DSTU2 FHIR Release 3 (STU)

This page is part of the FHIR Specification (v1.0.2: DSTU (v3.0.2: STU 2). 3). 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 R3 R2

7.3.6 13.1.6 Resource Coverage - Mappings

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

Mappings:

RIM Mapping

HL7 v2 Mapping

Canadian Dental Association eclaims standard

Canadian Pharmacy Associaiton eclaims standard

Workflow Mapping

Mappings for the coverage resource.

7.3.6.1 13.1.6.1 Mappings for RIM Mapping (http://hl7.org/v3)

Coverage Coverage
    issuer     identifier
    bin     status
    period     type
    type     policyHolder
    subscriberId     subscriber
    identifier     subscriberId
    group     beneficiary
    plan     relationship
    subPlan     period
    dependent     payor
    sequence     grouping
    subscriber         group
    network         groupDisplay
    contract         subGroup
        subGroupDisplay
        plan
        planDisplay
        subPlan
        subPlanDisplay
        class
        classDisplay
        subClass
        subClassDisplay
    dependent
    sequence
    order
    network
    contract

7.3.6.2 13.1.6.2 Mappings for HL7 v2 Mapping (http://hl7.org/v2)

Coverage
    issuer     identifier IN1-3 IN1-2
    bin     status
    period     type IN1-15
    policyHolder IN1-16, 18, 19-name of insured, address, date of birth
    subscriber IN1-16, 18, 19-name of insured, address, date of birth
    subscriberId IN1-16, 18, 19-name of insured, address, date of birth
    beneficiary IN1-16, 18, 19-name of insured, address, date of birth
    relationship
    period IN1-12 / IN1-13
    type     payor IN1-15 IN1-3
    subscriberId     grouping
    identifier         group IN1-2 IN1-8
    group         groupDisplay IN1-8
    plan         subGroup IN1-8
        subGroupDisplay IN1-8
        plan IN1-35
    subPlan         planDisplay IN1-35
        subPlan IN1-10
    dependent         subPlanDisplay IN1-10
        class IN1-35
        classDisplay IN1-35
        subClass IN1-35
        subClassDisplay IN1-35
    dependent - No exact HL7 v2 equivalent concept seems to exist; instance relationship can be inferred if ( ( PID-3 ??? IN1-49 ) & ( ?? IN2-72 ) )
    sequence     sequence No HL7 v2 equivalent concept seems to exist
    subscriber     order IN1-16, 18, 19-name of insured, address, date of birth - No exact HL7 v2 equivalent concept seems to exist;
    network     network
    contract     contract IN1-16, 18, 19

7.3.6.3 13.1.6.3 Mappings for Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/)

Coverage
    issuer     identifier A05 C02
    bin     status
    period     type
    type     policyHolder D01 through D09
    subscriber D01 through D09
    subscriberId D01 through D09
    beneficiary D01 through D09
    relationship C03
    period
    subscriberId     payor A05
    grouping
    identifier         group C02 C11 (Division,Section)
    group         groupDisplay C11 (Division,Section)
    plan         subGroup
        subGroupDisplay
        plan C01
    subPlan         planDisplay C01
        subPlan
    dependent         subPlanDisplay
C17         class C01
    sequence         classDisplay D11 C01
    subscriber         subClass D01 through D09 C01
    network         subClassDisplay C01
    dependent C17
    sequence D11
    order
    network D10
    contract     contract D01 through D09

7.3.6.4 13.1.6.4 Mappings for Canadian Pharmacy Associaiton eclaims standard (http://www.pharmacists.ca/)

Coverage
    issuer     identifier C.30 C.32, C.33, C.39
    bin     status
    period     type
    type     policyHolder C.35
    subscriber C.35
    subscriberId C.35
    beneficiary C.35
    relationship
    subscriberId     period
    identifier     payor C.32, C.33, C.39 C.30
    group     grouping
        group C.31
    plan         groupDisplay C.31
        subGroup
    subPlan         subGroupDisplay
    dependent         plan
    sequence         planDisplay
    subscriber         subPlan
C.35         subPlanDisplay
    network         class
    contract         classDisplay
        subClass
        subClassDisplay
    dependent
    sequence
    order
    network
    contract C.35

13.1.6.5 Mappings for Workflow Mapping (http://hl7.org/fhir/workflow)

Coverage Event
    identifier Event.identifier
    status Event.status
    type
    policyHolder
    subscriber
    subscriberId
    beneficiary Event.subject
    relationship
    period Event.occurrence
    payor
    grouping
        group
        groupDisplay
        subGroup
        subGroupDisplay
        plan
        planDisplay
        subPlan
        subPlanDisplay
        class
        classDisplay
        subClass
        subClassDisplay
    dependent
    sequence
    order
    network
    contract