Release 4B 5

This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0: R5 - STU ). The This is the current published version which supercedes in it's permanent home (it will always be available at this version is 5.0.0 . URL). For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R5 R4B R4 R3 R2

Coverage-example-2.xml

Example Coverage/7546D (XML)

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

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

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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"/> 
  
  <kind value="insurance"/>   <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 value="AB9876"/>   </subscriberId>   <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>   <insurer>     <reference value="Organization/2"/>   </insurer>   <class>     <type>       <coding>         <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>         <code value="group"/>       </coding>     </type>     <value>       <value value="WESTAIR"/>     </value>     <name value="Western Airlines"/>   </class>   <class>     <type>       <coding>         <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>         <code value="plan"/>       </coding>     </type>     <value>       <value value="BG4352"/>     </value>     <name value="Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"/>   </class>   <class>     <type>       <coding>         <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>         <code value="subplan"/>       </coding>     </type>     <value>       <value value="D15C9"/>     </value>     <name value="Platinum"/>   </class>   <order value="2"/>    <!--   Second after the national medical coverage   -->  <network value="5"/>   <costToBeneficiary>     <type>       <coding>         <system value="http://terminology.hl7.org/CodeSystem/coverage-copay-type"/>         <code value="gpvisit"/>    <!--   normally $40.00   -->      </coding>     </type>     <valueMoney>       <value value="20.00"/>       <currency value="USD"/>     </valueMoney>     <exception>       <type>         <coding>           <system value="http://terminology.hl7.org/CodeSystem/ex-coverage-financial-exception"/>           <code value="retired"/>         </coding>       </type>       <period>         <start value="2018-01-01"/>         <end value="2018-12-31"/>       </period>     </exception>   </costToBeneficiary>   <contract>     <reference value="Contract/INS-101"/>   </contract> 


</

Coverage

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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.