HL7 FHIR Implementation Guide: Simplify Health Equity Application Reviews IG Release 1 - US Realm | STU1
0.1.0 - ci-build
HL7 FHIR Implementation Guide: Simplify Health Equity Application Reviews IG Release 1 - US Realm | STU1 - Local Development build (v0.1.0). See the Directory of published versions
| Official URL: https://ig.fhir.safhir.io/ig/shear/StructureDefinition/SHEAR-InsurancePlan | Version: 0.1.0 | |||
| Active as of 2023-05-02 | Computable Name: SHEARInsurancePlan | |||
Data that reflect the product or service available under an insurance coverage provided to a member. The record will also contain a link to an assessment questionnaire that is used to determine eligibility for the product or service.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from PlannetInsurancePlan
| Name | Flags | Card. | Type | Description & Constraints![]() |
|---|---|---|---|---|
![]() | 0..* | PlannetInsurancePlan | Details of a Health Insurance product/plan provided by an organization | |
![]() ![]() | S | 1..1 | Meta | Metadata about the resource |
![]() ![]() ![]() | S | 1..1 | instant | When the resource version last changed |
![]() ![]() ![]() | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | |
![]() ![]() | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
![]() ![]() | 0..* | (Complex) | Screening Assessment Questionnaire URL: https://ig.fhir.safhir.io/ig/shear/StructureDefinition/SHEAR-ScreeningAssessment-extension | |
Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints![]() |
|---|---|---|---|---|
![]() | C | 0..* | PlannetInsurancePlan | Details of a Health Insurance product/plan provided by an organization |
![]() ![]() | SΣ | 1..1 | Meta | Metadata about the resource |
![]() ![]() ![]() | SΣ | 1..1 | instant | When the resource version last changed |
![]() ![]() ![]() | Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to |
![]() ![]() | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
![]() ![]() | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
![]() ![]() | 0..* | (Complex) | Screening Assessment Questionnaire URL: https://ig.fhir.safhir.io/ig/shear/StructureDefinition/SHEAR-ScreeningAssessment-extension | |
![]() ![]() | ?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() | ΣC | 0..* | Identifier | Business Identifier for Product |
![]() ![]() ![]() | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
![]() ![]() ![]() | SΣ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
![]() ![]() ![]() | SΣ | 0..1 | string | The value that is unique Example General: 123456 |
![]() ![]() ![]() | SΣ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
![]() ![]() | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. Fixed Value: active |
![]() ![]() | SΣ | 1..1 | CodeableConcept | Product Type Binding: Insurance Product Type VS (extensible) |
![]() ![]() | SΣC | 0..1 | string | Official name |
![]() ![]() | S | 0..* | string | Alternate names |
![]() ![]() | S | 0..1 | Period | When the product is available |
![]() ![]() | SΣ | 1..1 | Reference(Plan-Net Organization) | Plan issuer |
![]() ![]() | SΣ | 1..1 | Reference(Plan-Net Organization) | Product administrator |
![]() ![]() | SΣ | 0..* | Reference(Plan-Net Location) | Where product applies |
![]() ![]() | S | 0..* | BackboneElement | Contact for the product |
![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() | S | 0..1 | HumanName | A name associated with the contact |
![]() ![]() ![]() ![]() | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name. |
![]() ![]() ![]() ![]() | SΣ | 0..1 | string | Text representation of the full name |
![]() ![]() ![]() | S | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact |
![]() ![]() ![]() ![]() | SΣC | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point. |
![]() ![]() ![]() ![]() | SΣ | 0..1 | string | The actual contact point details |
![]() ![]() ![]() ![]() | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point. |
![]() ![]() | S | 0..* | Reference(Plan-Net Endpoint) | Technical endpoint |
![]() ![]() | S | 0..* | Reference(Plan-Net Network) | What networks are Included |
![]() ![]() | 0..* | BackboneElement | Cost sharing details for the plan | |
![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() | S | 0..1 | CodeableConcept | Categorization of the cost sharing for the plan Binding: Insurance Plan TypeVS (extensible) |
![]() ![]() ![]() | SΣ | 0..* | Reference(Plan-Net Location) | Where product applies |
Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| InsurancePlan.identifier.use | required | IdentifierUse |
| InsurancePlan.identifier.type | extensible | Identifier Type Codes |
| InsurancePlan.status | required | Fixed Value: active |
