FHIR Implementation Guide for ABDM
3.1.0 - active
FHIR Implementation Guide for ABDM
3.1.0 - active
FHIR Implementation Guide for ABDM - Local Development build (v3.1.0). See the Directory of published versions
| Official URL: https://nrces.in/ndhm/fhir/r4/StructureDefinition/InsurancePlan | Version: 3.1.0 | |||
| Draft as of 2023-08-10 | Computable Name: InsurancePlan | |||
This Profile describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
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 | |
  identifier | S | 1..1 | Identifier | Business Identifier that should be as provided by IRDAI for Indian insurance. |
| status | S | 1..1 | code | draft | active | retired | unknown |
 type | S | 1..1 | CodeableConcept | Kind of product Binding: InsurancePlan Type (example) |
 coding | 0..1 | Coding | Code defined by a terminology system | |
| system | 1..1 | uri | Identity of the terminology system | |
| code | 1..1 | code | Symbol in syntax defined by the system | |
 display | 1..1 | string | Representation defined by the system | |
| text | S | 0..1 | string | Plain text representation of the concept |
| name | S | 1..1 | string | Official name |
| alias | S | 0..* | string | Alternate names |
| period | S | 1..1 | Period | When the product is available |
 ownedBy | S | 1..1 | Reference(Organization) | Plan issuer |
| administeredBy | S | 1..1 | Reference(Organization) | Product administrator |
| coverageArea | S | 0..* | Reference(Location) | Where product applies |
| contact | S | 0..* | BackboneElement | Contact for the product |
| network | S | 0..* | Reference(Organization) | What networks are Included |
| coverage | S | 1..* | BackboneElement | Coverage details |
| type | 1..1 | CodeableConcept | Type of coverage Binding: Coverage Type (example) | |
| coding | 0..1 | Coding | Code defined by a terminology system | |
| system | 1..1 | uri | Identity of the terminology system | |
| code | 1..1 | code | Symbol in syntax defined by the system | |
| display | 1..1 | string | Representation defined by the system | |
| text | S | 0..1 | string | Plain text representation of the concept |
 benefit | S | 1..* | BackboneElement | List of benefits |
 type | 1..1 | CodeableConcept | Type of benefit Binding: Benefit Type (example) | |
| coding | 0..1 | Coding | Code defined by a terminology system | |
| system | 1..1 | uri | Identity of the terminology system | |
| code | 1..1 | code | Symbol in syntax defined by the system | |
| display | 1..1 | string | Representation defined by the system | |
| text | S | 0..1 | string | Plain text representation of the concept |
| plan | S | 1..* | BackboneElement | Plan details |
| type | S | 1..1 | CodeableConcept | Type of plan Binding: Plan Type (example) |
| coding | 0..1 | Coding | Code defined by a terminology system | |
| system | 1..1 | uri | Identity of the terminology system | |
| code | 1..1 | code | Symbol in syntax defined by the system | |
| display | 1..1 | string | Representation defined by the system | |
| text | S | 0..1 | string | Plain text representation of the concept |
| coverageArea | S | 0..* | Reference(Location) | Where product applies |
| network | 0..* | Reference(Organization) | What networks provide coverage | |
| generalCost | S | 0..* | BackboneElement | Overall costs |
| specificCost | S | 0..* | BackboneElement | Specific costs |
| category | S | 1..1 | CodeableConcept | General category of benefit Binding: Benefit Category (example) |
| coding | 0..1 | Coding | Code defined by a terminology system | |
| system | 1..1 | uri | Identity of the terminology system | |
| code | 1..1 | code | Symbol in syntax defined by the system | |
| display | 1..1 | string | Representation defined by the system | |
| text | S | 0..1 | string | Plain text representation of the concept |
| benefit | ||||
| type | 1..1 | CodeableConcept | Type of specific benefit Binding: ProductorService (example) | |
| coding | 0..1 | Coding | Code defined by a terminology system | |
| system | 1..1 | uri | Identity of the terminology system | |
| code | 1..1 | code | Symbol in syntax defined by the system | |
| display | 1..1 | string | Representation defined by the system | |
| text | S | 0..1 | string | Plain text representation of the concept |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| InsurancePlan.type | example | InsurancePlanType (a valid code from InsurancePlan Type) |
| InsurancePlan.coverage.type | example | CoverageType |
| InsurancePlan.coverage.benefit.type | example | BenefitType |
| InsurancePlan.plan.type | example | PlanType (a valid code from Plan Type) |
| InsurancePlan.plan.specificCost.category | example | BenefitCategory |
| InsurancePlan.plan.specificCost.benefit.type | example | ProductorService |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| InsurancePlan | C | 0..* | InsurancePlan | Details of a Health Insurance product/plan provided by an organization |
 implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
 identifier | SΣC | 1..1 | Identifier | Business Identifier that should be as provided by IRDAI for Indian insurance. |
| status | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. |
| type | SΣ | 1..1 | CodeableConcept | Kind of product Binding: InsurancePlan Type (example) |
| coding | Σ | 0..1 | Coding | Code defined by a terminology system |
| system | Σ | 1..1 | uri | Identity of the terminology system |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 1..1 | string | Representation defined by the system |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| name | SΣC | 1..1 | string | Official name |
