openIMIS FHIR R4 Implementation Guide
1.0.0 - ci-build
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
| 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:
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:
This structure is derived from InsurancePlan
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  InsurancePlan | 0..* | InsurancePlan | Details of a Health Insurance product/plan provided by an organization | |
  id | 0..1 | string | Organization UUID | |
 Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |
 insurance-plan-conversion | 0..1 | Reference(openIMIS Insurance Plan) | Conversion Product URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-conversion | |
| insurance-plan-max-installments | 1..1 | unsignedInt | Max Installments URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-max-installments | |
| insurance-plan-start-cycle | 0..4 | string | Start Cycle URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-start-cycle | |
| insurance-plan-period | 0..1 | Quantity | Administration Period URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period | |
| insurance-plan-period | 0..1 | Quantity | Grace Period Payment URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period | |
| insurance-plan-period | 0..1 | Quantity | Grace Period Renewal URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period | |
| insurance-plan-period | 0..1 | Quantity | Start 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 | S | 1..* | Identifier | Business Identifier for Product Slice: Unordered, Closed by value:type.coding.code |
  identifier:All Slices | Content/Rules for all slices | |||
 type | 1..1 | CodeableConcept | Description of identifier | |
 coding | ||||
  code | 0..1 | code | Symbol in syntax defined by the system Binding: openIMIS Identifiers Value Set (required) | |
 value | 1..1 | string | The value that is unique | |
| identifier:Code | S | 1..1 | Identifier | Business Identifier for Product |
 type | ||||
| coding | ||||
| code | 1..1 | code | Insurance Plan openIMIS Code Required Pattern: Code | |
 identifier:UUID | 0..1 | Identifier | Business Identifier for Product | |
| type | ||||
| coding | ||||
| code | 1..1 | code | InsurancePlan openIMIS UUID Required Pattern: UUID | |
| status | 1..1 | code | draft | active | retired | unknown Binding: Publication Status (InsurancePlan) (required) | |
| type | 1..1 | CodeableConcept | Type of Insurance Plan Binding: Coverage Type (InsurancePlan) (required) | |
| name | 1..1 | string | Official name | |
| alias | 0..0 | |||
| period | 1..1 | Period | When the product is available | |
| start | 1..1 | dateTime | Insurance Plan start date | |
| end | 1..1 | dateTime | Insurance Plan end date | |
| ownedBy | 0..0 | |||
| administeredBy | 0..0 | |||
 coverageArea | 1..1 | Reference(openIMIS Location) | Where product applies | |
| contact | 0..0 | |||
| endpoint | 0..0 | |||
| network | 0..0 | |||
| coverage | 1..1 | BackboneElement | Coverage details | |
| type | 1..1 | CodeableConcept | Type of coverage Binding: Coverage Type (InsurancePlan) (required) | |
| network | 0..0 | |||
| benefit | 1..1 | BackboneElement | List of benefits | |
| type | 1..1 | CodeableConcept | Type of benefit Binding: Coverage Type (InsurancePlan) (required) | |
| requirement | 0..0 | |||
| Slices for limit | 1..2 | BackboneElement | Benefit limits Slice: Unordered, Closed by value:code.coding.code | |
| limit:All Slices | Content/Rules for all slices | |||
| code | 1..1 | CodeableConcept | Benefit limit details Binding: Coverage Benefit Limit Types (InsurancePlan) (required) | |
| limit:period | 1..1 | BackboneElement | Benefit limits | |
 value | 1..1 | Quantity | Insurance Period (months) | |
| code | 0..1 | CodeableConcept | Benefit limit details Required Pattern: At least the following | |
 coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: period | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Period | |
| limit:memberCount | 0..1 | BackboneElement | Benefit limits | |
| value | 1..1 | Quantity | Member Count | |
| code | 0..1 | CodeableConcept | Benefit limit details Required Pattern: At least the following | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: memberCount | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Member Count | |
| plan | 1..1 | BackboneElement | Plan details | |
| identifier | 0..0 | |||
| type | 0..0 | |||
| coverageArea | 0..0 | |||
| network | 0..0 | |||
| Slices for generalCost | 1..1 | BackboneElement | Overall costs Slice: Unordered, Closed by value:type.coding.code | |
| generalCost:All Slices | Content/Rules for all slices | |||
 type | 1..1 | CodeableConcept | Type of cost Binding: General Cost Type (InsurancePlan) (required) | |
| cost | 1..1 | Money | Cost value | |
| comment | 0..0 | |||
