3.4. Retrieve MedMij Core - Payer (zib2020/R4)
3.4.1. Overview
| Id | 900000110 |
| Data service name without version (English) | Retrieve MedMij Core - Payer (zib2020/R4) |
| Data service name without version (Dutch) | Verzamelen MedMij Core - Betaler (zib2020/R4) |
| Data service version | 1.0.0-beta.2 |
| System role(s) | MMC-PAR-zib2020/R4-beta.2 (PHR) MMC-PAB-zib2020/R4-beta.2 (XIS) |
| Used in Implementation Guide(s) | Dental Care |
3.4.2. Functional model
| CIM | zib Payer |
| Functional version | 3.1.1(2020) |
The functional model can be found on ART-DECOR.
3.4.3. Technical specification
| FHIR profile(s) | http://nictiz.nl/fhir/StructureDefinition/nl-core-Payer.PayerPerson http://nictiz.nl/fhir/StructureDefinition/nl-core-Payer.InsuranceCompany http://nictiz.nl/fhir/StructureDefinition/nl-core-Payer-Organization |
| FHIR package | nictiz.fhir.nl.r4.nl-core version 0.12.0-beta.4 or compatible |
| FHIR version | R4 |
| Search request | GET [base]/Coverage |
| Must Support | Coverage
|
| CapabilityStatement(s) | MedMij Core Payer Retrieve MedMij Core Payer Serve |
The FHIR profiles are included below.
| NlcorePayerPayerPerson (Coverage) | C | ZibPayerPayerPerson | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| bankInformation | C | 0..* | Extension(Complex) |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| status | Σ ?! | 1..1 | codeBinding |
| type | Σ | 1..1 | CodeableConceptBindingPattern |
| policyHolder | Σ C | 0..1 | Reference(Organization | Patient | RelatedPerson) |
| subscriber | Σ C | 0..1 | Reference(Patient | RelatedPerson) |
| subscriberId | Σ | 0..1 | string |
| beneficiary | Σ C | 1..1 | Reference(Patient | NlcorePatient) |
| dependent | Σ | 0..1 | string |
| relationship | 0..1 | CodeableConceptBinding | |
| period | Σ C | 0..1 | Period |
| payor | Σ C | 1..1 | Reference(Organization | Patient | RelatedPerson | NlcoreContactPerson | NlcorePatient | NlcorePayerOrganization) |
| class | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| type | Σ | 1..1 | CodeableConceptBinding |
| value | Σ | 1..1 | string |
| name | Σ | 0..1 | string |
| order | Σ | 0..1 | positiveInt |
| network | Σ | 0..1 | string |
| costToBeneficiary | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| type | Σ | 0..1 | CodeableConceptBinding |
| value[x] | Σ | 1..1 | |
| valueMoney | Money | ||
| valueQuantity | SimpleQuantity | ||
| exception | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| type | Σ | 1..1 | CodeableConcept |
| period | Σ C | 0..1 | Period |
| subrogation | 0..1 | boolean | |
| contract | C | 0..* | Reference(Contract) |
--- We have skipped the narrative for better readability of the resource ---
</text>
</telecom>
</contact>
<description value="Payers are organizations or individuals that pay for the healthcare supplied to the patient. These organizations or individuals can be: facilities or people who financially guarantee or who are responsible for the patient (such as parents or guardians of minors), organizations with direct financial responsibility, combinations of these or the patient themselves." />
<purpose value="A derived profile from [zib-Payer](http://nictiz.nl/fhir/StructureDefinition/zib-Payer.PayerPerson) to provide a version better suited for implementation purposes. This profile augments the base profile with elements found in the various use cases that have adopted the zib." />
<copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." />
</mapping>
<definition value="Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment." />
<comment value="The zib Payer is split into two focal profiles on Coverage based on the PayerPerson and InsuranceCompany containers. These two containers cannot be profiled within one profile because they both require mapping different concepts on elements such as `.payor` and `.type`.\n\nThe zib container Payer.PayerPerson is mapped to this Coverage profile and uses the profiles nl-core-Patient, nl-core-ContactPerson and nl-core-Payer-Organization to capture the PayerName, AddressInformation and ContactInformation. These profiles are referenced using the `.payor` element." />
</base>
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
</constraint>
<human value="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 value="contained.where((('#'+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(canonical) = '#').exists()).not()).trace('unmatched', id).empty()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
</constraint>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="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." />
</extension>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
</base>
</extension>
</type>
</element>
<definition value="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." />
</base>
</type>
</constraint>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
<isModifierReason value="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" />
</element>
<comment value="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)." />
</base>
</type>
</constraint>
</extension>
</extension>
</extension>
</binding>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
</extension>
</extension>
<comment value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="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 value="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 value="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)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
</mapping>
</element>
<comment value="The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependant." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<comment value="When systems don't record an explicit status and no status can be derived from the `.period.start` and `.period.end` elements it is expected that only _active_ Coverage resources are exchanged." />
<requirements value="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'." />
</base>
</type>
</constraint>
<isModifierReason value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization." />
<requirements value="The order of application of coverages is dependent on the types of coverage." />
</base>
</type>
</coding>
</patternCodeableConcept>
</constraint>
</extension>
<description value="The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization." />
</binding>
</mapping>
</mapping>
</element>
<requirements value="This provides employer information in the case of Worker's Compensation and other policies." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<requirements value="The insurer requires this identifier on correspondance and claims (digital and otherwise)." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The party who benefits from the insurance coverage; the patient when products and/or services are provided." />
<requirements value="This is the party who receives treatment for which the costs are reimbursed under the coverage." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<comment value="Periodically the member number is constructed from the subscriberId and the dependant number." />
