Maestro de pacientes
0.2.0 - draft
Maestro de pacientes - Local Development build (v0.2.0). See the Directory of published versions
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:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Coverage
Path | Conformance | ValueSet |
Coverage.class.type | required | VSPrevision (a valid code from Prevision) |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
Slices for extension | 4..* | Extension | Extension Slice: Unordered, Open by value:url | |
DirigenteVecinal | S | 1..1 | boolean | Dirigente Vecinal URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/DirigenteVecinal |
Prais | S | 1..1 | boolean | PRAIS URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prais |
Antuco | S | 1..1 | boolean | Antuco URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Antuco |
Prilonco | S | 1..1 | boolean | Prilonco URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prilonco |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
status | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
policyHolder | SΣ | 1..1 | Reference(MINSAL Paciente ) | Owner of the policy |
beneficiary | SΣ | 1..1 | Reference(MINSAL Paciente ) | Plan beneficiary |
period | SΣ | 0..1 | Period | Coverage start and end dates |
payor | SΣ | 1..1 | Reference(Organization) | Issuer of the policy |
class | S | 1..1 | BackboneElement | Additional coverage classifications |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | SΣ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Prevision (required) |
coding | SΣ | 1..1 | Coding | Code defined by a terminology system |
system | SΣ | 1..1 | uri | Identity of the terminology system |
code | SΣ | 1..1 | code | Symbol in syntax defined by the system |
display | SΣ | 1..1 | string | Representation defined by the system |
value | SΣ | 1..1 | string | Value associated with the type |
Documentation for this format |
Path | Conformance | ValueSet |
Coverage.status | required | FinancialResourceStatusCodes |
Coverage.class.type | required | VSPrevision (a valid code from Prevision) |
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | Coverage | 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 : 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-4 | error | Coverage | If 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-5 | error | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | Coverage | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |||||
id | Σ | 0..1 | id | Logical id of this artifact | ||||
meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
contained | 0..* | Resource | Contained, inline Resources | |||||
Slices for extension | 4..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
DirigenteVecinal | S | 1..1 | boolean | Dirigente Vecinal URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/DirigenteVecinal | ||||
Prais | S | 1..1 | boolean | PRAIS URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prais | ||||
Antuco | S | 1..1 | boolean | Antuco URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Antuco | ||||
Prilonco | S | 1..1 | boolean | Prilonco URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prilonco | ||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
identifier | Σ | 0..* | Identifier | Business Identifier for the coverage | ||||
status | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
type | Σ | 0..1 | CodeableConcept | Coverage 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 | SΣ | 1..1 | Reference(MINSAL Paciente ) | Owner of the policy | ||||
subscriber | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | ||||
subscriberId | Σ | 0..1 | string | ID assigned to the subscriber | ||||
beneficiary | SΣ | 1..1 | Reference(MINSAL Paciente ) | Plan beneficiary | ||||
dependent | Σ | 0..1 | string | Dependent number | ||||
relationship | 0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | |||||
period | SΣ | 0..1 | Period | Coverage start and end dates | ||||
payor | SΣ | 1..1 | Reference(Organization) | Issuer of the policy | ||||
class | S | 1..1 | BackboneElement | Additional coverage classifications | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
type | SΣ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Prevision (required) | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | SΣ | 1..1 | Coding | Code defined by a terminology system | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
system | SΣ | 1..1 | uri | Identity of the terminology system | ||||
version | Σ | 0..1 | string | Version of the system - if relevant | ||||
code | SΣ | 1..1 | code | Symbol in syntax defined by the system | ||||
display | SΣ | 1..1 | string | Representation defined by the system | ||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
value | SΣ | 1..1 | string | Value associated with the type | ||||
name | Σ | 0..1 | string | Human readable description of the type and value | ||||
order | Σ | 0..1 | positiveInt | Relative order of the coverage | ||||
network | Σ | 0..1 | string | Insurer network | ||||
costToBeneficiary | 0..* | BackboneElement | Patient payments for services/products | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
type | Σ | 0..1 | CodeableConcept | Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified. | ||||
value[x] | Σ | 1..1 | The amount or percentage due from the beneficiary | |||||
valueQuantity | Quantity(SimpleQuantity) | |||||||
valueMoney | Money | |||||||
exception | 0..* | BackboneElement | Exceptions for patient payments | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
type | Σ | 1..1 | CodeableConcept | Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays. | ||||
period | Σ | 0..1 | Period | The effective period of the exception | ||||
subrogation | 0..1 | boolean | Reimbursement to insurer | |||||
contract | 0..* | Reference(Contract) | Contract details | |||||
Documentation for this format |
Path | Conformance | ValueSet | ||||
Coverage.language | preferred | CommonLanguages
| ||||
Coverage.status | required | FinancialResourceStatusCodes | ||||
Coverage.type | preferred | CoverageTypeAndSelf-PayCodes | ||||
Coverage.relationship | extensible | SubscriberRelationshipCodes | ||||
Coverage.class.type | required | VSPrevision (a valid code from Prevision) | ||||
Coverage.costToBeneficiary.type | extensible | CoverageCopayTypeCodes | ||||
Coverage.costToBeneficiary.exception.type | example | ExampleCoverageFinancialExceptionCodes |
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | Coverage | 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 : 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-4 | error | Coverage | If 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-5 | error | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | Coverage | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from Coverage
Summary
Mandatory: 10 elements
Must-Support: 16 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Differential View
This structure is derived from Coverage
Path | Conformance | ValueSet |
Coverage.class.type | required | VSPrevision (a valid code from Prevision) |
Key Elements View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
