FQL is a query language that allows you to retrieve, filter and project data from any data source containing FHIR Resources. It brings the power of three existing languages together: SQL, JSON and FhirPath. It allows you to create tables and is useful for gaining insight and perform quality control.
-
Default
What is FQL?
-
FQL Query resources
FQL Playground
Try Firely Query Language in our playground by using this scope as data source.
- FQL Documentation
-
FQL Language
Syntax specification
To learn more about FQL syntax choose this menu item.
-
YamlGen Generate resources
YamlGen Playground
Try YamlGen in our playground by using this scope as data source.
-
YamlGen Language
YamlGen Syntax specification
To learn more about YamlGen syntax choose this.
-
FHIRPath Inspect resource
FHIRPath Playground
Try out the FHIRPath playground and navigate inside this resource.
-
FHIRPath Documentation
FHIRPath Documentation
Find out what FHIRPath is or learn how to write FHIRPath scripts.
-
Project FHIR API
This is the location where you can find your resource using a FHIR client.
-
Simplifier FHIR API
The global endpoint is where users can search for all resources in Simplifier. Resources have a globally unique guid Id here.
-
Custom Example generation
Custom Example generation beta
Experiment with resource instance generation using YamlGen and based on this profile.
This feature is in beta. You can help us improve it by giving feedback with the feedback button at the top of the screen.
InsurancePlan
Details of a Health Insurance product/plan provided by an organization.
- type Profile on InsurancePlan
- FHIR R4
- status Draft
-
version4.6.0
The canonical from this resource does not match any claim in this context and conflicts with a claim from another scope.
http://hl7.org/fhir
Canonical claims are used to verify ownership of your canonical URLs.
You're probably missing a package or made a typo in your canonical.
- Could not resolve: http://hl7.org/fhir/StructureDefinition/Base
InsurancePlan | I | DomainResource | There are no (further) constraints on this element Element idInsurancePlan Details of a Health Insurance product/plan provided by an organization DefinitionDetails of a Health Insurance product/plan provided by an organization.
| |
identifier | Σ I | 0..* | Identifier | There are no (further) constraints on this element Element idInsurancePlan.identifier Business Identifier for Product DefinitionBusiness identifiers assigned to this health insurance product which remain constant as the resource is updated and propagates from server to server.
|
status | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idInsurancePlan.status draft | active | retired | unknown DefinitionThe current state of the health insurance product. Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI. Default interpretation is active. The lifecycle status of an artifact.
|
type | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element idInsurancePlan.type Kind of product DefinitionThe kind of health insurance product. Used to categorize the product/plan.
|
name | Σ I | 0..1 | string | There are no (further) constraints on this element Element idInsurancePlan.name Official name DefinitionOfficial name of the health insurance product as designated by the owner. If the name of the product/plan changes, consider putting the old name in the alias column so that it can still be located through searches.
|
alias | 0..* | string | There are no (further) constraints on this element Element idInsurancePlan.alias Alternate names DefinitionA list of alternate names that the product is known as, or was known as in the past. Over time products/plans go through many changes and can be known by different names. For searching knowing previous names that the product/plan was known by can be very useful. 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 product/plan.
| |
period | 0..1 | Period | There are no (further) constraints on this element Element idInsurancePlan.period When the product is available DefinitionThe period of time that the health insurance product is available. | |
ownedBy | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idInsurancePlan.ownedBy Plan issuer Alternate namesPayer DefinitionThe entity that is providing the health insurance product and underwriting the risk. This is typically an insurance carriers, other third-party payers, or health plan sponsors comonly referred to as 'payers'. |
administeredBy | Σ | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idInsurancePlan.administeredBy Product administrator DefinitionAn organization which administer other services such as underwriting, customer service and/or claims processing on behalf of the health insurance product owner. |
coverageArea | Σ | 0..* | Reference(Location) | There are no (further) constraints on this element Element idInsurancePlan.coverageArea Where product applies DefinitionThe geographic region in which a health insurance product's benefits apply. |
contact | 0..* | ExtendedContactDetail | There are no (further) constraints on this element Element idInsurancePlan.contact Official contact details relevant to the health insurance plan/product DefinitionThe contact details of communication devices available relevant to the specific Insurance Plan/Product. This can include addresses, phone numbers, fax numbers, mobile numbers, email addresses and web sites. Need to keep track of both simple contact details and also assigned contacts within larger organizations. The address/telecom use code 'home' are not to be used. ExtendedContactDetail Mappings
| |
endpoint | 0..* | Reference(Endpoint) | There are no (further) constraints on this element Element idInsurancePlan.endpoint Technical endpoint DefinitionThe technical endpoints providing access to services operated for the health insurance product. 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.
