{ "resourceType": "StructureDefinition", "id": "SatuSehatCoverage", "url": "https://fhir.kemkes.go.id/r4/StructureDefinition/Coverage", "name": "SatuSehatCoverage", "title": "Satu Sehat Coverage", "status": "active", "date": "2024-01-01", "description": "Defines the ID Core constraints and extensions on the Coverage resource for the minimal set of data to state the coverage information for patient.", "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "Coverage", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Coverage", "derivation": "constraint", "snapshot": { "element": [ { "id": "Coverage", "path": "Coverage", "short": "Insurance or medical plan or a payment agreement", "definition": "Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.", "comment": "The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers.", "min": 0, "max": "*", "base": { "path": "Coverage", "min": 0, "max": "*" }, "constraint": [ { "key": "dom-2", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources", "expression": "contained.contained.empty()", "xpath": "not(parent::f:contained and f:contained)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-4", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated", "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-3", "severity": "error", "human": "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", "expression": "contained.where(((id.exists() and ('#'+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(uri) = '#').exists()).not()).trace('unmatched', id).empty()", "xpath": "not(exists(for $contained in f:contained return $contained[not(exists(parent::*/descendant::f:reference/@value=concat('#', $contained/*/f:id/@value)) or exists(descendant::f:reference[@value='#']))]))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation", "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." } ], "key": "dom-6", "severity": "warning", "human": "A resource should have narrative for robust management", "expression": "text.`div`.exists()", "xpath": "exists(f:text/h:div)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-5", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a security label", "expression": "contained.meta.security.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:security))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" } ], "mustSupport": false, "isModifier": false, "mapping": [ { "identity": "rim", "map": "Entity. Role, or Act" }, { "identity": "workflow", "map": "Event" }, { "identity": "rim", "map": "Coverage" }, { "identity": "w5", "map": "financial.support" } ] }, { "id": "Coverage.id", "path": "Coverage.id", "short": "Logical id of this artifact", "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.", "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.", "min": 0, "max": "1", "base": { "path": "Resource.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "id" } ], "code": "id" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.meta", "path": "Coverage.meta", "short": "Metadata about the resource", "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.", "min": 0, "max": "1", "base": { "path": "Resource.meta", "min": 0, "max": "1" }, "type": [ { "code": "Meta" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.implicitRules", "path": "Coverage.implicitRules", "short": "A set of rules under which this content was created", "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.", "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.", "min": 0, "max": "1", "base": { "path": "Resource.implicitRules", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": true, "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation", "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.language", "path": "Coverage.language", "short": "Language of the resource content", "definition": "The base language in which the resource is written.", "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).", "min": 0, "max": "1", "base": { "path": "Resource.language", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet", "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages" }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "Language" } ], "strength": "preferred", "description": "IETF language tag", "valueSet": "http://hl7.org/fhir/ValueSet/languages" }, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.text", "path": "Coverage.text", "short": "Text summary of the resource, for human interpretation", "definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.", "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.", "alias": [ "narrative", "html", "xhtml", "display" ], "min": 0, "max": "1", "base": { "path": "DomainResource.text", "min": 0, "max": "1" }, "type": [ { "code": "Narrative" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" }, { "identity": "rim", "map": "Act.text?" } ] }, { "id": "Coverage.contained", "path": "Coverage.contained", "short": "Contained, inline Resources", "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.", "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.", "alias": [ "inline resources", "anonymous resources", "contained resources" ], "min": 0, "max": "*", "base": { "path": "DomainResource.contained", "min": 0, "max": "*" }, "type": [ { "code": "Resource" } ], "constraint": [ { "key": "dom-r4b", "severity": "warning", "human": "Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems", "expression": "($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)", "xpath": "not(f:Citation|f:Evidence|f:EvidenceReport|f:EvidenceVariable|f:MedicinalProductDefinition|f:PackagedProductDefinition|f:AdministrableProductDefinition|f:Ingredient|f:ClinicalUseDefinition|f:RegulatedAuthorization|f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic) or not(parent::f:Citation|parent::f:Evidence|parent::f:EvidenceReport|parent::f:EvidenceVariable|parent::f:MedicinalProductDefinition|parent::f:PackagedProductDefinition|parent::f:AdministrableProductDefinition|parent::f:Ingredient|parent::f:ClinicalUseDefinition|parent::f:RegulatedAuthorization|parent::f:SubstanceDefinition|f:SubscriptionStatus|f:SubscriptionTopic)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "Entity. Role, or Act" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.extension", "path": "Coverage.