Standard Health Record

CoverageProfile


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="shr-financial-Coverage"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <p><b>SHR Coverage Profile</b></p>
  <p>Health insurance coverage available (even if not used for payment for a given encounter).</p>
  <p><b>SHR Mapping Summary</b></p>
  <p><pre>shr.financial.Coverage maps to Coverage:
  Status maps to status
  Type maps to type
  InsuranceMemberId maps to subscriberId
  EffectiveTimePeriod maps to period
  PolicyHolder maps to policyHolder
</pre></p>
</div>
  </text>
  <url
       value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-financial-Coverage"/>
  <identifier>
    <system value="http://standardhealthrecord.org"/>
    <value value="shr.financial.Coverage"/>
  </identifier>
  <version value="0.1.0"/>
  <name value="CoverageProfile"/>
  <title value="SHR Coverage Profile"/>
  <status value="draft"/>
  <date value="2018-08-22T00:00:00-04:00"/>
  <publisher value="The MITRE Corporation: Standard Health Record Collaborative"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://standardhealthrecord.org"/>
    </telecom>
  </contact>
  <description
               value="Health insurance coverage available (even if not used for payment for a given encounter)."/>
  <purpose
           value="Health care programs and insurers are significant payors of health service costs."/>
  <fhirVersion value="3.0.1"/>
  <mapping>
    <identity value="workflow"/>
    <uri value="http://hl7.org/fhir/workflow"/>
    <name value="Workflow Mapping"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/w5"/>
    <name value="W5 Mapping"/>
  </mapping>
  <mapping>
    <identity value="cdanetv4"/>
    <uri value="http://www.cda-adc.ca/en/services/cdanet/"/>
    <name value="Canadian Dental Association eclaims standard"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <mapping>
    <identity value="cpha3pharm"/>
    <uri value="http://www.pharmacists.ca/"/>
    <name value="Canadian Pharmacy Associaiton eclaims standard"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="Coverage"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Coverage:shr-financial-Coverage">
      <path value="Coverage"/>
      <short value="SHR Coverage Profile"/>
      <definition
                  value="Health insurance coverage available (even if not used for payment for a given encounter)."/>
      <min value="0"/>
      <max value="*"/>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source value="DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource"/>
        <expression
                    value="contained.where((&#39;#&#39;+id in %resource.descendants().reference).not()).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $id))]))"/>
        <source value="DomainResource"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Coverage"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="financial.support"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.id">
      <path value="Coverage.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Coverage:shr-financial-Coverage.meta">
      <path value="Coverage.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Coverage:shr-financial-Coverage.implicitRules">
      <path value="Coverage.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content."/>
      <comment
               value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. 

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="Coverage:shr-financial-Coverage.language">
      <path value="Coverage.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comment
               value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="Coverage:shr-financial-Coverage.text">
      <path value="Coverage.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.contained">
      <path value="Coverage.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
      <comment
               value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension">
      <path value="Coverage.extension"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:subjectofinformation">
      <path value="Coverage.extension"/>
      <sliceName value="subjectofinformation"/>
      <definition
                  value="The person or thing that this entry relates to, usually the Person of Record (see Entry). However, not all entries have health information specifically about the patient, but in different contexts, could refer to a fetus, family member (living or dead), device, location, organization, behavior, finding, condition, wound, or intervention.