<requirements value="For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<comment value="Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others." />
<requirements value="To determine relationship between the patient and the subscriber to determine coordination of benefits." />
</base>
</type>
</constraint>
</extension>
<description value="The relationship between the Subscriber and the Beneficiary (insured/covered party/patient)." />
</binding>
</mapping>
</element>
<definition value="Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="In the PayerPerson concept a person is a natural person or a juridical person, such as an organization, municipality, etc." />
<comment value="If the resource referenced is conformant to one of the target zib profiles, these profiles provide a mapping to the relevant zib Payer concepts. If it is not conformant to one of these zib profiles, it SHALL have at least the following FHIR elements filled to be compliant with the subsequent zib Payer concepts:\n* `name.text` - PayerPerson::PayerName (NL-CM:1.1.5)\n* `address` - AddressInformation (NL-CM:1.1.17)\n* `telecom` - ContactInformation (NL-CM:1.1.12)" />
<requirements value="Need to identify the issuer to target for claim processing and for coordination of benefit processing." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
<comment value="For example may be used to identify a class of coverage or employer group, Policy, Plan." />
<requirements value="The codes provided on the health card which identify or confirm the specific policy for the insurer." />
</base>
</type>
</constraint>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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 value="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 value="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)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<definition value="The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan." />
</base>
</type>
</constraint>
</extension>
</binding>
</element>
<requirements value="The insurer issued label and value are necessary to identify the specific policy." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply." />
</base>
</type>
</constraint>
</mapping>
</element>
</extension>
<definition value="A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card." />
<comment value="For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment." />
</base>
</type>
</constraint>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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 value="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 value="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)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<requirements value="Needed to identify the category associated with the amount for the patient." />
</base>
</type>
</constraint>
</extension>
</binding>
</element>
<comment value="Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency." />
<requirements value="Needed to identify the amount for the patient associated with the category." />
</base>
</type>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
</extension>
<definition value="A suite of codes indicating exceptions or reductions to patient costs and their effective periods." />
</base>
</type>
</constraint>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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 value="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 value="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)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<requirements value="Needed to identify the exception associated with the amount for the patient." />
</base>
</type>
</constraint>
</extension>
<description value="The types of exceptions from the part or full value of financial obligations such as copays." />
</binding>
</element>
<requirements value="Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs." />
</base>
</type>
</constraint>
</element>
<definition value="When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs." />
<comment value="Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims." />
</base>
</type>
</constraint>
</element>
<requirements value="To reference the legally binding contract between the policy holder and the insurer." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</snapshot>
<comment value="The zib Payer is split into two focal profiles on Coverage based on the PayerPerson and InsuranceCompany containers. These two containers cannot be profiled within one profile because they both require mapping different concepts on elements such as `.payor` and `.type`.\n\nThe zib container Payer.PayerPerson is mapped to this Coverage profile and uses the profiles nl-core-Patient, nl-core-ContactPerson and nl-core-Payer-Organization to capture the PayerName, AddressInformation and ContactInformation. These profiles are referenced using the `.payor` element." />
</element>
</type>
</element>
</type>
</element>
</differential>
</StructureDefinition>
{
--- We have skipped the narrative for better readability of the resource ---
},
{
]
}
],
"description": "Payers are organizations or individuals that pay for the healthcare supplied to the patient. These organizations or individuals can be: facilities or people who financially guarantee or who are responsible for the patient (such as parents or guardians of minors), organizations with direct financial responsibility, combinations of these or the patient themselves.",
"purpose": "A derived profile from [zib-Payer](http://nictiz.nl/fhir/StructureDefinition/zib-Payer.PayerPerson) to provide a version better suited for implementation purposes. This profile augments the base profile with elements found in the various use cases that have adopted the zib.",
"copyright": "Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.",
{
}
],
{
"definition": "Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.",
"comment": "The zib Payer is split into two focal profiles on Coverage based on the PayerPerson and InsuranceCompany containers. These two containers cannot be profiled within one profile because they both require mapping different concepts on elements such as `.payor` and `.type`.\n\nThe zib container Payer.PayerPerson is mapped to this Coverage profile and uses the profiles nl-core-Patient, nl-core-ContactPerson and nl-core-Payer-Organization to capture the PayerName, AddressInformation and ContactInformation. These profiles are referenced using the `.payor` element.",
"Betaler",
"nl-core-Payer.PayerPerson"
],
},
{
},
{
"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 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(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
},
{
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
},
{
},
{
{
},
{
"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."
