Implementation Guide
23.1.0 - R4 APIs

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Logical Model: Eligibility - Detailed Descriptions

Active as of 2023-03-01

Definitions for the athena-eligibility-profile logical model.

Guidance on how to interpret the contents of this table can be found here

0. athena-eligibility-profile
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. athena-eligibility-profile.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control1..1
Typeid
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
4. athena-eligibility-profile.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Comments

Unique Id for this particular athena-eligibility-profile.

Control0..1
TypeMeta
Is Modifierfalse
Must Supportfalse
6. athena-eligibility-profile.pid
Definition

PatientId for Eligibility

ShortPID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource.
Comments

PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource.

Control1..1
Typeinteger
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
8. athena-eligibility-profile.patient
Definition

Who or what the athena-eligibility-profile is about. The athena-eligibility-profile can be about a person.

ShortWho/what is the patient for Eligibility
Control0..1
TypeReference(Patient)
10. athena-eligibility-profile.patient.reference
Definition

Who or what the athena-eligibility-profile is about. The athena-eligibility-profile can be about a person.

ShortReference to the Patient
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
12. athena-eligibility-profile.patient.display
Definition

Patient name for the athena-eligibility-profile is about.

ShortPatient name
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
14. athena-eligibility-profile.patientProfileId
Definition

Internal ID of patient used in non-clinical practice management data.

ShortPatient specific id for practice management data including financial information
Comments

Patient profile ID

Control1..1
TypeunsignedInt
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
16. athena-eligibility-profile.orderForClaims
Definition

Order of this visit insurance row relative to the other rows linked to this visit

ShortClaims-order link to the patient visit
Comments

Order of this visit insurance row relative to the other rows linked to this visit

Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
18. athena-eligibility-profile.patientInsuranceStatus
Definition

Status of Patient insurance

ShortStatus of Patient insurance
Comments

Status of Patient insurance

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
20. athena-eligibility-profile.patientInsuranceGroupId
Definition

Policy group number assigned by the insurance carrier.

ShortPolicy group number
Comments

Policy number

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
22. athena-eligibility-profile.patientInsuranceGroupName
Definition

Policy group name

ShortPolicy group name
Comments

Policy group name

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
24. athena-eligibility-profile.claimOfficeNumber
Definition

Office number of Claim.

ShortOffice number of Claim.
Comments

Office number of Claim.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
26. athena-eligibility-profile.insuredId
Definition

Insured person's insurance ID

ShortInsured person's insurance ID
Comments

Insured person's insurance ID

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
28. athena-eligibility-profile.patientInsuranceMediGapId
Definition

The Medigap ID for this insurance carrier if the policy type is set to Medigap.

ShortThe Medigap ID for this insurance carrier if the policy type is set to Medigap.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
30. athena-eligibility-profile.insuranceCardEffectiveDate
Definition

Effective date of this insurance policy.

ShortEffective date of this insurance policy.
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
32. athena-eligibility-profile.insuranceCardTerminationDate
Definition

Termination date of this insurance policy.

ShortTermination date of this insurance policy.
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
34. athena-eligibility-profile.patientCopayAmount
Definition

Patient copay for each Insurance Eligibility 271 parsed response

ShortPatient copay for each Insurance Eligibility 271 parsed response
Control0..1
TypeMoney
36. athena-eligibility-profile.patientCopayAmount.value
Definition

Amount of money for patient athena-payment-profile.

ShortMoney value
Comments

Payment amount.

Control0..1
Typedecimal
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
38. athena-eligibility-profile.patientCopayAmount.currency
Definition

Name of the the Currency

ShortCurrency
Comments

Currency in which the Payment payment has to been done.

Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
40. athena-eligibility-profile.patientInsuranceDeductible
Definition

Patient Insurance deductible 271 parsed response

ShortPatient Insurance deductible 271 parsed response
Control0..1
TypeMoney
42. athena-eligibility-profile.patientInsuranceDeductible.value
Definition

Amount of money for patient athena-payment-profile.

