Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business identifier(s) for this coverage Slice: Unordered, Open by value:system
identifier:VDASID	SΣ	0..1	Identifier	Business identifier(s) for this coverage
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: urn:oid:1.2.40.0.10.1.4.3.9.1
assigner	Σ	0..1	Reference(HL7® AT Core Organization Profile)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
kind	Σ	1..1	code	insurance | self-pay | other Binding: Kind (required) Required Pattern: insurance
policyHolder	Σ	0..1	Reference(HL7® AT Core Patient Profile | MOPED Hauptversicherter)	Owner of the policy
beneficiary	Σ	1..1	Reference(HL7® AT Core Patient Profile)	Plan beneficiary
insurer	Σ	0..1	Reference(SV Organization)	Issuer of the policy
Slices for class		0..*	BackboneElement	Additional coverage classifications Slice: Unordered, Open by value:type.coding
class:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, e.g. Group, Plan, Class, etc.
value	Σ	1..1	Identifier	Value associated with the type
class:Versichertenkategorien	S	0..1	BackboneElement	Versichertenkategorien
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs (required)
coding	Σ	1..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: group
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
value	Σ	1..1	Identifier	Value associated with the type
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	0..1	uri	The namespace for the identifier value Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.identifier:VDASID.​use	Base	required	IdentifierUse	📍5.0.0	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍5.0.0	FHIR Std.
Coverage.kind	Base	required	Kind	📍5.0.0	FHIR Std.
Coverage.class.type	Base	extensible	Coverage Class Codes	📍5.0.0	FHIR Std.
Coverage.class:Versichertenkategorien.​type	Base	required	http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs	?	Unknown
Coverage.class:Versichertenkategorien.​value.use	Base	required	IdentifierUse	📍5.0.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage			Coverage
Slices for identifier		0..*	Identifier	Business identifier(s) for this coverage Slice: Unordered, Open by value:system
identifier:VDASID	S	0..1	Identifier	Business identifier(s) for this coverage
system		1..1	uri	The namespace for the identifier value Required Pattern: urn:oid:1.2.40.0.10.1.4.3.9.1
assigner		0..1	Reference(HL7® AT Core Organization Profile)	Organization that issued id (may be just text)
kind		1..1	code	insurance | self-pay | other Required Pattern: insurance
paymentBy
party		1..1	Reference(HL7® AT Core Organization Profile)	Parties performing self-payment
policyHolder		0..1	Reference(HL7® AT Core Patient Profile | MOPED Hauptversicherter)	Owner of the policy
beneficiary		1..1	Reference(HL7® AT Core Patient Profile)	Plan beneficiary
insurer		0..1	Reference(SV Organization)	Issuer of the policy
Slices for class		0..*	BackboneElement	Additional coverage classifications Slice: Unordered, Open by value:type.coding
class:Versichertenkategorien	S	0..1	BackboneElement	Versichertenkategorien
type		1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs (required)
coding		1..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
code		1..1	code	Symbol in syntax defined by the system Fixed Value: group
value
system		0..1	uri	The namespace for the identifier value Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Coverage.class:Versichertenkategorien.​type	Base	required	http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs	?	Unknown