Slices for extension | 4..* | Extension | Extension Slice: Unordered, Open by value:url | |
DirigenteVecinal | S | 1..1 | boolean | Dirigente Vecinal URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/DirigenteVecinal |
Prais | S | 1..1 | boolean | PRAIS URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prais |
Antuco | S | 1..1 | boolean | Antuco URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Antuco |
Prilonco | S | 1..1 | boolean | Prilonco URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prilonco |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
status | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
policyHolder | SΣ | 1..1 | Reference(MINSAL Paciente ) | Owner of the policy |
beneficiary | SΣ | 1..1 | Reference(MINSAL Paciente ) | Plan beneficiary |
period | SΣ | 0..1 | Period | Coverage start and end dates |
payor | SΣ | 1..1 | Reference(Organization) | Issuer of the policy |
class | S | 1..1 | BackboneElement | Additional coverage classifications |
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
type | SΣ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Prevision (required) |
coding | SΣ | 1..1 | Coding | Code defined by a terminology system |
system | SΣ | 1..1 | uri | Identity of the terminology system |
code | SΣ | 1..1 | code | Symbol in syntax defined by the system |
display | SΣ | 1..1 | string | Representation defined by the system |
value | SΣ | 1..1 | string | Value associated with the type |
Documentation for this format |
Path | Conformance | ValueSet |
Coverage.status | required | FinancialResourceStatusCodes |
Coverage.class.type | required | VSPrevision (a valid code from Prevision) |
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | Coverage | 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 : 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-4 | error | Coverage | If 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-5 | error | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | Coverage | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints | ||||
---|---|---|---|---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |||||
id | Σ | 0..1 | id | Logical id of this artifact | ||||
meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
contained | 0..* | Resource | Contained, inline Resources | |||||
Slices for extension | 4..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
DirigenteVecinal | S | 1..1 | boolean | Dirigente Vecinal URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/DirigenteVecinal | ||||
Prais | S | 1..1 | boolean | PRAIS URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prais | ||||
Antuco | S | 1..1 | boolean | Antuco URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Antuco | ||||
Prilonco | S | 1..1 | boolean | Prilonco URL: https://interoperabilidad.minsal.cl/fhir/ig/mpi/StructureDefinition/Prilonco | ||||
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
identifier | Σ | 0..* | Identifier | Business Identifier for the coverage | ||||
status | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
type | Σ | 0..1 | CodeableConcept | Coverage 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 | SΣ | 1..1 | Reference(MINSAL Paciente ) | Owner of the policy | ||||
subscriber | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy | ||||
subscriberId | Σ | 0..1 | string | ID assigned to the subscriber | ||||
beneficiary | SΣ | 1..1 | Reference(MINSAL Paciente ) | Plan beneficiary | ||||
dependent | Σ | 0..1 | string | Dependent number | ||||
relationship | 0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | |||||
period | SΣ | 0..1 | Period | Coverage start and end dates | ||||
payor | SΣ | 1..1 | Reference(Organization) | Issuer of the policy | ||||
class | S | 1..1 | BackboneElement | Additional coverage classifications | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
type | SΣ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Prevision (required) | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
coding | SΣ | 1..1 | Coding | Code defined by a terminology system | ||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
system | SΣ | 1..1 | uri | Identity of the terminology system | ||||
version | Σ | 0..1 | string | Version of the system - if relevant | ||||
code | SΣ | 1..1 | code | Symbol in syntax defined by the system | ||||
display | SΣ | 1..1 | string | Representation defined by the system | ||||
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
text | Σ | 0..1 | string | Plain text representation of the concept | ||||
value | SΣ | 1..1 | string | Value associated with the type | ||||
name | Σ | 0..1 | string | Human readable description of the type and value | ||||
order | Σ | 0..1 | positiveInt | Relative order of the coverage | ||||
network | Σ | 0..1 | string | Insurer network | ||||
costToBeneficiary | 0..* | BackboneElement | Patient payments for services/products | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
type | Σ | 0..1 | CodeableConcept | Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified. | ||||
value[x] | Σ | 1..1 | The amount or percentage due from the beneficiary | |||||
valueQuantity | Quantity(SimpleQuantity) | |||||||
valueMoney | Money | |||||||
exception | 0..* | BackboneElement | Exceptions for patient payments | |||||
id | 0..1 | string | Unique id for inter-element referencing | |||||
extension | 0..* | Extension | Additional content defined by implementations | |||||
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
type | Σ | 1..1 | CodeableConcept | Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays. | ||||
period | Σ | 0..1 | Period | The effective period of the exception | ||||
subrogation | 0..1 | boolean | Reimbursement to insurer | |||||
contract | 0..* | Reference(Contract) | Contract details | |||||
Documentation for this format |
Path | Conformance | ValueSet | ||||
Coverage.language | preferred | CommonLanguages
| ||||
Coverage.status | required | FinancialResourceStatusCodes | ||||
Coverage.type | preferred | CoverageTypeAndSelf-PayCodes | ||||
Coverage.relationship | extensible | SubscriberRelationshipCodes | ||||
Coverage.class.type | required | VSPrevision (a valid code from Prevision) | ||||
Coverage.costToBeneficiary.type | extensible | CoverageCopayTypeCodes | ||||
Coverage.costToBeneficiary.exception.type | example | ExampleCoverageFinancialExceptionCodes |
Id | Grade | Path(s) | Details | Requirements |
dom-2 | error | Coverage | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
dom-3 | error | Coverage | 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 : 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-4 | error | Coverage | If 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-5 | error | Coverage | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
dom-6 | best practice | Coverage | A resource should have narrative for robust management : text.`div`.exists() | |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
This structure is derived from Coverage
Summary
Mandatory: 10 elements
Must-Support: 16 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Other representations of profile: CSV, Excel, Schematron