| Definition | The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due. | ||||
| Control | 0..1 | ||||
| Type | Reference(PatientRelatedPerson)) | ||||
| Requirements | This is the party who is entitled to the benfits under the policy. | ||||
| Comments | May be self or a parent in the case of dependants. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 118. Coverage.subscriberId | |||||
| Definition | The insurer assigned ID for the Subscriber. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Requirements | The insurer requires this identifier on correspondance and claims (digital and otherwise). | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 119. Coverage.beneficiary | |||||
| Definition | The party who benefits from the insurance coverage; the patient when products and/or services are provided. | ||||
| Control | 1..1 | ||||
| Type | Reference(Patient)) | ||||
| Requirements | This is the party who receives treatment for which the costs are reimbursed under the coverage. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 120. Coverage.dependent | |||||
| Definition | A unique identifier for a dependent under the coverage. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Requirements | For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary. | ||||
| Comments | Periodically the member number is constructed from the subscriberId and the dependant number. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 121. Coverage.relationship | |||||
| Definition | The relationship of beneficiary (patient) to the subscriber. | ||||
| Control | 0..1 | ||||
| Binding | The codes SHALL be taken from SubscriberRelationshipCodes; other codes may be used where these codes are not suitable The relationship between the Subscriber and the Beneficiary (insured/covered party/patient) | ||||
| Type | CodeableConcept | ||||
| Requirements | To determine relationship between the patient and the subscriber to determine coordination of benefits. | ||||
| Comments | Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 122. Coverage.period | |||||
| Definition | Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force. | ||||
| Control | 1..1 | ||||
| Type | Period | ||||
| Requirements | Some insurers require the submission of the coverage term. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 123. Coverage.payor | |||||
| Definition | The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. | ||||
| Control | 1..1 | ||||
| Type | Reference(OrganizationPatientRelatedPerson)) | ||||
| Requirements | Need to identify the issuer to target for claim processing and for coordination of benefit processing. | ||||
| Comments | May provide multiple identifiers such as insurance company identifier or business identifier (BIN number). For selfpay it may provide multiple paying persons and/or organizations. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 124. Coverage.class | |||||
| Definition | A suite of underwriter specific classifiers. | ||||
| Control | 0..* | ||||
| Type | BackboneElement | ||||
| Requirements | The codes provided on the health card which identify or confirm the specific policy for the insurer. | ||||
| Comments | For example may be used to identify a class of coverage or employer group, Policy, Plan. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 125. Coverage.class.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| 126. Coverage.class.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Alternate Names | extensionsuser content | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 127. Coverage.class.modifierExtension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensionsuser contentmodifiers | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 128. Coverage.class.type | |||||
| Definition | The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan. | ||||
| Control | 1..1 | ||||
| Binding | The codes SHALL be taken from Payer Coverage Class Value Set; other codes may be used where these codes are not suitable | ||||
| Type | CodeableConcept | ||||
| Requirements | The insurer issued label for a specific health card value. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 129. Coverage.class.value | |||||
| Definition | The alphanumeric string value associated with the insurer issued label. | ||||
| Control | 1..1 | ||||
| Type | string | ||||
| Requirements | The insurer issued label and value are necessary to identify the specific policy. | ||||
| Comments | For example, the Group or Plan number. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 130. Coverage.class.name | |||||
| Definition | A short description for the class. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Requirements | Used to provide a meaningful description in correspondence to the patient. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 131. Coverage.order | |||||
| Definition | The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care. | ||||
| Control | 0..1 | ||||
| Type | positiveInt | ||||
| Requirements | Used in managing the coordination of benefits. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 132. Coverage.network | |||||
| Definition | The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Requirements | Used in referral for treatment and in claims processing. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 133. Coverage.costToBeneficiary | |||||
| Definition | A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card. | ||||
| Control | 0..* | ||||
| Type | BackboneElement | ||||
| Requirements | Required by providers to manage financial transaction with the patient. | ||||
| Alternate Names | CoPayDeductibleExceptions | ||||
| Comments | For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 134. Coverage.costToBeneficiary.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| 135. Coverage.costToBeneficiary.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Alternate Names | extensionsuser content | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 136. Coverage.costToBeneficiary.modifierExtension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensionsuser contentmodifiers | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 137. Coverage.costToBeneficiary.type | |||||
| Definition | The category of patient centric costs associated with treatment. | ||||
| Control | 0..1 | ||||
| Binding | The codes SHALL be taken from CoverageCopayTypeCodes; other codes may be used where these codes are not suitable The types of services to which patient copayments are specified | ||||
| Type | CodeableConcept | ||||
| Requirements | Needed to identify the category associated with the amount for the patient. | ||||
| Comments | For example visit, specialist visits, emergency, inpatient care, etc. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 138. Coverage.costToBeneficiary.value[x] | |||||
| Definition | The amount due from the patient for the cost category. | ||||
| Control | 1..1 | ||||
| Type | Choice of: Quantity(SimpleQuantity), Money | ||||
| [x] Note | See Choice of Data Types for further information about how to use [x] | ||||
| Requirements | Needed to identify the amount for the patient associated with the category. | ||||
| Comments | Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 139. Coverage.costToBeneficiary.exception | |||||
| Definition | A suite of codes indicating exceptions or reductions to patient costs and their effective periods. | ||||
| Control | 0..* | ||||
| Type | BackboneElement | ||||
| Requirements | Required by providers to manage financial transaction with the patient. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 140. Coverage.costToBeneficiary.exception.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| XML Representation | In the XML format, this property is represented as an attribute. | ||||
| 141. Coverage.costToBeneficiary.exception.extension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Alternate Names | extensionsuser content | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 142. Coverage.costToBeneficiary.exception.modifierExtension | |||||
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true | ||||
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
| Alternate Names | extensionsuser contentmodifiers | ||||
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) | ||||
| 143. Coverage.costToBeneficiary.exception.type | |||||
| Definition | The code for the specific exception. | ||||
| Control | 1..1 | ||||
| Binding | For example codes, see ExampleCoverageFinancialExceptionCodes The types of exceptions from the part or full value of financial obligations such as copays | ||||
| Type | CodeableConcept | ||||
| Requirements | Needed to identify the exception associated with the amount for the patient. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 144. Coverage.costToBeneficiary.exception.period | |||||
| Definition | The timeframe during when the exception is in force. | ||||
| Control | 0..1 | ||||
| Type | Period | ||||
| Requirements | Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 145. Coverage.subrogation | |||||
| Definition | When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs. | ||||
| Control | 0..1 | ||||
| Type | boolean | ||||
| Requirements | See definition for when to be used. | ||||
| Comments | Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||
| 146. Coverage.contract | |||||
| Definition | The policy(s) which constitute this insurance coverage. | ||||
| Control | 0..* | ||||
| Type | Reference(Contract)) | ||||
| Requirements | To reference the legally binding contract between the policy holder and the insurer. | ||||
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) | ||||