| alias | S | 0..* | string | Alternate names |
| period | S | 1..1 | Period | When the product is available |
| ownedBy | SΣ | 1..1 | Reference(Organization) | Plan issuer |
| administeredBy | SΣ | 1..1 | Reference(Organization) | Product administrator |
| coverageArea | SΣ | 0..* | Reference(Location) | Where product applies |
| contact | S | 0..* | BackboneElement | Contact for the product |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| network | S | 0..* | Reference(Organization) | What networks are Included |
| coverage | S | 1..* | BackboneElement | Coverage details |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Type of coverage Binding: Coverage Type (example) | |
| coding | Σ | 0..1 | Coding | Code defined by a terminology system |
| system | Σ | 1..1 | uri | Identity of the terminology system |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 1..1 | string | Representation defined by the system |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| benefit | S | 1..* | BackboneElement | List of benefits |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Type of benefit Binding: Benefit Type (example) | |
| coding | Σ | 0..1 | Coding | Code defined by a terminology system |
| system | Σ | 1..1 | uri | Identity of the terminology system |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 1..1 | string | Representation defined by the system |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| plan | S | 1..* | BackboneElement | Plan details |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | S | 1..1 | CodeableConcept | Type of plan Binding: Plan Type (example) |
| coding | Σ | 0..1 | Coding | Code defined by a terminology system |
| system | Σ | 1..1 | uri | Identity of the terminology system |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 1..1 | string | Representation defined by the system |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| coverageArea | SΣ | 0..* | Reference(Location) | Where product applies |
| network | 0..* | Reference(Organization) | What networks provide coverage | |
| generalCost | S | 0..* | BackboneElement | Overall costs |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| specificCost | S | 0..* | BackboneElement | Specific costs |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| category | S | 1..1 | CodeableConcept | General category of benefit Binding: Benefit Category (example) |
| coding | Σ | 0..1 | Coding | Code defined by a terminology system |
| system | Σ | 1..1 | uri | Identity of the terminology system |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 1..1 | string | Representation defined by the system |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| benefit | 0..* | BackboneElement | Benefits list | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Type of specific benefit Binding: ProductorService (example) | |
| coding | Σ | 0..1 | Coding | Code defined by a terminology system |
| system | Σ | 1..1 | uri | Identity of the terminology system |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 1..1 | string | Representation defined by the system |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| InsurancePlan.status | required | PublicationStatus |
| InsurancePlan.type | example | InsurancePlanType (a valid code from InsurancePlan Type) |
| InsurancePlan.coverage.type | example | CoverageType |
| InsurancePlan.coverage.benefit.type | example | BenefitType |
| InsurancePlan.plan.type | example | PlanType (a valid code from Plan Type) |
| InsurancePlan.plan.specificCost.category | example | BenefitCategory |
| InsurancePlan.plan.specificCost.benefit.type | example | ProductorService |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | InsurancePlan | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | InsurancePlan | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | InsurancePlan | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | InsurancePlan | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | InsurancePlan | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ipn-1 | error | InsurancePlan | The organization SHALL at least have a name or an idendtifier, and possibly more than one : (identifier.count() + name.count()) > 0 |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| InsurancePlan | C | 0..* | InsurancePlan | Details of a Health Insurance product/plan provided by an organization | ||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
 extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier | SΣC | 1..1 | Identifier | Business Identifier that should be as provided by IRDAI for Indian insurance. | ||||
| status | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. | ||||
| type | SΣ | 1..1 | CodeableConcept | Kind of product Binding: InsurancePlan Type (example) | ||||
| 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..1 | 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 | 1..1 | uri | Identity of the terminology system | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 1..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | SΣ | 0..1 | string | Plain text representation of the concept | ||||
| name | SΣC | 1..1 | string | Official name | ||||
| alias | S | 0..* | string | Alternate names | ||||
| period | S | 1..1 | Period | When the product is available | ||||