| InsurancePlan.type | extensible | InsuranceProductTypeVS |
| InsurancePlan.contact.name.use | required | NameUse |
| InsurancePlan.contact.telecom.system | required | ContactPointSystem |
| InsurancePlan.contact.telecom.use | required | ContactPointUse |
| InsurancePlan.plan.type | extensible | InsurancePlanTypeVS |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | InsurancePlan | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | InsurancePlan | 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 | error | InsurancePlan | 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 | error | InsurancePlan | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | InsurancePlan | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ipn-1 | error | InsurancePlan | The organization SHALL at least have a name or an idendtifier, and possibly more than one : (identifier.count() + name.count()) > 0 | |
| network-or-plan-Network | error | InsurancePlan | If an insuranceplan does not define a network, then each plan must define one : network.exists() or plan.network.exists.allTrue() | |
| plan-type-is-distinct | error | InsurancePlan | Each InsurancePlan.plan should have a distinct plan.type. : plan.type.coding.code.isDistinct() |
| Name | Flags | Card. | Type | Description & Constraints![]() | ||||
|---|---|---|---|---|---|---|---|---|
![]() | C | 0..* | PlannetInsurancePlan | Details of a Health Insurance product/plan provided by an organization | ||||
![]() ![]() | Σ | 0..1 | id | Logical id of this artifact | ||||
![]() ![]() | SΣ | 1..1 | Meta | Metadata about the resource | ||||
![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
![]() ![]() ![]() | Σ | 0..1 | id | Version specific identifier | ||||
![]() ![]() ![]() | SΣ | 1..1 | instant | When the resource version last changed | ||||
![]() ![]() ![]() | Σ | 0..1 | uri | Identifies where the resource comes from | ||||
![]() ![]() ![]() | Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | ||||
![]() ![]() ![]() | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | ||||
![]() ![]() ![]() | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | ||||
![]() ![]() | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
![]() ![]() | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
![]() ![]() | 0..* | Resource | Contained, inline Resources | |||||
![]() ![]() | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
![]() ![]() | 0..* | (Complex) | Screening Assessment Questionnaire URL: https://ig.fhir.safhir.io/ig/shear/StructureDefinition/SHEAR-ScreeningAssessment-extension | |||||
![]() ![]() | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]() | ΣC | 0..* | Identifier | Business Identifier for Product | ||||
![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
![]() ![]() ![]() | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
![]() ![]() ![]() | SΣ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
![]() ![]() ![]() | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | ||||
![]() ![]() ![]() | SΣ | 0..1 | string | The value that is unique Example General: 123456 | ||||
![]() ![]() ![]() | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
![]() ![]() ![]() | SΣ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
![]() ![]() | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. Fixed Value: active | ||||
![]() ![]() | SΣ | 1..1 | CodeableConcept | Product Type Binding: Insurance Product Type VS (extensible) | ||||
![]() ![]() | SΣC | 0..1 | string | Official name | ||||
![]() ![]() | S | 0..* | string | Alternate names | ||||
![]() ![]() | S | 0..1 | Period | When the product is available | ||||
![]() ![]() | SΣ | 1..1 | Reference(Plan-Net Organization) | Plan issuer | ||||
![]() ![]() | SΣ | 1..1 | Reference(Plan-Net Organization) | Product administrator | ||||
![]() ![]() | SΣ | 0..* | Reference(Plan-Net Location) | Where product applies | ||||
![]() ![]() | S | 0..* | BackboneElement | Contact for the product | ||||
![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() | 0..1 | CodeableConcept | The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party. | |||||
![]() ![]() ![]() | S | 0..1 | HumanName | A name associated with the contact | ||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name. | ||||
![]() ![]() ![]() ![]() | SΣ | 0..1 | string | Text representation of the full name | ||||
![]() ![]() ![]() ![]() | Σ | 0..1 | string | Family name (often called 'Surname') | ||||
![]() ![]() ![]() ![]() | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name | ||||
![]() ![]() ![]() ![]() | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name | ||||
![]() ![]() ![]() ![]() | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name | ||||
