eCard-at FHIR ImplementationGuide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: ecard Anspruch Profile

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, Coverage/ecard-kostenanteilbefreit-example and Coverage/ecard-rezeptgebbefreit-example

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
kostenanteilbefreit		0..1	boolean	Kostenanteilbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-kostenanteilbefreit ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
rezeptgebbefreit		0..1	boolean	Rezeptgebührenbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-rezeptgebbefreit ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	Σ	1..1	Identifier	Business identifier(s) for this coverage ele-1: All FHIR elements must have a @value or children
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. ele-1: All FHIR elements must have a @value or children
kind	Σ	1..1	code	insurance | self-pay | other Binding: Kind (required) ele-1: All FHIR elements must have a @value or children
type	Σ	1..1	CodeableConcept	Coverage category such as medical or accident Binding: e-card Anspruchsarten Valueset (required) ele-1: All FHIR elements must have a @value or children
subscriber	Σ	0..1	Reference(HL7® AT Core Patient Profile | RelatedPerson)	Subscriber to the policy ele-1: All FHIR elements must have a @value or children
beneficiary	Σ	1..1	Reference(HL7® AT Core Patient Profile)	Plan beneficiary ele-1: All FHIR elements must have a @value or children
Slices for class		2..2	BackboneElement	Additional coverage classifications Slice: Unordered, Open by value:type.coding.code ele-1: All FHIR elements must have a @value or children
class:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, e.g. Group, Plan, Class, etc. ele-1: All FHIR elements must have a @value or children
value	Σ	1..1	Identifier	Value associated with the type ele-1: All FHIR elements must have a @value or children
class:Versichertenarten	S	1..1	BackboneElement	Additional coverage classifications ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: e-card Versichertenarten Valueset (required) ele-1: All FHIR elements must have a @value or children
value	Σ	1..1	Identifier	Value associated with the type ele-1: All FHIR elements must have a @value or children
class:Versichertenkategorien	S	1..1	BackboneElement	Additional coverage classifications ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: e-card Versichertenkategorien Valueset (required) ele-1: All FHIR elements must have a @value or children
value	Σ	1..1	Identifier	Value associated with the type ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|5.0.0 from the FHIR Standard
Coverage.kind	required	Kind http://hl7.org/fhir/ValueSet/coverage-kind|5.0.0 from the FHIR Standard
Coverage.type	required	EcardAnspruchsartenVS http://svc.co.at/Valueset/ecard-anspruchsarten-vs from this IG
Coverage.class.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class from the FHIR Standard
Coverage.class:Versichertenarten.type	required	ECardVersichertenartenVS (a valid code from e-card Versichertenart Codesystem) http://svc.co.at/Valueset/ecard-versichertenarten-vs from this IG
Coverage.class:Versichertenkategorien.type	required	EcardVersichertenkategorienVS (a valid code from e-card Versichertenkategorie Codesystem) http://svc.co.at/Valueset/ecard-versichertenkategorien-vs from this IG

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		1..1	Identifier	Business identifier(s) for this coverage
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 | RelatedPerson)	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	URI
Coverage.type	required	EcardAnspruchsartenVS http://svc.co.at/Valueset/ecard-anspruchsarten-vs from this IG
Coverage.class:Versichertenarten.type	required	ECardVersichertenartenVS (a valid code from e-card Versichertenart Codesystem) http://svc.co.at/Valueset/ecard-versichertenarten-vs from this IG
Coverage.class:Versichertenkategorien.type	required	EcardVersichertenkategorienVS (a valid code from e-card Versichertenkategorie Codesystem) http://svc.co.at/Valueset/ecard-versichertenkategorien-vs from this IG