| generalCost:lumpsum | 1..1 | BackboneElement | Overall costs | |
 type | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |
 coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: lumpsum | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Lumpsum | |
 groupSize | 1..1 | positiveInt | Threshold Member | |
| generalCost:premiumAdult | 0..1 | BackboneElement | Overall costs | |
| type | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: premiumAdult | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Premium Adult | |
| groupSize | 0..0 | |||
| generalCost:premiumChild | 0..1 | BackboneElement | Overall costs | |
| type | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: premiumChild | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Premium Child | |
| groupSize | 0..0 | |||
| generalCost:registrationLumpsum | 0..1 | BackboneElement | Overall costs | |
| type | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: registrationLumpsum | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Registration Lumpsum | |
| groupSize | 0..0 | |||
| generalCost:registrationFee | 0..1 | BackboneElement | Overall costs | |
| type | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: registrationFee | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Registration Fee | |
| groupSize | 0..0 | |||
| generalCost:generalAssemblyLumpSum | 0..1 | BackboneElement | Overall costs | |
| type | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: generalAssemblyLumpSum | |
| display | 1..1 | string | Representation defined by the system Fixed Value: General Assembly Lump Sum | |
| groupSize | 0..0 | |||
| generalCost:generalAssemblyFee | 0..1 | BackboneElement | Overall costs | |
| type | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: generalAssemblyFee | |
| display | 1..1 | string | Representation defined by the system Fixed Value: General Assembly Fee | |
| groupSize | 0..0 | |||
| specificCost | 0..0 | |||
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| InsurancePlan | I | 0..* | InsurancePlan | Details of a Health Insurance product/plan provided by an organization | ||||
 id | Σ | 0..1 | string | Organization UUID | ||||
 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 | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| insurance-plan-conversion | 0..1 | Reference(openIMIS Insurance Plan) | Conversion Product URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-conversion | |||||
| insurance-plan-max-installments | 1..1 | unsignedInt | Max Installments URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-max-installments | |||||
| insurance-plan-start-cycle | 0..4 | string | Start Cycle URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-start-cycle | |||||
| insurance-plan-period | 0..1 | Quantity | Administration Period URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period | |||||
| insurance-plan-period | 0..1 | Quantity | Grace Period Payment URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period | |||||
| insurance-plan-period | 0..1 | Quantity | Grace Period Renewal URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period | |||||
| insurance-plan-period | 0..1 | Quantity | Start 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..* | Extension | Extensions that cannot be ignored | ||||
| Slices for identifier | SΣI | 1..* | Identifier | Business Identifier for Product Slice: Unordered, Closed by value:type.coding.code | ||||
| identifier: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 Slice: Unordered, Open by value:url | |||||
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
| type | Σ | 1..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
| 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 | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 0..1 | code | Symbol in syntax defined by the system Binding: openIMIS Identifiers Value Set (required) | ||||
| 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 | ||||
| system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | ||||
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 | ||||
| period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
| identifier:Code | SΣI | 1..1 | Identifier | Business Identifier for Product | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
| 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 | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Insurance Plan openIMIS Code Required Pattern: Code | ||||
| 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 | ||||
| system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | ||||
| value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
| period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
| identifier:UUID | ΣI | 0..1 | Identifier | Business Identifier for Product | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . | ||||