ShortMoney value
Comments

Payment amount.

Control0..1
Typedecimal
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
44. athena-eligibility-profile.patientInsuranceDeductible.currency
Definition

Name of the the Currency

ShortCurrency
Comments

Currency in which the Payment payment has to been done.

Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
46. athena-eligibility-profile.champusBranch
Definition

A CHAMPUS branch identifies and tracks the branch of the military to which a patient belongs.

ShortA CHAMPUS branch identifies and tracks the branch of the military to which a patient belongs.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
48. athena-eligibility-profile.champusGrade
Definition

A CHAMPUS Grade list option identifies and tracks the ranking of a patient in the military

ShortA CHAMPUS Grade list option identifies and tracks the ranking of a patient in the military
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
50. athena-eligibility-profile.champusStatus
Definition

A CHAMPUS status identifies and tracks the status of a patient in the military (whether active or retired).

ShortA CHAMPUS status identifies and tracks the status of a patient in the military (whether active or retired).
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
52. athena-eligibility-profile.patientRelatedToInsured
Definition

Relation of patient with the Insured person.

ShortRelation of patient with the Insured person.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
54. athena-eligibility-profile.employer
Definition

Employer details

ShortEmployer details
Control0..1
TypeReference(Organization)
56. athena-eligibility-profile.employer.reference
Definition

Reference to employer

ShortInsurance Carrier Id refering to employer
Comments

Insurance Carrier Id refering to employer

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
58. athena-eligibility-profile.employer.display
Definition

Name of the the insurance Carrier

ShortInsurance carrier Name
Comments

Insurance carrier Name

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
60. athena-eligibility-profile.employeeId
Definition

Identifier for Employee

ShortIdentifier for Employee
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
62. athena-eligibility-profile.eligibilityVerified
Definition

Integer code for the eligibility status for this insurance carrier for this patient

ShortInteger code for the eligibility status for this insurance carrier for this patient
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
64. athena-eligibility-profile.eligibilityVerifiedDate
Definition

Date the eligibility information was verified.

ShortDate the eligibility information was verified.
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
66. athena-eligibility-profile.eligibilityVerifiedBy
Definition

Person who has verified Eligibility.

ShortPerson who has verified Eligibility.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
68. athena-eligibility-profile.eligibilityNotes
Definition

Notes from this insurance carrier about the eligibility for this patient.

ShortNotes from this insurance carrier about the eligibility for this patient.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
70. athena-eligibility-profile.patientInsuranceNotes
Definition

Patient InsuranceNotes

ShortInsuranceNotes related to patient
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
72. athena-eligibility-profile.insurancePolicyTypes
Definition

Insurance policy type

ShortInsurance policy type
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
74. athena-eligibility-profile.dateOfServiceFrom
Definition

Start date of service for this procedure

ShortStart date of service for this procedure
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
76. athena-eligibility-profile.dateOfServiceTo
Definition

Stop date of service for this procedure.

ShortStop date of service for this procedure.
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
78. athena-eligibility-profile.otherInsuredId
Definition

Insured person's another insurance ID

ShortInsured person's another insurance ID
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
80. athena-eligibility-profile.otherIdQualifier
Definition

OtherId Qualifier

ShortOtherId Qualifier
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
82. athena-eligibility-profile.otherCopayAmount
Definition

OtherCopayAmt for each Insurance Eligibility 271 parsed response

ShortOtherCopayAmt for each Insurance Eligibility 271 parsed response
Control0..1
TypeMoney
84. athena-eligibility-profile.otherCopayAmount.value
Definition

Amount of money for patient athena-payment-profile.

ShortMoney value
Comments

Payment amount.

Control0..1
Typedecimal
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
86. athena-eligibility-profile.otherCopayAmount.currency
Definition

Name of the the Currency

ShortCurrency
Comments

Currency in which the Payment payment has to been done.

Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
88. athena-eligibility-profile.familyDeductible
Definition

FamilyDeductible for each Insurance Eligibility 271 parsed response

ShortFamilyDeductible for each Insurance Eligibility 271 parsed response
Control0..1
TypeMoney
90. athena-eligibility-profile.familyDeductible.value
Definition

Amount of money for patient athena-payment-profile.

ShortMoney value
Comments

Payment amount.

Control0..1
Typedecimal
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
92. athena-eligibility-profile.familyDeductible.currency
Definition

Name of the the Currency

ShortCurrency
Comments

Currency in which the Payment payment has to been done.

Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
94. athena-eligibility-profile.coInsurance
Definition

CoInsurance for each Insurance Eligibility 271 parsed response

ShortCoInsurance for each Insurance Eligibility 271 parsed response
Control0..1
TypeMoney
96. athena-eligibility-profile.coInsurance.value
Definition

Amount of money for patient athena-payment-profile.

ShortMoney value
Comments

Payment amount.

Control0..1
Typedecimal
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
98. athena-eligibility-profile.coInsurance.currency
Definition

Name of the the Currency

ShortCurrency
Comments

Currency in which the Payment payment has to been done.

Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
100. athena-eligibility-profile.otherDeductible
Definition

OtherDeductible for each Insurance Eligibility 271 parsed response

ShortOtherDeductible for each Insurance Eligibility 271 parsed response
Control0..1
TypeMoney
102. athena-eligibility-profile.otherDeductible.value
Definition

Amount of money for patient athena-payment-profile.

ShortMoney value
Comments

Payment amount.

Control0..1
Typedecimal
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
104. athena-eligibility-profile.otherDeductible.currency
Definition

Name of the the Currency

ShortCurrency
Comments

Currency in which the Payment payment has to been done.

Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
106. athena-eligibility-profile.masterInsuranceCarriersId
Definition

If this carrier was imported from the master list, then this is the ID of the carrier that was imported.

ShortIf this carrier was imported from the master list, then this is the ID of the carrier that was imported.
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
108. athena-eligibility-profile.inactiveInsuranceCarrier
Definition

Flag for insurance carrier is marked inactive.

ShortFlag for insurance carrier is marked inactive.
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
110. athena-eligibility-profile.insuranceCarrier
Definition

insurance Carrier details

Shortinsurance Carrier details
Control0..1
TypeReference(Organization)
112. athena-eligibility-profile.insuranceCarrier.reference
Definition

Reference to Organization

ShortInsurance Carrier Id refering to Organization
Comments

Insurance Carrier Id refering to Organization

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
114. athena-eligibility-profile.insuranceCarrier.display
Definition

Name of the the insurance Carrier

ShortInsurance carrier Name
Comments

Insurance carrier Name

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
116. athena-eligibility-profile.collectionsGroup
Definition

Collections group to which this insurance carrier belongs.

ShortCollections group to which this insurance carrier belongs.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
118. athena-eligibility-profile.carrierType
Definition

Carrier type of this insurance carrier.

ShortCarrier type of this insurance carrier.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
120. athena-eligibility-profile.carrierTypeANSI
Definition

Carrier type ANSI of this insurance carrier

ShortCarrier type ANSI of this insurance carrier
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
122. athena-eligibility-profile.patientFinancialClass
Definition

Financial class of this insurance carrier.

ShortFinancial class of this insurance carrier.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
124. athena-eligibility-profile.insuranceGroupName
Definition

Insurance Group Name.

ShortInsurance Group Name.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

Guidance on how to interpret the contents of this table can be found here

0. athena-eligibility-profile
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. athena-eligibility-profile.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control1..1
Typeid
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
4. athena-eligibility-profile.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Comments

Unique Id for this particular athena-eligibility-profile.

Control0..1
TypeMeta
Is Modifierfalse
Must Supportfalse
Summarytrue
6. athena-eligibility-profile.pid
Definition

PatientId for Eligibility

ShortPID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource.
Comments

PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource.

Control1..1
Typeinteger
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
8. athena-eligibility-profile.patient
Definition

Who or what the athena-eligibility-profile is about. The athena-eligibility-profile can be about a person.

