Insurance Plan Profile Mapping
Supported Implementation Guides for FHIR-R4
HL7.FHIR.US.DAVINCI-PDEX-PLAN-NET\Plan-Net InsurancePlan - FHIR v4.0.1
FHIR Elements to BSC Data Mapping
FHIR Mapping |
meta.profile[0] |
identifier[0].use |
identifier[0].type.coding[0].system |
identifier[0].type.coding[0].code |
identifier[0].type.coding[0].userSelected |
identifier[0].system |
identifier[0].value |
status |
type[0].coding[0].system |
type[0].coding[0].code |
type[0].coding[0].display |
name |
alias[0] |
period.start |
period.end |
network[*].reference |
network[*].display |
coverage[0].type.coding[0].display |
coverage[0].benefit[0].type.text |
plan[*].identifier[0].use |
plan[*].identifier[0].type.coding[0].system |
plan[*].identifier[0] .type.coding[0].code |
plan[*].identifier[0] .type.coding[0].display |
plan[*].identifier[0] .type.coding[0].userSelected |
plan[*].identifier[0].type.text |
plan[*].identifier[0].system |
plan[*].identifier[0].value |
plan[*].type.coding[0].code |
plan[*].type.coding[0].display |
plan[*].network[*].reference |
plan[*].network[*].display |
plan[*].generalCost[0].type.coding[0].system |
plan[*].generalCost[0].type.coding[0].code |
plan[*].generalCost[0].type.coding[0].display |
plan[*].generalCost[0].cost.value |
plan[*].specificCost[*].category.coding[0].display |
plan[*].specificCost[*].benefit[*].type.coding[0].display |
plan[*].specificCost[*].benefit[*].cost[*].type.coding[0].display |
plan[*].specificCost[*].benefit[*].cost[*].applicability.coding[0].system |
plan[*].specificCost[*].benefit[*].cost[*].applicability.coding[0].code |
plan[*].specificCost[*].benefit[*].cost[*].applicability.coding[0].display |
plan[*].specificCost[*].benefit[*].cost[*].qualifiers[0].coding[0].display |
plan[*].specificCost[*].benefit[*].cost[*].value.value |
ownedBy.display |
administeredBy.display |
coverageArea[0].display |
plan[*].coverageArea |
Codesets Mapping
FHIR Data Element |
Valueset |
Binding |
status |
required |
|
type |
HL7.FHIR.US.DAVINCI-PDEX-PLAN-NET\Insurance Product Type - FHIR v4.0.1 |
extensible |
coverage.type |
(Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health) |
none |
plan.type |
HL7.FHIR.US.DAVINCI-PDEX-PLAN-NET\Insurance Plan Type - FHIR v4.0.1 |
extensible |
plan.specificCost.category |
(Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health) |
none |
plan.specificCost.benefit.type |
(preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care) |
none |
plan.specificCost.benefit.cost.type |
(copay; individual cap; family cap; coinsurance; deductible) |
none |
plan.specificCost.benefit.cost.applicability |
Valueset-insuranceplan-applicability - FHIR v4.0.1 (hl7.org) |
required |
plan.specificCost.benefit.cost.qualifiers |
(Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA)) |
none |