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
| 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 | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | InsurancePlan openIMIS UUID Required Pattern: UUID | ||||
| 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 | ||||
| system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient | ||||
| value | Σ | 0..1 | string | The value that is unique Example General: 123456 | ||||
| period | Σ | 0..1 | Period | Time period when id is/was valid for use | ||||
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) | ||||
| status | ?!Σ | 1..1 | code | draft | active | retired | unknown Binding: Publication Status (InsurancePlan) (required) | ||||
| type | Σ | 1..1 | CodeableConcept | Type of Insurance Plan Binding: Coverage Type (InsurancePlan) (required) | ||||
| name | ΣI | 1..1 | string | Official name | ||||
| period | 1..1 | Period | When the product is available | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| start | ΣI | 1..1 | dateTime | Insurance Plan start date | ||||
| end | ΣI | 1..1 | dateTime | Insurance Plan end date | ||||
| coverageArea | Σ | 1..1 | Reference(openIMIS Location) | Where product applies | ||||
| coverage | 1..1 | BackboneElement | Coverage details | |||||
| 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 | 1..1 | CodeableConcept | Type of coverage Binding: Coverage Type (InsurancePlan) (required) | |||||
| benefit | 1..1 | BackboneElement | List of benefits | |||||
| 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 | 1..1 | CodeableConcept | Type of benefit Binding: Coverage Type (InsurancePlan) (required) | |||||
| Slices for limit | 1..2 | BackboneElement | Benefit limits Slice: Unordered, Closed by value:code.coding.code | |||||
| limit: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 | ||||
| value | 0..1 | Quantity | Maximum value allowed | |||||
| code | 1..1 | CodeableConcept | Benefit limit details Binding: Coverage Benefit Limit Types (InsurancePlan) (required) | |||||
| limit:period | 1..1 | BackboneElement | Benefit limits | |||||
| 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 | ||||
| value | 1..1 | Quantity | Insurance Period (months) | |||||
| code | 0..1 | CodeableConcept | Benefit limit details Required Pattern: At least the following | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit | |||||
| version | 0..1 | string | Version of the system - if relevant | |||||
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: period | |||||
| display | 1..1 | string | Representation defined by the system Fixed Value: Period | |||||
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
| text | 0..1 | string | Plain text representation of the concept | |||||
| limit:memberCount | 0..1 | BackboneElement | Benefit limits | |||||
| 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 | ||||
| value | 1..1 | Quantity | Member Count | |||||
| code | 0..1 | CodeableConcept | Benefit limit details Required Pattern: At least the following | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit | |||||
| version | 0..1 | string | Version of the system - if relevant | |||||
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: memberCount | |||||
| display | 1..1 | string | Representation defined by the system Fixed Value: Member Count | |||||
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
| text | 0..1 | string | Plain text representation of the concept | |||||
| plan | 1..1 | BackboneElement | Plan details | |||||
| 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 | ||||
| Slices for generalCost | 1..1 | BackboneElement | Overall costs Slice: Unordered, Closed by value:type.coding.code | |||||
| generalCost: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 | 1..1 | CodeableConcept | Type of cost Binding: General Cost Type (InsurancePlan) (required) | |||||
| groupSize | 0..1 | positiveInt | Number of enrollees | |||||
| cost | 1..1 | Money | Cost value | |||||
| generalCost:lumpsum | 1..1 | BackboneElement | Overall costs | |||||
| 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 | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |||||
| version | 0..1 | string | Version of the system - if relevant | |||||
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: lumpsum | |||||
| display | 1..1 | string | Representation defined by the system Fixed Value: Lumpsum | |||||
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
| text | 0..1 | string | Plain text representation of the concept | |||||
| groupSize | 1..1 | positiveInt | Threshold Member | |||||
| cost | 0..1 | Money | Cost value | |||||
| comment | 0..1 | string | Additional cost information | |||||
| generalCost:premiumAdult | 0..1 | BackboneElement | Overall costs | |||||
