{ "resourceType": "StructureDefinition", "id": "SatuSehatCoverageEligibilityRequest", "url": "https://fhir.kemkes.go.id/r4/StructureDefinition/CoverageEligibilityRequest", "name": "SatuSehatCoverageEligibilityRequest", "title": "Satu Sehat Coverage Eligibility Request", "status": "active", "date": "2024-01-01", "description": "Defines the ID Core constraints and extensions on the CoverageEligibilityRequest resource for the minimal set of data to retrieve coverage information.", "fhirVersion": "4.0.1", "kind": "resource", "abstract": false, "type": "CoverageEligibilityRequest", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/CoverageEligibilityRequest", "derivation": "constraint", "snapshot": { "element": [ { "id": "CoverageEligibilityRequest", "path": "CoverageEligibilityRequest", "short": "CoverageEligibilityRequest resource", "definition": "The CoverageEligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.", "min": 0, "max": "*", "base": { "path": "CoverageEligibilityRequest", "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": "Request" }, { "identity": "w5", "map": "financial.support" } ] }, { "id": "CoverageEligibilityRequest.id", "path": "CoverageEligibilityRequest.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": "CoverageEligibilityRequest.meta", "path": "CoverageEligibilityRequest.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": "CoverageEligibilityRequest.implicitRules", "path": "CoverageEligibilityRequest.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": "CoverageEligibilityRequest.language", "path": "CoverageEligibilityRequest.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": "CoverageEligibilityRequest.text", "path": "CoverageEligibilityRequest.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 $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" }, { "identity": "rim", "map": "Act.text?" } ] }, { "id": "CoverageEligibilityRequest.contained", "path": "CoverageEligibilityRequest.contained", "short": "Contained, inline Resources", "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.", "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.", "alias": [ "inline resources", "anonymous resources", "contained resources" ], "min": 0, "max": "*", "base": { "path": "DomainResource.contained", "min": 0, "max": "*" }, "type": [ { "code": "Resource" } ], "constraint": [ { "key": "dom-r4b", "severity": "warning", "human": "Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems", "expression": "($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": "CoverageEligibilityRequest.extension", "path": "CoverageEligibilityRequest.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": "CoverageEligibilityRequest.modifierExtension", "path": "CoverageEligibilityRequest.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": "CoverageEligibilityRequest.identifier", "path": "CoverageEligibilityRequest.identifier", "short": "Business Identifier for coverage eligiblity request", "definition": "Berisi data ID lokal terkait program yang dijalankan dengan tipe data Identifier.", "requirements": "Allows coverage eligibility requests to be distinguished and referenced.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.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": false, "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": "Request.identifier" }, { "identity": "w5", "map": "FiveWs.identifier" } ] }, { "id": "CoverageEligibilityRequest.status", "path": "CoverageEligibilityRequest.status", "short": "active | cancelled | draft | entered-in-error", "definition": "Berisi data yang menyatakan status CoverageEligibilityRequest dengan tipe data code, yang nilainya mengacu pada contoh data terminologi Financial Resource Status Codes.", "comment": "This element is labeled as a modifier because the status contains codes that mark the resource 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": "CoverageEligibilityRequest.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 labeled 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": "EligibilityRequestStatus" } ], "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": "Request.status" }, { "identity": "w5", "map": "FiveWs.status" } ] }, { "id": "CoverageEligibilityRequest.priority", "path": "CoverageEligibilityRequest.priority", "short": "Desired processing priority", "definition": "Berisi data indikasi urgensi dari requestor 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 advise the prossesor on the urgency of the request.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.priority", "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": "ProcessPriority" } ], "strength": "example", "description": "The timeliness with which processing is required: STAT, normal, Deferred.", "valueSet": "http://hl7.org/fhir/ValueSet/process-priority" }, "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": "workflow", "map": "Request.priority" }, { "identity": "w5", "map": "FiveWs.class" } ] }, { "id": "CoverageEligibilityRequest.priority.id", "path": "CoverageEligibilityRequest.priority.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": "CoverageEligibilityRequest.priority.extension", "path": "CoverageEligibilityRequest.priority.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": "CoverageEligibilityRequest.priority.coding", "path": "CoverageEligibilityRequest.priority.coding", "short": "Code defined by a terminology system", "definition": "Berisi data indikasi urgensi dari requestor dengan tipe data Coding. Nilainya mengacu pada data terminologi Process Priority 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": "CoverageEligibilityRequest.priority.