| |
network | 0..* | Reference(Organization) | There are no (further) constraints on this element Element idInsurancePlan.network What networks are Included DefinitionReference to the network included in the health insurance product. Networks are represented as a hierarchy of organization resources. | |
coverage | 0..* | BackboneElement | There are no (further) constraints on this element Element idInsurancePlan.coverage Coverage details DefinitionDetails about the coverage offered by the insurance product. | |
type | 1..1 | CodeableConcept | There are no (further) constraints on this element Element idInsurancePlan.coverage.type Type of coverage DefinitionType of coverage (Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health). | |
network | 0..* | Reference(Organization) | There are no (further) constraints on this element Element idInsurancePlan.coverage.network What networks provide coverage DefinitionReference to the network that providing the type of coverage. Networks are represented as a hierarchy of organization resources. | |
benefit | 1..* | BackboneElement | There are no (further) constraints on this element Element idInsurancePlan.coverage.benefit List of benefits DefinitionSpecific benefits under this type of coverage. | |
type | 1..1 | CodeableConcept | There are no (further) constraints on this element Element idInsurancePlan.coverage.benefit.type Type of benefit DefinitionType of benefit (primary care; speciality care; inpatient; outpatient). | |
requirement | 0..1 | string | There are no (further) constraints on this element Element idInsurancePlan.coverage.benefit.requirement Referral requirements DefinitionThe referral requirements to have access/coverage for this benefit. | |
limit | 0..* | BackboneElement | There are no (further) constraints on this element Element idInsurancePlan.coverage.benefit.limit Benefit limits DefinitionThe specific limits on the benefit. | |
value | 0..1 | Quantity | There are no (further) constraints on this element Element idInsurancePlan.coverage.benefit.limit.value Maximum value allowed DefinitionThe maximum amount of a service item a plan will pay for a covered benefit. For examples. wellness visits, or eyeglasses. May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”. | |
code | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idInsurancePlan.coverage.benefit.limit.code Benefit limit details DefinitionThe specific limit on the benefit. Use | |
plan | 0..* | BackboneElement | There are no (further) constraints on this element Element idInsurancePlan.plan Plan details DefinitionDetails about an insurance plan. | |
identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element idInsurancePlan.plan.identifier Business Identifier for Product DefinitionBusiness identifiers assigned to this health insurance plan which remain constant as the resource is updated and propagates from server to server.
|
type | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idInsurancePlan.plan.type Type of plan DefinitionType of plan. For example, "Platinum" or "High Deductable". | |
coverageArea | Σ | 0..* | Reference(Location) | There are no (further) constraints on this element Element idInsurancePlan.plan.coverageArea Where product applies DefinitionThe geographic region in which a health insurance plan's benefits apply. |
network | 0..* | Reference(Organization) | There are no (further) constraints on this element Element idInsurancePlan.plan.network What networks provide coverage DefinitionReference to the network that providing the type of coverage. Networks are represented as a hierarchy of organization resources. | |
generalCost | 0..* | BackboneElement | There are no (further) constraints on this element Element idInsurancePlan.plan.generalCost Overall costs DefinitionOverall costs associated with the plan. | |
type | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idInsurancePlan.plan.generalCost.type Type of cost DefinitionType of cost. | |
groupSize | 0..1 | positiveInt | There are no (further) constraints on this element Element idInsurancePlan.plan.generalCost.groupSize Number of enrollees DefinitionNumber of participants enrolled in the plan. | |
cost | 0..1 | Money | There are no (further) constraints on this element Element idInsurancePlan.plan.generalCost.cost Cost value DefinitionValue of the cost. | |
comment | 0..1 | string | There are no (further) constraints on this element Element idInsurancePlan.plan.generalCost.comment Additional cost information DefinitionAdditional information about the general costs associated with this plan. | |
specificCost | 0..* | BackboneElement | There are no (further) constraints on this element Element idInsurancePlan.plan.specificCost Specific costs DefinitionCosts associated with the coverage provided by the product. | |
category | 1..1 | CodeableConcept | There are no (further) constraints on this element Element idInsurancePlan.plan.specificCost.category General category of benefit DefinitionGeneral category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health). | |
benefit | 0..* | BackboneElement | There are no (further) constraints on this element Element idInsurancePlan.plan.specificCost.benefit Benefits list DefinitionList of the specific benefits under this category of benefit. | |
type | 1..1 | CodeableConcept | There are no (further) constraints on this element Element idInsurancePlan.plan.specificCost.benefit.type Type of specific benefit DefinitionType of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care). | |
cost | 0..* | BackboneElement | There are no (further) constraints on this element Element idInsurancePlan.plan.specificCost.benefit.cost List of the costs DefinitionList of the costs associated with a specific benefit. | |
type | 1..1 | CodeableConcept | There are no (further) constraints on this element Element idInsurancePlan.plan.specificCost.benefit.cost.type Type of cost DefinitionType of cost (copay; individual cap; family cap; coinsurance; deductible). | |
applicability | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idInsurancePlan.plan.specificCost.benefit.cost.applicability in-network | out-of-network | other DefinitionWhether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other). Whether the cost applies to in-network or out-of-network providers. | |
qualifiers | 0..* | CodeableConcept | There are no (further) constraints on this element Element idInsurancePlan.plan.specificCost.benefit.cost.qualifiers Additional information about the cost DefinitionAdditional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA). | |
value | 0..1 | Quantity | There are no (further) constraints on this element Element idInsurancePlan.plan.specificCost.benefit.cost.value The actual cost value DefinitionThe actual cost value. (some of the costs may be represented as percentages rather than currency, e.g. 10% coinsurance). |