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.extension:primaryCareProvider", "path": "Coverage.extension", "sliceName": "primaryCareProvider", "short": "Primary Care Provider", "definition": "Berisi data pihak yang menjadi provider utama dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Organization.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "1", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": [ "https://fhir.kemkes.go.id/r4/StructureDefinition/PrimaryCareProvider" ] } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.modifierExtension", "path": "Coverage.modifierExtension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Extensions that cannot be ignored", "definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mustSupport": false, "isModifier": true, "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them", "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.identifier", "path": "Coverage.identifier", "short": "Business Identifier for the coverage", "definition": "Berisi data ID lokal terkait program yang dijalankan dengan tipe data Identifier.", "comment": "The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependant.", "requirements": "Allows coverages to be distinguished and referenced.", "min": 0, "max": "*", "base": { "path": "Coverage.identifier", "min": 0, "max": "*" }, "type": [ { "code": "Identifier" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)" }, { "identity": "rim", "map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" }, { "identity": "servd", "map": "Identifier" }, { "identity": "workflow", "map": "Event.identifier" }, { "identity": "w5", "map": "FiveWs.identifier" }, { "identity": "cdanetv4", "map": "C02" }, { "identity": "v2", "map": "IN1-2" }, { "identity": "rim", "map": ".id" }, { "identity": "cpha3pharm", "map": "C.32, C.33, C.39" } ] }, { "id": "Coverage.status", "path": "Coverage.status", "short": "active | cancelled | draft | entered-in-error", "definition": "Berisi data yang menyatakan status Coverage saat ini dengan tipe data code, yang nilainya mengacu pada data terminologi Financial Resource Status Codes.", "comment": "This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid.", "requirements": "Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.", "min": 1, "max": "1", "base": { "path": "Coverage.status", "min": 1, "max": "1" }, "type": [ { "code": "code" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": true, "isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid", "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CoverageStatus" } ], "strength": "required", "description": "A code specifying the state of the resource instance.", "valueSet": "http://hl7.org/fhir/ValueSet/fm-status|4.3.0" }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "workflow", "map": "Event.status" }, { "identity": "w5", "map": "FiveWs.status" }, { "identity": "rim", "map": "Act.status" } ] }, { "id": "Coverage.type", "path": "Coverage.type", "short": "Coverage category such as medical or accident", "definition": "Berisi data jenis pertanggungan (misalnya program sosial, rencana medis, pertanggungan kecelakaan, kesehatan kelompok, atau pembayaran oleh organisasi maupun individu) dengan tipe data CodeableConcept.", "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.", "requirements": "The order of application of coverages is dependent on the types of coverage.", "min": 0, "max": "1", "base": { "path": "Coverage.type", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CoverageType" } ], "strength": "preferred", "description": "The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.", "valueSet": "http://hl7.org/fhir/ValueSet/coverage-type" }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE" }, { "identity": "rim", "map": "CD" }, { "identity": "orim", "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD" }, { "identity": "w5", "map": "FiveWs.class" }, { "identity": "v2", "map": "IN1-15" } ] }, { "id": "Coverage.type.id", "path": "Coverage.type.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "id" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.type.extension", "path": "Coverage.type.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.type.coding", "path": "Coverage.type.coding", "short": "Code defined by a terminology system", "definition": "Berisi data jenis pertanggungan (misalnya program sosial, rencana medis, pertanggungan kecelakaan, kesehatan kelompok, atau pembayaran oleh organisasi maupun individu) dengan tipe data Coding. Nilainya mengacu pada data terminologi Coverage Type and Self-Pay Codes.", "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" }, { "identity": "rim", "map": "CV" }, { "identity": "orim", "map": "fhir:Coding rdfs:subClassOf dt:CDCoding" }, { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "Coverage.type.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Coverage.type.text", "short": "Plain text representation of the concept", "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.", "comment": "Very often the text is the same as a displayName of one of the codings.", "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.", "min": 0, "max": "1", "base": { "path": "CodeableConcept.