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "CoverageEligibilityRequest.priority.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": "CoverageEligibilityRequest.purpose", "path": "CoverageEligibilityRequest.purpose", "short": "auth-requirements | benefits | discovery | validation", "definition": "Berisi data kode untuk menentukan tujuan permintaan: persyaratan otorisasi sebelumnya untuk beberapa kategori layanan atau kode tagihan; manfaat untuk pertanggungan yang ditentukan atau ditemukan; penemuan dan pengembalian pertanggungan untuk pasien; dan/atau validasi bahwa pertanggungan yang ditentukan berlaku pada tanggal/ periode yang ditentukan atau 'sekarang' jika tidak ditentukan. dengan tipe data code, yang nilainya mengacu pada data terminologi EligibilityRequestPurpose.", "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size", "requirements": "To indicate the processing actions requested.", "min": 1, "max": "1", "base": { "path": "CoverageEligibilityRequest.purpose", "min": 1, "max": "*" }, "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": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "EligibilityRequestPurpose" } ], "strength": "required", "description": "A code specifying the types of information being requested.", "valueSet": "http://hl7.org/fhir/ValueSet/eligibilityrequest-purpose|4.3.0" }, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "w5", "map": "FiveWs.class" } ] }, { "id": "CoverageEligibilityRequest.patient", "path": "CoverageEligibilityRequest.patient", "short": "Intended recipient of products and services", "definition": "Berisi data pihak yang yang mendapat manfaat dari pertanggungan asuransi dan untuk siapa kelayakan sedang dicari dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient.", "comment": "1..1.", "requirements": "Required to provide context and coverage validation.", "min": 1, "max": "1", "base": { "path": "CoverageEligibilityRequest.patient", "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 $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ref-1", "severity": "error", "human": "SHALL have a contained resource if a local reference is provided", "expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))", "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])", "source": "http://hl7.org/fhir/StructureDefinition/Reference" } ], "mustSupport": false, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)" }, { "identity": "workflow", "map": "Request.subject" }, { "identity": "w5", "map": "FiveWs.subject[x]" }, { "identity": "w5", "map": "FiveWs.subject" } ] }, { "id": "CoverageEligibilityRequest.serviced[x]", "path": "CoverageEligibilityRequest.serviced[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "ordered": false, "rules": "open" }, "short": "Estimated date or dates of service", "definition": "Berisi data tanggal atau rentang tanggal ketika rangkaian layanan yang dilampirkan telah dilaksanakan atau selesai dilakukan.", "requirements": "Required to provide time context for the request.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.serviced[x]", "min": 0, "max": "1" }, "type": [ { "code": "date" }, { "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" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "w5", "map": "FiveWs.done[x]" } ] }, { "id": "CoverageEligibilityRequest.serviced[x]:servicedDate", "path": "CoverageEligibilityRequest.serviced[x]", "sliceName": "servicedDate", "short": "Estimated date or dates of service", "definition": "Berisi data tanggal atau rentang tanggal ketika rangkaian layanan yang dilampirkan telah dilaksanakan atau selesai dilakukan dengan tipe data date.", "requirements": "Required to provide time context for the request.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.serviced[x]", "min": 0, "max": "1" }, "type": [ { "code": "date" } ], "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": "w5", "map": "FiveWs.done[x]" } ] }, { "id": "CoverageEligibilityRequest.serviced[x]:servicedPeriod", "path": "CoverageEligibilityRequest.serviced[x]", "sliceName": "servicedPeriod", "short": "Estimated date or dates of service", "definition": "Berisi data tanggal atau rentang tanggal ketika rangkaian layanan yang dilampirkan telah dilaksanakan atau selesai dilakukan dengan tipe data Period.", "requirements": "Required to provide time context for the request.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.serviced[x]", "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" } ], "mustSupport": false, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "w5", "map": "FiveWs.done[x]" } ] }, { "id": "CoverageEligibilityRequest.created", "path": "CoverageEligibilityRequest.created", "short": "Creation date", "definition": "Berisi data tanggal ketika CoverageEligibilityRequest dibuat dengan tipe data dateTime, dengan format yang diperbolehkan YYYY, YYYY-MM, YYYY-MM-DD atau YYYY-MM-DDThh:mm:ss+zz:zz.", "requirements": "Need to record a timestamp for use by both the recipient and the issuer.", "min": 1, "max": "1", "base": { "path": "CoverageEligibilityRequest.created", "min": 1, "max": "1" }, "type": [ { "code": "dateTime" } ], "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": "workflow", "map": "Request.authoredOn" }, { "identity": "w5", "map": "FiveWs.recorded" } ] }, { "id": "CoverageEligibilityRequest.enterer", "path": "CoverageEligibilityRequest.enterer", "short": "Author", "definition": "Berisi data individu yang membuat melakukan permintaan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | PractitionerRole.", "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": "Some jurisdictions require the contact information for personnel completing eligibility requests.