CIMI alignment: SubjectOfInformation is not a Participation -- unlike CIMI. There&#39;s no action to participate in. Participant has extra unnecessary attributes, such as &#39;onBehalfOf&#39;."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-SubjectOfInformation-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:sourceofinformation">
      <path value="Coverage.extension"/>
      <sliceName value="sourceofinformation"/>
      <definition
                  value="The person or entity that provided the information in the entry, e.g. the subject (patient), medical professional, family member, device or software program, as distinct from who recorded the entry."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-SourceOfInformation-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:annotation">
      <path value="Coverage.extension"/>
      <sliceName value="annotation"/>
      <definition
                  value="An added or follow-up note, often after the fact, that contains metadata about who made the statement and when."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-element-Annotation-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:recordstatus">
      <path value="Coverage.extension"/>
      <sliceName value="recordstatus"/>
      <definition
                  value="Concept indicating the state of this record, e.g., &#39;entered in error&#39;."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-RecordStatus-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:recorded">
      <path value="Coverage.extension"/>
      <sliceName value="recorded"/>
      <definition
                  value="The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-Recorded-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:signed">
      <path value="Coverage.extension"/>
      <sliceName value="signed"/>
      <definition
                  value="Provenance information specific to the signing of the clinical statement."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-Signed-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:cosigned">
      <path value="Coverage.extension"/>
      <sliceName value="cosigned"/>
      <definition
                  value="Provenance information specific to the cosigning of the clinical statement."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-Cosigned-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:verified">
      <path value="Coverage.extension"/>
      <sliceName value="verified"/>
      <definition
                  value="Provenance information specific to the verification process associated with this statement (e.g., verifier, when verified, etc.)"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-Verified-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.modifierExtension">
      <path value="Coverage.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.identifier">
      <path value="Coverage.identifier"/>
      <short value="The primary coverage ID"/>
      <definition
                  value="The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatination of the Coverage.SubscriberID and the Coverage.dependant."/>
      <requirements
                    value="This value may uniquely identify the coverage or it may be used in conjunction with the additional identifiers below."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.identifier"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C02"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-2"/>
      </mapping>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.32, C.33, C.39"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.status">
      <path value="Coverage.status"/>
      <short value="active | cancelled | draft | entered-in-error"/>
      <definition value="The status of the resource instance."/>
      <comment
               value="This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CoverageStatus"/>
        </extension>
        <strength value="required"/>
        <description
                     value="A code specifying the state of the resource instance."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/fm-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="status"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.type">
      <path value="Coverage.type"/>
      <short value="Type of coverage such as medical or accident"/>
      <definition
                  value="The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization."/>
      <requirements
                    value="The order of application of coverages is dependent on the types of coverage."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CoverageType"/>
        </extension>
        <strength value="preferred"/>
        <description
                     value="The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/coverage-type"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-15"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="class"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.policyHolder">
      <path value="Coverage.policyHolder"/>
      <short value="Owner of the policy"/>
      <definition
                  value="The party who &#39;owns&#39; the insurance policy,  may be an individual, corporation or the subscriber&#39;s employer."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-entity-Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-entity-RelatedPerson"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-entity-Organization"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D01 through D09"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-16, 18,  19-name of insured, address, date of birth"/>
      </mapping>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.35"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.subscriber">
      <path value="Coverage.subscriber"/>
      <short value="Subscriber to the policy"/>
      <definition
                  value="The party who has signed-up for or &#39;owns&#39; the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D01 through D09"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-16, 18,  19-name of insured, address, date of birth"/>
      </mapping>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.35"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.subscriberId">
      <path value="Coverage.subscriberId"/>
      <short value="ID assigned to the Subscriber"/>
      <definition value="The insurer assigned ID for the Subscriber."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D01 through D09"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-16, 18,  19-name of insured, address, date of birth"/>
      </mapping>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.35"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.beneficiary">
      <path value="Coverage.beneficiary"/>
      <short value="Plan Beneficiary"/>
      <definition
                  value="The party who benefits from the insurance coverage., the patient when services are provided."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.subject"/>
      </mapping>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D01 through D09"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-16, 18,  19-name of insured, address, date of birth"/>
      </mapping>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.35"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.relationship">
      <path value="Coverage.relationship"/>
      <short value="Beneficiary relationship to the Subscriber"/>
      <definition
                  value="The relationship of beneficiary (patient) to the subscriber."/>