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "C*E.9. But note many systems use C*E.2 for this" }, { "identity": "rim", "map": "./originalText[mediaType/code=\"text/plain\"]/data" }, { "identity": "orim", "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" } ] }, { "id": "Coverage.policyHolder", "path": "Coverage.policyHolder", "short": "Owner of the policy", "definition": "Berisi data pihak yang memiliki polis asuransi dengan ID lokal terkait program yang dijalankan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient | RelatedPerson | Organization.", "comment": "For example: may be an individual, corporation or the subscriber's employer.", "requirements": "This provides employer information in the case of Worker's Compensation and other policies.", "min": 0, "max": "1", "base": { "path": "Coverage.policyHolder", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Organization" ] } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "w5", "map": "FiveWs.subject[x]" }, { "identity": "cdanetv4", "map": "D01 through D09" }, { "identity": "v2", "map": "IN1-16, 18, 19-name of insured, address, date of birth" }, { "identity": "cpha3pharm", "map": "C.35" }, { "identity": "w5", "map": "FiveWs.subject" } ] }, { "id": "Coverage.subscriber", "path": "Coverage.subscriber", "short": "Subscriber to the policy", "definition": "Berisi data pihak yang mendaftar atau kepada siapa manfaat polis diberikan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient | RelatedPerson.", "comment": "May be self or a parent in the case of dependants.", "requirements": "This is the party who is entitled to the benfits under the policy.", "min": 0, "max": "1", "base": { "path": "Coverage.subscriber", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson" ] } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "w5", "map": "FiveWs.subject[x]" }, { "identity": "cdanetv4", "map": "D01 through D09" }, { "identity": "v2", "map": "IN1-16, 18, 19-name of insured, address, date of birth" }, { "identity": "cpha3pharm", "map": "C.35" }, { "identity": "w5", "map": "FiveWs.subject" } ] }, { "id": "Coverage.subscriberId", "path": "Coverage.subscriberId", "short": "ID assigned to the subscriber", "definition": "Berisi data ID dari penanggung terkait program yang dijalankan dengan tipe data string.", "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size", "requirements": "The insurer requires this identifier on correspondance and claims (digital and otherwise).", "min": 0, "max": "1", "base": { "path": "Coverage.subscriberId", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "w5", "map": "FiveWs.subject[x]" }, { "identity": "cdanetv4", "map": "D01 through D09" }, { "identity": "v2", "map": "IN1-16, 18, 19-name of insured, address, date of birth" }, { "identity": "cpha3pharm", "map": "C.35" }, { "identity": "w5", "map": "FiveWs.subject" } ] }, { "id": "Coverage.beneficiary", "path": "Coverage.beneficiary", "short": "Plan beneficiary", "definition": "Berisi data pihak yang mendapat manfaat dari pertanggungan asuransi dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient.", "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.", "requirements": "This is the party who receives treatment for which the costs are reimbursed under the coverage.", "min": 1, "max": "1", "base": { "path": "Coverage.beneficiary", "min": 1, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient" ] } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "workflow", "map": "Event.subject" }, { "identity": "w5", "map": "FiveWs.subject[x]" }, { "identity": "cdanetv4", "map": "D01 through D09" }, { "identity": "v2", "map": "IN1-16, 18, 19-name of insured, address, date of birth" }, { "identity": "cpha3pharm", "map": "C.35" }, { "identity": "w5", "map": "FiveWs.subject" } ] }, { "id": "Coverage.dependent", "path": "Coverage.dependent", "short": "Dependent number", "definition": "Berisi data ID lokal untuk yang tertanggung terkait program yang dijalankan dengan tipe data string.", "comment": "Periodically the member number is constructed from the subscriberId and the dependant number.", "requirements": "For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary.", "min": 0, "max": "1", "base": { "path": "Coverage.dependent", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "cdanetv4", "map": "C17" }, { "identity": "v2", "map": "- No exact HL7 v2 equivalent concept seems to exist;" } ] }, { "id": "Coverage.relationship", "path": "Coverage.relationship", "short": "Beneficiary relationship to the subscriber", "definition": "Berisi data hubungan antara beneficiary dan subscriber dengan tipe data CodeableConcept.", "comment": "Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others.", "requirements": "To determine relationship between the patient and the subscriber to determine coordination of benefits.", "min": 0, "max": "1", "base": { "path": "Coverage.relationship", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "Relationship" } ], "strength": "extensible", "description": "The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).", "valueSet": "http://hl7.org/fhir/ValueSet/subscriber-relationship" }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE" }, { "identity": "rim", "map": "CD" }, { "identity": "orim", "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD" }, { "identity": "cdanetv4", "map": "C03" } ] }, { "id": "Coverage.relationship.id", "path": "Coverage.relationship.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "id" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.relationship.extension", "path": "Coverage.relationship.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.relationship.coding", "path": "Coverage.relationship.coding", "short": "Code defined by a terminology system", "definition": "Berisi data hubungan antara beneficiary dan subscriber dengan tipe data Coding. Nilainya mengacu pada data terminologi SubscriberPolicyholder Relationship Codes.", "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" }, { "identity": "rim", "map": "CV" }, { "identity": "orim", "map": "fhir:Coding rdfs:subClassOf dt:CDCoding" }, { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "Coverage.relationship.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Coverage.relationship.text", "short": "Plain text representation of the concept", "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.", "comment": "Very often the text is the same as a displayName of one of the codings.", "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.", "min": 0, "max": "1", "base": { "path": "CodeableConcept.