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.enterer", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole" ] } ], "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": "w5", "map": "FiveWs.author" } ] }, { "id": "CoverageEligibilityRequest.provider", "path": "CoverageEligibilityRequest.provider", "short": "Party responsible for the request", "definition": "Berisi data provider yang bertanggung jawab atas permintaan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | PractitionerRole | Organization.", "comment": "Typically this field would be 1..1 where this party is responsible for the eligibility request but not necessarily professionally responsible for the provision of the individual products and services listed below.", "requirements": "Needed to identify the requestor.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.provider", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "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": 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": "workflow", "map": "Request.requester" }, { "identity": "w5", "map": "FiveWs.source" } ] }, { "id": "CoverageEligibilityRequest.insurer", "path": "CoverageEligibilityRequest.insurer", "short": "Coverage issuer", "definition": "Berisi data penanggung yang mengeluarkan pertanggungan dan merupakan penerima permintaan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Organization.", "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": "Need to identify the recipient.", "min": 1, "max": "1", "base": { "path": "CoverageEligibilityRequest.insurer", "min": 1, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "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": "workflow", "map": "Request.performer" }, { "identity": "w5", "map": "FiveWs.who" } ] }, { "id": "CoverageEligibilityRequest.facility", "path": "CoverageEligibilityRequest.facility", "short": "Servicing facility", "definition": "Berisi data fasilitas yang menunjukkan tempat layanan diberikan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Location.", "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": "Insurance adjudication can be dependant on where services were delivered.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.facility", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Location" ] } ], "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": "w5", "map": "FiveWs.where[x]" } ] }, { "id": "CoverageEligibilityRequest.supportingInfo", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "SupportingInformation" } ], "path": "CoverageEligibilityRequest.supportingInfo", "short": "Supporting information", "definition": "Berisi data informasi tambahan mengenai pengecualian, pertimbangan khusus, kondisi, situasi, masalah sebelumnya atau saat ini dengan tipe data BackboneElement.", "comment": "Often there are multiple jurisdiction specific valuesets which are required.", "requirements": "Typically these information codes are required to support the services rendered or the adjudication of the services rendered.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.supportingInfo", "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": "CoverageEligibilityRequest.supportingInfo.id", "path": "CoverageEligibilityRequest.supportingInfo.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": "CoverageEligibilityRequest.supportingInfo.extension", "path": "CoverageEligibilityRequest.supportingInfo.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": "CoverageEligibilityRequest.supportingInfo.modifierExtension", "path": "CoverageEligibilityRequest.supportingInfo.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": "CoverageEligibilityRequest.supportingInfo.sequence", "path": "CoverageEligibilityRequest.supportingInfo.sequence", "short": "Information instance identifier", "definition": "Berisi data nomor unik untuk mengidentifikasi entri informasi dengan tipe data positiveInt.", "comment": "32 bit number; for values larger than this, use decimal", "requirements": "Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.", "min": 1, "max": "1", "base": { "path": "CoverageEligibilityRequest.supportingInfo.sequence", "min": 1, "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": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "CoverageEligibilityRequest.supportingInfo.information", "path": "CoverageEligibilityRequest.supportingInfo.information", "short": "Data to be provided", "definition": "Berisi data tambahan dengan tipe data Reference yang direferensikan ke data apapun (Any).", "comment": "Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.", "requirements": "To convey the data content to be provided when the information is more than a simple code or period.", "min": 1, "max": "1", "base": { "path": "CoverageEligibilityRequest.supportingInfo.information", "min": 1, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ] } ], "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)" } ] }, { "id": "CoverageEligibilityRequest.supportingInfo.appliesToAll", "path": "CoverageEligibilityRequest.supportingInfo.appliesToAll", "short": "Applies to all items", "definition": "Berisi data pendukung yang berlaku untuk semua detail item, produk/ layanan, dan kode billing tertentu dengan tipe data boolean.", "requirements": "Needed to convey that the information is universal to the request.