![]() ![]() ![]() ![]() | Σ | 0..1 | Period | Time period when name was/is in use | ||||
![]() ![]() ![]() | S | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact | ||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
![]() ![]() ![]() ![]() | SΣC | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point. | ||||
![]() ![]() ![]() ![]() | SΣ | 0..1 | string | The actual contact point details | ||||
![]() ![]() ![]() ![]() | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point. | ||||
![]() ![]() ![]() ![]() | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest) | ||||
![]() ![]() ![]() ![]() | Σ | 0..1 | Period | Time period when the contact point was/is in use | ||||
![]() ![]() ![]() | 0..1 | Address | Visiting or postal addresses for the contact | |||||
![]() ![]() | S | 0..* | Reference(Plan-Net Endpoint) | Technical endpoint | ||||
![]() ![]() | S | 0..* | Reference(Plan-Net Network) | What networks are Included | ||||
![]() ![]() | 0..* | BackboneElement | Coverage details | |||||
![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() | 1..1 | CodeableConcept | Type of coverage | |||||
![]() ![]() ![]() | 0..* | Reference(Organization) | What networks provide coverage | |||||
![]() ![]() ![]() | 1..* | BackboneElement | List of benefits | |||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Type of benefit | |||||
![]() ![]() ![]() ![]() | 0..1 | string | Referral requirements | |||||
![]() ![]() ![]() ![]() | 0..* | BackboneElement | Benefit limits | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() | 0..1 | Quantity | Maximum value allowed | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Benefit limit details | |||||
![]() ![]() | 0..* | BackboneElement | Cost sharing details for the plan | |||||
![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() | Σ | 0..* | Identifier | Business Identifier for Product | ||||
![]() ![]() ![]() | S | 0..1 | CodeableConcept | Categorization of the cost sharing for the plan Binding: Insurance Plan TypeVS (extensible) | ||||
![]() ![]() ![]() | SΣ | 0..* | Reference(Plan-Net Location) | Where product applies | ||||
![]() ![]() ![]() | 0..* | Reference(Plan-Net Network) | What networks provide coverage | |||||
![]() ![]() ![]() | 0..* | BackboneElement | Overall costs | |||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Type of cost | |||||
![]() ![]() ![]() ![]() | 0..1 | positiveInt | Number of enrollees | |||||
![]() ![]() ![]() ![]() | 0..1 | Money | Cost value | |||||
![]() ![]() ![]() ![]() | 0..1 | string | Additional cost information | |||||
![]() ![]() ![]() | 0..* | BackboneElement | Specific costs | |||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | General category of benefit | |||||
![]() ![]() ![]() ![]() | 0..* | BackboneElement | Benefits list | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Type of specific benefit | |||||
![]() ![]() ![]() ![]() ![]() | 0..* | BackboneElement | List of the costs | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Type of cost | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | in-network | out-of-network | other Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers. | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | CodeableConcept | Additional information about the cost | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | Quantity | The actual cost value | |||||
Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | ||||
| InsurancePlan.meta.security | extensible | All Security Labels | ||||
| InsurancePlan.meta.tag | example | CommonTags | ||||
| InsurancePlan.language | preferred | CommonLanguages
| ||||
| InsurancePlan.identifier.use | required | IdentifierUse | ||||
| InsurancePlan.identifier.type | extensible | Identifier Type Codes | ||||
| InsurancePlan.status | required | Fixed Value: active | ||||
| InsurancePlan.type | extensible | InsuranceProductTypeVS | ||||
| InsurancePlan.contact.purpose | extensible | ContactEntityType | ||||
| InsurancePlan.contact.name.use | required | NameUse | ||||
| InsurancePlan.contact.telecom.system | required | ContactPointSystem | ||||
| InsurancePlan.contact.telecom.use | required | ContactPointUse | ||||
| InsurancePlan.plan.type | extensible | InsurancePlanTypeVS | ||||
| InsurancePlan.plan.specificCost.benefit.cost.applicability | required | BenefitCostApplicability |
| Id | Grade | Path(s) | Details | Requirements |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from PlannetInsurancePlan
Differential View
This structure is derived from PlannetInsurancePlan
| Name | Flags | Card. | Type | Description & Constraints![]() |
|---|---|---|---|---|
![]() | 0..* | PlannetInsurancePlan | Details of a Health Insurance product/plan provided by an organization | |
