description: The HRex Coverage Profile defines the constraints for representing a member's healthcare insurance information to the Payer.  Coverage instances complying with this profile, sometimes together with the Patient which this profile references via `beneficiary`, allows a payer to identify a member in their system.
package_name: hl7.fhir.us.davinci-hrex
derivation: constraint
name: HRexCoverage
type: Coverage
elements:
  identifier:
    short: Also known as Member identifier
    mustSupport: true
    index: 0
    elements:
      value: {type: string, short: The value that is unique within the system., mustSupport: true, index: 1}
    required: [value]
  policyHolder:
    type: Reference
    refers: ['http://hl7.org/fhir/StructureDefinition/RelatedPerson', 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient', 'http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-organization']
    index: 2
  subscriber:
    type: Reference
    refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient']
    index: 3
  subscriberId: {short: Subscriber ID, mustSupport: true, index: 4}
  beneficiary:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-patient-demographics']
    index: 5
  dependent: {type: string, mustSupport: true, index: 6}
  payor:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-organization']
    index: 7
  class:
    index: 8
    slicing:
      rules: open
      discriminator:
      - {path: type, type: pattern}
      min: null
      slices:
        group:
          match:
            type:
              coding:
              - {code: group, system: 'http://terminology.hl7.org/CodeSystem/coverage-class'}
          schema:
            mustSupport: true
            index: 9
            elements:
              type:
                type: CodeableConcept
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: group, system: 'http://terminology.hl7.org/CodeSystem/coverage-class'}
                index: 10
              value: {mustSupport: true, index: 11}
            required: [value, type]
package_version: 1.0.0
class: profile
kind: resource
url: http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-coverage
base: http://hl7.org/fhir/StructureDefinition/Coverage
version: 1.0.0
required: [payor]