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "C*E.9. But note many systems use C*E.2 for this" }, { "identity": "rim", "map": "./originalText[mediaType/code=\"text/plain\"]/data" }, { "identity": "orim", "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" } ] }, { "id": "Coverage.period", "path": "Coverage.period", "short": "Coverage start and end dates", "definition": "Berisi data jangka waktu selama pertanggungan berlaku dengan tipe data Period.", "comment": "A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).", "requirements": "Some insurers require the submission of the coverage term.", "min": 0, "max": "1", "base": { "path": "Coverage.period", "min": 0, "max": "1" }, "type": [ { "code": "Period" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "per-1", "severity": "error", "human": "If present, start SHALL have a lower value than end", "expression": "start.hasValue().not() or end.hasValue().not() or (start <= end)", "xpath": "not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))", "source": "http://hl7.org/fhir/StructureDefinition/Period" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "DR" }, { "identity": "rim", "map": "IVL[lowClosed=\"true\" and highClosed=\"true\"] or URG[lowClosed=\"true\" and highClosed=\"true\"]" }, { "identity": "workflow", "map": "Event.occurrence[x]" }, { "identity": "w5", "map": "FiveWs.done[x]" }, { "identity": "v2", "map": "IN1-12 / IN1-13" }, { "identity": "rim", "map": "Act.effectiveTime" } ] }, { "id": "Coverage.payor", "path": "Coverage.payor", "short": "Issuer of the policy", "definition": "Berisi data penjamin program atau program atau pembayar dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient | RelatedPerson | Organization.", "comment": "May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).\nFor selfpay it may provide multiple paying persons and/or organizations.", "requirements": "Need to identify the issuer to target for claim processing and for coordination of benefit processing.", "min": 1, "max": "*", "base": { "path": "Coverage.payor", "min": 1, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson" ] } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "w5", "map": "FiveWs.author" }, { "identity": "cdanetv4", "map": "A05" }, { "identity": "v2", "map": "IN1-3" }, { "identity": "cpha3pharm", "map": "C.30" } ] }, { "id": "Coverage.class", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Class" } ], "path": "Coverage.class", "short": "Additional coverage classifications", "definition": "Berisi data klasifikasi dari penanggung dengan tipe data BackboneElement.", "comment": "For example may be used to identify a class of coverage or employer group, Policy, Plan.", "requirements": "The codes provided on the health card which identify or confirm the specific policy for the insurer.", "min": 0, "max": "*", "base": { "path": "Coverage.class", "min": 0, "max": "*" }, "type": [ { "code": "BackboneElement" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.class.id", "path": "Coverage.class.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "id" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.class.extension", "path": "Coverage.class.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.class.modifierExtension", "path": "Coverage.class.modifierExtension", "short": "Extensions that cannot be ignored even if unrecognized", "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).", "alias": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them", "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.class.type", "path": "Coverage.class.type", "short": "Type of class such as 'group' or 'plan'", "definition": "Berisi data jenis klasifikasi yang diberikan label atau nomor kelas khusus asuransi (misalnya digunakan untuk mengidentfikasi kelas pertanggungan, kelompok pekerja, polis, atau program) dengan tipe data CodeableConcept.", "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.", "requirements": "The insurer issued label for a specific health card value.", "min": 1, "max": "1", "base": { "path": "Coverage.class.type", "min": 1, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CoverageClass" } ], "strength": "extensible", "description": "The policy classifications, eg. Group, Plan, Class, etc.", "valueSet": "http://hl7.org/fhir/ValueSet/coverage-class" }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE" }, { "identity": "rim", "map": "CD" }, { "identity": "orim", "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD" } ] }, { "id": "Coverage.class.type.id", "path": "Coverage.class.type.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "id" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.class.type.extension", "path": "Coverage.class.type.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.class.type.coding", "path": "Coverage.class.type.coding", "short": "Code defined by a terminology system", "definition": "Berisi data jenis klasifikasi yang diberikan label atau nomor kelas khusus asuransi (misalnya digunakan untuk mengidentfikasi kelas pertanggungan, kelompok pekerja, polis, atau program) dengan tipe data Coding. Nilainya mengacu pada data terminologi Coverage Class Codes.", "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" }, { "identity": "rim", "map": "CV" }, { "identity": "orim", "map": "fhir:Coding rdfs:subClassOf dt:CDCoding" }, { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "Coverage.class.type.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Coverage.class.type.text", "short": "Plain text representation of the concept", "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.", "comment": "Very often the text is the same as a displayName of one of the codings.", "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.", "min": 0, "max": "1", "base": { "path": "CodeableConcept.