description: The PAYER_PLAN_PERIOD table captures details of the period of time that a Person is continuously enrolled under a specific health Plan benefit structure from a given Payer. Each Person receiving healthcare is typically covered by a health benefit plan, which pays for (fully or partially), or directly provides, the care. These benefit plans are provided by payers, such as health insurances or state or government agencies. In each plan the details of the health benefits are defined for the Person or her family, and the health benefit Plan might change over time typically with increasing utilization (reaching certain cost thresholds such as deductibles), plan availability and purchasing choices of the Person. The unique combinations of Payer organizations, health benefit Plans and time periods in which they are valid for a Person are recorded in this table.
package_name: hl7.fhir.uv.omop
derivation: specialization
name: PayerPlanPeriod
type: http://hl7.org/fhir/uv/omop/StructureDefinition/PayerPlanPeriod
elements:
  stop_reason_concept_id: {type: code, short: Stop Reason, index: 14}
  payer_concept_id: {type: code, short: Payer, index: 4}
  plan_source_value: {type: string, short: Plan Source Value, index: 8}
  payer_plan_period_start_date: {type: date, short: Payer Plan Period Start Date, index: 2}
  stop_reason_source_concept_id: {type: code, short: Stop Reason Source, index: 16}
  plan_concept_id: {type: code, short: Plan, index: 7}
  payer_plan_period_id: {type: code, short: Payer Plan Period Identifier, index: 0}
  sponsor_source_value: {type: string, short: Sponsor Source Value, index: 11}
  person_id:
    type: Reference
    short: Person
    refers: ['http://hl7.org/fhir/uv/omop/StructureDefinition/Person']
    index: 1
  sponsor_source_concept_id: {type: code, short: Sponsor Source, index: 12}
  payer_source_value: {type: string, short: Payer Source Value, index: 5}
  payer_source_concept_id: {type: code, short: Payer Source, index: 6}
  stop_reason_source_value: {type: string, short: Stop Reason Source Value, index: 15}
  sponsor_concept_id: {type: code, short: Sponsor, index: 10}
  plan_source_concept_id: {type: code, short: Plan Source, index: 9}
  family_source_value: {type: string, short: Family Source Value, index: 13}
  payer_plan_period_end_date: {type: date, short: Payer Plan Period End Date, index: 3}
package_version: 1.0.0-ballot
class: logical
kind: logical
url: http://hl7.org/fhir/uv/omop/StructureDefinition/PayerPlanPeriod
base: http://hl7.org/fhir/StructureDefinition/Base
version: 1.0.0-ballot
required: [payer_plan_period_end_date, payer_plan_period_id, payer_plan_period_start_date, person_id]