openIMIS FHIR R4 Implementation Guide
1.0.0 - ci-build

openIMIS FHIR R4 Implementation Guide - Local Development build (v1.0.0). See the Directory of published versions

Resource Profile: openIMIS Insurance Plan

Official URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/openimis-insurance-plan Version: 1.0.0
Active as of 2022-05-31 Responsible: openIMIS Initiative Computable Name: OpenIMISInsurancePlan

Defines an Insurance Plan for openIMIS which maps to a Product.

Usage:

Formal Views of Profile Content

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

This structure is derived from InsurancePlan

Summary

Mandatory: 24 elements (3 nested mandatory elements)
Must-Support: 2 elements
Prohibited: 20 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element InsurancePlan.identifier is sliced based on the value of value:type.coding.code (Closed)
  • The element InsurancePlan.coverage.benefit.limit is sliced based on the value of value:code.coding.code (Closed)
  • The element InsurancePlan.plan.generalCost is sliced based on the value of value:type.coding.code (Closed)

This structure is derived from InsurancePlan

NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan 0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
... id 0..1stringOrganization UUID
... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
... insurance-plan-conversion 0..1Reference(openIMIS Insurance Plan)Conversion Product
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-conversion
... insurance-plan-start-cycle 0..4stringStart Cycle
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-start-cycle
... insurance-plan-period 0..1QuantityAdministration Period
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period
... insurance-plan-period 0..1QuantityGrace Period Payment
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period
... insurance-plan-period 0..1QuantityGrace Period Renewal
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period
... insurance-plan-period 0..1QuantityStart Cycle
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period
... insurance-plan-discount 0..1(Complex)Renewal Discount
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-discount
... insurance-plan-discount 0..1(Complex)Enrolment Discount
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-discount
... Slices for identifier S1..*IdentifierBusiness Identifier for Product
Slice: Unordered, Closed by value:type.coding.code
.... identifier:All Slices Content/Rules for all slices
..... type 1..1CodeableConceptDescription of identifier
...... coding
....... code 0..1codeSymbol in syntax defined by the system
Binding: openIMIS Identifiers Value Set (required)
..... value 1..1stringThe value that is unique
.... identifier:Code S1..1IdentifierBusiness Identifier for Product
..... type
...... coding
....... code 1..1codeInsurance Plan openIMIS Code
Required Pattern: Code
.... identifier:UUID 0..1IdentifierBusiness Identifier for Product
..... type
...... coding
....... code 1..1codeInsurancePlan openIMIS UUID
Required Pattern: UUID
... status 1..1codedraft | active | retired | unknown
Binding: Publication Status (InsurancePlan) (required)
... type 1..1CodeableConceptType of Insurance Plan
Binding: Coverage Type (InsurancePlan) (required)
... name 1..1stringOfficial name
... alias 0..0
... period 1..1PeriodWhen the product is available
.... start 1..1dateTimeInsurance Plan start date
.... end 1..1dateTimeInsurance Plan end date
... ownedBy 0..0
... administeredBy 0..0
... coverageArea 1..1Reference(openIMIS Location)Where product applies
... contact 0..0
... endpoint 0..0
... network 0..0
... coverage 1..1BackboneElementCoverage details
.... type 1..1CodeableConceptType of coverage
Binding: Coverage Type (InsurancePlan) (required)
.... network 0..0
.... benefit 1..1BackboneElementList of benefits
..... type 1..1CodeableConceptType of benefit
Binding: Coverage Type (InsurancePlan) (required)
..... requirement 0..0
..... Slices for limit 1..2BackboneElementBenefit limits
Slice: Unordered, Closed by value:code.coding.code
...... limit:All Slices Content/Rules for all slices
....... code 1..1CodeableConceptBenefit limit details
Binding: Coverage Benefit Limit Types (InsurancePlan) (required)
...... limit:period 1..1BackboneElementBenefit limits
....... value 1..1QuantityInsurance Period (months)
....... code 0..1CodeableConceptBenefit limit details
Required Pattern: At least the following
........ coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
......... system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit
......... code1..1codeSymbol in syntax defined by the system
Fixed Value: period
......... display1..1stringRepresentation defined by the system
Fixed Value: Period
...... limit:memberCount 0..1BackboneElementBenefit limits
....... value 1..1QuantityMember Count
....... code 0..1CodeableConceptBenefit limit details
Required Pattern: At least the following
........ coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
......... system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit
......... code1..1codeSymbol in syntax defined by the system
Fixed Value: memberCount
......... display1..1stringRepresentation defined by the system
Fixed Value: Member Count
... plan 1..1BackboneElementPlan details
.... identifier 0..0
.... type 0..0
.... coverageArea 0..0
.... network 0..0
.... Slices for generalCost 1..1BackboneElementOverall costs
Slice: Unordered, Closed by value:type.coding.code
..... generalCost:All Slices Content/Rules for all slices
...... type 1..1CodeableConceptType of cost
Binding: General Cost Type (InsurancePlan) (required)
...... cost 1..1MoneyCost value
...... comment 0..0
..... generalCost:lumpsum 1..1BackboneElementOverall costs
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: lumpsum
........ display1..1stringRepresentation defined by the system
Fixed Value: Lumpsum
...... groupSize 1..1positiveIntThreshold Member
..... generalCost:premiumAdult 0..1BackboneElementOverall costs
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: premiumAdult
........ display1..1stringRepresentation defined by the system
Fixed Value: Premium Adult
...... groupSize 0..0
..... generalCost:premiumChild 0..1BackboneElementOverall costs
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: premiumChild
........ display1..1stringRepresentation defined by the system
Fixed Value: Premium Child
...... groupSize 0..0
..... generalCost:registrationLumpsum 0..1BackboneElementOverall costs
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: registrationLumpsum
........ display1..1stringRepresentation defined by the system
Fixed Value: Registration Lumpsum
...... groupSize 0..0
..... generalCost:registrationFee 0..1BackboneElementOverall costs
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: registrationFee
........ display1..1stringRepresentation defined by the system
Fixed Value: Registration Fee
...... groupSize 0..0
..... generalCost:generalAssemblyLumpSum 0..1BackboneElementOverall costs
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: generalAssemblyLumpSum
........ display1..1stringRepresentation defined by the system
Fixed Value: General Assembly Lump Sum
...... groupSize 0..0
..... generalCost:generalAssemblyFee 0..1BackboneElementOverall costs
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: generalAssemblyFee
........ display1..1stringRepresentation defined by the system
Fixed Value: General Assembly Fee
...... groupSize 0..0
.... specificCost 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan I0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
... id Σ0..1stringOrganization UUID
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
... insurance-plan-conversion 0..1Reference(openIMIS Insurance Plan)Conversion Product
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-conversion
... insurance-plan-max-installments 1..1unsignedIntMax Installments
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-max-installments
... insurance-plan-start-cycle 0..4stringStart Cycle
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-start-cycle
... insurance-plan-period 0..1QuantityAdministration Period
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period
... insurance-plan-period 0..1QuantityGrace Period Payment
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period
... insurance-plan-period 0..1QuantityGrace Period Renewal
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period
... insurance-plan-period 0..1QuantityStart Cycle
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period
... insurance-plan-discount 0..1(Complex)Renewal Discount
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-discount
... insurance-plan-discount 0..1(Complex)Enrolment Discount
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-discount
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... Slices for identifier SΣI1..*IdentifierBusiness Identifier for Product
Slice: Unordered, Closed by value:type.coding.code
.... identifier:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ1..1CodeableConceptDescription 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.

