description: Profile of Coverage for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.
package_name: fhir.onc.us-quality-core
derivation: constraint
name: USQualityCoreCoverage
type: Coverage
elements:
  policyHolder:
    type: Reference
    short: Owner of the policy
    refers: ['http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-organization', 'http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient', 'http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-relatedperson']
    index: 5
  beneficiary:
    type: Reference
    short: (USCDI+ Quality) (USCDI) Plan beneficiary
    refers: ['http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient']
    index: 7
  relationship: {short: (USCDI+ Quality) (USCDI) Beneficiary relationship to the subscriber, index: 8}
  type:
    short: (USCDI+ Quality) (USCDI) Coverage category such as medical or accident
    binding: {strength: extensible, valueSet: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'}
    index: 4
  payor:
    type: Reference
    short: (USCDI+ Quality) (USCDI) Issuer of the policy
    refers: ['http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-organization', 'http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient', 'http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-relatedperson']
    index: 10
  status: {short: (USCDI+ Quality) (USCDI) active | cancelled | draft | entered-in-error, index: 3}
  class:
    short: (USCDI+ Quality) (USCDI) Additional coverage classifications
    index: 11
    slicing:
      rules: open
      ordered: false
      description: Slice based on value pattern
      discriminator:
      - {path: type, type: pattern}
      min: null
      slices:
        group:
          match: {type: null}
          schema:
            short: (USCDI+ Quality) (USCDI) Group
            index: 12
            elements:
              value: {short: (USCDI+ Quality) (USCDI) Group Identifier, index: 13}
              name: {short: (USCDI+ Quality) (USCDI) Human readable description of the type and value, index: 14}
        plan:
          match: {type: null}
          schema:
            short: (USCDI+ Quality) (USCDI) Plan
            index: 15
            elements:
              value: {short: (USCDI+ Quality) (USCDI) Plan Number, index: 16}
              name: {short: (USCDI+ Quality) (USCDI) Plan Name, index: 17}
  identifier:
    short: (USCDI+ Quality) (USCDI) Member ID and other identifiers
    index: 0
    slicing:
      rules: open
      discriminator:
      - {path: type, type: pattern}
      min: null
      slices:
        memberid:
          match: {type: null}
          schema:
            short: (USCDI+ Quality) (USCDI) Member ID
            index: 1
            elements:
              type: {short: (USCDI+ Quality) (USCDI) Member Number identifier type, index: 2}
  period: {short: (USCDI+ Quality) (USCDI) Coverage start and end dates, index: 9}
  subscriberId: {short: (USCDI+ Quality) (USCDI) ID assigned to the subscriber, index: 6}
package_version: 0.5.0
class: profile
kind: resource
url: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-coverage
base: http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|6.1.0
version: 0.5.0
required: [payor]