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business identifier(s) for this coverage Slice: Unordered, Open by value:system
identifier:VDASID	SΣ	0..1	Identifier	Business identifier(s) for this coverage
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: urn:oid:1.2.40.0.10.1.4.3.9.1
value	ΣC	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(HL7® AT Core Organization Profile)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
kind	Σ	1..1	code	insurance | self-pay | other Binding: Kind (required) Required Pattern: insurance
paymentBy		0..*	BackboneElement	Self-pay parties and responsibility
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
party	Σ	1..1	Reference(HL7® AT Core Organization Profile)	Parties performing self-payment
responsibility	Σ	0..1	string	Party's responsibility
type	Σ	0..1	CodeableConcept	Coverage category such as medical or accident Binding: CoverageTypeAndSelfPayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
policyHolder	Σ	0..1	Reference(HL7® AT Core Patient Profile | MOPED Hauptversicherter)	Owner of the policy
subscriber	Σ	0..1	Reference(Patient | RelatedPerson)	Subscriber to the policy
subscriberId	Σ	0..*	Identifier	ID assigned to the subscriber
beneficiary	Σ	1..1	Reference(HL7® AT Core Patient Profile)	Plan beneficiary
dependent	Σ	0..1	string	Dependent number
relationship		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
period	Σ	0..1	Period	Coverage start and end dates
insurer	Σ	0..1	Reference(SV Organization)	Issuer of the policy
Slices for class		0..*	BackboneElement	Additional coverage classifications Slice: Unordered, Open by value:type.coding
class:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, e.g. Group, Plan, Class, etc.
value	Σ	1..1	Identifier	Value associated with the type
name	Σ	0..1	string	Human readable description of the type and value
class:Versichertenkategorien	S	0..1	BackboneElement	Versichertenkategorien
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs (required)
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: group
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value	Σ	1..1	Identifier	Value associated with the type
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs
value	ΣC	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
name	Σ	0..1	string	Human readable description of the type and value
order	Σ	0..1	positiveInt	Relative order of the coverage
network	Σ	0..1	string	Insurer network
costToBeneficiary		0..*	BackboneElement	Patient payments for services/products
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	CodeableConcept	Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example)
network		0..1	CodeableConcept	In or out of network Binding: NetworkTypeCodes (example)
unit		0..1	CodeableConcept	Individual or family Binding: UnitTypeCodes (example)
term		0..1	CodeableConcept	Annual or lifetime Binding: BenefitTermCodes (example)
value[x]	Σ	0..1		The amount or percentage due from the beneficiary
valueQuantity			Quantity(SimpleQuantity)
valueMoney			Money
exception		0..*	BackboneElement	Exceptions for patient payments
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.
period	Σ	0..1	Period	The effective period of the exception
subrogation		0..1	boolean	Reimbursement to insurer
contract		0..*	Reference(Contract)	Contract details
insurancePlan		0..1	Reference(InsurancePlan)	Insurance plan details
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.language	Base	required	All Languages	📍5.0.0	FHIR Std.
Coverage.identifier:VDASID.​use	Base	required	IdentifierUse	📍5.0.0	FHIR Std.
Coverage.identifier:VDASID.​type	Base	extensible	Identifier Type Codes	📍5.0.0	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍5.0.0	FHIR Std.
Coverage.kind	Base	required	Kind	📍5.0.0	FHIR Std.
Coverage.type	Base	preferred	Coverage Type and Self-Pay Codes	📍5.0.0	FHIR Std.
Coverage.relationship	Base	extensible	SubscriberPolicyholder Relationship Codes	📍5.0.0	FHIR Std.
Coverage.class.type	Base	extensible	Coverage Class Codes	📍5.0.0	FHIR Std.
Coverage.class:Versichertenkategorien.​type	Base	required	http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs	?	Unknown
Coverage.class:Versichertenkategorien.​value.use	Base	required	IdentifierUse	📍5.0.0	FHIR Std.
Coverage.class:Versichertenkategorien.​value.type	Base	extensible	Identifier Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​category	Base	example	Benefit Category Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​network	Base	example	Network Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​unit	Base	example	Unit Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​term	Base	example	Benefit Term Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📍5.0.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Summary

Mandatory: 0 element(2 nested mandatory elements)
Must-Support: 2 elements

Structures

This structure refers to these other structures:

• HL7® AT Core Organization Profile (http://hl7.at/fhir/HL7ATCoreProfiles/5.0.0/StructureDefinition/at-core-organization)
• HL7® AT Core Patient Profile (http://hl7.at/fhir/HL7ATCoreProfiles/5.0.0/StructureDefinition/at-core-patient)
• MOPED Hauptversicherter (https://elga.moped.at/StructureDefinition/Hauptversicherter)
• SV Organization (https://elga.moped.at/StructureDefinition/SVOrganization)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Coverage.identifier
• The element 1 is sliced based on the value of Coverage.class