...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ0..*CodingCode defined by a terminology system
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ0..1uriIdentity of the terminology system
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ0..1codeSymbol in syntax defined by the system
Binding: openIMIS Identifiers Value Set (required)
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... text Σ0..1stringPlain text representation of the concept
..... system Σ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ1..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:Code SΣI1..1IdentifierBusiness Identifier for Product
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ0..1CodeableConceptDescription 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.

...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ0..*CodingCode defined by a terminology system
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ0..1uriIdentity of the terminology system
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeInsurance Plan openIMIS Code
Required Pattern: Code
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... text Σ0..1stringPlain text representation of the concept
..... system Σ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ0..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:UUID ΣI0..1IdentifierBusiness Identifier for Product
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ0..1CodeableConceptDescription 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.

...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... coding Σ0..*CodingCode defined by a terminology system
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
....... system Σ0..1uriIdentity of the terminology system
....... version Σ0..1stringVersion of the system - if relevant
....... code Σ1..1codeInsurancePlan openIMIS UUID
Required Pattern: UUID
....... display Σ0..1stringRepresentation defined by the system
....... userSelected Σ0..1booleanIf this coding was chosen directly by the user
...... text Σ0..1stringPlain text representation of the concept
..... system Σ0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value Σ0..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
... status ?!Σ1..1codedraft | active | retired | unknown
Binding: Publication Status (InsurancePlan) (required)
... type Σ1..1CodeableConceptType of Insurance Plan
Binding: Coverage Type (InsurancePlan) (required)
... name ΣI1..1stringOfficial name
... period 1..1PeriodWhen the product is available
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... start ΣI1..1dateTimeInsurance Plan start date
.... end ΣI1..1dateTimeInsurance Plan end date
... coverageArea Σ1..1Reference(openIMIS Location)Where product applies
... coverage 1..1BackboneElementCoverage details
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type 1..1CodeableConceptType of coverage
Binding: Coverage Type (InsurancePlan) (required)
.... benefit 1..1BackboneElementList of benefits
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type 1..1CodeableConceptType of benefit
Binding: Coverage Type (InsurancePlan) (required)
..... Slices for limit 1..2BackboneElementBenefit limits
Slice: Unordered, Closed by value:code.coding.code
...... limit:All Slices Content/Rules for all slices
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
....... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
....... value 0..1QuantityMaximum value allowed
....... code 1..1CodeableConceptBenefit limit details
Binding: Coverage Benefit Limit Types (InsurancePlan) (required)
...... limit:period 1..1BackboneElementBenefit limits
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
....... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
....... value 1..1QuantityInsurance Period (months)
....... code 0..1CodeableConceptBenefit limit details
Required Pattern: At least the following
........ id0..1stringUnique id for inter-element referencing
........ extension0..*ExtensionAdditional content defined by implementations
........ coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
......... id0..1stringUnique id for inter-element referencing
......... extension0..*ExtensionAdditional content defined by implementations
......... system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit
......... version0..1stringVersion of the system - if relevant
......... code1..1codeSymbol in syntax defined by the system
Fixed Value: period
......... display1..1stringRepresentation defined by the system
Fixed Value: Period
......... userSelected0..1booleanIf this coding was chosen directly by the user
........ text0..1stringPlain text representation of the concept
...... limit:memberCount 0..1BackboneElementBenefit limits
....... id 0..1stringUnique id for inter-element referencing
....... extension 0..*ExtensionAdditional content defined by implementations
....... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
....... value 1..1QuantityMember Count
....... code 0..1CodeableConceptBenefit limit details
Required Pattern: At least the following
........ id0..1stringUnique id for inter-element referencing
........ extension0..*ExtensionAdditional content defined by implementations
........ coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
......... id0..1stringUnique id for inter-element referencing
......... extension0..*ExtensionAdditional content defined by implementations
......... system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit
......... version0..1stringVersion of the system - if relevant
......... code1..1codeSymbol in syntax defined by the system
Fixed Value: memberCount
......... display1..1stringRepresentation defined by the system
Fixed Value: Member Count
......... userSelected0..1booleanIf this coding was chosen directly by the user
........ text0..1stringPlain text representation of the concept
... plan 1..1BackboneElementPlan details