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "C*E.9. But note many systems use C*E.2 for this" }, { "identity": "rim", "map": "./originalText[mediaType/code=\"text/plain\"]/data" }, { "identity": "orim", "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" } ] }, { "id": "Coverage.class.value", "path": "Coverage.class.value", "short": "Value associated with the type", "definition": "Berisi data nilai string alfanumerik yang terkait dengan label yang dikeluarkan perusahaan asuransi dengan tipe data string.", "comment": "For example, the Group or Plan number.", "requirements": "The insurer issued label and value are necessary to identify the specific policy.", "min": 1, "max": "1", "base": { "path": "Coverage.class.value", "min": 1, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "cdanetv4", "map": "C11 (Division,Section)" }, { "identity": "v2", "map": "IN1-8" }, { "identity": "cpha3pharm", "map": "C.31" } ] }, { "id": "Coverage.class.name", "path": "Coverage.class.name", "short": "Human readable description of the type and value", "definition": "Berisi data deskripsi singkat untuk class dengan tipe data string.", "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size", "requirements": "Used to provide a meaningful description in correspondence to the patient.", "min": 0, "max": "1", "base": { "path": "Coverage.class.name", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "cdanetv4", "map": "C11 (Division,Section)" }, { "identity": "v2", "map": "IN1-8" }, { "identity": "cpha3pharm", "map": "C.31" } ] }, { "id": "Coverage.order", "path": "Coverage.order", "short": "Relative order of the coverage", "definition": "Berisi data urutan penerapan pertanggungan terkait program yang dijalankan terhadap pertanggungan lain yang saat ini berlaku dengan tipe data positiveInt.", "comment": "32 bit number; for values larger than this, use decimal", "requirements": "Used in managing the coordination of benefits.", "min": 0, "max": "1", "base": { "path": "Coverage.order", "min": 0, "max": "1" }, "type": [ { "code": "positiveInt" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "- No exact HL7 v2 equivalent concept seems to exist;" } ] }, { "id": "Coverage.network", "path": "Coverage.network", "short": "Insurer network", "definition": "Berisi data ID khusus penanggung untuk jaringan penyedia yang ditetapkan perusahaan asuransi di mana pemegang polis dapat mencari perawatan yang akan dicakup dengan tarif 'dalam jaringan', jika tidak, syarat dan ketentuan 'di luar jaringan' berlaku dengan tipe data string.", "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size", "requirements": "Used in referral for treatment and in claims processing.", "min": 0, "max": "1", "base": { "path": "Coverage.network", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "cdanetv4", "map": "D10" } ] }, { "id": "Coverage.costToBeneficiary", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "CostToBeneficiary" } ], "path": "Coverage.costToBeneficiary", "short": "Patient payments for services/products", "definition": "Berisi data kode yang menunjukan kategori biaya dan jumlah terkait yang telah dirinci dalam polis dan mungkin telah dimasukkan dalam kartu kesehatan dengan tipe data BackboneElement. Nilainya dapat berupa CoPay; Deductible; Exceptions.", "comment": "For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.", "requirements": "Required by providers to manage financial transaction with the patient.", "alias": [ "CoPay", "Deductible", "Exceptions" ], "min": 0, "max": "*", "base": { "path": "Coverage.costToBeneficiary", "min": 0, "max": "*" }, "type": [ { "code": "BackboneElement" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.costToBeneficiary.id", "path": "Coverage.costToBeneficiary.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "id" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.costToBeneficiary.extension", "path": "Coverage.costToBeneficiary.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.costToBeneficiary.modifierExtension", "path": "Coverage.costToBeneficiary.modifierExtension", "short": "Extensions that cannot be ignored even if unrecognized", "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).", "alias": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them", "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.costToBeneficiary.type", "path": "Coverage.costToBeneficiary.type", "short": "Cost category", "definition": "Berisi data kategori biaya sentris pasien yang terkait dengan pengobatan dengan tipe data CodeableConcept.", "comment": "For example visit, specialist visits, emergency, inpatient care, etc.", "requirements": "Needed to identify the category associated with the amount for the patient.", "min": 0, "max": "1", "base": { "path": "Coverage.costToBeneficiary.type", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CopayTypes" } ], "strength": "extensible", "description": "The types of services to which patient copayments are specified.", "valueSet": "http://hl7.org/fhir/ValueSet/coverage-copay-type" }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE" }, { "identity": "rim", "map": "CD" }, { "identity": "orim", "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD" } ] }, { "id": "Coverage.costToBeneficiary.type.id", "path": "Coverage.costToBeneficiary.type.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "id" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.costToBeneficiary.type.extension", "path": "Coverage.costToBeneficiary.type.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.costToBeneficiary.type.coding", "path": "Coverage.costToBeneficiary.type.coding", "short": "Code defined by a terminology system", "definition": "Berisi data kategori biaya sentris pasien yang terkait dengan pengobatan dengan tipe data Coding. Nilainya mengacu pada data terminologi Coverage Copay Type Codes.", "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" }, { "identity": "rim", "map": "CV" }, { "identity": "orim", "map": "fhir:Coding rdfs:subClassOf dt:CDCoding" }, { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "Coverage.costToBeneficiary.type.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Coverage.costToBeneficiary.type.text", "short": "Plain text representation of the concept", "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.", "comment": "Very often the text is the same as a displayName of one of the codings.", "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.", "min": 0, "max": "1", "base": { "path": "CodeableConcept.