<status value="active" /> <experimental value="false" /> <description value="Coverage that is enrolled in on a family rather than individual basis" /> <fhirVersion value="5.0.0" /> <mapping> <identity value="BPCS" /> <name value="Internal BPCS API" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Coverage" /> <baseDefinition value="https://bpcs.exchange/fhir/StructureDefinition/profile-Coverage-family-base" /> <derivation value="constraint" /> <differential> <element id="Coverage.contained"> <path value="Coverage.contained" /> <slicing> <discriminator> <type value="profile" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <min value="1" /> </element> <element id="Coverage.contained:provenance"> <path value="Coverage.contained" /> <sliceName value="provenance" /> <short value="Creation/Update/etc. Metadata" /> <definition value="Nested Provenance information referring to this resource that describes the creation, and sometimes the most recent update and/or inactivation of the record, specifically who was responsible and when it occurred" /> <min value="1" /> <type> <code value="Provenance" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/profile-Provenance" /> </type> <mustSupport value="true" /> </element> <element id="Coverage.extension:overpaidDeductible"> <path value="Coverage.extension" /> <sliceName value="overpaidDeductible" /> <type> <code value="Extension" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-OverpaidDeductibleStatus" /> </type> <mustSupport value="true" /> </element> <element id="Coverage.extension:privateInsuranceContribution"> <path value="Coverage.extension" /> <sliceName value="privateInsuranceContribution" /> <type> <code value="Extension" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-PrivateInsuranceContribution" /> </type> <mustSupport value="true" /> </element> <element id="Coverage.extension:basePrivateInsuranceCredit"> <path value="Coverage.extension" /> <sliceName value="basePrivateInsuranceCredit" /> <type> <code value="Extension" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-BasePrivateInsuranceCredit" /> </type> <mustSupport value="true" /> </element> <element id="Coverage.extension:baseDeductible"> <path value="Coverage.extension" /> <sliceName value="baseDeductible" /> <type> <code value="Extension" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-BaseDeductible" /> </type> <mustSupport value="true" /> </element> <element id="Coverage.extension:problemCode"> <path value="Coverage.extension" /> <sliceName value="problemCode" /> <type> <code value="Extension" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/ext-Resource-ProblemCode" /> </type> <mustSupport value="true" /> <mapping> <identity value="BPCS" /> <map value="FamilyDTO.problemCodes" /> </mapping> </element> <element id="Coverage.extension:problemCode.value[x]"> <path value="Coverage.extension.value[x]" /> <binding> <strength value="required" /> <valueSet value="https://bpcs.exchange/fhir/ValueSet/vs-Problem-family" /> </binding> </element> <element id="Coverage.costToBeneficiary"> <path value="Coverage.costToBeneficiary" /> <slicing> <discriminator> <type value="value" /> <path value="type" /> </discriminator> <rules value="open" /> </slicing> <comment value="This is the application number" /> <min value="4" /> <mustSupport value="true" /> </element> <element id="Coverage.costToBeneficiary:deductible"> <path value="Coverage.costToBeneficiary" /> <sliceName value="deductible" /> <min value="4" /> <mustSupport value="true" /> </element> <element id="Coverage.costToBeneficiary:deductible.extension"> <path value="Coverage.costToBeneficiary.extension" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Coverage.costToBeneficiary:deductible.extension:insuranceCredit"> <path value="Coverage.costToBeneficiary.extension" /> <sliceName value="insuranceCredit" /> <min value="1" /> <type> <code value="Extension" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-InsuranceCredit" /> </type> <mustSupport value="true" /> </element> <element id="Coverage.costToBeneficiary:deductible.extension:reachedDate"> <path value="Coverage.costToBeneficiary.extension" /> <sliceName value="reachedDate" /> <type> <code value="Extension" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-DeductibleDateReached" /> </type> <mustSupport value="true" /> </element> <element id="Coverage.costToBeneficiary:deductible.extension:deductiblePct"> <path value="Coverage.costToBeneficiary.extension" /> <sliceName value="deductiblePct" /> <type> <code value="Extension" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-DeductiblePct" /> </type> <mustSupport value="true" /> </element> <element id="Coverage.costToBeneficiary:deductible.type"> <path value="Coverage.costToBeneficiary.type" /> <min value="1" /> <patternCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/coverage-copay-type" /> <code value="deductible" /> </coding> </patternCodeableConcept> </element> <element id="Coverage.costToBeneficiary:deductible.unit"> <path value="Coverage.costToBeneficiary.unit" /> <min value="1" /> <patternCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/benefit-unit" /> <code value="family" /> </coding> </patternCodeableConcept> </element> <element id="Coverage.costToBeneficiary:deductible.term"> <path value="Coverage.costToBeneficiary.term" /> <min value="1" /> <type> <code value="CodeableConcept" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/profile-CodeableConcept-simple" /> </type> <mustSupport value="true" /> <binding> <strength value="required" /> <valueSet value="https://bpcs.exchange/fhir/ValueSet/vs-Term" /> </binding> </element> <element id="Coverage.costToBeneficiary:deductible.value[x]"> <path value="Coverage.costToBeneficiary.value[x]" /> <min value="1" /> <type> <code value="Money" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/profile-Money-CAD" /> </type> <type> <code value="Quantity" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/profile-Quantity-percentage" /> </type> <mustSupport value="true" /> <mapping> <identity value="BPCS" /> <map value="FamilyExpensesDTO.deductLvl1, deductLvl2, deductLvl3, deductLvl4 (based on quarter), FamilyHistoryDTO.dedLvl1Period1Ytd, dedLvl1Period2Ytd, dedLvl1Period3Ytd, dedLvl1Period4Ytd" /> </mapping> </element> </differential> </StructureDefinition>