}
],
}
],
{
},
{
},
{
},
{
}
]
},
{
"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.",
},
{
{
}
],
}
],
},
{
"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.",
},
],
{
}
],
},
{
"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.",
},
],
{
}
],
"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",
},
{
"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).",
},
],
{
}
],
{
},
{
},
{
}
],
}
},
{
"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.",
"narrative",
"html",
"xhtml",
"display"
],
},
],
{
}
],
]
},
{
"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.",
"inline resources",
"anonymous resources",
"contained resources"
],
},
],
]
},
{
},
"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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
{
},
{
}
],
"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.",
"extensions",
"user content",
"Bankgegevens"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/ext-Payer.BankInformation"
]
}
],
"ele-1"
],
{
},
{
}
],
{
},
{
},
{
}
]
},
{
"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).",
"extensions",
"user content"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
]
},
{
"comment": "The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependant.",
},
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"comment": "When systems don't record an explicit status and no status can be derived from the `.period.start` and `.period.end` elements it is expected that only _active_ Coverage resources are exchanged.",
"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'.",
},
],
{
}
],
"isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
{
}
],
},
{
},
{
},
{
}
]
},
{
"definition": "The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.",
},
],
},
{
}
],
{
}
],
"description": "The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.",
},
]
},
{
"requirements": "This provides employer information in the case of Worker's Compensation and other policies.",
},
{
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.",
},
{
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"requirements": "The insurer requires this identifier on correspondance and claims (digital and otherwise).",
},
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "The party who benefits from the insurance coverage; the patient when products and/or services are provided.",
"requirements": "This is the party who receives treatment for which the costs are reimbursed under the coverage.",
},
{
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient"
]
}
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"comment": "Periodically the member number is constructed from the subscriberId and the dependant number.",
"requirements": "For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary.",
},
],
{
}
],
{
},
{
}
]
},
{
"comment": "Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others.",
"requirements": "To determine relationship between the patient and the subscriber to determine coordination of benefits.",
},
],
{
}
],
{
}
],
"description": "The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).",
},
]
},
{
"definition": "Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.",
},
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"definition": "In the PayerPerson concept a person is a natural person or a juridical person, such as an organization, municipality, etc.",
"comment": "If the resource referenced is conformant to one of the target zib profiles, these profiles provide a mapping to the relevant zib Payer concepts. If it is not conformant to one of these zib profiles, it SHALL have at least the following FHIR elements filled to be compliant with the subsequent zib Payer concepts:\n* `name.text` - PayerPerson::PayerName (NL-CM:1.1.5)\n* `address` - AddressInformation (NL-CM:1.1.17)\n* `telecom` - ContactInformation (NL-CM:1.1.12)",
"requirements": "Need to identify the issuer to target for claim processing and for coordination of benefit processing.",
"BetalerPersoon"
],
},
{
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-Payer-Organization",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson"
]
}
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
{
}
],
"comment": "For example may be used to identify a class of coverage or employer group, Policy, Plan.",
"requirements": "The codes provided on the health card which identify or confirm the specific policy for the insurer.",
},
],
{
}
],
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
"definition": "The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan.",
},
],
{
}
],
{
}
],
}
},
{
"requirements": "The insurer issued label and value are necessary to identify the specific policy.",
},
],
{
}
],
{
},
{
},
{
}
]
},
{
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care.",
},
],
{
}
],
]
},
{
"definition": "The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply.",
},
],
{
}
],
]
},
{
{
}
],
"definition": "A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card.",
"comment": "For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.",
"CoPay",
"Deductible",
"Exceptions"
],
},
],
{
}
],
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
],
{
}
],
{
}
],
}
},
{
"comment": "Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.",
},
{
},
{
}
],
{
}
],
{
},
{
},
{
}
]
},
{
{
}
],
"definition": "A suite of codes indicating exceptions or reductions to patient costs and their effective periods.",
},
],
{
}
],
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
],
{
}
],
{
}
],
"description": "The types of exceptions from the part or full value of financial obligations such as copays.",
}
},
{
"requirements": "Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs.",
},
],
{
}
],
},
{
"definition": "When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.",
"comment": "Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims.",
},
],
{
}
],
},
{
"requirements": "To reference the legally binding contract between the policy holder and the insurer.",
},
],
{
}
],
{
},
{
},
{
},
{
}
]
}
]
},
{
"comment": "The zib Payer is split into two focal profiles on Coverage based on the PayerPerson and InsuranceCompany containers. These two containers cannot be profiled within one profile because they both require mapping different concepts on elements such as `.payor` and `.type`.\n\nThe zib container Payer.PayerPerson is mapped to this Coverage profile and uses the profiles nl-core-Patient, nl-core-ContactPerson and nl-core-Payer-Organization to capture the PayerName, AddressInformation and ContactInformation. These profiles are referenced using the `.payor` element.",
"nl-core-Payer.PayerPerson"
]
},
{
{
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient"
]
}
]
},
{
{
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-Payer-Organization",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactPerson"
]
}
]
}
]
}
}
| NlcorePayerInsuranceCompany (Coverage) | C | ZibPayerInsuranceCompany | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ | 0..* | Identifier |
| status | Σ ?! | 1..1 | codeBinding |
| type | Σ | 0..1 | CodeableConceptBinding |
| policyHolder | Σ C | 0..1 | Reference(Organization | Patient | RelatedPerson) |
| subscriber | Σ C | 0..1 | Reference(Patient | RelatedPerson) |
| subscriberId | Σ | 0..1 | string |
| beneficiary | Σ C | 1..1 | Reference(Patient | NlcorePatient) |
| dependent | Σ | 0..1 | string |
| relationship | 0..1 | CodeableConceptBinding | |
| period | Σ C | 0..1 | Period |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| start | Σ C | 0..1 | dateTime |
| end | Σ C | 0..1 | dateTime |
| payor | Σ C | 1..1 | Reference(Organization | Patient | RelatedPerson | NlcorePayerOrganization) |
| class | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| type | Σ | 1..1 | CodeableConceptBinding |
| value | Σ | 1..1 | string |
| name | Σ | 0..1 | string |
| order | Σ | 0..1 | positiveInt |
| network | Σ | 0..1 | string |
| costToBeneficiary | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| type | Σ | 0..1 | CodeableConceptBinding |
| value[x] | Σ | 1..1 | |
| valueMoney | Money | ||
| valueQuantity | SimpleQuantity | ||
| exception | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| type | Σ | 1..1 | CodeableConcept |
| period | Σ C | 0..1 | Period |
| subrogation | 0..1 | boolean | |
| contract | C | 0..* | Reference(Contract) |
--- We have skipped the narrative for better readability of the resource ---
</text>
</telecom>
</contact>
<description value="Payers are organizations or individuals that pay for the healthcare supplied to the patient. These organizations or individuals can be: facilities or people who financially guarantee or who are responsible for the patient (such as parents or guardians of minors), organizations with direct financial responsibility, combinations of these or the patient themselves." />
<purpose value="A derived profile from [zib-Payer](http://nictiz.nl/fhir/StructureDefinition/zib-Payer.InsuranceCompany) to provide a version better suited for implementation purposes. This profile augments the base profile with elements found in the various use cases that have adopted the zib." />
<copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." />
</mapping>
<definition value="Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment." />
<comment value="The zib Payer is split into two focal profiles on Coverage based on the PayerPerson and InsuranceCompany containers. These two containers cannot be profiled within one profile because they both require mapping different concepts on elements such as `.payor` and `.type`.\n\nThe zib container Payer.InsuranceCompany is mapped to this Coverage profile and uses the profile nl-core-Payer-Organization (<http://nictiz.nl/fhir/StructureDefinition/nl-core-Payer-Organization>) to capture the OrganizationName, IdentificationNumber, AddressInformation and ContactInformation. The nl-core-Payer-Organization profile is referenced using the `.payor` element." />
</base>
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
</constraint>
<human value="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 value="contained.where((('#'+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(canonical) = '#').exists()).not()).trace('unmatched', id).empty()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