      <requirements
                    value="To determine relationship between the patient and the subscriber."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Relationship"/>
        </extension>
        <strength value="example"/>
        <description
                     value="The relationship between the Policyholder and the Beneficiary (insured/covered party/patient)."/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/policyholder-relationship"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C03"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.period">
      <path value="Coverage.period"/>
      <short value="Coverage start and end dates"/>
      <definition
                  value="Time period during which the coverage is in force. A missing start date indicates the start date isn&#39;t known, a missing end date means the coverage is continuing to be in force."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Period"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.occurrence"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-12 / IN1-13"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.done"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.payor">
      <path value="Coverage.payor"/>
      <short value="Identifier for the plan or agreement issuer"/>
      <definition
                  value="The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. May provide multiple identifiers such as insurance company identifier or business identifier (BIN number)."/>
      <requirements
                    value="Need to identify the issuer to target for processing and for coordination of benefit processing."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="A05"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-3"/>
      </mapping>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.30"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.author"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name">
        <valueString value="Group"/>
      </extension>
      <path value="Coverage.grouping"/>
      <short value="Additional coverage classifications"/>
      <definition
                  value="A suite of underwrite specific classifiers, for example may be used to identify a class of coverage or employer group, Policy, Plan."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() | (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.id">
      <path value="Coverage.grouping.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition
                  value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.extension">
      <path value="Coverage.grouping.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.modifierExtension">
      <path value="Coverage.grouping.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.group">
      <path value="Coverage.grouping.group"/>
      <short value="An identifier for the group"/>
      <definition
                  value="Identifies a style or collective of coverage issued by the underwriter, for example may be used to identify an employer group. May also be referred to as a Policy or Group ID."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C11 (Division,Section)"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-8"/>
      </mapping>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.31"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.groupDisplay">
      <path value="Coverage.grouping.groupDisplay"/>
      <short value="Display text for an identifier for the group"/>
      <definition value="A short description for the group."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C11 (Division,Section)"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-8"/>
      </mapping>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.31"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.subGroup">
      <path value="Coverage.grouping.subGroup"/>
      <short value="An identifier for the subsection of the group"/>
      <definition
                  value="Identifies a style or collective of coverage issued by the underwriter, for example may be used to identify a subset of an employer group."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-8"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.subGroupDisplay">
      <path value="Coverage.grouping.subGroupDisplay"/>
      <short value="Display text for the subsection of the group"/>
      <definition value="A short description for the subgroup."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-8"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.plan">
      <path value="Coverage.grouping.plan"/>
      <short value="An identifier for the plan"/>
      <definition
                  value="Identifies a style or collective of coverage issued by the underwriter, for example may be used to identify a collection of benefits provided to employees. May be referred to as a Section or Division ID."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C01"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-35"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.planDisplay">
      <path value="Coverage.grouping.planDisplay"/>
      <short value="Display text for the plan"/>
      <definition value="A short description for the plan."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C01"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-35"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.subPlan">
      <path value="Coverage.grouping.subPlan"/>
      <short value="An identifier for the subsection of the plan"/>
      <definition
                  value="Identifies a sub-style or sub-collective of coverage issued by the underwriter, for example may be used to identify a subset of a collection of benefits provided to employees."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-10"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.subPlanDisplay">
      <path value="Coverage.grouping.subPlanDisplay"/>
      <short value="Display text for the subsection of the plan"/>
      <definition value="A short description for the subplan."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-10"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.class">
      <path value="Coverage.grouping.class"/>
      <short value="An identifier for the class"/>
      <definition
                  value="Identifies a style or collective of coverage issues by the underwriter, for example may be used to identify a class of coverage such as a level of deductables or co-payment."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C01"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-35"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.classDisplay">
      <path value="Coverage.grouping.classDisplay"/>
      <short value="Display text for the class"/>
      <definition value="A short description for the class."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C01"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-35"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.subClass">
      <path value="Coverage.grouping.subClass"/>
      <short value="An identifier for the subsection of the class"/>
      <definition
                  value="Identifies a sub-style or sub-collective of coverage issues by the underwriter, for example may be used to identify a subclass of coverage such as a sub-level of deductables or co-payment."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C01"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-35"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.grouping.subClassDisplay">
      <path value="Coverage.grouping.subClassDisplay"/>
