FHIRsmith: Coverage/Coverage-coverage-upmc-example.json

FHIR IG analytics

Package	hl7.fhir.us.health-care-surveys-reporting
Resource Type	Coverage
Id	Coverage-coverage-upmc-example.json
FHIR Version	R4

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Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: Coverage coverage-upmc-example

Language: en

Profile: US Core Coverage Profileversion: null6.1.0)

identifier: An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier./88800933501

status: Active

policyHolder: Dominique Ledner Female, DoB: 1965-06-22 ( MRN: Alaska Driver's License#abc123 (use: usual, ))

subscriber: Dominique Ledner Female, DoB: 1965-06-22 ( MRN: Alaska Driver's License#abc123 (use: usual, ))

subscriberId: 888009335

beneficiary: Dominique Ledner Female, DoB: 1965-06-22 ( MRN: Alaska Driver's License#abc123 (use: usual, ))

dependent: 01

relationship: Self

period: 2020-01-01 --> (ongoing)

payor: UPMC Health Plan

class
type: An employee group
value: MCHMO1
name: MEDICARE HMO PLAN

class
type: A specific suite of benefits.
value: GR5
name: GR5-HMO DEDUCTIBLE

network: GR5-HMO DEDUCTIBLE

Source1

{
  "resourceType": "Coverage",
  "id": "coverage-upmc-example",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|6.1.0"
    ]
  },
  "language": "en",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "identifier": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "MB",
            "display": "Member Number"
          }
        ],
        "text": "An identifier for the insured of an insurance policy (this insured always has a subscriber), usually assigned by the insurance carrier."
      },
      "system": "https://www.example.org/upmchealthplan.com/fhir/memberidentifier",
      "value": "88800933501",
      "assigner": {
        "reference": "Organization/organization-payer-upmc",
        "display": "UPMC Health Plan"
      }
    }
  ],
  "status": "active",
  "policyHolder": {
    "reference": "Patient/patient-ledner"
  },
  "subscriber": {
    "reference": "Patient/patient-ledner"
  },
  "subscriberId": "888009335",
  "beneficiary": {
    "reference": "Patient/patient-ledner"
  },
  "dependent": "01",
  "relationship": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code": "self"
      }
    ],
    "text": "Self"
  },
  "period": {
    "start": "2020-01-01"
  },
  "payor": [
    {
      "reference": "Organization/organization-payer-upmc",
      "display": "UPMC Health Plan"
    }
  ],
  "class": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code": "group",
            "display": "Group"
          }
        ],
        "text": "An employee group"
      },
      "value": "MCHMO1",
      "name": "MEDICARE HMO PLAN"
    },
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code": "plan",
            "display": "Plan"
          }
        ],
        "text": "A specific suite of benefits."
      },
      "value": "GR5",
      "name": "GR5-HMO DEDUCTIBLE"
    }
  ],
  "network": "GR5-HMO DEDUCTIBLE"
}