<status value="active" /> <experimental value="false" /> <date value="2023-11-08T18:50:34.9562827+00:00" /> <publisher value="b.Well Connected Health" /> <description value="Insurance coverage for a beneficiary" /> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166" /> <code value="US" /> <display value="United States of America" /> </coding> <text value="United States of America" /> </jurisdiction> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="Coverage" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Coverage" /> <derivation value="constraint" /> <differential> <element id="Coverage.id"> <path value="Coverage.id" /> <min value="1" /> </element> <element id="Coverage.meta"> <path value="Coverage.meta" /> <label value="meta" /> <min value="1" /> <type> <code value="Meta" /> <profile value="https://fhir.icanbwell.com/4_0_0/StructureDefinition/de-meta" /> </type> </element> <element id="Coverage.identifier"> <path value="Coverage.identifier" /> <label value="identifier" /> <slicing> <description value="slice by types" /> <rules value="open" /> </slicing> <short value="a value to identify the resource by" /> <type> <code value="Identifier" /> <profile value="https://fhir.icanbwell.com/4_0_0/StructureDefinition/de-identifier" /> </type> </element> <element id="Coverage.identifier.use"> <path value="Coverage.identifier.use" /> <label value="identifier" /> </element> <element id="Coverage.identifier:identifier-member-number"> <path value="Coverage.identifier" /> <sliceName value="identifier-member-number" /> <label value="member-number" /> <code> <system value="https://www.icanbwell.com/product-feature-code" /> </code> <short value="insurance coverage's unique identifier for the individual" /> <requirements value="system = source URI" /> <patternIdentifier id="member-number"> <type> <coding id="member-number-type"> <system value="http://terminology.hl7.org/CodeSystem/v2-0203" /> <code value="MB" /> </coding> </type> </patternIdentifier> </element> <element id="Coverage.identifier:medicare-beneficiary-id"> <path value="Coverage.identifier" /> <sliceName value="medicare-beneficiary-id" /> <label value="medicare-beneficiary-id" /> <short value="Medicare Beneficiary Identifier (US)" /> <patternIdentifier id="mbi"> <type> <coding id="mbi-type"> <system value="http://terminology.hl7.org/CodeSystem/v2-0203" /> <code value="MC" /> </coding> </type> <system value="http://hl7.org/fhir/sid/us-mbi" /> </patternIdentifier> </element> <element id="Coverage.status"> <path value="Coverage.status" /> <short value="Indicates validity of the resource" /> <comment value="record should remain active, even after coverage termination" /> <mustSupport value="true" /> </element> <element id="Coverage.type"> <path value="Coverage.type" /> <short value="Type of coverage represented" /> <type> <code value="CodeableConcept" /> <profile value="https://fhir.icanbwell.com/4_0_0/StructureDefinition/de-codeable-concept" /> </type> <mustSupport value="true" /> <binding> <strength value="extensible" /> <valueSet value="https://www.hl7.org/fhir/us/bwell/bwell-vs-coverage-type" /> </binding> </element> <element id="Coverage.subscriber"> <path value="Coverage.subscriber" /> <short value="Subscriber of the insurance plan policy" /> <comment value="this may be the same individual as the beneficiary" /> <type> <code value="Reference" /> <targetProfile value="https://fhir.icanbwell.com/4_0_0/StructureDefinition/pr-patient" /> </type> <mustSupport value="true" /> </element> <element id="Coverage.subscriberId"> <path value="Coverage.subscriberId" /> <short value="The subscribing individual's unique member number" /> <mustSupport value="true" /> </element> <element id="Coverage.beneficiary"> <path value="Coverage.beneficiary" /> <short value="Beneficiary of the insurance plan coverage" /> <type> <code value="Reference" /> <targetProfile value="https://fhir.icanbwell.com/4_0_0/StructureDefinition/pr-patient" /> </type> <mustSupport value="true" /> </element> <element id="Coverage.dependent"> <path value="Coverage.dependent" /> <short value="Sequence number for the dependent" /> <requirements value="Only needed if the individual is a dependent; If the individual is the subscriber, this should be omitted" /> <mustSupport value="true" /> </element> <element id="Coverage.relationship"> <path value="Coverage.relationship" /> <type> <code value="CodeableConcept" /> <profile value="https://fhir.icanbwell.com/4_0_0/StructureDefinition/de-codeable-concept" /> </type> <mustSupport value="true" /> <binding> <strength value="extensible" /> <valueSet value="https://www.hl7.org/fhir/us/bwell/bwell-vs-relationship" /> </binding> </element> <element id="Coverage.period"> <path value="Coverage.period" /> <short value="Effective date range" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Coverage.payor"> <path value="Coverage.payor" /> <short value="Paying entity" /> <comment value="Typically the Insurance Company" /> <type> <code value="Reference" /> <targetProfile value="https://fhir.icanbwell.com/4_0_0/StructureDefinition/pr-insurance-company" /> <targetProfile value="https://fhir.icanbwell.com/4_0_0/StructureDefinition/pr-partner-organization" /> </type> <mustSupport value="true" /> </element> <element id="Coverage.class"> <path value="Coverage.class" /> <slicing> <description value="Slice by type" /> <rules value="open" /> </slicing> <definition value="The codes provided on the health card which identify or confirm the specific policy for the insurer." /> <mustSupport value="true" /> </element> <element id="Coverage.class.type"> <path value="Coverage.class.type" /> <short value="Coded value to describe the class" /> <definition value="The policy classifications, eg. Group, Plan, Class, etc." /> <type> <code value="CodeableConcept" /> <profile value="https://fhir.icanbwell.com/4_0_0/StructureDefinition/de-codeable-concept" /> </type> <example> <label value="Group type" /> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/coverage-class" /> <code value="group" /> </coding> </valueCodeableConcept> </example> <mustSupport value="true" /> <binding> <strength value="extensible" /> <valueSet value="https://www.hl7.org/fhir/us/bwell/bwell-vs-coverage-class-type" /> </binding> </element> <element id="Coverage.class.value"> <path value="Coverage.class.value" /> <mustSupport value="true" /> </element> <element id="Coverage.class.name"> <path value="Coverage.class.name" /> <mustSupport value="true" /> </element> <element id="Coverage.class:Group"> <path value="Coverage.class" /> <sliceName value="Group" /> <short value="Insurance coverage group" /> </element> <element id="Coverage.class:Group.id"> <path value="Coverage.class.id" /> <min value="1" /> </element> <element id="Coverage.class:Group.type"> <path value="Coverage.class.type" /> <patternCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/coverage-class" /> <code value="group" /> </coding> </patternCodeableConcept> </element> <element id="Coverage.class:Subgroup"> <path value="Coverage.class" /> <sliceName value="Subgroup" /> <short value="Insurance coverage subgroup" /> </element> <element id="Coverage.class:Subgroup.id"> <path value="Coverage.class.id" /> <min value="1" /> </element> <element id="Coverage.class:Subgroup.type"> <path value="Coverage.class.type" /> <patternCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/coverage-class" /> <code value="subgroup" /> </coding> </patternCodeableConcept> </element> </differential> </StructureDefinition>