</constraint>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="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." />
</extension>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
</base>
</extension>
</type>
</element>
<definition value="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." />
</base>
</type>
</constraint>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
<isModifierReason value="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" />
</element>
<comment value="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)." />
</base>
</type>
</constraint>
</extension>
</extension>
</extension>
</binding>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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 value="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 value="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)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
</mapping>
</element>
<comment value="The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependant." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<comment value="Sending systems that don't record an explicit status can use the following guidance to infer a value from the zib:\n\n* StartDateTime is present and in the future: _draft_\n* EndDateTime is present:\n * and in the future: _active_\n * and in the past: _cancelled_\n* When no status can be derived from StartDateTime and EndDateTime it is expected that only _active_ Coverage resources are exchanged." />
<requirements value="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'." />
</base>
</type>
</constraint>
<isModifierReason value="This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid" />
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Type of insurance policy. Codes as returned in the Check for Right to Insurance." />
<requirements value="The order of application of coverages is dependent on the types of coverage." />
</base>
</type>
</constraint>
</extension>
<description value="The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization." />
<valueSet value="http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.1.1.1--20200901000000" />
</binding>
</mapping>
</mapping>
</mapping>
</element>
<requirements value="This provides employer information in the case of Worker's Compensation and other policies." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Number under which the insured person is registered at the insurance company This item maps the ‘Identification number of the card’ on EHIC field 8" />
<requirements value="The insurer requires this identifier on correspondance and claims (digital and otherwise)." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The party who benefits from the insurance coverage; the patient when products and/or services are provided." />
<requirements value="This is the party who receives treatment for which the costs are reimbursed under the coverage." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<comment value="Periodically the member number is constructed from the subscriberId and the dependant number." />
<requirements value="For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<comment value="Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others." />
<requirements value="To determine relationship between the patient and the subscriber to determine coordination of benefits." />
</base>
</type>
</constraint>
</extension>
<description value="The relationship between the Subscriber and the Beneficiary (insured/covered party/patient)." />
</binding>
</mapping>
</element>
<definition value="Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
</discriminator>
</slicing>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<comment value="If the low element is missing, the meaning is that the low boundary is not known." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Date until which the insurance policy coverage applies. This item maps the ‘Expiry date’ on EHIC field 9." />
<comment value="The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03." />
</base>
</type>
<meaningWhenMissing value="If the end of the period is missing, it means that the period is ongoing" />
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements." />
<comment value="May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).\nFor selfpay it may provide multiple paying persons and/or organizations." />
<requirements value="Need to identify the issuer to target for claim processing and for coordination of benefit processing." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
<comment value="For example may be used to identify a class of coverage or employer group, Policy, Plan." />
<requirements value="The codes provided on the health card which identify or confirm the specific policy for the insurer." />
</base>
</type>
</constraint>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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 value="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 value="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)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<definition value="The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan." />
</base>
</type>
</constraint>
</extension>
</binding>
</element>
<requirements value="The insurer issued label and value are necessary to identify the specific policy." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply." />
</base>
</type>
</constraint>
</mapping>
</element>
</extension>
<definition value="A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card." />
<comment value="For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment." />
</base>
</type>
</constraint>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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 value="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 value="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)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<requirements value="Needed to identify the category associated with the amount for the patient." />
</base>
</type>
</constraint>
</extension>
</binding>
</element>
<comment value="Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency." />
<requirements value="Needed to identify the amount for the patient associated with the category." />
</base>
</type>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
</extension>
<definition value="A suite of codes indicating exceptions or reductions to patient costs and their effective periods." />
</base>
</type>
</constraint>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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 value="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 value="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)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
<requirements value="Needed to identify the exception associated with the amount for the patient." />
</base>
</type>
</constraint>
</extension>
<description value="The types of exceptions from the part or full value of financial obligations such as copays." />
</binding>
</element>
<requirements value="Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs." />
</base>
</type>
</constraint>
</element>
<definition value="When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs." />
<comment value="Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims." />
</base>
</type>
</constraint>
</element>
<requirements value="To reference the legally binding contract between the policy holder and the insurer." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</snapshot>
<comment value="The zib Payer is split into two focal profiles on Coverage based on the PayerPerson and InsuranceCompany containers. These two containers cannot be profiled within one profile because they both require mapping different concepts on elements such as `.payor` and `.type`.\n\nThe zib container Payer.InsuranceCompany is mapped to this Coverage profile and uses the profile nl-core-Payer-Organization (<http://nictiz.nl/fhir/StructureDefinition/nl-core-Payer-Organization>) to capture the OrganizationName, IdentificationNumber, AddressInformation and ContactInformation. The nl-core-Payer-Organization profile is referenced using the `.payor` element." />
</element>
</type>
</element>
</type>
</element>
</differential>
</StructureDefinition>
{
--- We have skipped the narrative for better readability of the resource ---
},
{
]
}
],
"description": "Payers are organizations or individuals that pay for the healthcare supplied to the patient. These organizations or individuals can be: facilities or people who financially guarantee or who are responsible for the patient (such as parents or guardians of minors), organizations with direct financial responsibility, combinations of these or the patient themselves.",
"purpose": "A derived profile from [zib-Payer](http://nictiz.nl/fhir/StructureDefinition/zib-Payer.InsuranceCompany) to provide a version better suited for implementation purposes. This profile augments the base profile with elements found in the various use cases that have adopted the zib.",
"copyright": "Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.",
{
}
],
{
"definition": "Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.",
"comment": "The zib Payer is split into two focal profiles on Coverage based on the PayerPerson and InsuranceCompany containers. These two containers cannot be profiled within one profile because they both require mapping different concepts on elements such as `.payor` and `.type`.\n\nThe zib container Payer.InsuranceCompany is mapped to this Coverage profile and uses the profile nl-core-Payer-Organization (<http://nictiz.nl/fhir/StructureDefinition/nl-core-Payer-Organization>) to capture the OrganizationName, IdentificationNumber, AddressInformation and ContactInformation. The nl-core-Payer-Organization profile is referenced using the `.payor` element.",
"Betaler",
"Verzekering",
"nl-core-Payer.InsuranceCompany"
],
},
{
},
{
"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 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(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
},
{
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
},
{
},
{
{
},
{
"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."
