Maestro de pacientes
0.2.0 - draft Chile flag

Maestro de pacientes - Local Development build (v0.2.0). See the Directory of published versions

Resource Profile: MINSAL Cobertura de Salud del paciente

Official URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/MINSALCobertura Version: 0.2.0
Draft as of 2023-11-02 Computable Name: MINSALCobertura

Recurso para almacenar la cobertura del paciente

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..*CoverageInsurance or medical plan or a payment agreement
... Slices for extension 4..*ExtensionExtension
Slice: Unordered, Open by value:url
... DirigenteVecinal S1..1booleanDirigente Vecinal
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/DirigenteVecinal
... Prais S1..1booleanPRAIS
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prais
... Prilonco S1..1booleanPrilonco
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prilonco
... status S1..1codeactive | cancelled | draft | entered-in-error
... policyHolder S1..1Reference(MINSAL Paciente )Owner of the policy
... beneficiary S1..1Reference(MINSAL Paciente )Plan beneficiary
... period S0..1PeriodCoverage start and end dates
... payor S1..1Reference(Organization)Issuer of the policy
... class S1..1BackboneElementAdditional coverage classifications
.... type S1..1CodeableConceptType of class such as 'group' or 'plan'
Binding: Prevision (required)
..... coding S1..1CodingCode defined by a terminology system
...... system S1..1uriIdentity of the terminology system
...... code S1..1codeSymbol in syntax defined by the system
...... display S1..1stringRepresentation defined by the system
.... value S1..1stringValue associated with the type

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Coverage.class.typerequiredVSPrevision (a valid code from Prevision)
NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..*CoverageInsurance or medical plan or a payment agreement
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... Slices for extension 4..*ExtensionExtension
Slice: Unordered, Open by value:url
... DirigenteVecinal S1..1booleanDirigente Vecinal
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/DirigenteVecinal
... Antuco S1..1booleanAntuco
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Antuco
... Prilonco S1..1booleanPrilonco
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prilonco
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.

... policyHolder SΣ1..1Reference(MINSAL Paciente )Owner of the policy
... beneficiary SΣ1..1Reference(MINSAL Paciente )Plan beneficiary
... period SΣ0..1PeriodCoverage start and end dates
... payor SΣ1..1Reference(Organization)Issuer of the policy
... class S1..1BackboneElementAdditional coverage classifications
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type SΣ1..1CodeableConceptType of class such as 'group' or 'plan'
Binding: Prevision (required)
..... coding SΣ1..1CodingCode defined by a terminology system
...... system SΣ1..1uriIdentity of the terminology system
...... code SΣ1..1codeSymbol in syntax defined by the system
...... display SΣ1..1stringRepresentation defined by the system
.... value SΣ1..1stringValue associated with the type

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Coverage.statusrequiredFinancialResourceStatusCodes
Coverage.class.typerequiredVSPrevision (a valid code from Prevision)

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorCoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: 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()
dom-4errorCoverageIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCoverageIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCoverageA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..*CoverageInsurance or medical plan or a payment agreement
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 4..*ExtensionExtension
Slice: Unordered, Open by value:url
... DirigenteVecinal S1..1booleanDirigente Vecinal
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/DirigenteVecinal
... Prais S1..1booleanPRAIS
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prais
... Antuco S1..1booleanAntuco
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Antuco
... Prilonco S1..1booleanPrilonco
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prilonco
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for the coverage
... status ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.

... type Σ0..1CodeableConceptCoverage category such as medical or accident
Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.

... policyHolder SΣ1..1Reference(MINSAL Paciente )Owner of the policy
... subscriber Σ0..1Reference(Patient | RelatedPerson)Subscriber to the policy
... subscriberId Σ0..1stringID assigned to the subscriber
... beneficiary SΣ1..1Reference(MINSAL Paciente )Plan beneficiary
... dependent Σ0..1stringDependent number
... relationship 0..1CodeableConceptBeneficiary relationship to the subscriber
Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).

... period SΣ0..1PeriodCoverage start and end dates
... payor SΣ1..1Reference(Organization)Issuer of the policy
... class S1..1BackboneElementAdditional coverage classifications
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type SΣ1..1CodeableConceptType of class such as 'group' or 'plan'
Binding: Prevision (required)
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeSymbol in syntax defined by the system
...... display SΣ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... value SΣ1..1stringValue associated with the type
.... name Σ0..1stringHuman readable description of the type and value
... order Σ0..1positiveIntRelative order of the coverage
... network Σ0..1stringInsurer network
... costToBeneficiary 0..*BackboneElementPatient payments for services/products
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type Σ0..1CodeableConceptCost category
Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.

.... value[x] Σ1..1The amount or percentage due from the beneficiary
..... valueQuantityQuantity(SimpleQuantity)
..... valueMoneyMoney
.... exception 0..*BackboneElementExceptions for patient payments
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type Σ1..1CodeableConceptException category
Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.

