Núcleo de Interoperabilidad de Datos (NID) - MINSAL
0.4.8 - draft
Núcleo de Interoperabilidad de Datos (NID) - MINSAL
0.4.8 - draft
This page is part of the Núcleo de Interoperabilidad de Datos (NID) - MINSAL (v0.4.8: STU1 Draft) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions
| Official URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/MINSALCobertura | Version: 0.4.8 | |||
| Draft as of 2025-11-28 | Computable Name: MINSALCobertura | |||
Recurso para almacenar la cobertura del paciente
Usages:
You can also check for usages in the FHIR IG Statistics
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints Filter:   |
|---|---|---|---|---|
  Coverage |
C | 0..* | Coverage | Insurance or medical plan or a payment agreement Constraints: cov-cls-01, cov-cls-02 |
  implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
 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. |
 type |
SΣ | 1..1 | CodeableConcept | Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) |
 policyHolder |
SΣ | 1..1 | Reference(MINSAL Paciente) | Propietario de la póliza |
| beneficiary |
SΣ | 1..1 | Reference(MINSAL Paciente) | Referencia al beneficiario del plan de salud |
| period |
SΣ | 0..1 | Period | Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". |
| payor |
SΣ | 1..1 | Reference(CL Organización(1.9.4)) | Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) |
  Slices for class |
S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type |
   class:All Slices |
Content/Rules for all slices | |||
  modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. |
 value |
Σ | 1..1 | string | Value associated with the type |
 class:tramos |
S | 0..1 | BackboneElement | Tramos de FONASA, este valor es obligatorio en caso de ser FONASA |
 modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
 type |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
 id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
  coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
 id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Tramos de FONASA | |
 userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
 value |
Σ | 1..1 | string | Value associated with the type |
 Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
 extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
 value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Tramos de FONASA (required) | |
| class:plan |
S | 0..1 | BackboneElement | Nombre del plan de isapre |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Plan de ISAPRE | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value |
SΣ | 1..1 | string | Nombre del plan de isapre. |
| class:leyesPrev |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Otras Leyes Previsionales | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Previsionales (required) | |
| class:leyesRep |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 4 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Reparación | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Reparación (required) | |
| class:leyesPrio |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 5 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Priorización | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Grupo Marcas (required) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Coverage.status | Base | required | Financial Resource Status Codes | 📍4.0.1 | FHIR Std. |
| Coverage.type | Base | required | Previsión | 📦0.4.8 | This IG |
| Coverage.class.type | Base | extensible | Coverage Class Codes | 📍4.0.1 | FHIR Std. |
| Coverage.class:tramos.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:tramos.value.extension:valorClase.value[x] | Base | required | Tramos de FONASA | 📦0.4.8 | This IG |
| Coverage.class:plan.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrev.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrev.value.extension:valorClase.value[x] | Base | required | Leyes Previsionales | 📦0.4.8 | This IG |
| Coverage.class:leyesRep.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesRep.value.extension:valorClase.value[x] | Base | required | Leyes Reparación | 📦0.4.8 | This IG |
| Coverage.class:leyesPrio.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrio.value.extension:valorClase.value[x] | Base | required | Grupo Marcas | 📦0.4.8 | This IG |
| Id | Grade | Path(s) | Description | Expression |
| cov-cls-01 | error | Coverage | En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA |
type.coding.where(code = 1).exists() implies class.type.coding.where(code = 1).exists()
|
| cov-cls-02 | error | Coverage | En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE |
type.coding.where(code = 2).exists() implies class.type.coding.where(code = 2).exists()
|
| 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
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Coverage |
C | 0..* | Coverage | Insurance or medical plan or a payment agreement Constraints: cov-cls-01, cov-cls-02 |
| status |
S | 1..1 | code | active | cancelled | draft | entered-in-error |
| type |
S | 1..1 | CodeableConcept | Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) |
| policyHolder |
S | 1..1 | Reference(MINSAL Paciente) | Propietario de la póliza |
| beneficiary |
S | 1..1 | Reference(MINSAL Paciente) | Referencia al beneficiario del plan de salud |
| period |
S | 0..1 | Period | Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". |
| payor |