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "C*E.9. But note many systems use C*E.2 for this" }, { "identity": "rim", "map": "./originalText[mediaType/code=\"text/plain\"]/data" }, { "identity": "orim", "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" } ] }, { "id": "Coverage.costToBeneficiary.value[x]", "path": "Coverage.costToBeneficiary.value[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "ordered": false, "rules": "open" }, "short": "The amount or percentage due from the beneficiary", "definition": "Berisi data Jumlah yang harus dibayar dari pasien untuk kategori biaya.", "comment": "Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.", "requirements": "Needed to identify the amount for the patient associated with the category.", "min": 1, "max": "1", "base": { "path": "Coverage.costToBeneficiary.value[x]", "min": 1, "max": "1" }, "type": [ { "code": "Quantity", "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ] }, { "code": "Money" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "cdanetv4", "map": "C11 (Division,Section)" }, { "identity": "v2", "map": "IN1-8" }, { "identity": "cpha3pharm", "map": "C.31" } ] }, { "id": "Coverage.costToBeneficiary.value[x]:valueQuantity", "path": "Coverage.costToBeneficiary.value[x]", "sliceName": "valueQuantity", "short": "A fixed quantity (no comparator)", "definition": "Berisi data Jumlah yang harus dibayar dari pasien untuk kategori biaya dengan tipe data SimpleQuantity.", "comment": "The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.", "requirements": "Needed to identify the amount for the patient associated with the category.", "min": 0, "max": "1", "base": { "path": "Coverage.costToBeneficiary.value[x]", "min": 1, "max": "1" }, "type": [ { "code": "Quantity", "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ] } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "qty-3", "severity": "error", "human": "If a code for the unit is present, the system SHALL also be present", "expression": "code.empty() or system.exists()", "xpath": "not(exists(f:code)) or exists(f:system)", "source": "http://hl7.org/fhir/StructureDefinition/Quantity" }, { "key": "sqty-1", "severity": "error", "human": "The comparator is not used on a SimpleQuantity", "expression": "comparator.empty()", "xpath": "not(exists(f:comparator))", "source": "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "cdanetv4", "map": "C11 (Division,Section)" }, { "identity": "v2", "map": "IN1-8" }, { "identity": "cpha3pharm", "map": "C.31" }, { "identity": "v2", "map": "SN (see also Range) or CQ" }, { "identity": "rim", "map": "PQ, IVL, MO, CO, depending on the values" } ] }, { "id": "Coverage.costToBeneficiary.value[x]:valueMoney", "path": "Coverage.costToBeneficiary.value[x]", "sliceName": "valueMoney", "short": "The amount or percentage due from the beneficiary", "definition": "Berisi data Jumlah yang harus dibayar dari pasien untuk kategori biaya dengan tipe data Money.", "comment": "Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.", "requirements": "Needed to identify the amount for the patient associated with the category.", "min": 0, "max": "1", "base": { "path": "Coverage.costToBeneficiary.value[x]", "min": 1, "max": "1" }, "type": [ { "code": "Money" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "cdanetv4", "map": "C11 (Division,Section)" }, { "identity": "v2", "map": "IN1-8" }, { "identity": "cpha3pharm", "map": "C.31" } ] }, { "id": "Coverage.costToBeneficiary.exception", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Exemption" } ], "path": "Coverage.costToBeneficiary.exception", "short": "Exceptions for patient payments", "definition": "Berisi data kode yang menunjukkan pengecualian atau pengurangan biaya pasien dan periode efektifnya dengan tipe data BackboneElement.", "requirements": "Required by providers to manage financial transaction with the patient.", "min": 0, "max": "*", "base": { "path": "Coverage.costToBeneficiary.exception", "min": 0, "max": "*" }, "type": [ { "code": "BackboneElement" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.costToBeneficiary.exception.id", "path": "Coverage.costToBeneficiary.exception.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "id" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.costToBeneficiary.exception.extension", "path": "Coverage.costToBeneficiary.exception.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.costToBeneficiary.exception.modifierExtension", "path": "Coverage.costToBeneficiary.exception.modifierExtension", "short": "Extensions that cannot be ignored even if unrecognized", "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).", "alias": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them", "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.costToBeneficiary.exception.type", "path": "Coverage.costToBeneficiary.exception.type", "short": "Exception category", "definition": "Berisi data kode untuk pengecualian khusus. dengan tipe data CodeableConcept.", "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.", "requirements": "Needed to identify the exception associated with the amount for the patient.", "min": 1, "max": "1", "base": { "path": "Coverage.costToBeneficiary.exception.type", "min": 1, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "CoverageFinancialException" } ], "strength": "example", "description": "The types of exceptions from the part or full value of financial obligations such as copays.", "valueSet": "http://hl7.org/fhir/ValueSet/coverage-financial-exception" }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE" }, { "identity": "rim", "map": "CD" }, { "identity": "orim", "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD" } ] }, { "id": "Coverage.costToBeneficiary.exception.type.id", "path": "Coverage.costToBeneficiary.exception.type.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "id" } ], "code": "http://hl7.org/fhirpath/System.String" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.costToBeneficiary.exception.type.extension", "path": "Coverage.costToBeneficiary.exception.type.