ShortWho/what is the patient for Eligibility
Control0..1
TypeReference(Patient)
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
10. athena-eligibility-profile.patient.reference
Definition

Who or what the athena-eligibility-profile is about. The athena-eligibility-profile can be about a person.


A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

ShortReference to the PatientLiteral reference, Relative, internal or absolute URL
Comments

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Control0..1
This element is affected by the following invariants: ref-1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. athena-eligibility-profile.patient.display
Definition

Patient name for the athena-eligibility-profile is about.


Plain text narrative that identifies the resource in addition to the resource reference.

ShortPatient nameText alternative for the resource
Comments

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. athena-eligibility-profile.patientProfileId
Definition

Internal ID of patient used in non-clinical practice management data.

ShortPatient specific id for practice management data including financial information
Comments

Patient profile ID

Control1..1
TypeunsignedInt
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
16. athena-eligibility-profile.orderForClaims
Definition

Order of this visit insurance row relative to the other rows linked to this visit

ShortClaims-order link to the patient visit
Comments

Order of this visit insurance row relative to the other rows linked to this visit

Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
18. athena-eligibility-profile.patientInsuranceStatus
Definition

Status of Patient insurance

ShortStatus of Patient insurance
Comments

Status of Patient insurance

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
20. athena-eligibility-profile.patientInsuranceGroupId
Definition

Policy group number assigned by the insurance carrier.

ShortPolicy group number
Comments

Policy number

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
22. athena-eligibility-profile.patientInsuranceGroupName
Definition

Policy group name

ShortPolicy group name
Comments

Policy group name

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
24. athena-eligibility-profile.claimOfficeNumber
Definition

Office number of Claim.

ShortOffice number of Claim.
Comments

Office number of Claim.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
26. athena-eligibility-profile.insuredId
Definition

Insured person's insurance ID

ShortInsured person's insurance ID
Comments

Insured person's insurance ID

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
28. athena-eligibility-profile.patientInsuranceMediGapId
Definition

The Medigap ID for this insurance carrier if the policy type is set to Medigap.

ShortThe Medigap ID for this insurance carrier if the policy type is set to Medigap.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
30. athena-eligibility-profile.insuranceCardEffectiveDate
Definition

Effective date of this insurance policy.

ShortEffective date of this insurance policy.
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
32. athena-eligibility-profile.insuranceCardTerminationDate
Definition

Termination date of this insurance policy.

ShortTermination date of this insurance policy.
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
34. athena-eligibility-profile.patientCopayAmount
Definition

Patient copay for each Insurance Eligibility 271 parsed response

ShortPatient copay for each Insurance Eligibility 271 parsed response
Control0..1
TypeMoney
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. athena-eligibility-profile.patientCopayAmount.value
Definition

Amount of money for patient athena-payment-profile.


Numerical value (with implicit precision).

ShortMoney valueNumerical value (with implicit precision)
Comments

Payment amount.


Monetary values have their own rules for handling precision (refer to standard accounting text books).

Control0..1
Typedecimal
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

The amount of the currency. The value includes an implicit precision in the presentation of the value.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. athena-eligibility-profile.patientCopayAmount.currency
Definition

Name of the the Currency


ISO 4217 Currency Code.

ShortCurrencyISO 4217 Currency Code
Comments

Currency in which the Payment payment has to been done.

Control0..1
BindingThe codes SHALL be taken from Currencieshttp://hl7.org/fhir/ValueSet/currencies|4.0.1
(required to http://hl7.org/fhir/ValueSet/currencies|4.0.1)

A code indicating the currency, taken from ISO 4217.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

A code indicating the currency, taken from ISO 4217.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. athena-eligibility-profile.patientInsuranceDeductible
Definition

Patient Insurance deductible 271 parsed response

ShortPatient Insurance deductible 271 parsed response
Control0..1
TypeMoney
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. athena-eligibility-profile.patientInsuranceDeductible.value
Definition

Amount of money for patient athena-payment-profile.