| ownedBy | SΣ | 1..1 | Reference(Organization) | Plan issuer | ||||
| administeredBy | SΣ | 1..1 | Reference(Organization) | Product administrator | ||||
| coverageArea | SΣ | 0..* | Reference(Location) | Where product applies | ||||
| contact | S | 0..* | BackboneElement | Contact for the product | ||||
| 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 | ||||
| purpose | 0..1 | CodeableConcept | The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party. | |||||
| name | 0..1 | HumanName | A name associated with the contact | |||||
| telecom | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact | |||||
| address | 0..1 | Address | Visiting or postal addresses for the contact | |||||
| endpoint | 0..* | Reference(Endpoint) | Technical endpoint | |||||
| network | S | 0..* | Reference(Organization) | What networks are Included | ||||
| coverage | S | 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 (example) | |||||
| 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..1 | 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 | 1..1 | uri | Identity of the terminology system | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 1..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | SΣ | 0..1 | string | Plain text representation of the concept | ||||
| network | 0..* | Reference(Organization) | What networks provide coverage | |||||
| benefit | S | 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: Benefit Type (example) | |||||
| 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..1 | 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 | 1..1 | uri | Identity of the terminology system | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 1..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | SΣ | 0..1 | string | Plain text representation of the concept | ||||
| requirement | 0..1 | string | Referral requirements | |||||
| limit | 0..* | 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 | 0..1 | Quantity | Maximum value allowed | |||||
| code | 0..1 | CodeableConcept | Benefit limit details | |||||
| plan | S | 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 | ||||
| identifier | Σ | 0..* | Identifier | Business Identifier for Product | ||||
| type | S | 1..1 | CodeableConcept | Type of plan Binding: Plan Type (example) | ||||
| 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..1 | 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 | 1..1 | uri | Identity of the terminology system | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 1..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | SΣ | 0..1 | string | Plain text representation of the concept | ||||
| coverageArea | SΣ | 0..* | Reference(Location) | Where product applies | ||||
| network | 0..* | Reference(Organization) | What networks provide coverage | |||||
| generalCost | S | 0..* | 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 | |||||
| groupSize | 0..1 | positiveInt | Number of enrollees | |||||
| cost | 0..1 | Money | Cost value | |||||
| comment | 0..1 | string | Additional cost information | |||||
| specificCost | S | 0..* | BackboneElement | Specific 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 | ||||
| category | S | 1..1 | CodeableConcept | General category of benefit Binding: Benefit Category (example) | ||||
| 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..1 | 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 | 1..1 | uri | Identity of the terminology system | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 1..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | SΣ | 0..1 | string | Plain text representation of the concept | ||||
| benefit | 0..* | BackboneElement | Benefits list | |||||
| 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 specific benefit Binding: ProductorService (example) | |||||
| 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..1 | 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 | 1..1 | uri | Identity of the terminology system | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 1..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | SΣ | 0..1 | string | Plain text representation of the concept | ||||
| cost | 0..* | BackboneElement | List of the 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 | 1..1 | CodeableConcept | Type of cost | |||||
| applicability | 0..1 | CodeableConcept | in-network | out-of-network | other Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers. | |||||
| qualifiers | 0..* | CodeableConcept | Additional information about the cost | |||||
| value | 0..1 | Quantity | The actual cost value | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | ||||
| InsurancePlan.language | preferred | CommonLanguages
| ||||
| InsurancePlan.status | required | PublicationStatus | ||||
| InsurancePlan.type | example | InsurancePlanType (a valid code from InsurancePlan Type) | ||||
| InsurancePlan.contact.purpose | extensible | ContactEntityType | ||||
| InsurancePlan.coverage.type | example | CoverageType | ||||
| InsurancePlan.coverage.benefit.type | example | BenefitType | ||||
| InsurancePlan.plan.type | example | PlanType (a valid code from Plan Type) | ||||
| InsurancePlan.plan.specificCost.category | example | BenefitCategory | ||||
| InsurancePlan.plan.specificCost.benefit.type | example | ProductorService | ||||
| InsurancePlan.plan.specificCost.benefit.cost.applicability | required | BenefitCostApplicability |
