FHIR Implementation Guide for ABDM
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This page is part of the FHIR Implementation Guide for ABDM (v6.0.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Extension: StructureDefinition/Claim-SupportingInfoRequirement

Official URL: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement Version: 6.0.0
Draft as of 2024-01-24 Computable Name: ClaimSupportingInfoRequirement

This extension enumerates essential documentation necessary for a health insurance product. It provides a comprehensive list of documents such as identification proofs or medical records needed during the claims process.

Context of Use

This extension may be used on the following element(s):

  • Element ID InsurancePlan
  • Element ID InsurancePlan.coverage

Usage info

Usage:

Formal Views of Extension Content

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

This structure is derived from Extension

Summary

Complex Extension: This extension enumerates essential documentation necessary for a health insurance product. It provides a comprehensive list of documents such as identification proofs or medical records needed during the claims process.

  • category: CodeableConcept: An Extension
  • code: CodeableConcept: An Extension
  • documentationUrl: url: An Extension

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..*ExtensionEnumerates essential documentation necessary for a health insurance product during claim processing. e.g. proof of identity, proof of address
... extension 2..*ExtensionExtension
... extension:category 1..1ExtensionClassification of the supplied information e.g proof of identity, proof of address.
.... url 1..1uri"category"
.... value[x] 0..1CodeableConceptValue of extension
Binding: SupportingInfo Category (example): The valueset used for additional information category codes.

..... coding 0..1CodingCode defined by a terminology system
...... system 1..1uriIdentity of the terminology system
...... code 1..1codeSymbol in syntax defined by the system
...... display 1..1stringRepresentation defined by the system
... extension:code 1..*ExtensionAdditional content defined by implementations e.g ABHA ID, Adhar Card
.... url 1..1uri"code"
.... value[x] 0..1CodeableConceptValue of extension
Binding: SupportingInfo Code (example): The valueset used for additional information codes.

..... coding 0..1CodingCode defined by a terminology system
...... system 1..1uriIdentity of the terminology system
...... code 1..1codeSymbol in syntax defined by the system
...... display 1..1stringRepresentation defined by the system
.... url 1..1uri"documentationUrl"
.... value[x] 0..1urlValue of extension
... url 1..1uri"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement"
... value[x] 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..*ExtensionEnumerates essential documentation necessary for a health insurance product during claim processing. e.g. proof of identity, proof of address
... id 0..1stringUnique id for inter-element referencing
... Slices for extension 2..*ExtensionExtension
Slice: Unordered, Open by value:url
... extension:category 1..1ExtensionClassification of the supplied information e.g proof of identity, proof of address.
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1uri"category"
.... value[x] 0..1CodeableConceptValue of extension
Binding: SupportingInfo Category (example): The valueset used for additional information category codes.

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ0..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1uri"code"
.... value[x] 0..1CodeableConceptValue of extension
Binding: SupportingInfo Code (example): The valueset used for additional information codes.

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ0..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... extension:documentationUrl 0..1ExtensionUrl of the document or template that needs to be filled.
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1uri"documentationUrl"
.... value[x] 0..1urlValue of extension
... url 1..1uri"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement"

doco Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: This extension enumerates essential documentation necessary for a health insurance product. It provides a comprehensive list of documents such as identification proofs or medical records needed during the claims process.

  • category: CodeableConcept: An Extension
  • code: CodeableConcept: An Extension
  • documentationUrl: url: An Extension

Differential View

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..*ExtensionEnumerates essential documentation necessary for a health insurance product during claim processing. e.g. proof of identity, proof of address
... extension 2..*ExtensionExtension
... extension:category 1..1ExtensionClassification of the supplied information e.g proof of identity, proof of address.
.... url 1..1uri"category"
.... value[x] 0..1CodeableConceptValue of extension
Binding: SupportingInfo Category (example): The valueset used for additional information category codes.

..... coding 0..1CodingCode defined by a terminology system
...... system 1..1uriIdentity of the terminology system
...... code 1..1codeSymbol in syntax defined by the system
...... display 1..1stringRepresentation defined by the system
... extension:code 1..*ExtensionAdditional content defined by implementations e.g ABHA ID, Adhar Card
.... url 1..1uri"code"
.... value[x] 0..1CodeableConceptValue of extension
Binding: SupportingInfo Code (example): The valueset used for additional information codes.

..... coding 0..1CodingCode defined by a terminology system
...... system 1..1uriIdentity of the terminology system
...... code 1..1codeSymbol in syntax defined by the system
...... display 1..1stringRepresentation defined by the system
.... url 1..1uri"documentationUrl"
.... value[x] 0..1urlValue of extension
... url 1..1uri"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement"
... value[x] 0..0

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..*ExtensionEnumerates essential documentation necessary for a health insurance product during claim processing. e.g. proof of identity, proof of address
... id 0..1stringUnique id for inter-element referencing
... Slices for extension 2..*ExtensionExtension
Slice: Unordered, Open by value:url
... extension:category 1..1ExtensionClassification of the supplied information e.g proof of identity, proof of address.
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1uri"category"
.... value[x] 0..1CodeableConceptValue of extension
Binding: SupportingInfo Category (example): The valueset used for additional information category codes.

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ0..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1uri"code"
.... value[x] 0..1CodeableConceptValue of extension
Binding: SupportingInfo Code (example): The valueset used for additional information codes.

..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding Σ0..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ1..1codeSymbol in syntax defined by the system
...... display Σ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... extension:documentationUrl 0..1ExtensionUrl of the document or template that needs to be filled.
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... url 1..1uri"documentationUrl"
.... value[x] 0..1urlValue of extension
... url 1..1uri"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement"

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSetURI
Extension.extension:category.value[x]exampleSupportingInfoCategory (a valid code from SupportingInfo Category)
https://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-supportinginfo-category
from this IG
Extension.extension:code.value[x]exampleSupportingInfoCode
https://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-supportinginfo-code
from this IG

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()