<status value="active" /> <experimental value="false" /> <description value="The set of coverage elements available for population when recording a new bpcs individual coverage" /> <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="http://hl7.org/fhir/StructureDefinition/Coverage" /> <derivation value="constraint" /> <differential> <element id="Coverage"> <path value="Coverage" /> <mapping> <identity value="BPCS" /> <map value="RecipientPlanDTO" /> </mapping> </element> <element id="Coverage.extension:parent"> <path value="Coverage.extension" /> <sliceName value="parent" /> <type> <code value="Extension" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/ext-Coverage-Parent" /> </type> <mustSupport value="true" /> <mapping> <identity value="BPCS" /> <map value="**NEW** This will be information from the Application associated with this coverage. Specific syntax will be 'Coverage/' + [applicationNum] + '.' + [odbNum] + '.' + [start date] (no separators in date)" /> </mapping> </element> <element id="Coverage.status"> <path value="Coverage.status" /> <comment value="This will be 'active' or 'cancelled', depending on whether the coverage has an end date, where the current date is less than the end date." /> <mustSupport value="true" /> </element> <element id="Coverage.kind"> <path value="Coverage.kind" /> <patternCode value="insurance" /> <mustSupport value="true" /> </element> <element id="Coverage.beneficiary"> <path value="Coverage.beneficiary" /> <definition value="The patient for whom the insurance applies" /> <type> <code value="Reference" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/profile-Reference-rest" /> <targetProfile value="https://bpcs.exchange/fhir/StructureDefinition/profile-Patient-search" /> </type> <mustSupport value="true" /> <mapping> <identity value="BPCS" /> <map value="RecipientPlanDTO.odbNum, RecipientDeductibleDTO.odbNum" /> </mapping> </element> <element id="Coverage.period"> <path value="Coverage.period" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Coverage.period.start"> <path value="Coverage.period.start" /> <short value="coverageBegin/enrollmentEffectiveDate/registrationDate/mbrshpStartDate" /> <definition value="The earliest date on which benefits under this policy were available" /> <mustSupport value="true" /> <mapping> <identity value="BPCS" /> <map value="RecipientPlanDTO.effDate, RecipientDeductibleDTO.benefitYear (matching), FamilyMemberDTO.startDate, FamilyMemberHistoryDTO.membershipStartDate" /> </mapping> </element> <element id="Coverage.period.end"> <path value="Coverage.period.end" /> <definition value="The last date on which benefits under this policy were/will be available" /> <mustSupport value="true" /> <mapping> <identity value="BPCS" /> <map value="RecipientPlanDTO.endDate, RecipientDeductibleDTO.benefitYear (matching), FamilyMemberDTO.startDate, FamilyMemberHistoryDTO.membershipEndDate" /> </mapping> </element> <element id="Coverage.insurer"> <path value="Coverage.insurer" /> <min value="1" /> <patternReference> <reference value="Organization/bpcs" /> </patternReference> <mustSupport value="true" /> </element> <element id="Coverage.class"> <path value="Coverage.class" /> <slicing> <discriminator> <type value="value" /> <path value="type" /> </discriminator> <rules value="closed" /> </slicing> <min value="2" /> <mustSupport value="true" /> </element> <element id="Coverage.class:program"> <path value="Coverage.class" /> <sliceName value="program" /> <short value="Coverage plan info" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Coverage.class:program.type"> <path value="Coverage.class.type" /> <patternCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/coverage-class" /> <code value="plan" /> </coding> </patternCodeableConcept> <mustSupport value="true" /> </element> <element id="Coverage.class:program.value"> <path value="Coverage.class.value" /> <mustSupport value="true" /> </element> <element id="Coverage.class:program.value.system"> <path value="Coverage.class.value.system" /> <min value="1" /> <patternUri value="https://bpcs.exchange/fhir/CodeSystem/cs-ProgramPlan" /> </element> <element id="Coverage.class:program.value.value"> <path value="Coverage.class.value.value" /> <short value="BPCS Program id" /> <comment value="The binding is extensible to allow for the addition of new codes. Codes must be found in the current expansion of the value set." /> <min value="1" /> <mustSupport value="true" /> <binding> <strength value="extensible" /> <valueSet value="https://bpcs.exchange/fhir/ValueSet/vs-Program" /> </binding> <mapping> <identity value="BPCS" /> <map value="RecipientPlanDTO.program, RecipientDeductibleDTO.program (matching)" /> </mapping> </element> <element id="Coverage.class:plan"> <path value="Coverage.class" /> <sliceName value="plan" /> <short value="BPCS plan info" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Coverage.class:plan.type"> <path value="Coverage.class.type" /> <patternCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/coverage-class" /> <code value="subplan" /> </coding> </patternCodeableConcept> <mustSupport value="true" /> </element> <element id="Coverage.class:plan.value"> <path value="Coverage.class.value" /> <mustSupport value="true" /> </element> <element id="Coverage.class:plan.value.system"> <path value="Coverage.class.value.system" /> <min value="1" /> <patternUri value="https://bpcs.exchange/fhir/CodeSystem/cs-ProgramPlan" /> </element> <element id="Coverage.class:plan.value.value"> <path value="Coverage.class.value.value" /> <short value="BPCS plan id" /> <comment value="The binding is extensible to allow for the addition of new codes. Codes must be found in the current expansion of the value set." /> <min value="1" /> <mustSupport value="true" /> <binding> <strength value="extensible" /> <valueSet value="https://bpcs.exchange/fhir/ValueSet/vs-Plan" /> </binding> <mapping> <identity value="BPCS" /> <map value="RecipientPlanDTO.plan" /> </mapping> </element> </differential> </StructureDefinition>