{
"description": "Health insurance and payment information. Section A1.3 of the eHN guideline.",
"_filename": "StructureDefinition-Payer.json",
"package_name": "hl7.fhir.eu.laboratory",
"date": "2023-12-06T08:27:18+00:00",
"derivation": "specialization",
"publisher": "HL7 Europe",
"fhirVersion": "4.0.1",
"jurisdiction": [ {
"coding": [ {
"code": "150",
"system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
"display": "Europe"
} ]
} ],
"name": "PayerLabEhn",
"mapping": [ {
"uri": "http://hl7.org/v3",
"name": "RIM Mapping",
"identity": "rim"
} ],
"abstract": false,
"copyright": "Used by permission of HL7 Europe, all rights reserved Creative Commons License",
"type": "http://hl7.eu/fhir/laboratory/StructureDefinition/Payer",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "A.1.3 - Health insurance and payment information",
"package_version": "0.1.0-ballot",
"snapshot": {
"element": [ {
"id": "Payer",
"max": "*",
"min": 0,
"base": {
"max": "*",
"min": 0,
"path": "Base"
},
"path": "Payer",
"short": "A.1.3 - Health insurance and payment information",
"definition": "Health insurance and payment information. Section A1.3 of the eHN guideline.",
"isModifier": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "Payer.insurance",
"min": 0,
"definition": "Health insurance information is not always required, however, in some jurisdictions, the insurance number is also used as the patient identifier. It is necessary not just for identification but also forms access to funding for care.",
"short": "A.1.3.1 Health insurance information",
"type": [ {
"code": "BackboneElement"
} ],
"max": "1",
"id": "Payer.insurance",
"base": {
"max": "1",
"min": 0,
"path": "Payer.insurance"
}
}, {
"path": "Payer.insurance.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "Payer.insurance.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Payer.insurance.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "Payer.insurance.extension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "Payer.insurance.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "Payer.insurance.modifierExtension",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"id": "Payer.insurance.identifier",
"max": "*",
"min": 0,
"base": {
"max": "*",
"min": 0,
"path": "Payer.insurance.identifier"
},
"path": "Payer.insurance.identifier",
"type": [ {
"code": "Identifier"
} ],
"short": "A.1.3.1.1 Health insurance code",
"definition": "Unique health insurance company identification code."
}, {
"id": "Payer.insurance.name",
"max": "*",
"min": 0,
"base": {
"max": "*",
"min": 0,
"path": "Payer.insurance.name"
},
"path": "Payer.insurance.name",
"type": [ {
"code": "string"
} ],
"short": "A.1.3.1.2 Health insurance name",
"definition": "Full, official name of the healthcare insurance provider."
}, {
"id": "Payer.insurance.subjectIdentifier",
"max": "*",
"min": 0,
"base": {
"max": "*",
"min": 0,
"path": "Payer.insurance.subjectIdentifier"
},
"path": "Payer.insurance.subjectIdentifier",
"type": [ {
"code": "Identifier"
} ],
"short": "A.1.3.1.3 Health insurance number",
"definition": "Number or code under which the insured person is registered at the insurance provider."
} ]
},
"status": "draft",
"id": "9290b4cd-e3cb-4784-bc50-c4cdb9edb189",
"kind": "logical",
"url": "http://hl7.eu/fhir/laboratory/StructureDefinition/Payer",
"version": "0.1.0-ballot",
"differential": {
"element": [ {
"id": "Payer",
"path": "Payer",
"short": "A.1.3 - Health insurance and payment information",
"definition": "Health insurance and payment information. Section A1.3 of the eHN guideline."
}, {
"id": "Payer.insurance",
"max": "1",
"min": 0,
"path": "Payer.insurance",
"type": [ {
"code": "BackboneElement"
} ],
"short": "A.1.3.1 Health insurance information",
"definition": "Health insurance information is not always required, however, in some jurisdictions, the insurance number is also used as the patient identifier. It is necessary not just for identification but also forms access to funding for care."
}, {
"id": "Payer.insurance.identifier",
"max": "*",
"min": 0,
"path": "Payer.insurance.identifier",
"type": [ {
"code": "Identifier"
} ],
"short": "A.1.3.1.1 Health insurance code",
"definition": "Unique health insurance company identification code. "
}, {
"id": "Payer.insurance.name",
"max": "*",
"min": 0,
"path": "Payer.insurance.name",
"type": [ {
"code": "string"
} ],
"short": "A.1.3.1.2 Health insurance name",
"definition": "Full, official name of the healthcare insurance provider. "
}, {
"id": "Payer.insurance.subjectIdentifier",
"max": "*",
"min": 0,
"path": "Payer.insurance.subjectIdentifier",
"type": [ {
"code": "Identifier"
} ],
"short": "A.1.3.1.3 Health insurance number",
"definition": "Number or code under which the insured person is registered at the insurance provider. "
} ]
},
"contact": [ {
"name": "HL7 Europe",
"telecom": [ {
"value": "http://hl7.org/Special/committees/eu",
"system": "url"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Base"
}