      <short value="Display text for the subsection of the subclass"/>
      <definition value="A short description for the subclass."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C01"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-35"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.dependent">
      <path value="Coverage.dependent"/>
      <short value="Dependent number"/>
      <definition
                  value="A unique identifier for a dependent under the coverage."/>
      <requirements
                    value="For some coverage a single identifier is issued to the Subscriber and a dependent number issued to each beneficiary."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="C17"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="- No exact HL7 v2 equivalent concept seems to exist;"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.sequence">
      <path value="Coverage.sequence"/>
      <short value="The plan instance or sequence counter"/>
      <definition
                  value="An optional counter for a particular instance of the identified coverage which increments upon each renewal."/>
      <requirements
                    value="Some coverage, for example social plans, may be offered in short time increments, for example for a week or a month at a time, so while the rest of the plan details and identifiers may remain constant over time, the instance is incremented with each renewal and provided to the covered party on their &#39;card&#39;."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D11"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="No HL7 v2 equivalent concept seems to exist"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.order">
      <path value="Coverage.order"/>
      <short value="Relative order of the coverage"/>
      <definition
                  value="The order of applicability of this coverage relative to other coverages which are currently inforce. Note, there may be gaps in the numbering and this does not imply primary, secondard etc. as the specific positioning of coverages depends upon the episode of care."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="positiveInt"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="- No exact HL7 v2 equivalent concept seems to exist;"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.network">
      <path value="Coverage.network"/>
      <short value="Insurer network"/>
      <definition
                  value="The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the &#39;in-network&#39; rate, otherwise &#39;out of network&#39; terms and conditions apply."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D10"/>
      </mapping>
    </element>
    <element id="Coverage:shr-financial-Coverage.contract">
      <path value="Coverage.contract"/>
      <short value="Contract details"/>
      <definition
                  value="The policy(s) which constitute this insurance coverage."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Contract"/>
      </type>
      <mapping>
        <identity value="cdanetv4"/>
        <map value="D01 through D09"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="IN1-16, 18,  19"/>
      </mapping>
      <mapping>
        <identity value="cpha3pharm"/>
        <map value="C.35"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Coverage:shr-financial-Coverage">
      <path value="Coverage"/>
      <short value="SHR Coverage Profile"/>
      <definition
                  value="Health insurance coverage available (even if not used for payment for a given encounter)."/>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:subjectofinformation">
      <path value="Coverage.extension"/>
      <sliceName value="subjectofinformation"/>
      <definition
                  value="The person or thing that this entry relates to, usually the Person of Record (see Entry). However, not all entries have health information specifically about the patient, but in different contexts, could refer to a fetus, family member (living or dead), device, location, organization, behavior, finding, condition, wound, or intervention.
CIMI alignment: SubjectOfInformation is not a Participation -- unlike CIMI. There&#39;s no action to participate in. Participant has extra unnecessary attributes, such as &#39;onBehalfOf&#39;."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-SubjectOfInformation-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:sourceofinformation">
      <path value="Coverage.extension"/>
      <sliceName value="sourceofinformation"/>
      <definition
                  value="The person or entity that provided the information in the entry, e.g. the subject (patient), medical professional, family member, device or software program, as distinct from who recorded the entry."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-SourceOfInformation-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:annotation">
      <path value="Coverage.extension"/>
      <sliceName value="annotation"/>
      <definition
                  value="An added or follow-up note, often after the fact, that contains metadata about who made the statement and when."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-element-Annotation-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:recordstatus">
      <path value="Coverage.extension"/>
      <sliceName value="recordstatus"/>
      <definition
                  value="Concept indicating the state of this record, e.g., &#39;entered in error&#39;."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-RecordStatus-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:recorded">
      <path value="Coverage.extension"/>
      <sliceName value="recorded"/>
      <definition
                  value="The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-Recorded-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:signed">
      <path value="Coverage.extension"/>
      <sliceName value="signed"/>
      <definition
                  value="Provenance information specific to the signing of the clinical statement."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-Signed-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:cosigned">
      <path value="Coverage.extension"/>
      <sliceName value="cosigned"/>
      <definition
                  value="Provenance information specific to the cosigning of the clinical statement."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-Cosigned-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.extension:verified">
      <path value="Coverage.extension"/>
      <sliceName value="verified"/>
      <definition
                  value="Provenance information specific to the verification process associated with this statement (e.g., verifier, when verified, etc.)"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-core-Verified-extension"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.type">
      <path value="Coverage.type"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
        <profile
                 value="http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-CodeableConcept"/>
      </type>
    </element>
    <element id="Coverage:shr-financial-Coverage.policyHolder">
      <path value="Coverage.policyHolder"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-entity-Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-entity-RelatedPerson"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://standardhealthrecord.org/fhir/StructureDefinition/cimi-entity-Organization"/>
      </type>
    </element>
  </differential>
</StructureDefinition>