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... Slices for generalCost 1..1BackboneElementOverall costs
Slice: Unordered, Closed by value:type.coding.code
..... generalCost:All Slices Content/Rules for all slices
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... type 1..1CodeableConceptType of cost
Binding: General Cost Type (InsurancePlan) (required)
...... groupSize 0..1positiveIntNumber of enrollees
...... cost 1..1MoneyCost value
..... generalCost:lumpsum 1..1BackboneElementOverall costs
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ id0..1stringUnique id for inter-element referencing
........ extension0..*ExtensionAdditional content defined by implementations
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ version0..1stringVersion of the system - if relevant
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: lumpsum
........ display1..1stringRepresentation defined by the system
Fixed Value: Lumpsum
........ userSelected0..1booleanIf this coding was chosen directly by the user
....... text0..1stringPlain text representation of the concept
...... groupSize 1..1positiveIntThreshold Member
...... cost 0..1MoneyCost value
...... comment 0..1stringAdditional cost information
..... generalCost:premiumAdult 0..1BackboneElementOverall costs
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ id0..1stringUnique id for inter-element referencing
........ extension0..*ExtensionAdditional content defined by implementations
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ version0..1stringVersion of the system - if relevant
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: premiumAdult
........ display1..1stringRepresentation defined by the system
Fixed Value: Premium Adult
........ userSelected0..1booleanIf this coding was chosen directly by the user
....... text0..1stringPlain text representation of the concept
...... cost 0..1MoneyCost value
...... comment 0..1stringAdditional cost information
..... generalCost:premiumChild 0..1BackboneElementOverall costs
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ id0..1stringUnique id for inter-element referencing
........ extension0..*ExtensionAdditional content defined by implementations
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ version0..1stringVersion of the system - if relevant
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: premiumChild
........ display1..1stringRepresentation defined by the system
Fixed Value: Premium Child
........ userSelected0..1booleanIf this coding was chosen directly by the user
....... text0..1stringPlain text representation of the concept
...... cost 0..1MoneyCost value
...... comment 0..1stringAdditional cost information
..... generalCost:registrationLumpsum 0..1BackboneElementOverall costs
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ id0..1stringUnique id for inter-element referencing
........ extension0..*ExtensionAdditional content defined by implementations
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ version0..1stringVersion of the system - if relevant
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: registrationLumpsum
........ display1..1stringRepresentation defined by the system
Fixed Value: Registration Lumpsum
........ userSelected0..1booleanIf this coding was chosen directly by the user
....... text0..1stringPlain text representation of the concept
...... cost 0..1MoneyCost value
...... comment 0..1stringAdditional cost information
..... generalCost:registrationFee 0..1BackboneElementOverall costs
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ id0..1stringUnique id for inter-element referencing
........ extension0..*ExtensionAdditional content defined by implementations
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ version0..1stringVersion of the system - if relevant
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: registrationFee
........ display1..1stringRepresentation defined by the system
Fixed Value: Registration Fee
........ userSelected0..1booleanIf this coding was chosen directly by the user
....... text0..1stringPlain text representation of the concept
...... cost 0..1MoneyCost value
...... comment 0..1stringAdditional cost information
..... generalCost:generalAssemblyLumpSum 0..1BackboneElementOverall costs
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ id0..1stringUnique id for inter-element referencing
........ extension0..*ExtensionAdditional content defined by implementations
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ version0..1stringVersion of the system - if relevant
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: generalAssemblyLumpSum
........ display1..1stringRepresentation defined by the system
Fixed Value: General Assembly Lump Sum
........ userSelected0..1booleanIf this coding was chosen directly by the user
....... text0..1stringPlain text representation of the concept
...... cost 0..1MoneyCost value
...... comment 0..1stringAdditional cost information
..... generalCost:generalAssemblyFee 0..1BackboneElementOverall costs
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
...... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... id0..1stringUnique id for inter-element referencing
....... extension0..*ExtensionAdditional content defined by implementations
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ id0..1stringUnique id for inter-element referencing
........ extension0..*ExtensionAdditional content defined by implementations
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ version0..1stringVersion of the system - if relevant
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: generalAssemblyFee
........ display1..1stringRepresentation defined by the system
Fixed Value: General Assembly Fee
........ userSelected0..1booleanIf this coding was chosen directly by the user
....... text0..1stringPlain text representation of the concept
...... cost 0..1MoneyCost value
...... comment 0..1stringAdditional cost information