| Id | Grade | Path(s) | Details | Requirements |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from InsurancePlan
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 | |
| identifier | S | 1..1 | Identifier | Business Identifier that should be as provided by IRDAI for Indian insurance. |
| status | S | 1..1 | code | draft | active | retired | unknown |
| type | S | 1..1 | CodeableConcept | Kind of product Binding: InsurancePlan Type (example) |
| coding | 0..1 | Coding | Code defined by a terminology system | |
| system | 1..1 | uri | Identity of the terminology system | |
| code | 1..1 | code | Symbol in syntax defined by the system | |
| display | 1..1 | string | Representation defined by the system | |
| text | S | 0..1 | string | Plain text representation of the concept |
| name | S | 1..1 | string | Official name |
| alias | S | 0..* | string | Alternate names |
| period | S | 1..1 | Period | When the product is available |
| ownedBy | S | 1..1 | Reference(Organization) | Plan issuer |
| administeredBy | S | 1..1 | Reference(Organization) | Product administrator |
| coverageArea | S | 0..* | Reference(Location) | Where product applies |
| contact | S | 0..* | BackboneElement | Contact for the product |
| network | S | 0..* | Reference(Organization) | What networks are Included |
| coverage | S | 1..* | BackboneElement | Coverage details |
| type | 1..1 | CodeableConcept | Type of coverage Binding: Coverage Type (example) | |
| coding | 0..1 | Coding | Code defined by a terminology system | |
| system | 1..1 | uri | Identity of the terminology system | |
| code | 1..1 | code | Symbol in syntax defined by the system | |
| display | 1..1 | string | Representation defined by the system | |
| text | S | 0..1 | string | Plain text representation of the concept |
| benefit | S | 1..* | BackboneElement | List of benefits |
| type | 1..1 | CodeableConcept | Type of benefit Binding: Benefit Type (example) | |
| coding | 0..1 | Coding | Code defined by a terminology system | |
| system | 1..1 | uri | Identity of the terminology system | |
| code | 1..1 | code | Symbol in syntax defined by the system | |
| display | 1..1 | string | Representation defined by the system | |
| text | S | 0..1 | string | Plain text representation of the concept |
| plan | S | 1..* | BackboneElement | Plan details |
| type | S | 1..1 | CodeableConcept | Type of plan Binding: Plan Type (example) |
| coding | 0..1 | Coding | Code defined by a terminology system | |
| system | 1..1 | uri | Identity of the terminology system | |
| code | 1..1 | code | Symbol in syntax defined by the system | |
| display | 1..1 | string | Representation defined by the system | |
| text | S | 0..1 | string | Plain text representation of the concept |
| coverageArea | S | 0..* | Reference(Location) | Where product applies |
| network | 0..* | Reference(Organization) | What networks provide coverage | |
| generalCost | S | 0..* | BackboneElement | Overall costs |
| specificCost | S | 0..* | BackboneElement | Specific costs |
| category | S | 1..1 | CodeableConcept | General category of benefit Binding: Benefit Category (example) |
| coding | 0..1 | Coding | Code defined by a terminology system | |
| system | 1..1 | uri | Identity of the terminology system | |
| code | 1..1 | code | Symbol in syntax defined by the system | |
| display | 1..1 | string | Representation defined by the system | |
| text | S | 0..1 | string | Plain text representation of the concept |
| benefit | ||||
| type | 1..1 | CodeableConcept | Type of specific benefit Binding: ProductorService (example) | |
| coding | 0..1 | Coding | Code defined by a terminology system | |
| system | 1..1 | uri | Identity of the terminology system | |
| code | 1..1 | code | Symbol in syntax defined by the system | |
| display | 1..1 | string | Representation defined by the system | |
| text | S | 0..1 | string | Plain text representation of the concept |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| InsurancePlan.type | example | InsurancePlanType (a valid code from InsurancePlan Type) |
| InsurancePlan.coverage.type | example | CoverageType |
| InsurancePlan.coverage.benefit.type | example | BenefitType |
| InsurancePlan.plan.type | example | PlanType (a valid code from Plan Type) |
| InsurancePlan.plan.specificCost.category | example | BenefitCategory |
| InsurancePlan.plan.specificCost.benefit.type | example | ProductorService |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| InsurancePlan | C | 0..* | InsurancePlan | Details of a Health Insurance product/plan provided by an organization |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | SΣC | 1..1 | Identifier | Business Identifier that should be as provided by IRDAI for Indian insurance. |
| status | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. |
| type | SΣ | 1..1 | CodeableConcept | Kind of product Binding: InsurancePlan Type (example) |
| coding | Σ | 0..1 | Coding | Code defined by a terminology system |
| system | Σ | 1..1 | uri | Identity of the terminology system |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 1..1 | string | Representation defined by the system |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| name | SΣC | 1..1 | string | Official name |
| alias | S | 0..* | string | Alternate names |
| period | S | 1..1 | Period | When the product is available |
| ownedBy | SΣ | 1..1 | Reference(Organization) | Plan issuer |
| administeredBy | SΣ | 1..1 | Reference(Organization) | Product administrator |
