{
  "resourceType": "StructureDefinition",
  "id": "srx-fhir-profile-coverage",
  "meta": {
    "versionId": "4",
    "lastUpdated": "2018-02-26T17:43:58.835+00:00"
  },
  "url": "http://fhir-es.transcendinsights.com/stu3/StructureDefinition/srx-fhir-profile-coverage",
  "name": "srx-fhir-profile-coverage",
  "status": "draft",
  "date": "2017-11-17T21:35:33.094+00:00",
  "fhirVersion": "3.0.1",
  "mapping": [
    {
      "identity": "PATIENT-COVERAGE",
      "name": "SRX PATIENT COVERAGE"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Coverage",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Coverage",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Coverage.id",
        "path": "Coverage.id",
        "max": "0",
        "mustSupport": false
      },
      {
        "id": "Coverage.meta.id",
        "path": "Coverage.meta.id",
        "max": "0"
      },
      {
        "id": "Coverage.meta.extension",
        "path": "Coverage.meta.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Coverage.meta.extension:source-filename",
        "path": "Coverage.meta.extension",
        "sliceName": "source-filename",
        "definition": "Filename.",
        "type": [
          {
            "code": "Extension",
            "profile": "http://fhir-es.transcendinsights.com/stu3/StructureDefinition/source-filename"
          }
        ]
      },
      {
        "id": "Coverage.meta.extension:resource-date-created",
        "path": "Coverage.meta.extension",
        "sliceName": "resource-date-created",
        "definition": "Date/Time the resource was created.",
        "min": 1,
        "type": [
          {
            "code": "Extension",
            "profile": "http://fhir-es.transcendinsights.com/stu3/StructureDefinition/resource-date-created"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Coverage.meta.extension:data-source-entity",
        "path": "Coverage.meta.extension",
        "sliceName": "data-source-entity",
        "type": [
          {
            "code": "Extension",
            "profile": "http://fhir-es.transcendinsights.com/stu3/StructureDefinition/data-source-entity"
          }
        ]
      },
      {
        "id": "Coverage.implicitRules",
        "path": "Coverage.implicitRules",
        "max": "0"
      },
      {
        "id": "Coverage.language",
        "path": "Coverage.language",
        "max": "0"
      },
      {
        "id": "Coverage.text",
        "path": "Coverage.text",
        "max": "0"
      },
      {
        "id": "Coverage.contained",
        "path": "Coverage.contained",
        "max": "0"
      },
      {
        "id": "Coverage.identifier",
        "path": "Coverage.identifier",
        "short": "The patient ID",
        "definition": "The unique identifier of the member.",
        "min": 1,
        "max": "1",
        "example": [
          {
            "label": "coverage identifier",
            "valueIdentifier": {
              "system": "http://fhir-es.transcendinsights.com/stu3/NamingSystem/humana-patient-identifier",
              "value": "10060303"
            }
          }
        ],
        "mapping": [
          {
            "identity": "PATIENT-COVERAGE",
            "map": "PATIENT_ID"
          }
        ]
      },
      {
        "id": "Coverage.identifier.id",
        "path": "Coverage.identifier.id",
        "max": "0"
      },
      {
        "id": "Coverage.identifier.use",
        "path": "Coverage.identifier.use",
        "max": "0",
        "fixedCode": "official"
      },
      {
        "id": "Coverage.identifier.type",
        "path": "Coverage.identifier.type",
        "max": "0"
      },
      {
        "id": "Coverage.identifier.type.id",
        "path": "Coverage.identifier.type.id",
        "max": "0"
      },
      {
        "id": "Coverage.identifier.type.coding",
        "path": "Coverage.identifier.type.coding",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Coverage.identifier.type.coding.id",
        "path": "Coverage.identifier.type.coding.id",
        "max": "0"
      },
      {
        "id": "Coverage.identifier.type.coding.system",
        "path": "Coverage.identifier.type.coding.system",
        "min": 1,
        "fixedUri": "http://hl7.org/fhir/v2/0203"
      },
      {
        "id": "Coverage.identifier.type.coding.version",