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan I0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
... Slices for identifier ΣI1..*IdentifierBusiness Identifier for Product
Slice: Unordered, Closed by value:type.coding.code
.... identifier:Code ΣI1..1IdentifierBusiness Identifier for Product

doco Documentation for this format

This structure is derived from InsurancePlan

Summary

Mandatory: 24 elements (3 nested mandatory elements)
Must-Support: 2 elements
Prohibited: 20 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element InsurancePlan.identifier is sliced based on the value of value:type.coding.code (Closed)
  • The element InsurancePlan.coverage.benefit.limit is sliced based on the value of value:code.coding.code (Closed)
  • The element InsurancePlan.plan.generalCost is sliced based on the value of value:type.coding.code (Closed)

Differential View

This structure is derived from InsurancePlan

NameFlagsCard.TypeDescription & Constraintsdoco
.. InsurancePlan 0..*InsurancePlanDetails of a Health Insurance product/plan provided by an organization
... id 0..1stringOrganization UUID
... Slices for extension 1..*ExtensionExtension
Slice: Unordered, Open by value:url
... insurance-plan-conversion 0..1Reference(openIMIS Insurance Plan)Conversion Product
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-conversion
... insurance-plan-start-cycle 0..4stringStart Cycle
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-start-cycle
... insurance-plan-period 0..1QuantityAdministration Period
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period
... insurance-plan-period 0..1QuantityGrace Period Payment
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period
... insurance-plan-period 0..1QuantityGrace Period Renewal
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period
... insurance-plan-period 0..1QuantityStart Cycle
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period
... insurance-plan-discount 0..1(Complex)Renewal Discount
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-discount
... insurance-plan-discount 0..1(Complex)Enrolment Discount
URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-discount
... Slices for identifier S1..*IdentifierBusiness Identifier for Product
Slice: Unordered, Closed by value:type.coding.code
.... identifier:All Slices Content/Rules for all slices
..... type 1..1CodeableConceptDescription of identifier
...... coding
....... code 0..1codeSymbol in syntax defined by the system
Binding: openIMIS Identifiers Value Set (required)
..... value 1..1stringThe value that is unique
.... identifier:Code S1..1IdentifierBusiness Identifier for Product
..... type
...... coding
....... code 1..1codeInsurance Plan openIMIS Code
Required Pattern: Code
.... identifier:UUID 0..1IdentifierBusiness Identifier for Product
..... type
...... coding
....... code 1..1codeInsurancePlan openIMIS UUID
Required Pattern: UUID
... status 1..1codedraft | active | retired | unknown
Binding: Publication Status (InsurancePlan) (required)
... type 1..1CodeableConceptType of Insurance Plan
Binding: Coverage Type (InsurancePlan) (required)
... name 1..1stringOfficial name
... alias 0..0
... period 1..1PeriodWhen the product is available
.... start 1..1dateTimeInsurance Plan start date
.... end 1..1dateTimeInsurance Plan end date
... ownedBy 0..0
... administeredBy 0..0
... coverageArea 1..1Reference(openIMIS Location)Where product applies
... contact 0..0
... endpoint 0..0
... network 0..0
... coverage 1..1BackboneElementCoverage details
.... type 1..1CodeableConceptType of coverage
Binding: Coverage Type (InsurancePlan) (required)
.... network 0..0
.... benefit 1..1BackboneElementList of benefits
..... type 1..1CodeableConceptType of benefit
Binding: Coverage Type (InsurancePlan) (required)
..... requirement 0..0
..... Slices for limit 1..2BackboneElementBenefit limits
Slice: Unordered, Closed by value:code.coding.code
...... limit:All Slices Content/Rules for all slices
....... code 1..1CodeableConceptBenefit limit details
Binding: Coverage Benefit Limit Types (InsurancePlan) (required)
...... limit:period 1..1BackboneElementBenefit limits
....... value 1..1QuantityInsurance Period (months)
....... code 0..1CodeableConceptBenefit limit details
Required Pattern: At least the following
........ coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
......... system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit
......... code1..1codeSymbol in syntax defined by the system
Fixed Value: period
......... display1..1stringRepresentation defined by the system
Fixed Value: Period
...... limit:memberCount 0..1BackboneElementBenefit limits
....... value 1..1QuantityMember Count
....... code 0..1CodeableConceptBenefit limit details
Required Pattern: At least the following
........ coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
......... system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit
......... code1..1codeSymbol in syntax defined by the system
Fixed Value: memberCount
......... display1..1stringRepresentation defined by the system
Fixed Value: Member Count
... plan 1..1BackboneElementPlan details
.... identifier 0..0
.... type 0..0
.... coverageArea 0..0
.... network 0..0
.... Slices for generalCost 1..1BackboneElementOverall costs
Slice: Unordered, Closed by value:type.coding.code
..... generalCost:All Slices Content/Rules for all slices
...... type 1..1CodeableConceptType of cost
Binding: General Cost Type (InsurancePlan) (required)
...... cost 1..1MoneyCost value
...... comment 0..0
..... generalCost:lumpsum 1..1BackboneElementOverall costs
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following
....... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
........ system1..1uriIdentity of the terminology system
Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type
........ code1..1codeSymbol in syntax defined by the system
Fixed Value: lumpsum
........ display1..1stringRepresentation defined by the system
Fixed Value: Lumpsum
...... groupSize 1..1positiveIntThreshold Member
..... generalCost:premiumAdult 0..1BackboneElementOverall costs
...... type 0..1CodeableConceptType of cost
Required Pattern: At least the following