Moderne Patient:innenabrechnung und Datenkommunikation on FHIR (MOPED)
0.1.0 - ci-build

Moderne Patient:innenabrechnung und Datenkommunikation on FHIR (MOPED) - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: SVCCoverage - Mappings

Draft as of 2024-10-31

Mappings for the SVCCoverage resource profile.

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

SVCCoverage
CoverageEvent
   identifierEvent.identifier
   statusEvent.status
   beneficiaryEvent.subject
   periodEvent.occurrence[x]

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

SVCCoverage
Coveragefinancial.support
   identifierFiveWs.identifier
   statusFiveWs.status
   typeFiveWs.class
   policyHolderFiveWs.subject[x]
   subscriberFiveWs.subject[x]
   subscriberIdFiveWs.subject[x]
   beneficiaryFiveWs.subject[x]
   periodFiveWs.done[x]

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

SVCCoverage
CoverageEntity, Role, or Act,Coverage
   textAct.text?
   containedn/a
   modifierExtensionn/a
   identifier.id
   statusAct.status
   paymentBy
      idn/a
      extensionn/a
      modifierExtensionn/a
   periodAct.effectiveTime
   class
      idn/a
      extensionn/a
      modifierExtensionn/a
      type
   class (Versichertenarten)
      idn/a
      extensionn/a
      modifierExtensionn/a
      type
         idn/a
         extensionn/a
         codingunion(., ./translation)
            idn/a
            extensionn/a
            system./codeSystem
            version./codeSystemVersion
            code./code
            displayCV.displayName
            userSelectedCD.codingRationale
         text./originalText[mediaType/code="text/plain"]/data
   class (Versichertenkategorien)
      idn/a
      extensionn/a
      modifierExtensionn/a
      type
         idn/a
         extensionn/a
         codingunion(., ./translation)
            idn/a
            extensionn/a
            system./codeSystem
            version./codeSystemVersion
            code./code
            displayCV.displayName
            userSelectedCD.codingRationale
         text./originalText[mediaType/code="text/plain"]/data
   costToBeneficiary
      idn/a
      extensionn/a
      modifierExtensionn/a
      exception
         idn/a
         extensionn/a
         modifierExtensionn/a
   contractn/a

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

SVCCoverage
Coverage
   identifierC02
   policyHolderD01 through D09
   subscriberD01 through D09
   subscriberIdD01 through D09
   beneficiaryD01 through D09
   dependentC17
   relationshipC03
   class
      valueC11 (Division,Section)
      nameC11 (Division,Section)
   class (Versichertenarten)
      valueC11 (Division,Section)
      nameC11 (Division,Section)
   class (Versichertenkategorien)
      valueC11 (Division,Section)
      nameC11 (Division,Section)
   networkD10
   costToBeneficiary
      value[x]C11 (Division,Section)
   contractD01 through D09

Mappings for Canadian Pharmacy Association eclaims standard (http://www.pharmacists.ca/)

SVCCoverage
Coverage
   identifierC.32, C.33, C.39
   policyHolderC.35
   subscriberC.35
   subscriberIdC.35
   beneficiaryC.35
   class
      valueC.31
      nameC.31
   class (Versichertenarten)
      valueC.31
      nameC.31
   class (Versichertenkategorien)
      valueC.31
      nameC.31
   costToBeneficiary
      value[x]C.31
   contractC.35

Mappings for HL7 V2 Mapping (http://hl7.org/v2)

SVCCoverage
Coverage
   typeIN1-15
   policyHolderIN1-16, 18, 19-name of insured, address, date of birth
   subscriberIN1-16, 18, 19-name of insured, address, date of birth
   subscriberIdIN1-16, 18, 19-name of insured, address, date of birth
   beneficiaryIN1-16, 18, 19-name of insured, address, date of birth
   dependent- No exact HL7 V2 equivalent concept seems to exist;
   periodIN1-12 / IN1-13
   class
      type
      valueIN1-2
      nameIN1-8
   class (Versichertenarten)
      type
         codingC*E.1-8, C*E.10-22
            systemC*E.3
            versionC*E.7
            codeC*E.1
            displayC*E.2 - but note this is not well followed
            userSelectedSometimes implied by being first
         textC*E.9. But note many systems use C*E.2 for this
      valueIN1-2
      nameIN1-8
   class (Versichertenkategorien)
      type
         codingC*E.1-8, C*E.10-22
            systemC*E.3
            versionC*E.7
            codeC*E.1
            displayC*E.2 - but note this is not well followed
            userSelectedSometimes implied by being first
         textC*E.9. But note many systems use C*E.2 for this
      valueIN1-2
      nameIN1-8
   costToBeneficiary
      value[x]IN1-8
   contractIN1-16, 18, 19