Numerical value (with implicit precision).

ShortMoney valueNumerical value (with implicit precision)
Comments

Payment amount.


Monetary values have their own rules for handling precision (refer to standard accounting text books).

Control0..1
Typedecimal
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

The amount of the currency. The value includes an implicit precision in the presentation of the value.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. athena-eligibility-profile.patientInsuranceDeductible.currency
Definition

Name of the the Currency


ISO 4217 Currency Code.

ShortCurrencyISO 4217 Currency Code
Comments

Currency in which the Payment payment has to been done.

Control0..1
BindingThe codes SHALL be taken from Currencieshttp://hl7.org/fhir/ValueSet/currencies|4.0.1
(required to http://hl7.org/fhir/ValueSet/currencies|4.0.1)

A code indicating the currency, taken from ISO 4217.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

A code indicating the currency, taken from ISO 4217.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. athena-eligibility-profile.champusBranch
Definition

A CHAMPUS branch identifies and tracks the branch of the military to which a patient belongs.

ShortA CHAMPUS branch identifies and tracks the branch of the military to which a patient belongs.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
48. athena-eligibility-profile.champusGrade
Definition

A CHAMPUS Grade list option identifies and tracks the ranking of a patient in the military

ShortA CHAMPUS Grade list option identifies and tracks the ranking of a patient in the military
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
50. athena-eligibility-profile.champusStatus
Definition

A CHAMPUS status identifies and tracks the status of a patient in the military (whether active or retired).

ShortA CHAMPUS status identifies and tracks the status of a patient in the military (whether active or retired).
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
52. athena-eligibility-profile.patientRelatedToInsured
Definition

Relation of patient with the Insured person.

ShortRelation of patient with the Insured person.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
54. athena-eligibility-profile.employer
Definition

Employer details

ShortEmployer details
Control0..1
TypeReference(Organization)
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
56. athena-eligibility-profile.employer.reference
Definition

Reference to employer


A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

ShortInsurance Carrier Id refering to employerLiteral reference, Relative, internal or absolute URL
Comments

Insurance Carrier Id refering to employer


Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Control0..1
This element is affected by the following invariants: ref-1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. athena-eligibility-profile.employer.display
Definition

Name of the the insurance Carrier


Plain text narrative that identifies the resource in addition to the resource reference.

ShortInsurance carrier NameText alternative for the resource
Comments

Insurance carrier Name


This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. athena-eligibility-profile.employeeId
Definition

Identifier for Employee

ShortIdentifier for Employee
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
62. athena-eligibility-profile.eligibilityVerified
Definition

Integer code for the eligibility status for this insurance carrier for this patient

ShortInteger code for the eligibility status for this insurance carrier for this patient
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
64. athena-eligibility-profile.eligibilityVerifiedDate
Definition

Date the eligibility information was verified.

ShortDate the eligibility information was verified.
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
66. athena-eligibility-profile.eligibilityVerifiedBy
Definition

Person who has verified Eligibility.

ShortPerson who has verified Eligibility.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
68. athena-eligibility-profile.eligibilityNotes
Definition

Notes from this insurance carrier about the eligibility for this patient.

ShortNotes from this insurance carrier about the eligibility for this patient.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
70. athena-eligibility-profile.patientInsuranceNotes
Definition

Patient InsuranceNotes

ShortInsuranceNotes related to patient
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
72. athena-eligibility-profile.insurancePolicyTypes
Definition

Insurance policy type

ShortInsurance policy type
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
74. athena-eligibility-profile.dateOfServiceFrom
Definition

Start date of service for this procedure

ShortStart date of service for this procedure
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
76. athena-eligibility-profile.dateOfServiceTo
Definition

Stop date of service for this procedure.