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "Coverage.costToBeneficiary.exception.type.coding", "path": "Coverage.costToBeneficiary.exception.type.coding", "short": "Code defined by a terminology system", "definition": "Berisi data kode untuk pengecualian khusus. dengan tipe data Coding. Nilainya mengacu pada data terminologi Example Coverage Financial Exception Codes.", "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.", "min": 0, "max": "*", "base": { "path": "CodeableConcept.coding", "min": 0, "max": "*" }, "type": [ { "code": "Coding" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" }, { "identity": "rim", "map": "CV" }, { "identity": "orim", "map": "fhir:Coding rdfs:subClassOf dt:CDCoding" }, { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "Coverage.costToBeneficiary.exception.type.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Coverage.costToBeneficiary.exception.type.text", "short": "Plain text representation of the concept", "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.", "comment": "Very often the text is the same as a displayName of one of the codings.", "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.", "min": 0, "max": "1", "base": { "path": "CodeableConcept.text", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "C*E.9. But note many systems use C*E.2 for this" }, { "identity": "rim", "map": "./originalText[mediaType/code=\"text/plain\"]/data" }, { "identity": "orim", "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" } ] }, { "id": "Coverage.costToBeneficiary.exception.period", "path": "Coverage.costToBeneficiary.exception.period", "short": "The effective period of the exception", "definition": "Berisi data jangka waktu selama pengecualian berlaku dengan tipe data Period.", "comment": "A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. \"the patient was an inpatient of the hospital for this time range\") or one value from the range applies (e.g. \"give to the patient between these two times\").\n\nPeriod is not used for a duration (a measure of elapsed time). See [Duration](datatypes.html#Duration).", "requirements": "Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs.", "min": 0, "max": "1", "base": { "path": "Coverage.costToBeneficiary.exception.period", "min": 0, "max": "1" }, "type": [ { "code": "Period" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "per-1", "severity": "error", "human": "If present, start SHALL have a lower value than end", "expression": "start.hasValue().not() or end.hasValue().not() or (start <= end)", "xpath": "not(exists(f:start/@value)) or not(exists(f:end/@value)) or (xs:dateTime(f:start/@value) <= xs:dateTime(f:end/@value))", "source": "http://hl7.org/fhir/StructureDefinition/Period" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "DR" }, { "identity": "rim", "map": "IVL[lowClosed=\"true\" and highClosed=\"true\"] or URG[lowClosed=\"true\" and highClosed=\"true\"]" } ] }, { "id": "Coverage.subrogation", "path": "Coverage.subrogation", "short": "Reimbursement to insurer", "definition": "Berisi data informasi apakah subrogasi Ya/Tidak (true/false) dengan tipe data boolean.", "comment": "Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims.", "requirements": "See definition for when to be used.", "min": 0, "max": "1", "base": { "path": "Coverage.subrogation", "min": 0, "max": "1" }, "type": [ { "code": "boolean" } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "Coverage.contract", "path": "Coverage.contract", "short": "Contract details", "definition": "Berisi data polis yang merupakan pertanggungan asuransi dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Contract.", "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.", "requirements": "To reference the legally binding contract between the policy holder and the insurer.", "min": 0, "max": "*", "base": { "path": "Coverage.contract", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Contract" ] } ], "condition": [ "ele-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children unless an empty Parameters resource", "expression": "hasValue() or (children().count() > id.count()) or $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "cdanetv4", "map": "D01 through D09" }, { "identity": "v2", "map": "IN1-16, 18, 19" }, { "identity": "cpha3pharm", "map": "C.35" } ] } ] }, "differential": { "element": [ { "id": "Coverage.extension:primaryCareProvider", "path": "Coverage.extension", "sliceName": "primaryCareProvider", "definition": "Berisi data pihak yang menjadi provider utama dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Organization.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "https://fhir.kemkes.go.id/r4/StructureDefinition/PrimaryCareProvider" ] } ] }, { "id": "Coverage.identifier", "path": "Coverage.identifier", "definition": "Berisi data ID lokal terkait program yang dijalankan dengan tipe data Identifier." }, { "id": "Coverage.status", "path": "Coverage.status", "definition": "Berisi data yang menyatakan status Coverage saat ini dengan tipe data code, yang nilainya mengacu pada data terminologi Financial Resource Status Codes." }, { "id": "Coverage.type", "path": "Coverage.type", "definition": "Berisi data jenis pertanggungan (misalnya program sosial, rencana medis, pertanggungan kecelakaan, kesehatan kelompok, atau pembayaran oleh organisasi maupun individu) dengan tipe data CodeableConcept." }, { "id": "Coverage.type.coding", "path": "Coverage.type.coding", "definition": "Berisi data jenis pertanggungan (misalnya program sosial, rencana medis, pertanggungan kecelakaan, kesehatan kelompok, atau pembayaran oleh organisasi maupun individu) dengan tipe data Coding. Nilainya mengacu pada data terminologi Coverage Type and Self-Pay Codes." }, { "id": "Coverage.policyHolder", "path": "Coverage.policyHolder", "definition": "Berisi data pihak yang memiliki polis asuransi dengan ID lokal terkait program yang dijalankan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient | RelatedPerson | Organization." }, { "id": "Coverage.subscriber", "path": "Coverage.subscriber", "definition": "Berisi data pihak yang mendaftar atau kepada siapa manfaat polis diberikan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient | RelatedPerson." }, { "id": "Coverage.subscriberId", "path": "Coverage.subscriberId", "definition": "Berisi