..... period Σ0..1PeriodThe effective period of the exception
... subrogation 0..1booleanReimbursement to insurer
... contract 0..*Reference(Contract)Contract details

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Coverage.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Coverage.statusrequiredFinancialResourceStatusCodes
Coverage.typepreferredCoverageTypeAndSelf-PayCodes
Coverage.relationshipextensibleSubscriberRelationshipCodes
Coverage.class.typerequiredVSPrevision (a valid code from Prevision)
Coverage.costToBeneficiary.typeextensibleCoverageCopayTypeCodes
Coverage.costToBeneficiary.exception.typeexampleExampleCoverageFinancialExceptionCodes

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorCoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: 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()
dom-4errorCoverageIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCoverageIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCoverageA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Differential View

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..*CoverageInsurance or medical plan or a payment agreement
... Slices for extension 4..*ExtensionExtension
Slice: Unordered, Open by value:url
... DirigenteVecinal S1..1booleanDirigente Vecinal
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/DirigenteVecinal
... Prais S1..1booleanPRAIS
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prais
... Prilonco S1..1booleanPrilonco
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prilonco
... status S1..1codeactive | cancelled | draft | entered-in-error
... policyHolder S1..1Reference(MINSAL Paciente )Owner of the policy
... beneficiary S1..1Reference(MINSAL Paciente )Plan beneficiary
... period S0..1PeriodCoverage start and end dates
... payor S1..1Reference(Organization)Issuer of the policy
... class S1..1BackboneElementAdditional coverage classifications
.... type S1..1CodeableConceptType of class such as 'group' or 'plan'
Binding: Prevision (required)
..... coding S1..1CodingCode defined by a terminology system
...... system S1..1uriIdentity of the terminology system
...... code S1..1codeSymbol in syntax defined by the system
...... display S1..1stringRepresentation defined by the system
.... value S1..1stringValue associated with the type

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Coverage.class.typerequiredVSPrevision (a valid code from Prevision)

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..*CoverageInsurance or medical plan or a payment agreement
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... Slices for extension 4..*ExtensionExtension
Slice: Unordered, Open by value:url
... DirigenteVecinal S1..1booleanDirigente Vecinal
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/DirigenteVecinal
... Antuco S1..1booleanAntuco
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Antuco
... Prilonco S1..1booleanPrilonco
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prilonco
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.

... policyHolder SΣ1..1Reference(MINSAL Paciente )Owner of the policy
... beneficiary SΣ1..1Reference(MINSAL Paciente )Plan beneficiary
... period SΣ0..1PeriodCoverage start and end dates
... payor SΣ1..1Reference(Organization)Issuer of the policy
... class S1..1BackboneElementAdditional coverage classifications
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type SΣ1..1CodeableConceptType of class such as 'group' or 'plan'
Binding: Prevision (required)
..... coding SΣ1..1CodingCode defined by a terminology system
...... system SΣ1..1uriIdentity of the terminology system
...... code SΣ1..1codeSymbol in syntax defined by the system
...... display SΣ1..1stringRepresentation defined by the system
.... value SΣ1..1stringValue associated with the type

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Coverage.statusrequiredFinancialResourceStatusCodes
Coverage.class.typerequiredVSPrevision (a valid code from Prevision)

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorCoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: 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()
dom-4errorCoverageIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCoverageIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCoverageA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..*CoverageInsurance or medical plan or a payment agreement
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 4..*ExtensionExtension
Slice: Unordered, Open by value:url
... DirigenteVecinal S1..1booleanDirigente Vecinal
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/DirigenteVecinal
... Prais S1..1booleanPRAIS
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prais
... Antuco S1..1booleanAntuco
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Antuco
... Prilonco S1..1booleanPrilonco
URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prilonco
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for the coverage
... status ?!SΣ1..1codeactive | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.

... type Σ0..1CodeableConceptCoverage category such as medical or accident
Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.

... policyHolder SΣ1..1Reference(MINSAL Paciente )Owner of the policy
... subscriber Σ0..1Reference(Patient | RelatedPerson)Subscriber to the policy
... subscriberId Σ0..1stringID assigned to the subscriber
... beneficiary SΣ1..1Reference(MINSAL Paciente )Plan beneficiary
... dependent Σ0..1stringDependent number
... relationship 0..1CodeableConceptBeneficiary relationship to the subscriber
Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).

... period SΣ0..1PeriodCoverage start and end dates
... payor SΣ1..1Reference(Organization)Issuer of the policy
... class S1..1BackboneElementAdditional coverage classifications
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type SΣ1..1CodeableConceptType of class such as 'group' or 'plan'
Binding: Prevision (required)
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... coding SΣ1..1CodingCode defined by a terminology system
...... id 0..1stringUnique id for inter-element referencing
...... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
...... system SΣ1..1uriIdentity of the terminology system
...... version Σ0..1stringVersion of the system - if relevant
...... code SΣ1..1codeSymbol in syntax defined by the system
...... display SΣ1..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
.... value SΣ1..1stringValue associated with the type
.... name Σ0..1stringHuman readable description of the type and value
... order Σ0..1positiveIntRelative order of the coverage
... network Σ0..1stringInsurer network
... costToBeneficiary 0..*BackboneElementPatient payments for services/products
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... type Σ0..1CodeableConceptCost category
Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.

.... value[x] Σ1..1The amount or percentage due from the beneficiary
..... valueQuantityQuantity(SimpleQuantity)
..... valueMoneyMoney
.... exception 0..*BackboneElementExceptions for patient payments
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... type Σ1..1CodeableConceptException category
Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.

..... period Σ0..1PeriodThe effective period of the exception
... subrogation 0..1booleanReimbursement to insurer
... contract 0..*Reference(Contract)Contract details

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Coverage.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Coverage.statusrequiredFinancialResourceStatusCodes
Coverage.typepreferredCoverageTypeAndSelf-PayCodes
Coverage.relationshipextensibleSubscriberRelationshipCodes
Coverage.class.typerequiredVSPrevision (a valid code from Prevision)
Coverage.costToBeneficiary.typeextensibleCoverageCopayTypeCodes
Coverage.costToBeneficiary.exception.typeexampleExampleCoverageFinancialExceptionCodes

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorCoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: 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()
dom-4errorCoverageIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorCoverageIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceCoverageA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel, Schematron