Financial instrument which may be used to reimburse or pay for or reimburse health care products and services.

Health care programs and insurers are significant payors of health service costs.

The program main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or plan underwriter Case ID. May be constructed as the concatination of the Coverage.SubscriberID and the Coverage.dependant.

This value may uniquely identify the coverage or payor. it may be used in conjunction with the additional identifiers below.

The status of the resource instance.

This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid.

The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.

The order of application of coverages is dependent on the types of coverage.

The party who 'owns' the insurance policy, may be an individual, corporation or the subscriber's employer.

Need The party who has signed-up for or 'owns' the contractual relationship to identify the issuer policy or to target whom the benefit of the policy for processing and services rendered to them or their family is due.

The insurer assigned ID for coordination of benefit processing. the Subscriber.

Business Identification Number (BIN number) used to identify The party who benefits from the routing of eclaims if insurance coverage., the insurer themselves don't have a BIN number for all patient when services are provided.

The relationship of their business. beneficiary (patient) to the subscriber.

To determine relationship between the patient and the subscriber.

Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.

The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health. program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).

Need to identify the issuer to target for processing and for coordination of benefit processing.

The order of application A suite of coverages is dependent on the types underwrite specific classifiers, for example may be used to identify a class of coverage. coverage or employer group, Policy, Plan.

The id Identifies a style or collective of coverage issued to by the subscriber. underwriter, for example may be used to identify an employer group. May also be referred to as a Policy or Group ID.

The main (and possibly only) identifier A short description for the coverage - often referred to as a Member Id, Subscriber Id, Certificate number or Personal Health Number or Case ID. group.

Identifies a business identifer, not style or collective of coverage issued by the underwriter, for example may be used to identify a resource identifier (see discussion ) subset of an employer group.

This value may uniquely identify the coverage or it may be used in conjunction with A short description for the additional identifiers below. subgroup.

Identifies a style or collective of coverage issues issued by the underwriter, for example may be used to identify a class collection of coverage or employer group. benefits provided to employees. May also be referred to as a Policy Section or Group Division ID.

A short description for the plan.

Identifies a sub-style or sub-collective of coverage issued by the underwriter, for example may be used to identify a subset of a collection of benefits provided to employees.

A short description for the subplan.

Identifies a style or collective of coverage issues by the underwriter, for example may be used to identify a class of coverage or employer group. May also be referred to such as a Policy level of deductables or Group ID. co-payment.

A short description for the class.

Identifies a sub-style or sub-collective of coverage issues by the underwriter, for example may be used to identify a specific employer group within a class subclass of employers. May be referred to coverage such as a Section sub-level of deductables or Division ID. co-payment.

A short description for the subclass.

A unique identifier for a dependent under the coverage.

For some coverage a single identifier is issued to the PolicyHolder Subscriber and a dependent number issues to each issued to each of their dependents to track and manage the plan. beneficiary.

An optional counter for a particular instance of the identified coverage which increments upon each renewal.

Some coverage, for example social plans, may be offered in short time increments, for example for a week or a month at a time, so while the rest of the plan details and identifiers may remain constant over time, the instance is incremented with each renewal and provided to the covered party on their 'card'.

The party who 'owns' the insurance contractual relationship order of applicability of this coverage relative to other coverages which are currently inforce. Note, there may be gaps in the policy or to whom numbering and this does not imply primary, secondard etc. as the benefit specific positioning of coverages depends upon the policy is due. episode of care.

The insurer-specific identifier for a community the insurer-defined network of providers. providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply.

The policy(s) which constitute this insurance coverage.