![]() ![]() | S | 1..1 | Meta | Metadata about the resource |
![]() ![]() ![]() | S | 1..1 | instant | When the resource version last changed |
![]() ![]() ![]() | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | |
![]() ![]() | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
![]() ![]() | 0..* | (Complex) | Screening Assessment Questionnaire URL: https://ig.fhir.safhir.io/ig/shear/StructureDefinition/SHEAR-ScreeningAssessment-extension | |
Documentation for this format | ||||
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints![]() |
|---|---|---|---|---|
![]() | C | 0..* | PlannetInsurancePlan | Details of a Health Insurance product/plan provided by an organization |
![]() ![]() | SΣ | 1..1 | Meta | Metadata about the resource |
![]() ![]() ![]() | SΣ | 1..1 | instant | When the resource version last changed |
![]() ![]() ![]() | Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to |
![]() ![]() | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
![]() ![]() | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
![]() ![]() | 0..* | (Complex) | Screening Assessment Questionnaire URL: https://ig.fhir.safhir.io/ig/shear/StructureDefinition/SHEAR-ScreeningAssessment-extension | |
![]() ![]() | ?! | 0..* | Extension | Extensions that cannot be ignored |
![]() ![]() | ΣC | 0..* | Identifier | Business Identifier for Product |
![]() ![]() ![]() | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
![]() ![]() ![]() | SΣ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
![]() ![]() ![]() | SΣ | 0..1 | string | The value that is unique Example General: 123456 |
![]() ![]() ![]() | SΣ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
![]() ![]() | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. Fixed Value: active |
![]() ![]() | SΣ | 1..1 | CodeableConcept | Product Type Binding: Insurance Product Type VS (extensible) |
![]() ![]() | SΣC | 0..1 | string | Official name |
![]() ![]() | S | 0..* | string | Alternate names |
![]() ![]() | S | 0..1 | Period | When the product is available |
![]() ![]() | SΣ | 1..1 | Reference(Plan-Net Organization) | Plan issuer |
![]() ![]() | SΣ | 1..1 | Reference(Plan-Net Organization) | Product administrator |
![]() ![]() | SΣ | 0..* | Reference(Plan-Net Location) | Where product applies |
![]() ![]() | S | 0..* | BackboneElement | Contact for the product |
![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() | S | 0..1 | HumanName | A name associated with the contact |
![]() ![]() ![]() ![]() | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name. |
![]() ![]() ![]() ![]() | SΣ | 0..1 | string | Text representation of the full name |
![]() ![]() ![]() | S | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact |
![]() ![]() ![]() ![]() | SΣC | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point. |
![]() ![]() ![]() ![]() | SΣ | 0..1 | string | The actual contact point details |
![]() ![]() ![]() ![]() | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point. |
![]() ![]() | S | 0..* | Reference(Plan-Net Endpoint) | Technical endpoint |
![]() ![]() | S | 0..* | Reference(Plan-Net Network) | What networks are Included |
![]() ![]() | 0..* | BackboneElement | Cost sharing details for the plan | |
![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
![]() ![]() ![]() | S | 0..1 | CodeableConcept | Categorization of the cost sharing for the plan Binding: Insurance Plan TypeVS (extensible) |
![]() ![]() ![]() | SΣ | 0..* | Reference(Plan-Net Location) | Where product applies |
Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| InsurancePlan.identifier.use | required | IdentifierUse |
| InsurancePlan.identifier.type | extensible | Identifier Type Codes |
| InsurancePlan.status | required | Fixed Value: active |
| InsurancePlan.type | extensible | InsuranceProductTypeVS |
| InsurancePlan.contact.name.use | required | NameUse |
| InsurancePlan.contact.telecom.system | required | ContactPointSystem |
| InsurancePlan.contact.telecom.use | required | ContactPointUse |
| InsurancePlan.plan.type | extensible | InsurancePlanTypeVS |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | InsurancePlan | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | InsurancePlan | 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 | error | InsurancePlan | 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 | error | InsurancePlan | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | InsurancePlan | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ipn-1 | error | InsurancePlan | The organization SHALL at least have a name or an idendtifier, and possibly more than one : (identifier.count() + name.count()) > 0 | |