S | 1..1 | Reference(CL Organización(1.9.4)) | Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) |
| Slices for class |
S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type |
| class:tramos |
S | 0..1 | BackboneElement | Tramos de FONASA, este valor es obligatorio en caso de ser FONASA |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Tramos de FONASA | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Tramos de FONASA (required) | |
| class:plan |
S | 0..1 | BackboneElement | Nombre del plan de isapre |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Plan de ISAPRE | |
| value |
S | 1..1 | string | Nombre del plan de isapre. |
| class:leyesPrev |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Otras Leyes Previsionales | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Previsionales (required) | |
| class:leyesRep |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 4 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Reparación | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Reparación (required) | |
| class:leyesPrio |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 5 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Priorización | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Grupo Marcas (required) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Coverage.type | Base | required | Previsión | 📦0.4.8 | This IG |
| Coverage.class:tramos.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:tramos.value.extension:valorClase.value[x] | Base | required | Tramos de FONASA | 📦0.4.8 | This IG |
| Coverage.class:plan.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrev.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrev.value.extension:valorClase.value[x] | Base | required | Leyes Previsionales | 📦0.4.8 | This IG |
| Coverage.class:leyesRep.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesRep.value.extension:valorClase.value[x] | Base | required | Leyes Reparación | 📦0.4.8 | This IG |
| Coverage.class:leyesPrio.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrio.value.extension:valorClase.value[x] | Base | required | Grupo Marcas | 📦0.4.8 | This IG |
| Id | Grade | Path(s) | Description | Expression |
| cov-cls-01 | error | Coverage | En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA |
type.coding.where(code = 1).exists() implies class.type.coding.where(code = 1).exists()
|
| cov-cls-02 | error | Coverage | En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE |
type.coding.where(code = 2).exists() implies class.type.coding.where(code = 2).exists()
|
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| Coverage |
C | 0..* | Coverage | Insurance or medical plan or a payment agreement Constraints: cov-cls-01, cov-cls-02 | ||||
| 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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| 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 |
SΣ | 1..1 | CodeableConcept | Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) | ||||
| policyHolder |
SΣ | 1..1 | Reference(MINSAL Paciente) | Propietario de la póliza | ||||
| 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) | Referencia al beneficiario del plan de salud | ||||
| 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 | Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". | ||||
| payor |
SΣ | 1..1 | Reference(CL Organización(1.9.4)) | Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) | ||||
| Slices for class |
S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type | ||||
| class:All Slices |
Content/Rules for all slices | |||||||
| 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 | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. | ||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:tramos |
S | 0..1 | BackboneElement | Tramos de FONASA, este valor es obligatorio en caso de ser FONASA | ||||
| 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 | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Tramos de FONASA | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Tramos de FONASA (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length:1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:plan |
S | 0..1 | BackboneElement | Nombre del plan de isapre | ||||
| 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 | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Plan de ISAPRE | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
SΣ | 1..1 | string | Nombre del plan de isapre. | ||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:leyesPrev |
S | 0..* | BackboneElement | Nombre de la ley previsional | ||||
| 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 | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Otras Leyes Previsionales | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Previsionales (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length:1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:leyesRep |
S | 0..* | BackboneElement | Nombre de la ley previsional | ||||
| 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 | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 4 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Reparación | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Reparación (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length:1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:leyesPrio |
S | 0..* | BackboneElement | Nombre de la ley previsional | ||||