}
],
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"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.",
},
{
{
}
],
}
],
},
{
"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.",
},
],
{
}
],
},
{
"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.",
},
],
{
}
],
"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",
},
{
"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).",
},
],
{
}
],
{
},
{
},
{
}
],
}
},
{
"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.",
"narrative",
"html",
"xhtml",
"display"
],
},
],
{
}
],
]
},
{
"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.",
"inline resources",
"anonymous resources",
"contained resources"
],
},
],
]
},
{
"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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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).",
"extensions",
"user content"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
]
},
{
"comment": "The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependant.",
},
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"comment": "Sending systems that don't record an explicit status can use the following guidance to infer a value from the zib:\n\n* StartDateTime is present and in the future: _draft_\n* EndDateTime is present:\n * and in the future: _active_\n * and in the past: _cancelled_\n* When no status can be derived from StartDateTime and EndDateTime it is expected that only _active_ Coverage resources are exchanged.",
"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'.",
},
],
{
}
],
"isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
{
}
],
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"Verzekeringssoort"
],
},
],
{
}
],
{
}
],
"description": "The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.1.1.1--20200901000000"
},
{
},
{
},
{
}
]
},
{
"requirements": "This provides employer information in the case of Worker's Compensation and other policies.",
},
{
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.",
},
{
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson"
]
}
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "Number under which the insured person is registered at the insurance company This item maps the ‘Identification number of the card’ on EHIC field 8",
"requirements": "The insurer requires this identifier on correspondance and claims (digital and otherwise).",
"VerzekerdeNummer"
],
},
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "The party who benefits from the insurance coverage; the patient when products and/or services are provided.",
"requirements": "This is the party who receives treatment for which the costs are reimbursed under the coverage.",
},
{
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient"
]
}
],
{
}
],
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
"comment": "Periodically the member number is constructed from the subscriberId and the dependant number.",
"requirements": "For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary.",
},
],
{
}
],
{
},
{
}
]
},
{
"comment": "Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others.",
"requirements": "To determine relationship between the patient and the subscriber to determine coordination of benefits.",
},
],
{
}
],
{
}
],
"description": "The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).",
},
]
},
{
"definition": "Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.",
},
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
],
},
"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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"BeginDatumTijd"
],
},
],
"per-1"
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "Date until which the insurance policy coverage applies. This item maps the ‘Expiry date’ on EHIC field 9.",
"comment": "The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.",
"EindDatumTijd"
],
},
],
"per-1"
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements.",
"comment": "May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).\nFor selfpay it may provide multiple paying persons and/or organizations.",
"requirements": "Need to identify the issuer to target for claim processing and for coordination of benefit processing.",
"Verzekeraar"
],
},
{
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-Payer-Organization"
]
}
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
{
}
],
"comment": "For example may be used to identify a class of coverage or employer group, Policy, Plan.",
"requirements": "The codes provided on the health card which identify or confirm the specific policy for the insurer.",
},
],
{
}
],
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
"definition": "The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan.",
},
],
{
}
],
{
}
],
}
},
{
"requirements": "The insurer issued label and value are necessary to identify the specific policy.",
},
],
{
}
],
{
},
{
},
{
}
]
},
{
},
],
{
}
],
{
},
{
},
{
}
]
},
{
"definition": "The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care.",
},
],
{
}
],
]
},
{
"definition": "The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply.",
},
],
{
}
],
]
},
{
{
}
],
"definition": "A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card.",
"comment": "For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.",
"CoPay",
"Deductible",
"Exceptions"
],
},
],
{
}
],
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
],
{
}
],
{
}
],
}
},
{
"comment": "Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency.",
},
{
},
{
}
],
{
}
],
{
},
{
},
{
}
]
},
{
{
}
],
"definition": "A suite of codes indicating exceptions or reductions to patient costs and their effective periods.",
},
],
{
}
],
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
],
{
}
],
{
}
],
"description": "The types of exceptions from the part or full value of financial obligations such as copays.",
}
},
{
"requirements": "Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs.",
},
],
{
}
],
},
{
"definition": "When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.",
"comment": "Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims.",
},
],
{
}
],
},
{
"requirements": "To reference the legally binding contract between the policy holder and the insurer.",
},
],
{
}
],
{
},
{
},
{
},
{
}
]
}
]
},
{
"comment": "The zib Payer is split into two focal profiles on Coverage based on the PayerPerson and InsuranceCompany containers. These two containers cannot be profiled within one profile because they both require mapping different concepts on elements such as `.payor` and `.type`.\n\nThe zib container Payer.InsuranceCompany is mapped to this Coverage profile and uses the profile nl-core-Payer-Organization (<http://nictiz.nl/fhir/StructureDefinition/nl-core-Payer-Organization>) to capture the OrganizationName, IdentificationNumber, AddressInformation and ContactInformation. The nl-core-Payer-Organization profile is referenced using the `.payor` element.",
"nl-core-Payer.InsuranceCompany"
]
},
{
{
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient"
]
}
]
},
{
{
"http://hl7.org/fhir/StructureDefinition/Organization",
"http://hl7.org/fhir/StructureDefinition/Patient",
"http://hl7.org/fhir/StructureDefinition/RelatedPerson",
"http://nictiz.nl/fhir/StructureDefinition/nl-core-Payer-Organization"
]
}
]
}
]
}
}
| NlcorePayerOrganization (Organization) | C | ZibPayerOrganization | |
| id | Σ | 0..1 | string |
| meta | Σ | 0..1 | Meta |
| implicitRules | Σ ?! | 0..1 | uri |
| language | 0..1 | codeBinding | |
| text | 0..1 | Narrative | |
| contained | 0..* | Resource | |
| extension | C | 0..* | Extension |
| modifierExtension | ?! C | 0..* | Extension |
| identifier | Σ C | 0..* | Identifier |
| uzovi | Σ C | 0..1 | IdentifierPattern |