| coverageArea | SΣ | 0..* | Reference(Location) | Where product applies |
| contact | S | 0..* | BackboneElement | Contact for the product |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| network | S | 0..* | Reference(Organization) | What networks are Included |
| coverage | S | 1..* | BackboneElement | Coverage details |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Type of coverage Binding: Coverage Type (example) | |
| coding | Σ | 0..1 | Coding | Code defined by a terminology system |
| system | Σ | 1..1 | uri | Identity of the terminology system |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 1..1 | string | Representation defined by the system |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| benefit | S | 1..* | BackboneElement | List of benefits |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Type of benefit Binding: Benefit Type (example) | |
| coding | Σ | 0..1 | Coding | Code defined by a terminology system |
| system | Σ | 1..1 | uri | Identity of the terminology system |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 1..1 | string | Representation defined by the system |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| plan | S | 1..* | BackboneElement | Plan details |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | S | 1..1 | CodeableConcept | Type of plan Binding: Plan Type (example) |
| coding | Σ | 0..1 | Coding | Code defined by a terminology system |
| system | Σ | 1..1 | uri | Identity of the terminology system |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 1..1 | string | Representation defined by the system |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| coverageArea | SΣ | 0..* | Reference(Location) | Where product applies |
| network | 0..* | Reference(Organization) | What networks provide coverage | |
| generalCost | S | 0..* | BackboneElement | Overall costs |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| specificCost | S | 0..* | BackboneElement | Specific costs |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| category | S | 1..1 | CodeableConcept | General category of benefit Binding: Benefit Category (example) |
| coding | Σ | 0..1 | Coding | Code defined by a terminology system |
| system | Σ | 1..1 | uri | Identity of the terminology system |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 1..1 | string | Representation defined by the system |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| benefit | 0..* | BackboneElement | Benefits list | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Type of specific benefit Binding: ProductorService (example) | |
| coding | Σ | 0..1 | Coding | Code defined by a terminology system |
| system | Σ | 1..1 | uri | Identity of the terminology system |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system |
| display | Σ | 1..1 | string | Representation defined by the system |
| text | SΣ | 0..1 | string | Plain text representation of the concept |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| InsurancePlan.status | required | PublicationStatus |
| InsurancePlan.type | example | InsurancePlanType (a valid code from InsurancePlan Type) |
| InsurancePlan.coverage.type | example | CoverageType |
| InsurancePlan.coverage.benefit.type | example | BenefitType |
| InsurancePlan.plan.type | example | PlanType (a valid code from Plan Type) |
| InsurancePlan.plan.specificCost.category | example | BenefitCategory |
| InsurancePlan.plan.specificCost.benefit.type | example | ProductorService |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | InsurancePlan | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | InsurancePlan | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | InsurancePlan | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | InsurancePlan | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | InsurancePlan | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ipn-1 | error | InsurancePlan | The organization SHALL at least have a name or an idendtifier, and possibly more than one : (identifier.count() + name.count()) > 0 |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| InsurancePlan | C | 0..* | InsurancePlan | Details of a Health Insurance product/plan provided by an organization | ||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier | SΣC | 1..1 | Identifier | Business Identifier that should be as provided by IRDAI for Indian insurance. | ||||
| status | ?!SΣ | 1..1 | code | draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. | ||||
| type | SΣ | 1..1 | CodeableConcept | Kind of product Binding: InsurancePlan Type (example) | ||||
| 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..1 | 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 | 1..1 | uri | Identity of the terminology system | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 1..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | SΣ | 0..1 | string | Plain text representation of the concept | ||||
| name | SΣC | 1..1 | string | Official name | ||||
| alias | S | 0..* | string | Alternate names | ||||
| period | S | 1..1 | Period | When the product is available | ||||
| ownedBy | SΣ | 1..1 | Reference(Organization) | Plan issuer | ||||
| administeredBy | SΣ | 1..1 | Reference(Organization) | Product administrator | ||||
| coverageArea | SΣ | 0..* | Reference(Location) | Where product applies | ||||
| contact | S | 0..* | BackboneElement | Contact for the product | ||||
| 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 | ||||