ShortStop date of service for this procedure.
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
78. athena-eligibility-profile.otherInsuredId
Definition

Insured person's another insurance ID

ShortInsured person's another insurance ID
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
80. athena-eligibility-profile.otherIdQualifier
Definition

OtherId Qualifier

ShortOtherId Qualifier
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
82. athena-eligibility-profile.otherCopayAmount
Definition

OtherCopayAmt for each Insurance Eligibility 271 parsed response

ShortOtherCopayAmt for each Insurance Eligibility 271 parsed response
Control0..1
TypeMoney
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. athena-eligibility-profile.otherCopayAmount.value
Definition

Amount of money for patient athena-payment-profile.


Numerical value (with implicit precision).

ShortMoney valueNumerical value (with implicit precision)
Comments

Payment amount.


Monetary values have their own rules for handling precision (refer to standard accounting text books).

Control0..1
Typedecimal
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

The amount of the currency. The value includes an implicit precision in the presentation of the value.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. athena-eligibility-profile.otherCopayAmount.currency
Definition

Name of the the Currency


ISO 4217 Currency Code.

ShortCurrencyISO 4217 Currency Code
Comments

Currency in which the Payment payment has to been done.

Control0..1
BindingThe codes SHALL be taken from Currencieshttp://hl7.org/fhir/ValueSet/currencies|4.0.1
(required to http://hl7.org/fhir/ValueSet/currencies|4.0.1)

A code indicating the currency, taken from ISO 4217.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

A code indicating the currency, taken from ISO 4217.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. athena-eligibility-profile.familyDeductible
Definition

FamilyDeductible for each Insurance Eligibility 271 parsed response

ShortFamilyDeductible for each Insurance Eligibility 271 parsed response
Control0..1
TypeMoney
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. athena-eligibility-profile.familyDeductible.value
Definition

Amount of money for patient athena-payment-profile.


Numerical value (with implicit precision).

ShortMoney valueNumerical value (with implicit precision)
Comments

Payment amount.


Monetary values have their own rules for handling precision (refer to standard accounting text books).

Control0..1
Typedecimal
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

The amount of the currency. The value includes an implicit precision in the presentation of the value.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. athena-eligibility-profile.familyDeductible.currency
Definition

Name of the the Currency


ISO 4217 Currency Code.

ShortCurrencyISO 4217 Currency Code
Comments

Currency in which the Payment payment has to been done.

Control0..1
BindingThe codes SHALL be taken from Currencieshttp://hl7.org/fhir/ValueSet/currencies|4.0.1
(required to http://hl7.org/fhir/ValueSet/currencies|4.0.1)

A code indicating the currency, taken from ISO 4217.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

A code indicating the currency, taken from ISO 4217.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. athena-eligibility-profile.coInsurance
Definition

CoInsurance for each Insurance Eligibility 271 parsed response

ShortCoInsurance for each Insurance Eligibility 271 parsed response
Control0..1
TypeMoney
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. athena-eligibility-profile.coInsurance.value
Definition

Amount of money for patient athena-payment-profile.


Numerical value (with implicit precision).

ShortMoney valueNumerical value (with implicit precision)
Comments

Payment amount.


Monetary values have their own rules for handling precision (refer to standard accounting text books).

Control0..1
Typedecimal
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

The amount of the currency. The value includes an implicit precision in the presentation of the value.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. athena-eligibility-profile.coInsurance.currency
Definition

Name of the the Currency


ISO 4217 Currency Code.

ShortCurrencyISO 4217 Currency Code
Comments

Currency in which the Payment payment has to been done.

Control0..1
BindingThe codes SHALL be taken from Currencieshttp://hl7.org/fhir/ValueSet/currencies|4.0.1
(required to http://hl7.org/fhir/ValueSet/currencies|4.0.1)

A code indicating the currency, taken from ISO 4217.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

A code indicating the currency, taken from ISO 4217.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. athena-eligibility-profile.otherDeductible
Definition

OtherDeductible for each Insurance Eligibility 271 parsed response

ShortOtherDeductible for each Insurance Eligibility 271 parsed response
Control0..1
TypeMoney
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. athena-eligibility-profile.otherDeductible.value
Definition

Amount of money for patient athena-payment-profile.


Numerical value (with implicit precision).