| 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 | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 5 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Priorización | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Grupo Marcas (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length:1048576 | |||||
| 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 | Status | Usage | ValueSet | Version | Source |
| Coverage.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| Coverage.status | Base | required | Financial Resource Status Codes | 📍4.0.1 | FHIR Std. |
| Coverage.type | Base | required | Previsión | 📦0.4.8 | This IG |
| Coverage.relationship | Base | extensible | SubscriberPolicyholder Relationship Codes | 📍4.0.1 | FHIR Std. |
| Coverage.class.type | Base | extensible | Coverage Class Codes | 📍4.0.1 | FHIR Std. |
| Coverage.class:tramos.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:tramos.value.extension:valorClase.value[x] | Base | required | Tramos de FONASA | 📦0.4.8 | This IG |
| Coverage.class:plan.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrev.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrev.value.extension:valorClase.value[x] | Base | required | Leyes Previsionales | 📦0.4.8 | This IG |
| Coverage.class:leyesRep.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesRep.value.extension:valorClase.value[x] | Base | required | Leyes Reparación | 📦0.4.8 | This IG |
| Coverage.class:leyesPrio.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrio.value.extension:valorClase.value[x] | Base | required | Grupo Marcas | 📦0.4.8 | This IG |
| Coverage.costToBeneficiary.type | Base | extensible | Coverage Copay Type Codes | 📍4.0.1 | FHIR Std. |
| Coverage.costToBeneficiary.exception.type | Base | example | Example Coverage Financial Exception Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| cov-cls-01 | error | Coverage | En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA |
type.coding.where(code = 1).exists() implies class.type.coding.where(code = 1).exists()
|
| cov-cls-02 | error | Coverage | En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE |
type.coding.where(code = 2).exists() implies class.type.coding.where(code = 2).exists()
|
| 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: 2 elements(8 nested mandatory elements)
Must-Support: 17 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Coverage |
C | 0..* | Coverage | Insurance or medical plan or a payment agreement Constraints: cov-cls-01, cov-cls-02 |
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
| 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. |
| type |
SΣ | 1..1 | CodeableConcept | Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) |
| policyHolder |
SΣ | 1..1 | Reference(MINSAL Paciente) | Propietario de la póliza |
| beneficiary |
SΣ | 1..1 | Reference(MINSAL Paciente) | Referencia al beneficiario del plan de salud |
| period |
SΣ | 0..1 | Period | Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". |
| payor |
SΣ | 1..1 | Reference(CL Organización(1.9.4)) | Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) |
| Slices for class |
S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type |
| class:All Slices |
Content/Rules for all slices | |||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. |
| value |
Σ | 1..1 | string | Value associated with the type |
| class:tramos |
S | 0..1 | BackboneElement | Tramos de FONASA, este valor es obligatorio en caso de ser FONASA |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Tramos de FONASA | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Tramos de FONASA (required) | |
| class:plan |
S | 0..1 | BackboneElement | Nombre del plan de isapre |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Plan de ISAPRE | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value |
SΣ | 1..1 | string | Nombre del plan de isapre. |
| class:leyesPrev |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Otras Leyes Previsionales | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Previsionales (required) | |
| class:leyesRep |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 4 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Reparación | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Reparación (required) | |
| class:leyesPrio |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 5 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Priorización | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
| value |
Σ | 1..1 | string | Value associated with the type |
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Grupo Marcas (required) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Coverage.status | Base | required | Financial Resource Status Codes | 📍4.0.1 | FHIR Std. |
| Coverage.type | Base | required | Previsión | 📦0.4.8 | This IG |
| Coverage.class.type | Base | extensible | Coverage Class Codes | 📍4.0.1 | FHIR Std. |
| Coverage.class:tramos.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:tramos.value.extension:valorClase.value[x] | Base | required | Tramos de FONASA | 📦0.4.8 | This IG |
| Coverage.class:plan.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrev.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrev.value.extension:valorClase.value[x] | Base | required | Leyes Previsionales | 📦0.4.8 | This IG |