| purpose | 0..1 | CodeableConcept | The type of contact Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party. | |||||
| name | 0..1 | HumanName | A name associated with the contact | |||||
| telecom | 0..* | ContactPoint | Contact details (telephone, email, etc.) for a contact | |||||
| address | 0..1 | Address | Visiting or postal addresses for the contact | |||||
| endpoint | 0..* | Reference(Endpoint) | Technical endpoint | |||||
| network | S | 0..* | Reference(Organization) | What networks are Included | ||||
| coverage | S | 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 (example) | |||||
| 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..1 | 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 | 1..1 | uri | Identity of the terminology system | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 1..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | SΣ | 0..1 | string | Plain text representation of the concept | ||||
| network | 0..* | Reference(Organization) | What networks provide coverage | |||||
| benefit | S | 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: Benefit Type (example) | |||||
| 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..1 | 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 | 1..1 | uri | Identity of the terminology system | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 1..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | SΣ | 0..1 | string | Plain text representation of the concept | ||||
| requirement | 0..1 | string | Referral requirements | |||||
| limit | 0..* | 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 | 0..1 | Quantity | Maximum value allowed | |||||
| code | 0..1 | CodeableConcept | Benefit limit details | |||||
| plan | S | 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 | ||||
| identifier | Σ | 0..* | Identifier | Business Identifier for Product | ||||
| type | S | 1..1 | CodeableConcept | Type of plan Binding: Plan Type (example) | ||||
| 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..1 | 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 | 1..1 | uri | Identity of the terminology system | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 1..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | SΣ | 0..1 | string | Plain text representation of the concept | ||||
| coverageArea | SΣ | 0..* | Reference(Location) | Where product applies | ||||
| network | 0..* | Reference(Organization) | What networks provide coverage | |||||
| generalCost | S | 0..* | 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 | |||||
| groupSize | 0..1 | positiveInt | Number of enrollees | |||||
| cost | 0..1 | Money | Cost value | |||||
| comment | 0..1 | string | Additional cost information | |||||
| specificCost | S | 0..* | BackboneElement | Specific 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 | ||||
| category | S | 1..1 | CodeableConcept | General category of benefit Binding: Benefit Category (example) | ||||
| 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..1 | 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 | 1..1 | uri | Identity of the terminology system | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 1..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | SΣ | 0..1 | string | Plain text representation of the concept | ||||
| benefit | 0..* | BackboneElement | Benefits list | |||||
| 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 specific benefit Binding: ProductorService (example) | |||||
| 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..1 | 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 | 1..1 | uri | Identity of the terminology system | ||||
| version | Σ | 0..1 | string | Version of the system - if relevant | ||||
| code | Σ | 1..1 | code | Symbol in syntax defined by the system | ||||
| display | Σ | 1..1 | string | Representation defined by the system | ||||
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text | SΣ | 0..1 | string | Plain text representation of the concept | ||||
| cost | 0..* | BackboneElement | List of the 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 | 1..1 | CodeableConcept | Type of cost | |||||
| applicability | 0..1 | CodeableConcept | in-network | out-of-network | other Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers. | |||||
| qualifiers | 0..* | CodeableConcept | Additional information about the cost | |||||
| value | 0..1 | Quantity | The actual cost value | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | ||||
| InsurancePlan.language | preferred | CommonLanguages
| ||||
| InsurancePlan.status | required | PublicationStatus | ||||
| InsurancePlan.type | example | InsurancePlanType (a valid code from InsurancePlan Type) | ||||
| InsurancePlan.contact.purpose | extensible | ContactEntityType | ||||
| InsurancePlan.coverage.type | example | CoverageType | ||||
| InsurancePlan.coverage.benefit.type | example | BenefitType | ||||
| InsurancePlan.plan.type | example | PlanType (a valid code from Plan Type) | ||||
| InsurancePlan.plan.specificCost.category | example | BenefitCategory | ||||
| InsurancePlan.plan.specificCost.benefit.type | example | ProductorService | ||||
| InsurancePlan.plan.specificCost.benefit.cost.applicability | required | BenefitCostApplicability |
| Id | Grade | Path(s) | Details | Requirements |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from InsurancePlan
Other representations of profile: CSV, Excel, Schematron