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.supportingInfo.appliesToAll", "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": "CoverageEligibilityRequest.insurance", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Insurance" } ], "path": "CoverageEligibilityRequest.insurance", "short": "Patient insurance information", "definition": "Berisi data instrumen keuangan untuk penggantian produk dan layanan perawatan kesehatan dengan tipe data BackboneElement.", "comment": "All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.", "requirements": "There must be at least one coverage for which eligibility is requested.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.insurance", "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": "CoverageEligibilityRequest.insurance.id", "path": "CoverageEligibilityRequest.insurance.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": "CoverageEligibilityRequest.insurance.extension", "path": "CoverageEligibilityRequest.insurance.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": "CoverageEligibilityRequest.insurance.modifierExtension", "path": "CoverageEligibilityRequest.insurance.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": "CoverageEligibilityRequest.insurance.focal", "path": "CoverageEligibilityRequest.insurance.focal", "short": "Applicable coverage", "definition": "Berisi data penanda untuk menunjukkan resource Coverage akan digunakan untuk evaluasi permintaan bila dinyatakan True dengan tipe data booelan.", "comment": "A patient may (will) have multiple insurance policies which provide reimburement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for evaluating this request. Other requests would be created to request evaluation against the other listed policies.", "requirements": "To identify which coverage in the list is being used to evaluate this request.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.insurance.focal", "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": "CoverageEligibilityRequest.insurance.coverage", "path": "CoverageEligibilityRequest.insurance.coverage", "short": "Insurance information", "definition": "Berisi data referensi ke informasi tingkat kartu asuransi yang terdapat pada resource Coverage. Perusahaan asuransi yang mengeluarkan pertanggungan akan menggunakan perincian ini untuk menemukan pertanggungan aktual pasien dalam sistem informasi perusahaan asuransi dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Coverage.", "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": "Required to allow the adjudicator to locate the correct policy and history within their information system.", "min": 1, "max": "1", "base": { "path": "CoverageEligibilityRequest.insurance.coverage", "min": 1, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Coverage" ] } ], "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)" } ] }, { "id": "CoverageEligibilityRequest.insurance.businessArrangement", "path": "CoverageEligibilityRequest.insurance.businessArrangement", "short": "Additional provider contract number", "definition": "Berisi data nomor perjanjian bisnis yang dibuat antara penyedia dan perusahaan asuransi dengan tujuan pemrosesan bisnis khusus dengan tipe data string.", "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size", "requirements": "Providers may have multiple business arrangements with a given insurer and must supply the specific contract number for adjudication.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.insurance.businessArrangement", "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": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "CoverageEligibilityRequest.item", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Details" } ], "path": "CoverageEligibilityRequest.item", "short": "Item to be evaluated for eligibiity", "definition": "Berisi data manfaat dan saldo opsional saat ini serta detail otorisasi berdasarkan kategori atau layanan dengan tipe data BackboneElement.", "requirements": "The items to be processed for the request.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item", "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": "CoverageEligibilityRequest.item.id", "path": "CoverageEligibilityRequest.item.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": "CoverageEligibilityRequest.item.extension", "path": "CoverageEligibilityRequest.item.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": "CoverageEligibilityRequest.item.modifierExtension", "path": "CoverageEligibilityRequest.item.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": "CoverageEligibilityRequest.item.supportingInfoSequence", "path": "CoverageEligibilityRequest.item.supportingInfoSequence", "short": "Applicable exception or supporting information", "definition": "Berisi data pengecualian, ketentuan khusus, dan informasi pendukung yang berlaku untuk produk atau layanan dengan tipe data positiveInt.", "comment": "32 bit number; for values larger than this, use decimal", "requirements": "Needed to support or inform the consideration for eligibility.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.supportingInfoSequence", "min": 0, "max": "*" }, "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": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "CoverageEligibilityRequest.item.category", "path": "CoverageEligibilityRequest.item.category", "short": "Benefit classification", "definition": "Berisi data kode untuk mengidentifikasi jenis manfaat umum dari produk dan layanan dengan tipe data CodeableConcept.", "comment": "Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.", "requirements": "Needed to convey the category of service or product for which eligibility is sought.