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 |
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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 |
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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 |
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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 |