eCard-at FHIR ImplementationGuide - Local Development build (v0.1.0). See the Directory of published versions
Resource Profile: ecardAnspruch Profile
| Official URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-profile | Version: 0.1.0 | |||
| Draft as of 2023-09-06 | Computable Name: EcardAnspruch | |||
HL7® Austria FHIR® e-card Profile für coverage in Österreich. Der SVC e-card Anspruch basiert auf der FHIR® Coverage Resource und bildet die Versicherungsansprüche der e-card Versicherten ab. Das Profil identifiziert die Kernelemente der Ressource, Erweiterungen, die Begrifflichkeiten sowie die benötigten Value Sets, die das Profil e-card Anspruch braucht.
Usage:
- Examples for this Resource Profile: Coverage/e-card-Anspruchsart-example, Coverage/e-card-Versichertenart-example, Coverage/e-card-Versichertenkategorie-example, Coverage/ecard-Anspruch-example... Show 2 more
Formal Views of Profile Content
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Coverage
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
  Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
 kostenanteilbefreit | 0..1 | boolean | Kostenanteilbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-kostenanteilbefreit | |
| rezeptgebbefreit | 0..1 | boolean | Rezeptgebührenbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-rezeptgebbefreit | |
 identifier | 0..0 | |||
| type | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: e-card Anspruchsarten Valueset (required) | |
| policyHolder | 0..0 | |||
 subscriber | 0..1 | Reference(HL7® AT Core Patient Profile) | Subscriber to the policy | |
| subscriberId | 0..0 | |||
| beneficiary | 1..1 | Reference(HL7® AT Core Patient Profile) | Plan beneficiary | |
| dependent | 0..0 | |||
| relationship | 0..0 | |||
| period | 0..0 | |||
  Slices for class | 2..2 | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type.coding.code | |
  class:Versichertenarten | S | 1..1 | BackboneElement | Additional coverage classifications |
  type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: e-card Versichertenarten Valueset (required) | |
  coding | ||||
 system | 0..1 | uri | Identity of the terminology system Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenart-cs | |
 class:Versichertenkategorien | S | 1..1 | BackboneElement | Additional coverage classifications |
| type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: e-card Versichertenkategorien Valueset (required) | |
| coding | ||||
| system | 0..1 | uri | Identity of the terminology system Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs | |
| order | 0..0 | |||
| network | 0..0 | |||
| costToBeneficiary | 0..0 | |||
| Documentation for this format | ||||
Terminology Bindings (Differential)
| Path | Conformance | ValueSet |
| Coverage.type | required | EcardAnspruchsartenVS |
| Coverage.class:Versichertenarten.type | required | ECardVersichertenartenVS (a valid code from e-card Versichertenart Codesystem) |
| Coverage.class:Versichertenkategorien.type | required | EcardVersichertenkategorienVS (a valid code from e-card Versichertenkategorie Codesystem) |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
 implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| kostenanteilbefreit | 0..1 | boolean | Kostenanteilbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-kostenanteilbefreit | |
| rezeptgebbefreit | 0..1 | boolean | Rezeptgebührenbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-rezeptgebbefreit | |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
 type | Σ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: e-card Anspruchsarten Valueset (required) |
| subscriber | Σ | 0..1 | Reference(HL7® AT Core Patient Profile) | Subscriber to the policy |
| beneficiary | Σ | 1..1 | Reference(HL7® AT Core Patient Profile) | Plan beneficiary |
| payor | Σ | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy |
| Slices for class | 2..2 | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type.coding.code | |
| class:All Slices | Content/Rules for all slices | |||
 modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. |
 value | Σ | 1..1 | string | Value associated with the type |
| class:Versichertenarten | S | 1..1 | BackboneElement | Additional coverage classifications |
 modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: e-card Versichertenarten Valueset (required) |
 value | Σ | 1..1 | string | Value associated with the type |
| class:Versichertenkategorien | S | 1..1 | BackboneElement | Additional coverage classifications |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: e-card Versichertenkategorien Valueset (required) |
| value | Σ | 1..1 | string | Value associated with the type |
| Documentation for this format | ||||
Terminology Bindings
| Path | Conformance | ValueSet |
| Coverage.status | required | FinancialResourceStatusCodes |
| Coverage.type | required | EcardAnspruchsartenVS |
| Coverage.class.type | extensible | CoverageClassCodes |
| Coverage.class:Versichertenarten.type | required | ECardVersichertenartenVS (a valid code from e-card Versichertenart Codesystem) |
| Coverage.class:Versichertenkategorien.type | required | EcardVersichertenkategorienVS (a valid code from e-card Versichertenkategorie Codesystem) |
Constraints
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Coverage | 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 | Coverage | 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 | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Coverage | 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() |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| kostenanteilbefreit | 0..1 | boolean | Kostenanteilbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-kostenanteilbefreit | |||||
| rezeptgebbefreit | 0..1 | boolean | Rezeptgebührenbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-rezeptgebbefreit | |||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
| type | Σ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: e-card Anspruchsarten Valueset (required) | ||||
| subscriber | Σ | 0..1 | Reference(HL7® AT Core Patient Profile) | Subscriber to the policy | ||||
| beneficiary | Σ | 1..1 | Reference(HL7® AT Core Patient Profile) | Plan beneficiary | ||||