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: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter Set
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	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Business identifier(s) for this coverage
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
kind	Σ	1..1	code	insurance | self-pay | other Binding: Kind (required)
paymentBy		0..*	BackboneElement	Self-pay parties and responsibility
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
party	Σ	1..1	Reference(Patient | RelatedPerson | Organization)	Parties performing self-payment
responsibility	Σ	0..1	string	Party's responsibility
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 | RelatedPerson)	Subscriber to the policy
beneficiary	Σ	1..1	Reference(HL7® AT Core Patient Profile)	Plan beneficiary
insurer	Σ	0..1	Reference(Organization)	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, e.g. Group, Plan, Class, etc.
value	Σ	1..1	Identifier	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	id	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	id	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	ΣC	0..1	code	Symbol in syntax defined by the system
display	ΣC	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	Identifier	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	id	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	id	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	ΣC	0..1	code	Symbol in syntax defined by the system
display	ΣC	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	Identifier	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
insurancePlan		0..1	Reference(InsurancePlan)	Insurance plan details
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Coverage.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 from the FHIR Standard
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|5.0.0 from the FHIR Standard
Coverage.kind	required	Kind http://hl7.org/fhir/ValueSet/coverage-kind|5.0.0 from the FHIR Standard
Coverage.type	required	EcardAnspruchsartenVS http://svc.co.at/Valueset/ecard-anspruchsarten-vs from this IG
Coverage.class.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class from the FHIR Standard
Coverage.class:Versichertenarten.type	required	ECardVersichertenartenVS (a valid code from e-card Versichertenart Codesystem) http://svc.co.at/Valueset/ecard-versichertenarten-vs from this IG
Coverage.class:Versichertenkategorien.type	required	EcardVersichertenkategorienVS (a valid code from e-card Versichertenkategorie Codesystem) http://svc.co.at/Valueset/ecard-versichertenkategorien-vs from this IG
Coverage.costToBeneficiary.type	extensible	CoverageCopayTypeCodes http://hl7.org/fhir/ValueSet/coverage-copay-type from the FHIR Standard
Coverage.costToBeneficiary.category	example	BenefitCategoryCodes http://hl7.org/fhir/ValueSet/ex-benefitcategory from the FHIR Standard
Coverage.costToBeneficiary.network	example	NetworkTypeCodes http://hl7.org/fhir/ValueSet/benefit-network from the FHIR Standard
Coverage.costToBeneficiary.unit	example	UnitTypeCodes http://hl7.org/fhir/ValueSet/benefit-unit from the FHIR Standard
Coverage.costToBeneficiary.term	example	BenefitTermCodes http://hl7.org/fhir/ValueSet/benefit-term from the FHIR Standard
Coverage.costToBeneficiary.exception.type	example	ExampleCoverageFinancialExceptionCodes http://hl7.org/fhir/ValueSet/coverage-financial-exception from the FHIR Standard

This structure is derived from Coverage

Summary

Mandatory: 4 elements
Must-Support: 2 elements
Prohibited: 8 elements

Structures

This structure refers to these other structures:

• HL7® AT Core Patient Profile (http://hl7.at/fhir/HL7ATCoreProfiles/5.0.0/StructureDefinition/at-core-patient)

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 1 is sliced based on the value of Coverage.class

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
kostenanteilbefreit		0..1	boolean	Kostenanteilbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-kostenanteilbefreit ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
rezeptgebbefreit		0..1	boolean	Rezeptgebührenbefreit laut Versicherungsanspruch URL: http://fhir.hl7.at/eCard-at/StructureDefinition/ecard-anspruch-rezeptgebbefreit ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	Σ	1..1	Identifier	Business identifier(s) for this coverage ele-1: All FHIR elements must have a @value or children
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. ele-1: All FHIR elements must have a @value or children
kind	Σ	1..1	code	insurance | self-pay | other Binding: Kind (required) ele-1: All FHIR elements must have a @value or children
type	Σ	1..1	CodeableConcept	Coverage category such as medical or accident Binding: e-card Anspruchsarten Valueset (required) ele-1: All FHIR elements must have a @value or children
subscriber	Σ	0..1	Reference(HL7® AT Core Patient Profile | RelatedPerson)	Subscriber to the policy ele-1: All FHIR elements must have a @value or children
beneficiary	Σ	1..1	Reference(HL7® AT Core Patient Profile)	Plan beneficiary ele-1: All FHIR elements must have a @value or children
Slices for class		2..2	BackboneElement	Additional coverage classifications Slice: Unordered, Open by value:type.coding.code ele-1: All FHIR elements must have a @value or children
class:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, e.g. Group, Plan, Class, etc. ele-1: All FHIR elements must have a @value or children
value	Σ	1..1	Identifier	Value associated with the type ele-1: All FHIR elements must have a @value or children
class:Versichertenarten	S	1..1	BackboneElement	Additional coverage classifications ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: e-card Versichertenarten Valueset (required) ele-1: All FHIR elements must have a @value or children
value	Σ	1..1	Identifier	Value associated with the type ele-1: All FHIR elements must have a @value or children
class:Versichertenkategorien	S	1..1	BackboneElement	Additional coverage classifications ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: e-card Versichertenkategorien Valueset (required) ele-1: All FHIR elements must have a @value or children
value	Σ	1..1	Identifier	Value associated with the type ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|5.0.0 from the FHIR Standard
Coverage.kind	required	Kind http://hl7.org/fhir/ValueSet/coverage-kind|5.0.0 from the FHIR Standard
Coverage.type	required	EcardAnspruchsartenVS http://svc.co.at/Valueset/ecard-anspruchsarten-vs from this IG
Coverage.class.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class from the FHIR Standard
Coverage.class:Versichertenarten.type	required	ECardVersichertenartenVS (a valid code from e-card Versichertenart Codesystem) http://svc.co.at/Valueset/ecard-versichertenarten-vs from this IG
Coverage.class:Versichertenkategorien.type	required	EcardVersichertenkategorienVS (a valid code from e-card Versichertenkategorie Codesystem) http://svc.co.at/Valueset/ecard-versichertenkategorien-vs from this IG