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.category", "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": "BenefitCategory" } ], "strength": "example", "description": "Benefit categories such as: oral, medical, vision etc.", "valueSet": "http://hl7.org/fhir/ValueSet/ex-benefitcategory" }, "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": "CoverageEligibilityRequest.item.category.id", "path": "CoverageEligibilityRequest.item.category.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": "CoverageEligibilityRequest.item.category.extension", "path": "CoverageEligibilityRequest.item.category.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": "CoverageEligibilityRequest.item.category.coding", "path": "CoverageEligibilityRequest.item.category.coding", "short": "Code defined by a terminology system", "definition": "Berisi data kode untuk mengidentifikasi jenis manfaat umum dari produk dan layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Benefit Category 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": "CoverageEligibilityRequest.item.category.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "CoverageEligibilityRequest.item.category.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": "CoverageEligibilityRequest.item.productOrService", "path": "CoverageEligibilityRequest.item.productOrService", "short": "Billing, service, product, or drug code", "definition": "Berisi data produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data CodeableConcept.", "comment": "Code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI).", "requirements": "Needed to convey the actual service or product for which eligibility is sought.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.productOrService", "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": "ServiceProduct" } ], "strength": "example", "description": "Allowable service and product codes.", "valueSet": "http://hl7.org/fhir/ValueSet/service-uscls" }, "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": "CoverageEligibilityRequest.item.productOrService.id", "path": "CoverageEligibilityRequest.item.productOrService.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": "CoverageEligibilityRequest.item.productOrService.extension", "path": "CoverageEligibilityRequest.item.productOrService.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": "CoverageEligibilityRequest.item.productOrService.coding", "path": "CoverageEligibilityRequest.item.productOrService.coding", "short": "Code defined by a terminology system", "definition": "Berisi data produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi USCLS 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": "CoverageEligibilityRequest.item.productOrService.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "CoverageEligibilityRequest.item.productOrService.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": "CoverageEligibilityRequest.item.modifier", "path": "CoverageEligibilityRequest.item.modifier", "short": "Product or service billing modifiers", "definition": "Berisi data tipifikasi item atau pengubah kode untuk menyatakan konteks tambahan untuk produk atau layanan dengan tipe data CodeableConcept.", "comment": "For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.", "requirements": "To support provision of the item or to charge an elevated fee.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.modifier", "min": 0, "max": "*" }, "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": "Modifiers" } ], "strength": "example", "description": "Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.", "valueSet": "http://hl7.org/fhir/ValueSet/claim-modifiers" }, "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": "CoverageEligibilityRequest.item.modifier.id", "path": "CoverageEligibilityRequest.item.modifier.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": "CoverageEligibilityRequest.item.modifier.extension", "path": "CoverageEligibilityRequest.item.modifier.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": "CoverageEligibilityRequest.item.modifier.coding", "path": "CoverageEligibilityRequest.item.modifier.coding", "short": "Code defined by a terminology system", "definition": "Berisi data tipifikasi item atau pengubah kode untuk menyatakan konteks tambahan untuk produk atau layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Modifier types 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": "CoverageEligibilityRequest.item.modifier.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "CoverageEligibilityRequest.item.modifier.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": "CoverageEligibilityRequest.item.provider", "path": "CoverageEligibilityRequest.item.provider", "short": "Perfoming practitioner", "definition": "Berisi data praktisi yang bertanggung jawab atas penyediaan produk atau layanan kepada dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | Coverage.", "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": "Needed to support the evaluation of the eligibility.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.provider", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole" ] } ], "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": "workflow", "map": "Request.requester" }, { "identity": "w5", "map": "FiveWs.source" } ] }, { "id": "CoverageEligibilityRequest.item.quantity", "path": "CoverageEligibilityRequest.item.quantity", "short": "Count of products or services", "definition": "Berisi data jumlah pengulangan layanan atau produk 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": "Required when the product or service code does not convey the quantity provided.