        "path": "Coverage.identifier.type.coding.version",
        "max": "0"
      },
      {
        "id": "Coverage.identifier.type.coding.code",
        "path": "Coverage.identifier.type.coding.code",
        "short": "Patient identifier code",
        "definition": "The code that identifies patient internal identifiers.",
        "min": 1,
        "fixedCode": "PI"
      },
      {
        "id": "Coverage.identifier.type.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Coverage.identifier.type.coding.display",
        "definition": "Patient internal identifier",
        "defaultValueString": "Patient ID"
      },
      {
        "id": "Coverage.identifier.type.coding.userSelected",
        "path": "Coverage.identifier.type.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Coverage.identifier.type.text",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Coverage.identifier.type.text",
        "max": "0"
      },
      {
        "id": "Coverage.identifier.system",
        "path": "Coverage.identifier.system",
        "min": 1,
        "fixedUri": "http://fhir-es.transcendinsights.com/stu3/NamingSystem/humana-patient-identifier"
      },
      {
        "id": "Coverage.identifier.value",
        "path": "Coverage.identifier.value",
        "definition": "The patient identifier",
        "min": 1,
        "mapping": [
          {
            "identity": "PATIENT-COVERAGE",
            "map": "PATIENT_ID"
          }
        ]
      },
      {
        "id": "Coverage.identifier.period",
        "path": "Coverage.identifier.period",
        "max": "0"
      },
      {
        "id": "Coverage.identifier.assigner",
        "path": "Coverage.identifier.assigner",
        "max": "0"
      },
      {
        "id": "Coverage.status",
        "path": "Coverage.status",
        "definition": "The status of the coverage.",
        "min": 1,
        "fixedCode": "active",
        "example": [
          {
            "label": "Coverage status example",
            "valueCode": "active"
          }
        ],
        "mustSupport": false
      },
      {
        "id": "Coverage.type",
        "path": "Coverage.type",
        "short": "Type of coverage such as medical or pharmacy.",
        "definition": "The type of coverage: drug policy(DRUGPOL), vision care policy(VISPOL), mental health policy (MENTPOL),  helath insurance plan policy (HIP).",
        "max": "0",
        "mustSupport": false,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "CoverageType"
            }
          ],
          "strength": "preferred",
          "valueSetUri": "http://hl7.org/fhir/ValueSet/coverage-type"
        }
      },
      {
        "id": "Coverage.type.id",
        "path": "Coverage.type.id",
        "max": "0"
      },
      {
        "id": "Coverage.type.coding.id",
        "path": "Coverage.type.coding.id",
        "max": "0"
      },
      {
        "id": "Coverage.type.coding.system",
        "path": "Coverage.type.coding.system",
        "min": 1,
        "fixedUri": "https://www.hl7.org/fhir/v3/ActCoverageTypeCode/vs.html",
        "mustSupport": true
      },
      {
        "id": "Coverage.type.coding.version",
        "path": "Coverage.type.coding.version",
        "max": "0"
      },
      {
        "id": "Coverage.type.coding.code",
        "path": "Coverage.type.coding.code",
        "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g DRUGPOL).",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.type.coding.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Coverage.type.coding.display",
        "definition": "A string describing the type of coverage.",
        "mustSupport": true
      },
      {
        "id": "Coverage.type.coding.userSelected",
        "path": "Coverage.type.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Coverage.type.text",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Coverage.type.text",
        "max": "0"
      },
      {
        "id": "Coverage.policyHolder",
        "path": "Coverage.policyHolder",
        "max": "0",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
          },
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
          }
        ]
      },
      {
        "id": "Coverage.policyHolder.id",
        "path": "Coverage.policyHolder.id",