ShortMoney valueNumerical value (with implicit precision)
Comments

Payment amount.


Monetary values have their own rules for handling precision (refer to standard accounting text books).

Control0..1
Typedecimal
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

The amount of the currency. The value includes an implicit precision in the presentation of the value.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. athena-eligibility-profile.otherDeductible.currency
Definition

Name of the the Currency


ISO 4217 Currency Code.

ShortCurrencyISO 4217 Currency Code
Comments

Currency in which the Payment payment has to been done.

Control0..1
BindingThe codes SHALL be taken from Currencieshttp://hl7.org/fhir/ValueSet/currencies|4.0.1
(required to http://hl7.org/fhir/ValueSet/currencies|4.0.1)

A code indicating the currency, taken from ISO 4217.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

A code indicating the currency, taken from ISO 4217.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. athena-eligibility-profile.masterInsuranceCarriersId
Definition

If this carrier was imported from the master list, then this is the ID of the carrier that was imported.

ShortIf this carrier was imported from the master list, then this is the ID of the carrier that was imported.
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
108. athena-eligibility-profile.inactiveInsuranceCarrier
Definition

Flag for insurance carrier is marked inactive.

ShortFlag for insurance carrier is marked inactive.
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
110. athena-eligibility-profile.insuranceCarrier
Definition

insurance Carrier details

Shortinsurance Carrier details
Control0..1
TypeReference(Organization)
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
112. athena-eligibility-profile.insuranceCarrier.reference
Definition

Reference to Organization


A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

ShortInsurance Carrier Id refering to OrganizationLiteral reference, Relative, internal or absolute URL
Comments

Insurance Carrier Id refering to Organization


Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Control0..1
This element is affected by the following invariants: ref-1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. athena-eligibility-profile.insuranceCarrier.display
Definition

Name of the the insurance Carrier


Plain text narrative that identifies the resource in addition to the resource reference.

ShortInsurance carrier NameText alternative for the resource
Comments

Insurance carrier Name


This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. athena-eligibility-profile.collectionsGroup
Definition

Collections group to which this insurance carrier belongs.

ShortCollections group to which this insurance carrier belongs.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
118. athena-eligibility-profile.carrierType
Definition

Carrier type of this insurance carrier.

ShortCarrier type of this insurance carrier.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
120. athena-eligibility-profile.carrierTypeANSI
Definition

Carrier type ANSI of this insurance carrier

ShortCarrier type ANSI of this insurance carrier
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
122. athena-eligibility-profile.patientFinancialClass
Definition

Financial class of this insurance carrier.

ShortFinancial class of this insurance carrier.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
124. athena-eligibility-profile.insuranceGroupName
Definition

Insurance Group Name.

ShortInsurance Group Name.
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

Guidance on how to interpret the contents of this table can be found here

0. athena-eligibility-profile
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. athena-eligibility-profile.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control1..1
Typeid
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
4. athena-eligibility-profile.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Comments

Unique Id for this particular athena-eligibility-profile.

Control0..1
TypeMeta
Is Modifierfalse
Must Supportfalse
Summarytrue
6. athena-eligibility-profile.pid
Definition

PatientId for Eligibility

ShortPID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource.
Comments

PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource.

Control1..1
Typeinteger
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
8. athena-eligibility-profile.patient
Definition

Who or what the athena-eligibility-profile is about. The athena-eligibility-profile can be about a person.

ShortWho/what is the patient for Eligibility
Control0..1
TypeReference(Patient)
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
10. athena-eligibility-profile.patient.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
12. athena-eligibility-profile.patient.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on athena-eligibility-profile.patient.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 14. athena-eligibility-profile.patient.reference
    Definition

    Who or what the athena-eligibility-profile is about. The athena-eligibility-profile can be about a person.

    ShortReference to the Patient
    Comments

    Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

    Control0..1
    This element is affected by the following invariants: ref-1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. athena-eligibility-profile.patient.type
    Definition

    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

    ShortType the reference refers to (e.g. "Patient")
    Comments

    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

    Control0..1
    BindingUnless not suitable, these codes SHALL be taken from ResourceType
    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

    Aa resource (or, for logical models, the URI of the logical model).