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business identifier(s) for this coverage Slice: Unordered, Open by value:system
identifier:VDASID	SΣ	0..1	Identifier	Business identifier(s) for this coverage
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: urn:oid:1.2.40.0.10.1.4.3.9.1
assigner	Σ	0..1	Reference(HL7® AT Core Organization Profile)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
kind	Σ	1..1	code	insurance | self-pay | other Binding: Kind (required) Required Pattern: insurance
policyHolder	Σ	0..1	Reference(HL7® AT Core Patient Profile | MOPED Hauptversicherter)	Owner of the policy
beneficiary	Σ	1..1	Reference(HL7® AT Core Patient Profile)	Plan beneficiary
insurer	Σ	0..1	Reference(SV Organization)	Issuer of the policy
Slices for class		0..*	BackboneElement	Additional coverage classifications Slice: Unordered, Open by value:type.coding
class:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, e.g. Group, Plan, Class, etc.
value	Σ	1..1	Identifier	Value associated with the type
class:Versichertenkategorien	S	0..1	BackboneElement	Versichertenkategorien
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs (required)
coding	Σ	1..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: group
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
value	Σ	1..1	Identifier	Value associated with the type
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	0..1	uri	The namespace for the identifier value Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.identifier:VDASID.​use	Base	required	IdentifierUse	📍5.0.0	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍5.0.0	FHIR Std.
Coverage.kind	Base	required	Kind	📍5.0.0	FHIR Std.
Coverage.class.type	Base	extensible	Coverage Class Codes	📍5.0.0	FHIR Std.
Coverage.class:Versichertenkategorien.​type	Base	required	http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs	?	Unknown
Coverage.class:Versichertenkategorien.​value.use	Base	required	IdentifierUse	📍5.0.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage			Coverage
Slices for identifier		0..*	Identifier	Business identifier(s) for this coverage Slice: Unordered, Open by value:system
identifier:VDASID	S	0..1	Identifier	Business identifier(s) for this coverage
system		1..1	uri	The namespace for the identifier value Required Pattern: urn:oid:1.2.40.0.10.1.4.3.9.1
assigner		0..1	Reference(HL7® AT Core Organization Profile)	Organization that issued id (may be just text)
kind		1..1	code	insurance | self-pay | other Required Pattern: insurance
paymentBy
party		1..1	Reference(HL7® AT Core Organization Profile)	Parties performing self-payment
policyHolder		0..1	Reference(HL7® AT Core Patient Profile | MOPED Hauptversicherter)	Owner of the policy
beneficiary		1..1	Reference(HL7® AT Core Patient Profile)	Plan beneficiary
insurer		0..1	Reference(SV Organization)	Issuer of the policy
Slices for class		0..*	BackboneElement	Additional coverage classifications Slice: Unordered, Open by value:type.coding
class:Versichertenkategorien	S	0..1	BackboneElement	Versichertenkategorien
type		1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs (required)
coding		1..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
code		1..1	code	Symbol in syntax defined by the system Fixed Value: group
value
system		0..1	uri	The namespace for the identifier value Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Coverage.class:Versichertenkategorien.​type	Base	required	http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs	?	Unknown