| network-or-plan-Network | error | InsurancePlan | If an insuranceplan does not define a network, then each plan must define one : network.exists() or plan.network.exists.allTrue() | |
| plan-type-is-distinct | error | InsurancePlan | Each InsurancePlan.plan should have a distinct plan.type. : plan.type.coding.code.isDistinct() |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints![]() | ||||
|---|---|---|---|---|---|---|---|---|
![]() | C | 0..* | PlannetInsurancePlan | Details of a Health Insurance product/plan provided by an organization | ||||
![]() ![]() | Σ | 0..1 | id | Logical id of this artifact | ||||
![]() ![]() | SΣ | 1..1 | Meta | Metadata about the resource | ||||
![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
![]() ![]() ![]() | Σ | 0..1 | id | Version specific identifier | ||||
![]() ![]() ![]() | SΣ | 1..1 | instant | When the resource version last changed | ||||
![]() ![]() ![]() | Σ | 0..1 | uri | Identifies where the resource comes from | ||||
![]() ![]() ![]() | Σ | 1..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | ||||
![]() ![]() ![]() | Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | ||||
![]() ![]() ![]() | Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | ||||
![]() ![]() | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
![]() ![]() | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
![]() ![]() | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
![]() ![]() | 0..* | Resource | Contained, inline Resources | |||||
![]() ![]() | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
![]() ![]() | 0..* | (Complex) | Screening Assessment Questionnaire URL: https://ig.fhir.safhir.io/ig/shear/StructureDefinition/SHEAR-ScreeningAssessment-extension | |||||
![]() ![]() | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
![]() ![]() | ΣC | 0..* | Identifier | Business Identifier for Product | ||||
![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
![]() ![]() ![]() | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
![]() ![]() ![]() | SΣ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
![]() ![]() ![]() | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | ||||
![]() ![]() ![]() | SΣ | 0..1 | string | The value that is unique Example General: 123456 | ||||
![]() ![]() ![]() | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
![]() ![]() ![]() | SΣ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
![]() ![]() | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. Fixed Value: active | ||||
![]() ![]() | SΣ | 1..1 | CodeableConcept | Product Type Binding: Insurance Product Type VS (extensible) | ||||
![]() ![]() | SΣC | 0..1 | string | Official name | ||||
![]() ![]() | S | 0..* | string | Alternate names | ||||
![]() ![]() | S | 0..1 | Period | When the product is available | ||||
![]() ![]() | SΣ | 1..1 | Reference(Plan-Net Organization) | Plan issuer | ||||
![]() ![]() | SΣ | 1..1 | Reference(Plan-Net Organization) | Product administrator | ||||
![]() ![]() | SΣ | 0..* | Reference(Plan-Net Location) | Where product applies | ||||
![]() ![]() | S | 0..* | BackboneElement | Contact for the product | ||||
![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() | 0..1 | CodeableConcept | The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party. | |||||
![]() ![]() ![]() | S | 0..1 | HumanName | A name associated with the contact | ||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..1 | code | usual | official | temp | nickname | anonymous | old | maiden Binding: NameUse (required): The use of a human name. | ||||
![]() ![]() ![]() ![]() | SΣ | 0..1 | string | Text representation of the full name | ||||
![]() ![]() ![]() ![]() | Σ | 0..1 | string | Family name (often called 'Surname') | ||||
![]() ![]() ![]() ![]() | Σ | 0..* | string | Given names (not always 'first'). Includes middle names This repeating element order: Given Names appear in the correct order for presenting the name | ||||
![]() ![]() ![]() ![]() | Σ | 0..* | string | Parts that come before the name This repeating element order: Prefixes appear in the correct order for presenting the name | ||||
![]() ![]() ![]() ![]() | Σ | 0..* | string | Parts that come after the name This repeating element order: Suffixes appear in the correct order for presenting the name | ||||
![]() ![]() ![]() ![]() | Σ | 0..1 | Period | Time period when name was/is in use | ||||
![]() ![]() ![]() | S | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact | ||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
![]() ![]() ![]() ![]() | SΣC | 0..1 | code | phone | fax | email | pager | url | sms | other Binding: ContactPointSystem (required): Telecommunications form for contact point. | ||||
