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

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: RX02 - JSON Representation

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{
  "resourceType" : "InsurancePlan",
  "id" : "RX02",
  "meta" : {
    "profile" : [
      "https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/openimis-insurance-plan"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource \"RX02\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-openimis-insurance-plan.html\">openIMIS Insurance Plan</a></p></div><p><b>Max Installments (InsurancePlan)</b>: 3</p><p><b>Cycle Start (InsurancePlan)</b>: 01-03</p><p><b>Cycle Start (InsurancePlan)</b>: 01-07</p><p><b>Cycle Start (InsurancePlan)</b>: 01-10</p><p><b>Period (InsurancePlan)</b>: 1 months</p><p><b>Period (InsurancePlan)</b>: 1 months</p><p><b>Period (InsurancePlan)</b>: 1 months</p><p><b>Period (InsurancePlan)</b>: 1 months</p><blockquote><p><b>Discount (InsurancePlan)</b></p><p><b>value</b>: 50</p><p><b>value</b>: 2 months</p></blockquote><blockquote><p><b>Discount (InsurancePlan)</b></p><p><b>value</b>: 80</p><p><b>value</b>: 2 months</p></blockquote><p><b>identifier</b>: Unique code: RX01</p><p><b>status</b>: active</p><p><b>type</b>: Medical <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#medical)</span></p><p><b>name</b>: Regional fixed enrolment</p><p><b>period</b>: 2023-10-01 --&gt; 2030-12-31</p><p><b>coverageArea</b>: <a href=\"Location-Upper-River-Region.html\">Location/Upper-River-Region</a> \"Upper River Region\"</p><blockquote><p><b>coverage</b></p><p><b>type</b>: Medical <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#medical)</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: Medical <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-insurance-plan-type.html\">Insurance plan type</a>#medical)</span></p><blockquote><p><b>limit</b></p><p><b>value</b>: 12 month</p><p><b>code</b>: Period <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-coverage-benefit-limit.html\">Coverage Benefit Limit Types (InsurancePlan)</a>#period)</span></p></blockquote><blockquote><p><b>limit</b></p><p><b>value</b>: 10 member</p><p><b>code</b>: Member Count <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-coverage-benefit-limit.html\">Coverage Benefit Limit Types (InsurancePlan)</a>#memberCount)</span></p></blockquote></blockquote></blockquote><blockquote><p><b>plan</b></p><blockquote><p><b>generalCost</b></p><p><b>type</b>: Lumpsum <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-general-cost-type.html\">General Cost Type (InsurancePlan)</a>#lumpsum)</span></p><p><b>groupSize</b>: 3</p></blockquote><blockquote><p><b>generalCost</b></p><p><b>type</b>: Premium Adult <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-general-cost-type.html\">General Cost Type (InsurancePlan)</a>#premiumAdult)</span></p></blockquote><blockquote><p><b>generalCost</b></p><p><b>type</b>: Premium Child <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-general-cost-type.html\">General Cost Type (InsurancePlan)</a>#premiumChild)</span></p></blockquote><blockquote><p><b>generalCost</b></p><p><b>type</b>: Registration Fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-insurance-plan-general-cost-type.html\">General Cost Type (InsurancePlan)</a>#registrationFee)</span></p></blockquote></blockquote></div>"
  },
  "extension" : [
    {
      "url" : "https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-max-installments",
      "valueUnsignedInt" : 3
    },
    {
      "url" : "https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-start-cycle",
      "valueString" : "01-03"
    },
    {
      "url" : "https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-start-cycle",
      "valueString" : "01-07"
    },
    {
      "url" : "https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-start-cycle",
      "valueString" : "01-10"
    },
    {
      "url" : "https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period",
      "valueQuantity" : {
        "value" : 1,
        "unit" : "months"
      }
    },
    {
      "url" : "https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period",
      "valueQuantity" : {
        "value" : 1,
        "unit" : "months"
      }
    },
    {
      "url" : "https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period",
      "valueQuantity" : {
        "value" : 1,
        "unit" : "months"
      }
    },
    {
      "url" : "https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-period",
      "valueQuantity" : {
        "value" : 1,
        "unit" : "months"
      }
    },
    {
      "extension" : [
        {
          "url" : "Percentage",
          "valueDecimal" : 50
        },
        {
          "url" : "Period",
          "valueQuantity" : {
            "value" : 2,
            "unit" : "months"
          }
        }
      ],
      "url" : "https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-discount"
    },
    {
      "extension" : [
        {
          "url" : "Percentage",
          "valueDecimal" : 80
        },
        {
          "url" : "Period",
          "valueQuantity" : {
            "value" : 2,
            "unit" : "months"
          }
        }
      ],
      "url" : "https://openimis.github.io/openimis_fhir_r4_ig/StructureDefinition/insurance-plan-discount"
    }
  ],
  "identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/openimis-identifiers",
            "code" : "Code"
          }
        ]
      },
      "value" : "RX01"
    }
  ],
  "status" : "active",
  "type" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
          "code" : "medical",
          "display" : "Medical"
        }
      ]
    }
  ],
  "name" : "Regional fixed enrolment",
  "period" : {
    "start" : "2023-10-01",
    "end" : "2030-12-31"
  },
  "coverageArea" : [
    {
      "reference" : "Location/Upper-River-Region"
    }
  ],
  "coverage" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
            "code" : "medical",
            "display" : "Medical"
          }
        ]
      },
      "benefit" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
                "code" : "medical",
                "display" : "Medical"
              }
            ]
          },
          "limit" : [
            {
              "value" : {
                "value" : 12,
                "unit" : "month"
              },
              "code" : {
                "coding" : [
                  {
                    "system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit",
                    "code" : "period",
                    "display" : "Period"
                  }
                ]
              }
            },
            {
              "value" : {
                "value" : 10,
                "unit" : "member"
              },
              "code" : {
                "coding" : [
                  {
                    "system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-coverage-benefit-limit",
                    "code" : "memberCount",
                    "display" : "Member Count"
                  }
                ]
              }
            }
          ]
        }
      ]
    }
  ],
  "plan" : [
    {
      "generalCost" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type",
                "code" : "lumpsum",
                "display" : "Lumpsum"
              }
            ]
          },
          "groupSize" : 3,
          "cost" : {
            "value" : 1500,
            "currency" : "EUR"
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type",
                "code" : "premiumAdult",
                "display" : "Premium Adult"
              }
            ]
          },
          "cost" : {
            "value" : 150,
            "currency" : "EUR"
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type",
                "code" : "premiumChild",
                "display" : "Premium Child"
              }
            ]
          },
          "cost" : {
            "value" : 70,
            "currency" : "EUR"
          }
        },
        {
          "type" : {
            "coding" : [
              {
                "system" : "https://openimis.github.io/openimis_fhir_r4_ig/CodeSystem/insurance-plan-general-cost-type",
                "code" : "registrationFee",
                "display" : "Registration Fee"
              }
            ]
          },
          "cost" : {
            "value" : 200,
            "currency" : "EUR"
          }
        }
      ]
    }
  ]
}