| payor | Σ | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy | ||||
| Slices for class | 2..2 | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type.coding.code | |||||
| class:All Slices | Content/Rules for all slices | |||||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. | ||||
| value | Σ | 1..1 | string | Value associated with the type | ||||
| name | Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:Versichertenarten | S | 1..1 | BackboneElement | Additional coverage classifications | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
 type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: e-card Versichertenarten Valueset (required) | ||||
 id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding | Σ | 0..* | Coding | Code defined by a terminology system | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system | Σ | 0..1 | uri | Identity of the terminology system Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenart-cs | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | Σ | 0..1 | string | Plain text representation of the concept | ||||
| value | Σ | 1..1 | string | Value associated with the type | ||||
| name | Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:Versichertenkategorien | S | 1..1 | BackboneElement | Additional coverage classifications | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: e-card Versichertenkategorien Valueset (required) | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding | Σ | 0..* | Coding | Code defined by a terminology system | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system | Σ | 0..1 | uri | Identity of the terminology system Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | Σ | 0..1 | string | Plain text representation of the concept | ||||
| value | Σ | 1..1 | string | Value associated with the type | ||||
| name | Σ | 0..1 | string | Human readable description of the type and value | ||||
| subrogation | 0..1 | boolean | Reimbursement to insurer | |||||
| contract | 0..* | Reference(Contract) | Contract details | |||||
| Documentation for this format | ||||||||
Terminology Bindings
| Path | Conformance | ValueSet | ||||
| Coverage.language | preferred | CommonLanguages
| ||||
| Coverage.status | required | FinancialResourceStatusCodes | ||||
| Coverage.type | required | EcardAnspruchsartenVS | ||||
| Coverage.class.type | extensible | CoverageClassCodes | ||||
| Coverage.class:Versichertenarten.type | required | ECardVersichertenartenVS (a valid code from e-card Versichertenart Codesystem) | ||||
| Coverage.class:Versichertenkategorien.type | required | EcardVersichertenkategorienVS (a valid code from e-card Versichertenkategorie Codesystem) | ||||
| Coverage.costToBeneficiary.type | extensible | CoverageCopayTypeCodes | ||||
| Coverage.costToBeneficiary.exception.type | example | ExampleCoverageFinancialExceptionCodes |
Constraints
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Coverage | 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 | Coverage | 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 | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Coverage | 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() |
This structure is derived from Coverage
Summary
Mandatory: 3 elements
Must-Support: 2 elements
Prohibited: 9 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
- http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-kostenanteilbefreit
- http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-rezeptgebbefreit
Slices
This structure defines the following Slices:
- The element Coverage.class is sliced based on the value of value:type.coding.code
Differential View
This structure is derived from Coverage
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| kostenanteilbefreit | 0..1 | boolean | Kostenanteilbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-kostenanteilbefreit | |
| rezeptgebbefreit | 0..1 | boolean | Rezeptgebührenbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-rezeptgebbefreit | |
| identifier | 0..0 | |||
| type | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: e-card Anspruchsarten Valueset (required) | |
| policyHolder | 0..0 | |||
| subscriber | 0..1 | Reference(HL7® AT Core Patient Profile) | Subscriber to the policy | |
| subscriberId | 0..0 | |||
| beneficiary | 1..1 | Reference(HL7® AT Core Patient Profile) | Plan beneficiary | |
| dependent | 0..0 | |||
| relationship | 0..0 | |||
| period | 0..0 | |||
| Slices for class | 2..2 | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type.coding.code | |
| class:Versichertenarten | S | 1..1 | BackboneElement | Additional coverage classifications |
| type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: e-card Versichertenarten Valueset (required) | |
| coding | ||||
| system | 0..1 | uri | Identity of the terminology system Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenart-cs | |
| class:Versichertenkategorien | S | 1..1 | BackboneElement | Additional coverage classifications |
| type | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: e-card Versichertenkategorien Valueset (required) | |
| coding | ||||
| system | 0..1 | uri | Identity of the terminology system Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs | |
| order | 0..0 | |||
| network | 0..0 | |||
| costToBeneficiary | 0..0 | |||
| Documentation for this format | ||||
Terminology Bindings (Differential)
| Path | Conformance | ValueSet |
| Coverage.type | required | EcardAnspruchsartenVS |
| Coverage.class:Versichertenarten.type | required | ECardVersichertenartenVS (a valid code from e-card Versichertenart Codesystem) |
| Coverage.class:Versichertenkategorien.type | required | EcardVersichertenkategorienVS (a valid code from e-card Versichertenkategorie Codesystem) |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| kostenanteilbefreit | 0..1 | boolean | Kostenanteilbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-kostenanteilbefreit | |
| rezeptgebbefreit | 0..1 | boolean | Rezeptgebührenbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-rezeptgebbefreit | |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
| type | Σ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: e-card Anspruchsarten Valueset (required) |
| subscriber | Σ | 0..1 | Reference(HL7® AT Core Patient Profile) | Subscriber to the policy |
