FHIR Release 3 (STU) R4 Ballot #2 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.0.2: STU 3). (v3.5.0: R4 Ballot #2). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Coverage-example-2.xml

Financial Management Work Group Maturity Level : N/A Ballot Status : Informative Compartments : Patient , RelatedPerson

Raw XML ( canonical form + also see XML Format Specification )

Jump past Narrative

General Person Secondary Coverage Example (id = "7546D") 

<?xml version="1.0" encoding="UTF-8"?>


<Coverage xmlns="http://hl7.org/fhir">
  <id value="7546D"/> 

  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the coverage</div> 
  </text> 

  <identifier> 
    <system value="http://xyz.com/codes/identifier"/> 
    <value value="AB98761"/> 
  </identifier> 

  <status value="active"/> 

  <type> 
    <coding> 
      

      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/> 
      <code value="EHCPOL"/> 
      <display value="extended healthcare"/> 
    </coding> 
  </type> 

  <subscriber> 
    <reference value="Patient/5"/> 
  </subscriber> 

  <subscriberId value="AB9876"/> 

  <beneficiary> 
    <reference value="Patient/5"/> 
  </beneficiary> 

  <dependent value="1"/> 


  <relationship> 
    <coding> 
      <code value="self"/> 
    </coding>    
  </relationship> 

  <period>  
    <start value="2011-03-17"/> 
    <end value="2012-03-17"/> 
  </period> 

  <payor> 
    <reference value="Organization/2"/> 
  </payor> 

  
    
    
    
    
    
    
  

  <class> 
    <type> 
      <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/> 
      <code value="group"/> 
    </type> 
    <value value="WESTAIR"/> 
    <name value="Western Airlines"/> 
  </class> 

  

  <class> 
    <type> 
      <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/> 
      <code value="plan"/> 
    </type> 
    <value value="BG4352"/> 
    <name value="Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"/> 
  </class> 

  <class> 
    <type> 
      <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/> 
      <code value="subplan"/> 
    </type> 
    <value value="D15C9"/> 
    <name value="Platinum"/> 
  </class> 

  <order value="2"/>  <!--   Second after the national medical coverage   -->
  



  <network value="5"/> 

  <contract> 
    

    <reference value="Contract/INS-101"/> 
  </contract> 



</

Coverage

>

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.