| Coverage.class:leyesRep.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesRep.value.extension:valorClase.value[x] | Base | required | Leyes Reparación | 📦0.4.8 | This IG |
| Coverage.class:leyesPrio.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrio.value.extension:valorClase.value[x] | Base | required | Grupo Marcas | 📦0.4.8 | This IG |
| Id | Grade | Path(s) | Description | Expression |
| cov-cls-01 | error | Coverage | En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA |
type.coding.where(code = 1).exists() implies class.type.coding.where(code = 1).exists()
|
| cov-cls-02 | error | Coverage | En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE |
type.coding.where(code = 2).exists() implies class.type.coding.where(code = 2).exists()
|
| 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()
|
Differential View
This structure is derived from Coverage
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Coverage |
C | 0..* | Coverage | Insurance or medical plan or a payment agreement Constraints: cov-cls-01, cov-cls-02 |
| status |
S | 1..1 | code | active | cancelled | draft | entered-in-error |
| type |
S | 1..1 | CodeableConcept | Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) |
| policyHolder |
S | 1..1 | Reference(MINSAL Paciente) | Propietario de la póliza |
| beneficiary |
S | 1..1 | Reference(MINSAL Paciente) | Referencia al beneficiario del plan de salud |
| period |
S | 0..1 | Period | Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". |
| payor |
S | 1..1 | Reference(CL Organización(1.9.4)) | Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) |
| Slices for class |
S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type |
| class:tramos |
S | 0..1 | BackboneElement | Tramos de FONASA, este valor es obligatorio en caso de ser FONASA |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Tramos de FONASA | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Tramos de FONASA (required) | |
| class:plan |
S | 0..1 | BackboneElement | Nombre del plan de isapre |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Plan de ISAPRE | |
| value |
S | 1..1 | string | Nombre del plan de isapre. |
| class:leyesPrev |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Otras Leyes Previsionales | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Previsionales (required) | |
| class:leyesRep |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 4 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Reparación | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Reparación (required) | |
| class:leyesPrio |
S | 0..* | BackboneElement | Nombre de la ley previsional |
| type |
1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | |
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 5 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Priorización | |
| value |
||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase |
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Grupo Marcas (required) | |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Coverage.type | Base | required | Previsión | 📦0.4.8 | This IG |
| Coverage.class:tramos.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:tramos.value.extension:valorClase.value[x] | Base | required | Tramos de FONASA | 📦0.4.8 | This IG |
| Coverage.class:plan.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrev.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrev.value.extension:valorClase.value[x] | Base | required | Leyes Previsionales | 📦0.4.8 | This IG |
| Coverage.class:leyesRep.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesRep.value.extension:valorClase.value[x] | Base | required | Leyes Reparación | 📦0.4.8 | This IG |
| Coverage.class:leyesPrio.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrio.value.extension:valorClase.value[x] | Base | required | Grupo Marcas | 📦0.4.8 | This IG |
| Id | Grade | Path(s) | Description | Expression |
| cov-cls-01 | error | Coverage | En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA |
type.coding.where(code = 1).exists() implies class.type.coding.where(code = 1).exists()
|
| cov-cls-02 | error | Coverage | En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE |
type.coding.where(code = 2).exists() implies class.type.coding.where(code = 2).exists()
|
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| Coverage |
C | 0..* | Coverage | Insurance or medical plan or a payment agreement Constraints: cov-cls-01, cov-cls-02 | ||||
| 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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| 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 |
SΣ | 1..1 | CodeableConcept | Tipo de seguro. (FONASA, ISAPRE u Otros) Binding: Previsión (required) | ||||
| policyHolder |
SΣ | 1..1 | Reference(MINSAL Paciente) | Propietario de la póliza | ||||
| 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) | Referencia al beneficiario del plan de salud | ||||
| 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 | Desde cuando es beneficiario. En caso de finalizar el contrato debe incluirse el "end". | ||||
| payor |
SΣ | 1..1 | Reference(CL Organización(1.9.4)) | Entidad que paga el seguro. (FONASA, Alguna Isapre u otros) | ||||
| Slices for class |
S | 0..* | BackboneElement | Additional coverage classifications Slice: Unordered, Open by value:type | ||||
| class:All Slices |
Content/Rules for all slices | |||||||
| 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 | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. | ||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:tramos |