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.quantity", "min": 0, "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": false, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "v2", "map": "SN (see also Range) or CQ" }, { "identity": "rim", "map": "PQ, IVL, MO, CO, depending on the values" } ] }, { "id": "CoverageEligibilityRequest.item.unitPrice", "path": "CoverageEligibilityRequest.item.unitPrice", "short": "Fee, charge or cost per item", "definition": "Berisi data jumlah yang dibebankan kepada pasien oleh penyedia untuk satu unit dengan tipe data Money.", "requirements": "Needed to support the evaluation of the eligibility.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.unitPrice", "min": 0, "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": false, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "MO" } ] }, { "id": "CoverageEligibilityRequest.item.facility", "path": "CoverageEligibilityRequest.item.facility", "short": "Servicing facility", "definition": "Berisi data fasilitas yang menunjukkan tempat layanan diberikan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Location | Organization.", "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": "Needed to support the evaluation of the eligibility.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.facility", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Location", "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": 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)" } ] }, { "id": "CoverageEligibilityRequest.item.diagnosis", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Diagnosis" } ], "path": "CoverageEligibilityRequest.item.diagnosis", "short": "Applicable diagnosis", "definition": "Berisi data diagnosis pasien yang diminta pelayanannya dengan tipe data BackboneElement.", "requirements": "Needed to support the evaluation of the eligibility.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.diagnosis", "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" }, { "identity": "v2", "map": "Request.reasonReference" } ] }, { "id": "CoverageEligibilityRequest.item.diagnosis.id", "path": "CoverageEligibilityRequest.item.diagnosis.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": "CoverageEligibilityRequest.item.diagnosis.extension", "path": "CoverageEligibilityRequest.item.diagnosis.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": "CoverageEligibilityRequest.item.diagnosis.modifierExtension", "path": "CoverageEligibilityRequest.item.diagnosis.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 $this is Parameters", "xpath": "@value|f:*|h:div|self::f:Parameters", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them", "isSummary": true, "mapping": [ { "identity": "rim", "map": "n/a" }, { "identity": "rim", "map": "N/A" } ] }, { "id": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]", "path": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "ordered": false, "rules": "open" }, "short": "Nature of illness or problem", "definition": "Berisi data ID lokal terkait program yang dijalankan dengan tipe data Identifier.", "requirements": "Provides health context for the evaluation of the products and/or services.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" }, { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Condition" ] } ], "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": "ICD10" } ], "strength": "example", "description": "ICD10 Diagnostic codes.", "valueSet": "http://hl7.org/fhir/ValueSet/icd-10" }, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]:diagnosisCodeableConcept", "path": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]", "sliceName": "diagnosisCodeableConcept", "short": "Nature of illness or problem", "definition": "Berisi data penyakit atau masalah dalam bentuk kode dengan tipe data CodeableConcept.", "requirements": "Provides health context for the evaluation of the products and/or services.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]", "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": "ICD10" } ], "strength": "example", "description": "ICD10 Diagnostic codes.", "valueSet": "http://hl7.org/fhir/ValueSet/icd-10" }, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]:diagnosisReference", "path": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]", "sliceName": "diagnosisReference", "short": "Nature of illness or problem", "definition": "Berisi data penyakit atau masalah dalam bentuk kode atau yang direferensikan ke resource Condition dengan tipe data Reference yang nilainya dapat mengacu pada contoh data terminologi ICD-10 Codes.", "requirements": "Provides health context for the evaluation of the products and/or services.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Condition" ] } ], "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": "CoverageEligibilityRequest.item.detail", "path": "CoverageEligibilityRequest.item.detail", "short": "Product or service details", "definition": "Berisi data rencana/ proposal/ aturan yang menjelaskan layanan yang diusulkan secara rinci ID dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Any.", "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": "Needed to provide complex service proposal such as a Device or a plan.", "min": 0, "max": "1", "base": { "path": "CoverageEligibilityRequest.item.detail", "min": 0, "max": "*" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ] } ], "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)" } ] } ] }, "differential": { "element": [ { "id": "CoverageEligibilityRequest.identifier", "path": "CoverageEligibilityRequest.identifier", "definition": "Berisi data ID lokal terkait program yang dijalankan dengan tipe