        "max": "0"
      },
      {
        "id": "Coverage.policyHolder.identifier",
        "path": "Coverage.policyHolder.identifier",
        "max": "0"
      },
      {
        "id": "Coverage.subscriber",
        "path": "Coverage.subscriber",
        "short": "Member ID",
        "definition": "The member identifier.",
        "max": "0",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
          }
        ],
        "mustSupport": false,
        "mapping": [
          {
            "identity": "PATIENT-COVERAGE",
            "map": "DEPENDENT_ID (PK)"
          }
        ]
      },
      {
        "id": "Coverage.subscriber.id",
        "path": "Coverage.subscriber.id",
        "max": "0"
      },
      {
        "id": "Coverage.subscriber.reference",
        "path": "Coverage.subscriber.reference",
        "max": "0"
      },
      {
        "id": "Coverage.subscriber.identifier",
        "path": "Coverage.subscriber.identifier",
        "max": "0"
      },
      {
        "id": "Coverage.subscriber.display",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Coverage.subscriber.display",
        "max": "0"
      },
      {
        "id": "Coverage.subscriberId",
        "path": "Coverage.subscriberId",
        "definition": "The insurer assigned Member ID for the Subscriber.",
        "mapping": [
          {
            "identity": "PATIENT-COVERAGE",
            "map": "MEMBER_ID"
          }
        ]
      },
      {
        "id": "Coverage.beneficiary",
        "path": "Coverage.beneficiary",
        "max": "0",
        "mustSupport": false
      },
      {
        "id": "Coverage.beneficiary.id",
        "path": "Coverage.beneficiary.id",
        "max": "0"
      },
      {
        "id": "Coverage.beneficiary.identifier",
        "path": "Coverage.beneficiary.identifier",
        "max": "0"
      },
      {
        "id": "Coverage.relationship",
        "path": "Coverage.relationship",
        "max": "0",
        "mustSupport": false,
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "Relationship"
            }
          ],
          "strength": "example",
          "valueSetUri": "http://hl7.org/fhir/ValueSet/policyholder-relationship"
        }
      },
      {
        "id": "Coverage.relationship.id",
        "path": "Coverage.relationship.id",
        "max": "0"
      },
      {
        "id": "Coverage.relationship.coding.id",
        "path": "Coverage.relationship.coding.id",
        "max": "0"
      },
      {
        "id": "Coverage.relationship.coding.system",
        "path": "Coverage.relationship.coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.relationship.coding.code",
        "path": "Coverage.relationship.coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.relationship.coding.userSelected",
        "path": "Coverage.relationship.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Coverage.relationship.text",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
            "valueBoolean": true
          }
        ],
        "path": "Coverage.relationship.text",
        "max": "0"
      },
      {
        "id": "Coverage.period",
        "path": "Coverage.period",
        "example": [
          {
            "label": "Coverage period example",
            "valuePeriod": {
              "start": "2017-11-01",
              "end": "2017-11-30"
            }
          }
        ],
        "mustSupport": false
      },
      {
        "id": "Coverage.period.id",
        "path": "Coverage.period.id",
        "max": "0"
      },
      {
        "id": "Coverage.period.start",
        "path": "Coverage.period.start",
        "min": 1,
        "mapping": [
          {
            "identity": "PATIENT-COVERAGE",
            "map": "ELIGIBILITY_START_DATE"
          }
        ]
      },
      {
        "id": "Coverage.period.end",
        "path": "Coverage.period.end",
        "min": 1,
        "mapping": [
          {
            "identity": "PATIENT-COVERAGE",
            "map": "ELIGIBILITY_END_DATE"
          }
        ]
      },
      {
        "id": "Coverage.payor",
        "path": "Coverage.payor",
        "max": "0"
      },
      {
        "id": "Coverage.grouping",
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name",
            "valueString": "Group"
          }
        ],