| active | Σ ?! | 0..1 | boolean |
| type | Σ | 0..* | CodeableConcept |
| name | Σ C | 0..1 | string |
| alias | 0..* | string | |
| telecom | C | 0..* | ContactPoint |
| telephoneNumbers | C | 0..* | NlcoreContactInformationTelephoneNumbers |
| emailAddresses | C | 0..* | NlcoreContactInformationEmailAddresses |
| address | C | 0..* | NlcoreAddressInformation |
| partOf | Σ C | 0..1 | Reference(Organization) |
| contact | 0..* | BackboneElement | |
| id | 0..1 | string | |
| extension | C | 0..* | Extension |
| modifierExtension | Σ ?! C | 0..* | Extension |
| purpose | 0..1 | CodeableConceptBinding | |
| name | 0..1 | HumanName | |
| telecom | C | 0..* | ContactPoint |
| address | 0..1 | Address | |
| endpoint | C | 0..* | Reference(Endpoint) |
--- We have skipped the narrative for better readability of the resource ---
</text>
</telecom>
</contact>
<description value="Payers are organizations or individuals that pay for the healthcare supplied to the patient. These organizations or individuals can be: facilities or people who financially guarantee or who are responsible for the patient (such as parents or guardians of minors), organizations with direct financial responsibility, combinations of these or the patient themselves." />
<purpose value="A derived profile from [zib-Payer-Organization](http://nictiz.nl/fhir/StructureDefinition/zib-Payer-Organization) to provide a version better suited for implementation purposes. This profile augments the base profile with elements found in the various use cases that have adopted the zib." />
<copyright value="Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise." />
</mapping>
<definition value="A formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc." />
<comment value="The zib Payer is split into two focal profiles on Coverage based on the PayerPerson and InsuranceCompany containers. These profiles can refer to respectively an Organization as PayerPerson or an InsuranceCompany. This profile can thus represent either the PayerName or InsuranceCompany concept and both the AddressInformation and ContactInformation concepts of the zib." />
</base>
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
</constraint>
<human value="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 value="contained.where((('#'+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(canonical) = '#').exists()).not()).trace('unmatched', id).empty()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
</constraint>
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
</constraint>
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="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." />
</extension>
</constraint>
<human value="The organization SHALL at least have a name or an identifier, and possibly more than one" />
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
</base>
</extension>
</type>
</element>
<definition value="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." />
</base>
</type>
</constraint>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
<isModifierReason value="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" />
</element>
<comment value="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)." />
</base>
</type>
</constraint>
</extension>
</extension>
</extension>
</binding>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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 value="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 value="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)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
</mapping>
</element>
</discriminator>
</slicing>
<definition value="Identifier for the organization that is used to identify the organization across multiple disparate systems." />
<requirements value="Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<requirements value="Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization." />
</base>
</type>
</patternIdentifier>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<comment value="This active flag is not intended to be used to mark an organization as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used.\n\nThis element is labeled as a modifier because it may be used to mark that the resource was created in error." />
<requirements value="Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI." />
</base>
</type>
<meaningWhenMissing value="This resource is generally assumed to be active if no value is provided for the active element" />
</constraint>
<isModifierReason value="This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid" />
</mapping>
</mapping>
</mapping>
<map value="./Status (however this concept in ServD more covers why the organization is active or not, could be delisted, deregistered, not operational yet) this could alternatively be derived from ./StartDate and ./EndDate and given a context date." />
</mapping>
</element>
<comment value="Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes\n\nWhen considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.\n\nWe expect that some jurisdictions will profile this optionality to be a single cardinality." />
<requirements value="Need to be able to track the kind of organization that this is - different organization types have different uses." />
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<definition value="Full, official name of the healthcare insurance company or paying organization. If the UZOVI number is entered as an identification number, this will be the name as listed in the UZOVI register and the name which is returned in the Check for Right to Insurance (COV)." />
<comment value="If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<short value="A list of alternate names that the organization is known as, or was known as in the past" />
<definition value="A list of alternate names that the organization is known as, or was known as in the past." />
<comment value="There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization." />
<requirements value="Over time locations and organizations go through many changes and can be known by different names.\n\nFor searching knowing previous names that the organization was known by can be very useful." />
</base>
</type>
</constraint>
</mapping>
</element>
</discriminator>
</slicing>
<comment value="The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc." />
<comment value="Implementation of the "TelephoneNumbers" concept of zib ContactInformation.\n\nPlease note that, although the zib concepts TelecomType and NumberType are functionally equivalent to the FHIR concepts `ContactPoint.system` and `ContactPoint.use` respectively, a mismatch occurs on the concept of mobile phone numbers; the zib uses the first concept and FHIR the second. For this reason, the ValueSet on `ContactPoint.system` is too narrow and the zib code will need to be communicated using the ext-CodeSpecification extension." />
</base>
<profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-TelephoneNumbers" />
</type>
</constraint>
<source value="http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelephoneNumbers" />
</constraint>
<source value="http://nictiz.nl/fhir/StructureDefinition/zib-ContactInformation-TelephoneNumbers" />
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc." />
</base>
<profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-EmailAddresses" />
</type>
</constraint>
</constraint>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
</extension>
</extension>
<definition value="An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world." />