S | 0..1 | BackboneElement | Tramos de FONASA, este valor es obligatorio en caso de ser FONASA | ||||
| 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 | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 1 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Tramos de FONASA | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Tramos de FONASA (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length:1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:plan |
S | 0..1 | BackboneElement | Nombre del plan de isapre | ||||
| 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 | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 2 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Plan de ISAPRE | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
SΣ | 1..1 | string | Nombre del plan de isapre. | ||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:leyesPrev |
S | 0..* | BackboneElement | Nombre de la ley previsional | ||||
| 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 | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 3 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Otras Leyes Previsionales | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Previsionales (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length:1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:leyesRep |
S | 0..* | BackboneElement | Nombre de la ley previsional | ||||
| 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 | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 4 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Reparación | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Leyes Reparación (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length:1048576 | |||||
| name |
Σ | 0..1 | string | Human readable description of the type and value | ||||
| class:leyesPrio |
S | 0..* | BackboneElement | Nombre de la ley previsional | ||||
| 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 | Type of class such as 'group' or 'plan' Binding: Clase de Cobertura de Salud (extensible) Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: https://interoperabilidad.minsal.cl/fhir/ig/nid/CodeSystem/CSClasesDeCobertura | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 5 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Leyes de Priorización | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| value |
Σ | 1..1 | string | Value associated with the type | ||||
| id |
0..1 | string | xml:id (or equivalent in JSON) | |||||
| Slices for extension |
1..1 | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:valorClase |
S | 1..1 | (Complex) | Valor de la Clase URL: https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..0 | Extension Slice: Unordered, Open by value:url | ||||||
| url |
1..1 | uri | "https://interoperabilidad.minsal.cl/fhir/ig/nid/StructureDefinition/ValorDeLaClase" | |||||
| value[x] |
1..1 | Coding | Valor de la Clase del Coverage Binding: Grupo Marcas (required) | |||||
| value |
0..1 | string | Primitive value for string Max Length:1048576 | |||||
| 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 | Status | Usage | ValueSet | Version | Source |
| Coverage.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| Coverage.status | Base | required | Financial Resource Status Codes | 📍4.0.1 | FHIR Std. |
| Coverage.type | Base | required | Previsión | 📦0.4.8 | This IG |
| Coverage.relationship | Base | extensible | SubscriberPolicyholder Relationship Codes | 📍4.0.1 | FHIR Std. |
| Coverage.class.type | Base | extensible | Coverage Class Codes | 📍4.0.1 | FHIR Std. |
| Coverage.class:tramos.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:tramos.value.extension:valorClase.value[x] | Base | required | Tramos de FONASA | 📦0.4.8 | This IG |
| Coverage.class:plan.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrev.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrev.value.extension:valorClase.value[x] | Base | required | Leyes Previsionales | 📦0.4.8 | This IG |
| Coverage.class:leyesRep.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesRep.value.extension:valorClase.value[x] | Base | required | Leyes Reparación | 📦0.4.8 | This IG |
| Coverage.class:leyesPrio.type | Base | extensible | Clase de Cobertura de Salud | 📦0.4.8 | This IG |
| Coverage.class:leyesPrio.value.extension:valorClase.value[x] | Base | required | Grupo Marcas | 📦0.4.8 | This IG |
| Coverage.costToBeneficiary.type | Base | extensible | Coverage Copay Type Codes | 📍4.0.1 | FHIR Std. |
| Coverage.costToBeneficiary.exception.type | Base | example | Example Coverage Financial Exception Codes | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| cov-cls-01 | error | Coverage | En caso de que el coverga.type es FONASA entonces debe inlcuir el Tramo de FONASA |
type.coding.where(code = 1).exists() implies class.type.coding.where(code = 1).exists()
|
| cov-cls-02 | error | Coverage | En caso de que el coverga.type es ISAPRE entonces debe inlcuir el Plan de ISAPRE |
type.coding.where(code = 2).exists() implies class.type.coding.where(code = 2).exists()
|
| 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: 2 elements(8 nested mandatory elements)
Must-Support: 17 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Slices
This structure defines the following Slices:
Other representations of profile: CSV, Excel, Schematron