        "path": "Coverage.grouping",
        "definition": "A suite of classifiers used to identify the tenancy information including Customer, Client and State.",
        "min": 1,
        "mustSupport": false
      },
      {
        "id": "Coverage.grouping.id",
        "path": "Coverage.grouping.id",
        "max": "0"
      },
      {
        "id": "Coverage.grouping.group",
        "path": "Coverage.grouping.group",
        "short": "Customer ID",
        "definition": "The Payer identifier for the patient population. The Payer ID is the second level in a multitenancy hierarchy and it maps up to the Customer ID.",
        "min": 1,
        "example": [
          {
            "label": "Customer tenant example",
            "valueString": "010"
          }
        ],
        "mustSupport": false,
        "mapping": [
          {
            "identity": "PATIENT-COVERAGE",
            "map": "PAYER_ID"
          }
        ]
      },
      {
        "id": "Coverage.grouping.groupDisplay",
        "path": "Coverage.grouping.groupDisplay",
        "short": "Display text for the tenant customer",
        "definition": "A short description for the customer.",
        "fixedString": "Customer",
        "mustSupport": false
      },
      {
        "id": "Coverage.grouping.subGroup",
        "path": "Coverage.grouping.subGroup",
        "short": "An identifier for the state/group id",
        "definition": "The state or Group ID for the patient population. The Group ID is the fourth level in a multitenancy hierarchy and maps up to the Plan ID.",
        "example": [
          {
            "label": "Tenant state example",
            "valueString": "CA"
          }
        ],
        "mustSupport": false,
        "mapping": [
          {
            "identity": "PATIENT-COVERAGE",
            "map": "GROUP_ID"
          }
        ]
      },
      {
        "id": "Coverage.grouping.subGroupDisplay",
        "path": "Coverage.grouping.subGroupDisplay",
        "short": "Display text for the state",
        "definition": "A short description for the state where the policy was sold.",
        "fixedString": "State",
        "mustSupport": false
      },
      {
        "id": "Coverage.grouping.plan",
        "path": "Coverage.grouping.plan",
        "short": "An identifier for the tenant client.",
        "definition": "The client identifier for the patient population. The client ID is the third level in a multitenancy hierarchy and it maps up to the customer ID.",
        "min": 1,
        "mustSupport": false,
        "mapping": [
          {
            "identity": "PATIENT-COVERAGE",
            "map": "PLAN_ID"
          }
        ]
      },
      {
        "id": "Coverage.grouping.planDisplay",
        "path": "Coverage.grouping.planDisplay",
        "short": "Display text for the client.",
        "definition": "A short description for the tenant client.",
        "fixedString": "Client",
        "mustSupport": false
      },
      {
        "id": "Coverage.grouping.subPlan",
        "path": "Coverage.grouping.subPlan",
        "max": "0"
      },
      {
        "id": "Coverage.grouping.subPlanDisplay",
        "path": "Coverage.grouping.subPlanDisplay",
        "max": "0"
      },
      {
        "id": "Coverage.grouping.class",
        "path": "Coverage.grouping.class",
        "max": "0"
      },
      {
        "id": "Coverage.grouping.classDisplay",
        "path": "Coverage.grouping.classDisplay",
        "max": "0"
      },
      {
        "id": "Coverage.grouping.subClass",
        "path": "Coverage.grouping.subClass",
        "max": "0"
      },
      {
        "id": "Coverage.grouping.subClassDisplay",
        "path": "Coverage.grouping.subClassDisplay",
        "max": "0"
      },
      {
        "id": "Coverage.dependent",
        "path": "Coverage.dependent",
        "max": "0"
      },
      {
        "id": "Coverage.sequence",
        "path": "Coverage.sequence",
        "max": "0"
      },
      {
        "id": "Coverage.order",
        "path": "Coverage.order",
        "max": "0"
      },
      {
        "id": "Coverage.network",
        "path": "Coverage.network",
        "max": "0"
      },
      {
        "id": "Coverage.contract",
        "path": "Coverage.contract",
        "max": "0"
      }
    ]
  }
}