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business identifier(s) for this coverage Slice: Unordered, Open by value:system
identifier:VDASID	SΣ	0..1	Identifier	Business identifier(s) for this coverage
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: urn:oid:1.2.40.0.10.1.4.3.9.1
value	ΣC	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(HL7® AT Core Organization Profile)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
kind	Σ	1..1	code	insurance | self-pay | other Binding: Kind (required) Required Pattern: insurance
paymentBy		0..*	BackboneElement	Self-pay parties and responsibility
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
party	Σ	1..1	Reference(HL7® AT Core Organization Profile)	Parties performing self-payment
responsibility	Σ	0..1	string	Party's responsibility
type	Σ	0..1	CodeableConcept	Coverage category such as medical or accident Binding: CoverageTypeAndSelfPayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
policyHolder	Σ	0..1	Reference(HL7® AT Core Patient Profile | MOPED Hauptversicherter)	Owner of the policy
subscriber	Σ	0..1	Reference(Patient | RelatedPerson)	Subscriber to the policy
subscriberId	Σ	0..*	Identifier	ID assigned to the subscriber
beneficiary	Σ	1..1	Reference(HL7® AT Core Patient Profile)	Plan beneficiary
dependent	Σ	0..1	string	Dependent number
relationship		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
period	Σ	0..1	Period	Coverage start and end dates
insurer	Σ	0..1	Reference(SV Organization)	Issuer of the policy
Slices for class		0..*	BackboneElement	Additional coverage classifications Slice: Unordered, Open by value:type.coding
class:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, e.g. Group, Plan, Class, etc.
value	Σ	1..1	Identifier	Value associated with the type
name	Σ	0..1	string	Human readable description of the type and value
class:Versichertenkategorien	S	0..1	BackboneElement	Versichertenkategorien
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs (required)
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/coverage-class
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: group
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value	Σ	1..1	Identifier	Value associated with the type
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	0..1	uri	The namespace for the identifier value Required Pattern: http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs
value	ΣC	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
name	Σ	0..1	string	Human readable description of the type and value
order	Σ	0..1	positiveInt	Relative order of the coverage
network	Σ	0..1	string	Insurer network
costToBeneficiary		0..*	BackboneElement	Patient payments for services/products
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	CodeableConcept	Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example)
network		0..1	CodeableConcept	In or out of network Binding: NetworkTypeCodes (example)
unit		0..1	CodeableConcept	Individual or family Binding: UnitTypeCodes (example)
term		0..1	CodeableConcept	Annual or lifetime Binding: BenefitTermCodes (example)
value[x]	Σ	0..1		The amount or percentage due from the beneficiary
valueQuantity			Quantity(SimpleQuantity)
valueMoney			Money
exception		0..*	BackboneElement	Exceptions for patient payments
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.
period	Σ	0..1	Period	The effective period of the exception
subrogation		0..1	boolean	Reimbursement to insurer
contract		0..*	Reference(Contract)	Contract details
insurancePlan		0..1	Reference(InsurancePlan)	Insurance plan details
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.language	Base	required	All Languages	📍5.0.0	FHIR Std.
Coverage.identifier:VDASID.​use	Base	required	IdentifierUse	📍5.0.0	FHIR Std.
Coverage.identifier:VDASID.​type	Base	extensible	Identifier Type Codes	📍5.0.0	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍5.0.0	FHIR Std.
Coverage.kind	Base	required	Kind	📍5.0.0	FHIR Std.
Coverage.type	Base	preferred	Coverage Type and Self-Pay Codes	📍5.0.0	FHIR Std.
Coverage.relationship	Base	extensible	SubscriberPolicyholder Relationship Codes	📍5.0.0	FHIR Std.
Coverage.class.type	Base	extensible	Coverage Class Codes	📍5.0.0	FHIR Std.
Coverage.class:Versichertenkategorien.​type	Base	required	http://svc.co.at/CodeSystem/ecard-versichertenkategorie-cs	?	Unknown
Coverage.class:Versichertenkategorien.​value.use	Base	required	IdentifierUse	📍5.0.0	FHIR Std.
Coverage.class:Versichertenkategorien.​value.type	Base	extensible	Identifier Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​category	Base	example	Benefit Category Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​network	Base	example	Network Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​unit	Base	example	Unit Type Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​term	Base	example	Benefit Term Codes	📍5.0.0	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📍5.0.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Summary

Mandatory: 0 element(2 nested mandatory elements)
Must-Support: 2 elements

Structures

This structure refers to these other structures:

• HL7® AT Core Organization Profile (http://hl7.at/fhir/HL7ATCoreProfiles/5.0.0/StructureDefinition/at-core-organization)
• HL7® AT Core Patient Profile (http://hl7.at/fhir/HL7ATCoreProfiles/5.0.0/StructureDefinition/at-core-patient)
• MOPED Hauptversicherter (https://elga.moped.at/StructureDefinition/Hauptversicherter)
• SV Organization (https://elga.moped.at/StructureDefinition/SVOrganization)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Coverage.identifier
• The element 1 is sliced based on the value of Coverage.class