<comment value="This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the [zib AddressInformation v1.1 (2020)](https://zibs.nl/wiki/AddressInformation-v1.1(2020EN)). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype.\n\nTo have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements.\n\n**Separate address parts**\n\nThe first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad.\n\n**Custom address types**\n\nThe second addition is that the zib defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the zib concepts are mapped to the various FHIR elements (see the ConceptMaps <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse> and <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType> as well). The code from the zib should also be included using the extension on `Address.extension:addressType`.\n\n| zib | .ext:addressType | .use | .type |\n|-----------------------------------|------------------|------|----------|\n| Postal Address/Postadres | PST | | postal |\n| Primary Home/Officieel adres | HP | home | both |\n| Visit Address/Woon-/verblijfadres | PHYS | home | physical |\n| Temporary Address/Tijdelijk adres | TMP | temp | |\n| Work Place/Werkadres | WP | work | |\n| Vacation Home/Vakantie adres | HV | temp | |\n\nIf `Address.type` is _both_ then this is to be understood as a dual purpose address (postal and physical), unless a specific _postal_ type address is added. Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses.\n\nNote: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the zib ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension." />
<requirements value="May need to keep track of the organization's addresses for contacting, billing or reporting requirements." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</mapping>
</element>
<requirements value="Need to be able to track the hierarchy of organizations within an organization." />
</base>
</extension>
</type>
</constraint>
</mapping>
</mapping>
</mapping>
</element>
<comment value="Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use." />
</base>
</type>
</constraint>
</mapping>
</element>
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
</base>
</extension>
</type>
</mapping>
</element>
<definition value="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 value="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." />
</base>
</type>
</constraint>
</constraint>
</mapping>
</element>
<definition value="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 value="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 value="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)." />
</base>
</type>
</constraint>
</constraint>
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them" />
</mapping>
</element>
</base>
</type>
</constraint>
</extension>
</binding>
</mapping>
</element>
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="A contact detail (e.g. a telephone number or an email address) by which the party may be contacted." />
<requirements value="People have (primary) ways to contact them in some way such as phone, email." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<requirements value="May need to keep track of a contact party's address for contacting, billing or reporting requirements." />
</base>
</type>
</constraint>
</mapping>
</mapping>
</element>
<definition value="Technical endpoints providing access to services operated for the organization." />
<requirements value="Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose." />
</base>
</type>
</constraint>
</mapping>
</element>
</snapshot>
</element>
<profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-TelephoneNumbers" />
</type>
</element>
<profile value="http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-EmailAddresses" />
</type>
</element>
</type>
</element>
</differential>
</StructureDefinition>
{
--- We have skipped the narrative for better readability of the resource ---
},
{
]
}
],
"description": "Payers are organizations or individuals that pay for the healthcare supplied to the patient. These organizations or individuals can be: facilities or people who financially guarantee or who are responsible for the patient (such as parents or guardians of minors), organizations with direct financial responsibility, combinations of these or the patient themselves.",
"purpose": "A derived profile from [zib-Payer-Organization](http://nictiz.nl/fhir/StructureDefinition/zib-Payer-Organization) to provide a version better suited for implementation purposes. This profile augments the base profile with elements found in the various use cases that have adopted the zib.",
"copyright": "Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.",
{
}
],
{
"definition": "A formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc.",
"comment": "The zib Payer is split into two focal profiles on Coverage based on the PayerPerson and InsuranceCompany containers. These profiles can refer to respectively an Organization as PayerPerson or an InsuranceCompany. This profile can thus represent either the PayerName or InsuranceCompany concept and both the AddressInformation and ContactInformation concepts of the zib.",
"Verzekeraar",
"nl-core-Payer-Organization"
],
},
{
},
{
"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 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(canonical) = '#').exists()).not()).trace('unmatched', id).empty()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
},
{
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
},
{
},
{
{
},
{
"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."
}
],
},
{
"human": "The organization SHALL at least have a name or an identifier, and possibly more than one",
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"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.",
},
{
{
}
],
}
],
},
{
"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.",
},
],
{
}
],
},
{
"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.",
},
],
{
}
],
"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",
},
{
"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).",
},
],
{
}
],
{
},
{
},
{
}
],
}
},
{
"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.",
"narrative",
"html",
"xhtml",
"display"
],
},
],
{
}
],
]
},
{
"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.",
"inline resources",
"anonymous resources",
"contained resources"
],
},
],
]
},
{
"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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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).",
"extensions",
"user content"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
]
},
{
},
"definition": "Identifier for the organization that is used to identify the organization across multiple disparate systems.",
"requirements": "Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.",
},
],
"org-1"
],
{
}
],
{
},
{
},
{
},
{
}
]
},
{
"requirements": "Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.",
"IdentificatieNummer"
],
},
],
},
"org-1"
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"comment": "This active flag is not intended to be used to mark an organization as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used.\n\nThis element is labeled as a modifier because it may be used to mark that the resource was created in error.",
"requirements": "Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.",
},
],
"meaningWhenMissing": "This resource is generally assumed to be active if no value is provided for the active element",
{
}
],
"isModifierReason": "This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid",
{
},
{
},
{
},
{
"map": "./Status (however this concept in ServD more covers why the organization is active or not, could be delisted, deregistered, not operational yet) this could alternatively be derived from ./StartDate and ./EndDate and given a context date."