data Identifier.", "max": "1" }, { "id": "CoverageEligibilityRequest.status", "path": "CoverageEligibilityRequest.status", "definition": "Berisi data yang menyatakan status CoverageEligibilityRequest dengan tipe data code, yang nilainya mengacu pada contoh data terminologi Financial Resource Status Codes." }, { "id": "CoverageEligibilityRequest.priority", "path": "CoverageEligibilityRequest.priority", "definition": "Berisi data indikasi urgensi dari requestor dengan tipe data CodeableConcept." }, { "id": "CoverageEligibilityRequest.priority.coding", "path": "CoverageEligibilityRequest.priority.coding", "definition": "Berisi data indikasi urgensi dari requestor dengan tipe data Coding. Nilainya mengacu pada data terminologi Process Priority Codes." }, { "id": "CoverageEligibilityRequest.purpose", "path": "CoverageEligibilityRequest.purpose", "definition": "Berisi data kode untuk menentukan tujuan permintaan: persyaratan otorisasi sebelumnya untuk beberapa kategori layanan atau kode tagihan; manfaat untuk pertanggungan yang ditentukan atau ditemukan; penemuan dan pengembalian pertanggungan untuk pasien; dan/atau validasi bahwa pertanggungan yang ditentukan berlaku pada tanggal/ periode yang ditentukan atau 'sekarang' jika tidak ditentukan. dengan tipe data code, yang nilainya mengacu pada data terminologi EligibilityRequestPurpose.", "max": "1" }, { "id": "CoverageEligibilityRequest.patient", "path": "CoverageEligibilityRequest.patient", "definition": "Berisi data pihak yang yang mendapat manfaat dari pertanggungan asuransi dan untuk siapa kelayakan sedang dicari dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Patient." }, { "id": "CoverageEligibilityRequest.serviced[x]", "path": "CoverageEligibilityRequest.serviced[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "ordered": false, "rules": "open" }, "definition": "Berisi data tanggal atau rentang tanggal ketika rangkaian layanan yang dilampirkan telah dilaksanakan atau selesai dilakukan." }, { "id": "CoverageEligibilityRequest.serviced[x]:servicedDate", "path": "CoverageEligibilityRequest.serviced[x]", "sliceName": "servicedDate", "definition": "Berisi data tanggal atau rentang tanggal ketika rangkaian layanan yang dilampirkan telah dilaksanakan atau selesai dilakukan dengan tipe data date.", "min": 0, "max": "1", "type": [ { "code": "date" } ] }, { "id": "CoverageEligibilityRequest.serviced[x]:servicedPeriod", "path": "CoverageEligibilityRequest.serviced[x]", "sliceName": "servicedPeriod", "definition": "Berisi data tanggal atau rentang tanggal ketika rangkaian layanan yang dilampirkan telah dilaksanakan atau selesai dilakukan dengan tipe data Period.", "min": 0, "max": "1", "type": [ { "code": "Period" } ] }, { "id": "CoverageEligibilityRequest.created", "path": "CoverageEligibilityRequest.created", "definition": "Berisi data tanggal ketika CoverageEligibilityRequest dibuat dengan tipe data dateTime, dengan format yang diperbolehkan YYYY, YYYY-MM, YYYY-MM-DD atau YYYY-MM-DDThh:mm:ss+zz:zz." }, { "id": "CoverageEligibilityRequest.enterer", "path": "CoverageEligibilityRequest.enterer", "definition": "Berisi data individu yang membuat melakukan permintaan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | PractitionerRole." }, { "id": "CoverageEligibilityRequest.provider", "path": "CoverageEligibilityRequest.provider", "definition": "Berisi data provider yang bertanggung jawab atas permintaan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | PractitionerRole | Organization." }, { "id": "CoverageEligibilityRequest.insurer", "path": "CoverageEligibilityRequest.insurer", "definition": "Berisi data penanggung yang mengeluarkan pertanggungan dan merupakan penerima permintaan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Organization." }, { "id": "CoverageEligibilityRequest.facility", "path": "CoverageEligibilityRequest.facility", "definition": "Berisi data fasilitas yang menunjukkan tempat layanan diberikan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Location." }, { "id": "CoverageEligibilityRequest.supportingInfo", "path": "CoverageEligibilityRequest.supportingInfo", "definition": "Berisi data informasi tambahan mengenai pengecualian, pertimbangan khusus, kondisi, situasi, masalah sebelumnya atau saat ini dengan tipe data BackboneElement.", "max": "1" }, { "id": "CoverageEligibilityRequest.supportingInfo.sequence", "path": "CoverageEligibilityRequest.supportingInfo.sequence", "definition": "Berisi data nomor unik untuk mengidentifikasi entri informasi dengan tipe data positiveInt." }, { "id": "CoverageEligibilityRequest.supportingInfo.information", "path": "CoverageEligibilityRequest.supportingInfo.information", "definition": "Berisi data tambahan dengan tipe data Reference yang direferensikan ke data apapun (Any)." }, { "id": "CoverageEligibilityRequest.supportingInfo.appliesToAll", "path": "CoverageEligibilityRequest.supportingInfo.appliesToAll", "definition": "Berisi data pendukung yang berlaku untuk semua detail item, produk/ layanan, dan kode billing tertentu dengan tipe data boolean." }, { "id": "CoverageEligibilityRequest.insurance", "path": "CoverageEligibilityRequest.insurance", "definition": "Berisi data instrumen keuangan untuk penggantian produk dan layanan perawatan kesehatan dengan tipe data BackboneElement.", "max": "1" }, { "id": "CoverageEligibilityRequest.insurance.focal", "path": "CoverageEligibilityRequest.insurance.focal", "definition": "Berisi data penanda untuk menunjukkan resource Coverage akan digunakan untuk evaluasi permintaan bila dinyatakan True dengan tipe data