![]() ![]() ![]() ![]() | SΣ | 0..1 | string | The actual contact point details | ||||
![]() ![]() ![]() ![]() | ?!Σ | 0..1 | code | home | work | temp | old | mobile - purpose of this contact point Binding: ContactPointUse (required): Use of contact point. | ||||
![]() ![]() ![]() ![]() | Σ | 0..1 | positiveInt | Specify preferred order of use (1 = highest) | ||||
![]() ![]() ![]() ![]() | Σ | 0..1 | Period | Time period when the contact point was/is in use | ||||
![]() ![]() ![]() | 0..1 | Address | Visiting or postal addresses for the contact | |||||
![]() ![]() | S | 0..* | Reference(Plan-Net Endpoint) | Technical endpoint | ||||
![]() ![]() | S | 0..* | Reference(Plan-Net Network) | What networks are Included | ||||
![]() ![]() | 0..* | BackboneElement | Coverage details | |||||
![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() | 1..1 | CodeableConcept | Type of coverage | |||||
![]() ![]() ![]() | 0..* | Reference(Organization) | What networks provide coverage | |||||
![]() ![]() ![]() | 1..* | BackboneElement | List of benefits | |||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Type of benefit | |||||
![]() ![]() ![]() ![]() | 0..1 | string | Referral requirements | |||||
![]() ![]() ![]() ![]() | 0..* | BackboneElement | Benefit limits | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() | 0..1 | Quantity | Maximum value allowed | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Benefit limit details | |||||
![]() ![]() | 0..* | BackboneElement | Cost sharing details for the plan | |||||
![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() | Σ | 0..* | Identifier | Business Identifier for Product | ||||
![]() ![]() ![]() | S | 0..1 | CodeableConcept | Categorization of the cost sharing for the plan Binding: Insurance Plan TypeVS (extensible) | ||||
![]() ![]() ![]() | SΣ | 0..* | Reference(Plan-Net Location) | Where product applies | ||||
![]() ![]() ![]() | 0..* | Reference(Plan-Net Network) | What networks provide coverage | |||||
![]() ![]() ![]() | 0..* | BackboneElement | Overall costs | |||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | Type of cost | |||||
![]() ![]() ![]() ![]() | 0..1 | positiveInt | Number of enrollees | |||||
![]() ![]() ![]() ![]() | 0..1 | Money | Cost value | |||||
![]() ![]() ![]() ![]() | 0..1 | string | Additional cost information | |||||
![]() ![]() ![]() | 0..* | BackboneElement | Specific costs | |||||
![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | General category of benefit | |||||
![]() ![]() ![]() ![]() | 0..* | BackboneElement | Benefits list | |||||
![]() ![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Type of specific benefit | |||||
![]() ![]() ![]() ![]() ![]() | 0..* | BackboneElement | List of the costs | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | string | Unique id for inter-element referencing | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | Extension | Additional content defined by implementations | |||||
![]() ![]() ![]() ![]() ![]() ![]() | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
![]() ![]() ![]() ![]() ![]() ![]() | 1..1 | CodeableConcept | Type of cost | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | CodeableConcept | in-network | out-of-network | other Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers. | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..* | CodeableConcept | Additional information about the cost | |||||
![]() ![]() ![]() ![]() ![]() ![]() | 0..1 | Quantity | The actual cost value | |||||
Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | ||||
| InsurancePlan.meta.security | extensible | All Security Labels | ||||
| InsurancePlan.meta.tag | example | CommonTags | ||||
| InsurancePlan.language | preferred | CommonLanguages
| ||||
| InsurancePlan.identifier.use | required | IdentifierUse | ||||
| InsurancePlan.identifier.type | extensible | Identifier Type Codes | ||||
| InsurancePlan.status | required | Fixed Value: active | ||||
| InsurancePlan.type | extensible | InsuranceProductTypeVS | ||||
| InsurancePlan.contact.purpose | extensible | ContactEntityType | ||||
| InsurancePlan.contact.name.use | required | NameUse | ||||
| InsurancePlan.contact.telecom.system | required | ContactPointSystem | ||||
| InsurancePlan.contact.telecom.use | required | ContactPointUse | ||||
| InsurancePlan.plan.type | extensible | InsurancePlanTypeVS | ||||
| InsurancePlan.plan.specificCost.benefit.cost.applicability | required | BenefitCostApplicability |
| Id | Grade | Path(s) | Details | Requirements |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from PlannetInsurancePlan
Other representations of profile: CSV, Excel, Schematron