}
]
},
{
"comment": "Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes\n\nWhen considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.\n\nWe expect that some jurisdictions will profile this optionality to be a single cardinality.",
"requirements": "Need to be able to track the kind of organization that this is - different organization types have different uses.",
},
],
{
}
],
{
}
],
},
{
},
{
},
{
},
{
}
]
},
{
"definition": "Full, official name of the healthcare insurance company or paying organization. If the UZOVI number is entered as an identification number, this will be the name as listed in the UZOVI register and the name which is returned in the Check for Right to Insurance (COV).",
"comment": "If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches.",
"OrganisatieNaam",
"BetalerNaam"
],
},
],
"org-1"
],
{
}
],
{
},
{
},
{
},
{
},
{
}
]
},
{
"short": "A list of alternate names that the organization is known as, or was known as in the past",
"definition": "A list of alternate names that the organization is known as, or was known as in the past.",
"comment": "There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization.",
"requirements": "Over time locations and organizations go through many changes and can be known by different names.\n\nFor searching knowing previous names that the organization was known by can be very useful.",
},
],
{
}
],
]
},
{
},
"comment": "The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.",
"Contactgegevens"
],
},
],
"org-3"
],
{
},
{
}
],
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.",
"comment": "Implementation of the \"TelephoneNumbers\" concept of zib ContactInformation.\n\nPlease note that, although the zib concepts TelecomType and NumberType are functionally equivalent to the FHIR concepts `ContactPoint.system` and `ContactPoint.use` respectively, a mismatch occurs on the concept of mobile phone numbers; the zib uses the first concept and FHIR the second. For this reason, the ValueSet on `ContactPoint.system` is too narrow and the zib code will need to be communicated using the ext-CodeSpecification extension.",
"Telefoonnummers",
"nl-core-ContactInformation-TelephoneNumbers"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-TelephoneNumbers"
]
}
],
"org-3",
"ele-1"
],
{
},
{
},
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "Details for all kinds of technology mediated contact points for a person or organization, including telephone, email, etc.",
"EmailAdressen",
"nl-core-ContactInformation-EmailAddresses"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-EmailAddresses"
]
}
],
"org-3",
"ele-1"
],
{
},
{
},
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
{
},
{
}
],
"definition": "An address expressed using postal conventions (as opposed to GPS or other location definition formats). This data type may be used to convey addresses for use in delivering mail as well as for visiting locations which might not be valid for mail delivery. There are a variety of postal address formats defined around the world.",
"comment": "This datatype defines a common basis for expressing all addresses around the world, but adds extensions to express Dutch addresses specifically, according to the [zib AddressInformation v1.1 (2020)](https://zibs.nl/wiki/AddressInformation-v1.1(2020EN)). A Dutch Address still is a proper FHIR Address, which means that systems that cannot interpret the extensions will still be able to render and work with this datatype.\n\nTo have true compatibility an implementer SHOULD use the core Address parts as intended. To have addresses work for Dutch context, the implementer SHOULD in addition use the extension elements.\n\n**Separate address parts**\n\nThe first addition is that Dutch addresses make certain address parts separately communicable. These parts are required for use in true Dutch systems when dealing with Dutch addresses, but may not have value for international systems when information gets sent abroad.\n\n**Custom address types**\n\nThe second addition is that the zib defines its own ValueSet for address types, which can only be partially expressed using the FHIR Address datatype and requires a mapping to multiple elements. The table below explains how the zib concepts are mapped to the various FHIR elements (see the ConceptMaps <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressUse> and <http://nictiz.nl/fhir/ConceptMap/AdresSoortCodelijst-to-AddressType> as well). The code from the zib should also be included using the extension on `Address.extension:addressType`.\n\n| zib | .ext:addressType | .use | .type |\n|-----------------------------------|------------------|------|----------|\n| Postal Address/Postadres | PST | | postal |\n| Primary Home/Officieel adres | HP | home | both |\n| Visit Address/Woon-/verblijfadres | PHYS | home | physical |\n| Temporary Address/Tijdelijk adres | TMP | temp | |\n| Work Place/Werkadres | WP | work | |\n| Vacation Home/Vakantie adres | HV | temp | |\n\nIf `Address.type` is _both_ then this is to be understood as a dual purpose address (postal and physical), unless a specific _postal_ type address is added. Systems that support importing it like this are encouraged to do so, otherwise they may need to import this as two separate addresses.\n\nNote: FHIR core defines the AD-use extension to further specify the postal address type. However, the ValueSet used in that extension doesn't completely match the zib ValueSet. Therefore, a custom extension has been made. This doesn't preclude the use of the AD-use extension.",
"requirements": "May need to keep track of the organization's addresses for contacting, billing or reporting requirements.",
"Adresgegevens",
"nl-core-AddressInformation"
],
},
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-AddressInformation"
]
}
],
"org-2",
"ele-1"
],
{
},
{
}
],
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
},
{
}
]
},
{
},
{
{
}
],
"http://hl7.org/fhir/StructureDefinition/Organization"
]
}
],
{
}
],
{
},
{
},
{
}
]
},
{
"comment": "Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.",
},
],
{
}
],
]
},
{
"xmlAttr"
],
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
},
{
{
}
],
}
],
]
},
{
"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.",
"extensions",
"user content"
],
},
],
{
},
{
}
],
]
},
{
"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).",
"extensions",
"user content",
"modifiers"
],
},
],
{
},
{
}
],
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
]
},
{
},
],
{
}
],
{
}
],
},
]
},
{
},
],
{
}
],
]
},
{
"definition": "A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.",
},
],
{
}
],
]
},
{
"requirements": "May need to keep track of a contact party's address for contacting, billing or reporting requirements.",
},
],
{
}
],
]
},
{
"requirements": "Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.",
},
],
{
}
],
]
}
]
},
{
},
{
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-TelephoneNumbers"
]
}
]
},
{
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-ContactInformation-EmailAddresses"
]
}
]
},
{
{
"http://nictiz.nl/fhir/StructureDefinition/nl-core-AddressInformation"
]
}
]
}
]
}
}