| 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 | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |||||
| version | 0..1 | string | Version of the system - if relevant | |||||
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: premiumAdult | |||||
| display | 1..1 | string | Representation defined by the system Fixed Value: Premium Adult | |||||
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
| text | 0..1 | string | Plain text representation of the concept | |||||
| cost | 0..1 | Money | Cost value | |||||
| comment | 0..1 | string | Additional cost information | |||||
| generalCost:premiumChild | 0..1 | BackboneElement | Overall costs | |||||
| 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 | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |||||
| version | 0..1 | string | Version of the system - if relevant | |||||
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: premiumChild | |||||
| display | 1..1 | string | Representation defined by the system Fixed Value: Premium Child | |||||
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
| text | 0..1 | string | Plain text representation of the concept | |||||
| cost | 0..1 | Money | Cost value | |||||
| comment | 0..1 | string | Additional cost information | |||||
| generalCost:registrationLumpsum | 0..1 | BackboneElement | Overall costs | |||||
| 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 | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |||||
| version | 0..1 | string | Version of the system - if relevant | |||||
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: registrationLumpsum | |||||
| display | 1..1 | string | Representation defined by the system Fixed Value: Registration Lumpsum | |||||
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
| text | 0..1 | string | Plain text representation of the concept | |||||
| cost | 0..1 | Money | Cost value | |||||
| comment | 0..1 | string | Additional cost information | |||||
| generalCost:registrationFee | 0..1 | BackboneElement | Overall costs | |||||
| 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 | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |||||
| version | 0..1 | string | Version of the system - if relevant | |||||
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: registrationFee | |||||
| display | 1..1 | string | Representation defined by the system Fixed Value: Registration Fee | |||||
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
| text | 0..1 | string | Plain text representation of the concept | |||||
| cost | 0..1 | Money | Cost value | |||||
| comment | 0..1 | string | Additional cost information | |||||
| generalCost:generalAssemblyLumpSum | 0..1 | BackboneElement | Overall costs | |||||
| 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 | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |||||
| version | 0..1 | string | Version of the system - if relevant | |||||
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: generalAssemblyLumpSum | |||||
| display | 1..1 | string | Representation defined by the system Fixed Value: General Assembly Lump Sum | |||||
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
| text | 0..1 | string | Plain text representation of the concept | |||||
| cost | 0..1 | Money | Cost value | |||||
| comment | 0..1 | string | Additional cost information | |||||
| generalCost:generalAssemblyFee | 0..1 | BackboneElement | Overall costs | |||||
| 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 | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |||||
| version | 0..1 | string | Version of the system - if relevant | |||||
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: generalAssemblyFee | |||||
| display | 1..1 | string | Representation defined by the system Fixed Value: General Assembly Fee | |||||
| userSelected | 0..1 | boolean | If this coding was chosen directly by the user | |||||
| text | 0..1 | string | Plain text representation of the concept | |||||
| cost | 0..1 | Money | Cost value | |||||
| comment | 0..1 | string | Additional cost information | |||||
| Documentation for this format | ||||||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| InsurancePlan | I | 0..* | InsurancePlan | Details of a Health Insurance product/plan provided by an organization |
| Slices for identifier | ΣI | 1..* | Identifier | Business Identifier for Product Slice: Unordered, Closed by value:type.coding.code |
| identifier:Code | ΣI | 1..1 | Identifier | Business Identifier for Product |
| 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:
Differential View
This structure is derived from InsurancePlan
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| InsurancePlan | 0..* | InsurancePlan | Details of a Health Insurance product/plan provided by an organization | |
| id | 0..1 | string | Organization UUID | |
| Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |
| insurance-plan-conversion | 0..1 | Reference(openIMIS Insurance Plan) | Conversion Product URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-conversion | |
| insurance-plan-max-installments | 1..1 | unsignedInt | Max Installments URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-max-installments | |
| insurance-plan-start-cycle | 0..4 | string | Start Cycle URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-start-cycle | |
| insurance-plan-period | 0..1 | Quantity | Administration Period URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period | |
| insurance-plan-period | 0..1 | Quantity | Grace Period Payment URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period | |
| insurance-plan-period | 0..1 | Quantity | Grace Period Renewal URL: https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period | |
| insurance-plan-period | 0..1 | Quantity | Start 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 | S | 1..* | Identifier | Business Identifier for Product Slice: Unordered, Closed by value:type.coding.code |
| identifier:All Slices | Content/Rules for all slices | |||
| type | 1..1 | CodeableConcept | Description of identifier | |
| coding | ||||
| code | 0..1 | code | Symbol in syntax defined by the system Binding: openIMIS Identifiers Value Set (required) | |
| value | 1..1 | string | The value that is unique | |
| identifier:Code | S | 1..1 | Identifier | Business Identifier for Product |
| type | ||||
| coding | ||||
| code | 1..1 | code | Insurance Plan openIMIS Code Required Pattern: Code | |
| identifier:UUID | 0..1 | Identifier | Business Identifier for Product | |
| type | ||||
| coding | ||||
| code | 1..1 | code | InsurancePlan openIMIS UUID Required Pattern: UUID | |
| status | 1..1 | code | draft | active | retired | unknown Binding: Publication Status (InsurancePlan) (required) | |
| type | 1..1 | CodeableConcept | Type of Insurance Plan Binding: Coverage Type (InsurancePlan) (required) | |
| name | 1..1 | string | Official name | |
| alias | 0..0 | |||
| period | 1..1 | Period | When the product is available | |
| start | 1..1 | dateTime | Insurance Plan start date | |
| end | 1..1 | dateTime | Insurance Plan end date | |
| ownedBy | 0..0 | |||
| administeredBy | 0..0 | |||
| coverageArea | 1..1 | Reference(openIMIS Location) | Where product applies | |
| contact | 0..0 | |||
| endpoint | 0..0 | |||
| network | 0..0 | |||
| coverage | 1..1 | BackboneElement | Coverage details | |
| type | 1..1 | CodeableConcept | Type of coverage Binding: Coverage Type (InsurancePlan) (required) | |
| network | 0..0 | |||
| benefit | 1..1 | BackboneElement | List of benefits | |
| type | 1..1 | CodeableConcept | Type of benefit Binding: Coverage Type (InsurancePlan) (required) | |
| requirement | 0..0 | |||
| Slices for limit | 1..2 | BackboneElement | Benefit limits Slice: Unordered, Closed by value:code.coding.code | |
| limit:All Slices | Content/Rules for all slices | |||
| code | 1..1 | CodeableConcept | Benefit limit details Binding: Coverage Benefit Limit Types (InsurancePlan) (required) | |
| limit:period | 1..1 | BackboneElement | Benefit limits | |
| value | 1..1 | Quantity | Insurance Period (months) | |
| code | 0..1 | CodeableConcept | Benefit limit details Required Pattern: At least the following | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: period | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Period | |
| limit:memberCount | 0..1 | BackboneElement | Benefit limits | |
| value | 1..1 | Quantity | Member Count | |
| code | 0..1 | CodeableConcept | Benefit limit details Required Pattern: At least the following | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: memberCount | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Member Count | |
| plan | 1..1 | BackboneElement | Plan details | |
| identifier | 0..0 | |||
| type | 0..0 | |||
| coverageArea | 0..0 | |||
| network | 0..0 | |||
| Slices for generalCost | 1..1 | BackboneElement | Overall costs Slice: Unordered, Closed by value:type.coding.code | |
| generalCost:All Slices | Content/Rules for all slices | |||
| type | 1..1 | CodeableConcept | Type of cost Binding: General Cost Type (InsurancePlan) (required) | |
| cost | 1..1 | Money | Cost value | |
| comment | 0..0 | |||
| generalCost:lumpsum | 1..1 | BackboneElement | Overall costs | |
| type | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following | |
| coding | 1..* | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: lumpsum | |
| display | 1..1 | string | Representation defined by the system Fixed Value: Lumpsum | |
| groupSize | 1..1 | positiveInt | Threshold Member | |
| generalCost:premiumAdult | 0..1 | BackboneElement | Overall costs | |
| type | 0..1 | CodeableConcept | Type of cost Required Pattern: At least the following |