booelan." }, { "id": "CoverageEligibilityRequest.insurance.coverage", "path": "CoverageEligibilityRequest.insurance.coverage", "definition": "Berisi data referensi ke informasi tingkat kartu asuransi yang terdapat pada resource Coverage. Perusahaan asuransi yang mengeluarkan pertanggungan akan menggunakan perincian ini untuk menemukan pertanggungan aktual pasien dalam sistem informasi perusahaan asuransi dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Coverage." }, { "id": "CoverageEligibilityRequest.insurance.businessArrangement", "path": "CoverageEligibilityRequest.insurance.businessArrangement", "definition": "Berisi data nomor perjanjian bisnis yang dibuat antara penyedia dan perusahaan asuransi dengan tujuan pemrosesan bisnis khusus dengan tipe data string." }, { "id": "CoverageEligibilityRequest.item", "path": "CoverageEligibilityRequest.item", "definition": "Berisi data manfaat dan saldo opsional saat ini serta detail otorisasi berdasarkan kategori atau layanan dengan tipe data BackboneElement.", "max": "1" }, { "id": "CoverageEligibilityRequest.item.supportingInfoSequence", "path": "CoverageEligibilityRequest.item.supportingInfoSequence", "definition": "Berisi data pengecualian, ketentuan khusus, dan informasi pendukung yang berlaku untuk produk atau layanan dengan tipe data positiveInt.", "max": "1" }, { "id": "CoverageEligibilityRequest.item.category", "path": "CoverageEligibilityRequest.item.category", "definition": "Berisi data kode untuk mengidentifikasi jenis manfaat umum dari produk dan layanan dengan tipe data CodeableConcept." }, { "id": "CoverageEligibilityRequest.item.category.coding", "path": "CoverageEligibilityRequest.item.category.coding", "definition": "Berisi data kode untuk mengidentifikasi jenis manfaat umum dari produk dan layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Benefit Category Codes." }, { "id": "CoverageEligibilityRequest.item.productOrService", "path": "CoverageEligibilityRequest.item.productOrService", "definition": "Berisi data produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data CodeableConcept." }, { "id": "CoverageEligibilityRequest.item.productOrService.coding", "path": "CoverageEligibilityRequest.item.productOrService.coding", "definition": "Berisi data produk, layanan, obat, atau kode tagihan lainnya untuk item tersebut dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi USCLS Codes." }, { "id": "CoverageEligibilityRequest.item.modifier", "path": "CoverageEligibilityRequest.item.modifier", "definition": "Berisi data tipifikasi item atau pengubah kode untuk menyatakan konteks tambahan untuk produk atau layanan dengan tipe data CodeableConcept.", "max": "1" }, { "id": "CoverageEligibilityRequest.item.modifier.coding", "path": "CoverageEligibilityRequest.item.modifier.coding", "definition": "Berisi data tipifikasi item atau pengubah kode untuk menyatakan konteks tambahan untuk produk atau layanan dengan tipe data Coding yang nilainya dapat mengacu pada contoh data terminologi Modifier types Codes." }, { "id": "CoverageEligibilityRequest.item.provider", "path": "CoverageEligibilityRequest.item.provider", "definition": "Berisi data praktisi yang bertanggung jawab atas penyediaan produk atau layanan kepada dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Practitioner | Coverage." }, { "id": "CoverageEligibilityRequest.item.quantity", "path": "CoverageEligibilityRequest.item.quantity", "definition": "Berisi data jumlah pengulangan layanan atau produk dengan tipe data SimpleQuantity." }, { "id": "CoverageEligibilityRequest.item.unitPrice", "path": "CoverageEligibilityRequest.item.unitPrice", "definition": "Berisi data jumlah yang dibebankan kepada pasien oleh penyedia untuk satu unit dengan tipe data Money." }, { "id": "CoverageEligibilityRequest.item.facility", "path": "CoverageEligibilityRequest.item.facility", "definition": "Berisi data fasilitas yang menunjukkan tempat layanan diberikan dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Location | Organization." }, { "id": "CoverageEligibilityRequest.item.diagnosis", "path": "CoverageEligibilityRequest.item.diagnosis", "definition": "Berisi data diagnosis pasien yang diminta pelayanannya dengan tipe data BackboneElement.", "max": "1" }, { "id": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]", "path": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]", "slicing": { "discriminator": [ { "type": "type", "path": "$this" } ], "ordered": false, "rules": "open" }, "definition": "Berisi data ID lokal terkait program yang dijalankan dengan tipe data Identifier." }, { "id": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]:diagnosisCodeableConcept", "path": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]", "sliceName": "diagnosisCodeableConcept", "definition": "Berisi data penyakit atau masalah dalam bentuk kode dengan tipe data CodeableConcept.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ] }, { "id": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]:diagnosisReference", "path": "CoverageEligibilityRequest.item.diagnosis.diagnosis[x]", "sliceName": "diagnosisReference", "definition": "Berisi data penyakit atau masalah dalam bentuk kode atau yang direferensikan ke resource Condition dengan tipe data Reference yang nilainya dapat mengacu pada contoh data terminologi ICD-10 Codes.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Condition" ] } ] }, { "id": "CoverageEligibilityRequest.item.detail", "path": "CoverageEligibilityRequest.item.detail", "definition": "Berisi data rencana/ proposal/ aturan yang menjelaskan layanan yang diusulkan secara rinci ID dengan tipe data Reference yang direferensikan ke data yang tersimpan di resource Any.", "max": "1" } ] } }