data ID dari penanggung terkait program yang dijalankan dengan tipe data string." }, { "id": "Coverage.beneficiary", "path": "Coverage.beneficiary", "definition": "Berisi data pihak yang mendapat manfaat dari pertanggungan asuransi dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient." }, { "id": "Coverage.dependent", "path": "Coverage.dependent", "definition": "Berisi data ID lokal untuk yang tertanggung terkait program yang dijalankan dengan tipe data string." }, { "id": "Coverage.relationship", "path": "Coverage.relationship", "definition": "Berisi data hubungan antara beneficiary dan subscriber dengan tipe data CodeableConcept." }, { "id": "Coverage.relationship.coding", "path": "Coverage.relationship.coding", "definition": "Berisi data hubungan antara beneficiary dan subscriber dengan tipe data Coding. Nilainya mengacu pada data terminologi SubscriberPolicyholder Relationship Codes." }, { "id": "Coverage.period", "path": "Coverage.period", "definition": "Berisi data jangka waktu selama pertanggungan berlaku dengan tipe data Period." }, { "id": "Coverage.payor", "path": "Coverage.payor", "definition": "Berisi data penjamin program atau program atau pembayar dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient | RelatedPerson | Organization." }, { "id": "Coverage.class", "path": "Coverage.class", "definition": "Berisi data klasifikasi dari penanggung dengan tipe data BackboneElement." }, { "id": "Coverage.class.type", "path": "Coverage.class.type", "definition": "Berisi data jenis klasifikasi yang diberikan label atau nomor kelas khusus asuransi (misalnya digunakan untuk mengidentfikasi kelas pertanggungan, kelompok pekerja, polis, atau program) dengan tipe data CodeableConcept." }, { "id": "Coverage.class.type.coding", "path": "Coverage.class.type.coding", "definition": "Berisi data jenis klasifikasi yang diberikan label atau nomor kelas khusus asuransi (misalnya digunakan untuk mengidentfikasi kelas pertanggungan, kelompok pekerja, polis, atau program) dengan tipe data Coding. Nilainya mengacu pada data terminologi Coverage Class Codes." }, { "id": "Coverage.class.value", "path": "Coverage.class.value", "definition": "Berisi data nilai string alfanumerik yang terkait dengan label yang dikeluarkan perusahaan asuransi dengan tipe data string." }, { "id": "Coverage.class.name", "path": "Coverage.class.name", "definition": "Berisi data deskripsi singkat untuk class dengan tipe data string." }, { "id": "Coverage.order", "path": "Coverage.order", "definition": "Berisi data urutan penerapan pertanggungan terkait program yang dijalankan terhadap pertanggungan lain yang saat ini berlaku dengan tipe data positiveInt." }, { "id": "Coverage.network", "path": "Coverage.network", "definition": "Berisi data ID khusus penanggung untuk jaringan penyedia yang ditetapkan perusahaan asuransi di mana pemegang polis dapat mencari perawatan yang akan dicakup dengan tarif 'dalam jaringan', jika tidak, syarat dan ketentuan 'di luar jaringan' berlaku dengan tipe data string." }, { "id": "Coverage.costToBeneficiary", "path": "Coverage.costToBeneficiary", "definition": "Berisi data kode yang menunjukan kategori biaya dan jumlah terkait yang telah dirinci dalam polis dan mungkin telah dimasukkan dalam kartu kesehatan dengan tipe data BackboneElement. Nilainya dapat berupa CoPay; Deductible; Exceptions." }, { "id": "Coverage.costToBeneficiary.type", "path": "Coverage.costToBeneficiary.type", "definition": "Berisi data kategori biaya sentris pasien yang terkait dengan pengobatan dengan tipe data CodeableConcept." }, { "id": "Coverage.costToBeneficiary.type.coding", "path": "Coverage.costToBeneficiary.type.coding", "definition": "Berisi data kategori biaya sentris pasien yang terkait dengan pengobatan dengan tipe data Coding. Nilainya mengacu pada data terminologi Coverage Copay Type Codes." }, { "id": "Coverage.costToBeneficiary.value[x]", "path": "Coverage.costToBeneficiary.value[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "ordered": false, "rules": "open" }, "definition": "Berisi data Jumlah yang harus dibayar dari pasien untuk kategori biaya." }, { "id": "Coverage.costToBeneficiary.value[x]:valueQuantity", "path": "Coverage.costToBeneficiary.value[x]", "sliceName": "valueQuantity", "definition": "Berisi data Jumlah yang harus dibayar dari pasien untuk kategori biaya dengan tipe data SimpleQuantity.", "min": 0, "max": "1", "type": [ { "code": "Quantity", "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ] } ] }, { "id": "Coverage.costToBeneficiary.value[x]:valueMoney", "path": "Coverage.costToBeneficiary.value[x]", "sliceName": "valueMoney", "definition": "Berisi data Jumlah yang harus dibayar dari pasien untuk kategori biaya dengan tipe data Money.", "min": 0, "max": "1", "type": [ { "code": "Money" } ] }, { "id": "Coverage.costToBeneficiary.exception", "path": "Coverage.costToBeneficiary.exception", "definition": "Berisi data kode yang menunjukkan pengecualian atau pengurangan biaya pasien dan periode efektifnya dengan tipe data BackboneElement." }, { "id": "Coverage.costToBeneficiary.exception.type", "path": "Coverage.costToBeneficiary.exception.type", "definition": "Berisi data kode untuk pengecualian khusus. dengan tipe data CodeableConcept." }, { "id": "Coverage.costToBeneficiary.exception.type.coding", "path": "Coverage.costToBeneficiary.exception.type.coding", "definition": "Berisi data kode untuk pengecualian khusus. dengan tipe data Coding. Nilainya mengacu pada data terminologi Example Coverage Financial Exception Codes." }, { "id": "Coverage.costToBeneficiary.exception.period", "path": "Coverage.costToBeneficiary.exception.period", "definition": "Berisi data jangka waktu selama pengecualian berlaku dengan tipe data Period." }, { "id": "Coverage.subrogation", "path": "Coverage.subrogation", "definition": "Berisi data informasi apakah subrogasi Ya/Tidak (true/false) dengan tipe data boolean." }, { "id": "Coverage.contract", "path": "Coverage.contract", "definition": "Berisi data polis yang merupakan pertanggungan asuransi dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Contract." } ] } }