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		1..1	Identifier	Business identifier(s) for this coverage
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 | RelatedPerson)	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	URI
Coverage.type	required	EcardAnspruchsartenVS http://svc.co.at/Valueset/ecard-anspruchsarten-vs from this IG
Coverage.class:Versichertenarten.type	required	ECardVersichertenartenVS (a valid code from e-card Versichertenart Codesystem) http://svc.co.at/Valueset/ecard-versichertenarten-vs from this IG
Coverage.class:Versichertenkategorien.type	required	EcardVersichertenkategorienVS (a valid code from e-card Versichertenkategorie Codesystem) http://svc.co.at/Valueset/ecard-versichertenkategorien-vs from this IG

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: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter Set
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	?!Σ	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Business identifier(s) for this coverage
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
kind	Σ	1..1	code	insurance | self-pay | other Binding: Kind (required)
paymentBy		0..*	BackboneElement	Self-pay parties and responsibility
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
party	Σ	1..1	Reference(Patient | RelatedPerson | Organization)	Parties performing self-payment
responsibility	Σ	0..1	string	Party's responsibility
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 | RelatedPerson)	Subscriber to the policy
beneficiary	Σ	1..1	Reference(HL7® AT Core Patient Profile)	Plan beneficiary
insurer	Σ	0..1	Reference(Organization)	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, e.g. Group, Plan, Class, etc.
value	Σ	1..1	Identifier	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	id	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	id	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	ΣC	0..1	code	Symbol in syntax defined by the system
display	ΣC	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	Identifier	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	id	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	id	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	ΣC	0..1	code	Symbol in syntax defined by the system
display	ΣC	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	Identifier	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
insurancePlan		0..1	Reference(InsurancePlan)	Insurance plan details
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Coverage.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 from the FHIR Standard
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|5.0.0 from the FHIR Standard
Coverage.kind	required	Kind http://hl7.org/fhir/ValueSet/coverage-kind|5.0.0 from the FHIR Standard
Coverage.type	required	EcardAnspruchsartenVS http://svc.co.at/Valueset/ecard-anspruchsarten-vs from this IG
Coverage.class.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class from the FHIR Standard
Coverage.class:Versichertenarten.type	required	ECardVersichertenartenVS (a valid code from e-card Versichertenart Codesystem) http://svc.co.at/Valueset/ecard-versichertenarten-vs from this IG
Coverage.class:Versichertenkategorien.type	required	EcardVersichertenkategorienVS (a valid code from e-card Versichertenkategorie Codesystem) http://svc.co.at/Valueset/ecard-versichertenkategorien-vs from this IG
Coverage.costToBeneficiary.type	extensible	CoverageCopayTypeCodes http://hl7.org/fhir/ValueSet/coverage-copay-type from the FHIR Standard
Coverage.costToBeneficiary.category	example	BenefitCategoryCodes http://hl7.org/fhir/ValueSet/ex-benefitcategory from the FHIR Standard
Coverage.costToBeneficiary.network	example	NetworkTypeCodes http://hl7.org/fhir/ValueSet/benefit-network from the FHIR Standard
Coverage.costToBeneficiary.unit	example	UnitTypeCodes http://hl7.org/fhir/ValueSet/benefit-unit from the FHIR Standard
Coverage.costToBeneficiary.term	example	BenefitTermCodes http://hl7.org/fhir/ValueSet/benefit-term from the FHIR Standard
Coverage.costToBeneficiary.exception.type	example	ExampleCoverageFinancialExceptionCodes http://hl7.org/fhir/ValueSet/coverage-financial-exception from the FHIR Standard

This structure is derived from Coverage

Summary

Mandatory: 4 elements
Must-Support: 2 elements
Prohibited: 8 elements

Structures

This structure refers to these other structures:

• HL7® AT Core Patient Profile (http://hl7.at/fhir/HL7ATCoreProfiles/5.0.0/StructureDefinition/at-core-patient)

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 1 is sliced based on the value of Coverage.class

Other representations of profile: CSV, Excel, Schematron