| beneficiary | Σ | 1..1 | Reference(HL7® AT Core Patient Profile) | Plan beneficiary |
| payor | Σ | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy |
| Slices for class | 2..2 | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type.coding.code | |
| class:All Slices | Content/Rules for all slices | |||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. |
| value | Σ | 1..1 | string | Value associated with the type |
| class:Versichertenarten | S | 1..1 | BackboneElement | Additional coverage classifications |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: e-card Versichertenarten Valueset (required) |
| value | Σ | 1..1 | string | Value associated with the type |
| class:Versichertenkategorien | S | 1..1 | BackboneElement | Additional coverage classifications |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: e-card Versichertenkategorien Valueset (required) |
| value | Σ | 1..1 | string | Value associated with the type |
| Documentation for this format | ||||
Terminology Bindings
| Path | Conformance | ValueSet |
| Coverage.status | required | FinancialResourceStatusCodes |
| Coverage.type | required | EcardAnspruchsartenVS |
| Coverage.class.type | extensible | CoverageClassCodes |
| Coverage.class:Versichertenarten.type | required | ECardVersichertenartenVS (a valid code from e-card Versichertenart Codesystem) |
| Coverage.class:Versichertenkategorien.type | required | EcardVersichertenkategorienVS (a valid code from e-card Versichertenkategorie Codesystem) |
Constraints
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Coverage | 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 | Coverage | 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 | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Coverage | 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() |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| kostenanteilbefreit | 0..1 | boolean | Kostenanteilbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-kostenanteilbefreit | |||||
| rezeptgebbefreit | 0..1 | boolean | Rezeptgebührenbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-rezeptgebbefreit | |||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
| type | Σ | 1..1 | CodeableConcept | Coverage category such as medical or accident Binding: e-card Anspruchsarten Valueset (required) | ||||
| subscriber | Σ | 0..1 | Reference(HL7® AT Core Patient Profile) | Subscriber to the policy | ||||
| beneficiary | Σ | 1..1 | Reference(HL7® AT Core Patient Profile) | Plan beneficiary | ||||
| payor | Σ | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy | ||||
| Slices for class | 2..2 | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type.coding.code | |||||
| class:All Slices | Content/Rules for all slices | |||||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. | ||||
| value | Σ | 1..1 | string | Value associated with the type | ||||
| name | Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:Versichertenarten | S | 1..1 | BackboneElement | Additional coverage classifications | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: e-card Versichertenarten Valueset (required) | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding | Σ | 0..* | Coding | Code defined by a terminology system | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system | Σ | 0..1 | uri | Identity of the terminology system Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenart-cs | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | Σ | 0..1 | string | Plain text representation of the concept | ||||
| value | Σ | 1..1 | string | Value associated with the type | ||||
| name | Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:Versichertenkategorien | S | 1..1 | BackboneElement | Additional coverage classifications | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| type | Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: e-card Versichertenkategorien Valueset (required) | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding | Σ | 0..* | Coding | Code defined by a terminology system | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system | Σ | 0..1 | uri | Identity of the terminology system Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | Σ | 0..1 | string | Plain text representation of the concept | ||||
| value | Σ | 1..1 | string | Value associated with the type | ||||
| name | Σ | 0..1 | string | Human readable description of the type and value | ||||
| subrogation | 0..1 | boolean | Reimbursement to insurer | |||||
| contract | 0..* | Reference(Contract) | Contract details | |||||
| Documentation for this format | ||||||||
Terminology Bindings
| Path | Conformance | ValueSet | ||||
| Coverage.language | preferred | CommonLanguages
| ||||
| Coverage.status | required | FinancialResourceStatusCodes | ||||
| Coverage.type | required | EcardAnspruchsartenVS | ||||
| Coverage.class.type | extensible | CoverageClassCodes | ||||
| Coverage.class:Versichertenarten.type | required | ECardVersichertenartenVS (a valid code from e-card Versichertenart Codesystem) | ||||
| Coverage.class:Versichertenkategorien.type | required | EcardVersichertenkategorienVS (a valid code from e-card Versichertenkategorie Codesystem) | ||||
| Coverage.costToBeneficiary.type | extensible | CoverageCopayTypeCodes | ||||
| Coverage.costToBeneficiary.exception.type | example | ExampleCoverageFinancialExceptionCodes |
Constraints
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | Coverage | 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 | Coverage | 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 | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | Coverage | 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() |
This structure is derived from Coverage
Summary
Mandatory: 3 elements
Must-Support: 2 elements
Prohibited: 9 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
- http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-kostenanteilbefreit
- http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-rezeptgebbefreit
Slices
This structure defines the following Slices:
- The element Coverage.class is sliced based on the value of value:type.coding.code
Other representations of profile: CSV, Excel, Schematron