    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. athena-eligibility-profile.patient.identifier
    Definition

    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

    ShortLogical reference, when literal reference is not known
    Comments

    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. athena-eligibility-profile.patient.display
    Definition

    Patient name for the athena-eligibility-profile is about.

    ShortPatient name
    Comments

    This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. athena-eligibility-profile.patientProfileId
    Definition

    Internal ID of patient used in non-clinical practice management data.

    ShortPatient specific id for practice management data including financial information
    Comments

    Patient profile ID

    Control1..1
    TypeunsignedInt
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    24. athena-eligibility-profile.orderForClaims
    Definition

    Order of this visit insurance row relative to the other rows linked to this visit

    ShortClaims-order link to the patient visit
    Comments

    Order of this visit insurance row relative to the other rows linked to this visit

    Control0..1
    Typeinteger
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    26. athena-eligibility-profile.patientInsuranceStatus
    Definition

    Status of Patient insurance

    ShortStatus of Patient insurance
    Comments

    Status of Patient insurance

    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    28. athena-eligibility-profile.patientInsuranceGroupId
    Definition

    Policy group number assigned by the insurance carrier.

    ShortPolicy group number
    Comments

    Policy number

    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    30. athena-eligibility-profile.patientInsuranceGroupName
    Definition

    Policy group name

    ShortPolicy group name
    Comments

    Policy group name

    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    32. athena-eligibility-profile.claimOfficeNumber
    Definition

    Office number of Claim.

    ShortOffice number of Claim.
    Comments

    Office number of Claim.

    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    34. athena-eligibility-profile.insuredId
    Definition

    Insured person's insurance ID

    ShortInsured person's insurance ID
    Comments

    Insured person's insurance ID

    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    36. athena-eligibility-profile.patientInsuranceMediGapId
    Definition

    The Medigap ID for this insurance carrier if the policy type is set to Medigap.

    ShortThe Medigap ID for this insurance carrier if the policy type is set to Medigap.
    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    38. athena-eligibility-profile.insuranceCardEffectiveDate
    Definition

    Effective date of this insurance policy.

    ShortEffective date of this insurance policy.
    Control0..1
    TypedateTime
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    40. athena-eligibility-profile.insuranceCardTerminationDate
    Definition

    Termination date of this insurance policy.

    ShortTermination date of this insurance policy.
    Control0..1
    TypedateTime
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    42. athena-eligibility-profile.patientCopayAmount
    Definition

    Patient copay for each Insurance Eligibility 271 parsed response

    ShortPatient copay for each Insurance Eligibility 271 parsed response
    Control0..1
    TypeMoney
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. athena-eligibility-profile.patientCopayAmount.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    46. athena-eligibility-profile.patientCopayAmount.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on athena-eligibility-profile.patientCopayAmount.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 48. athena-eligibility-profile.patientCopayAmount.value
      Definition

      Amount of money for patient athena-payment-profile.

      ShortMoney value
      Comments

      Payment amount.

      Control0..1
      Typedecimal
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      The amount of the currency. The value includes an implicit precision in the presentation of the value.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. athena-eligibility-profile.patientCopayAmount.currency
      Definition

      Name of the the Currency

      ShortCurrency
      Comments

      Currency in which the Payment payment has to been done.

      Control0..1
      BindingThe codes SHALL be taken from Currencies
      (required to http://hl7.org/fhir/ValueSet/currencies|4.0.1)

      A code indicating the currency, taken from ISO 4217.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      A code indicating the currency, taken from ISO 4217.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. athena-eligibility-profile.patientInsuranceDeductible
      Definition

      Patient Insurance deductible 271 parsed response

      ShortPatient Insurance deductible 271 parsed response
      Control0..1
      TypeMoney
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. athena-eligibility-profile.patientInsuranceDeductible.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      56. athena-eligibility-profile.patientInsuranceDeductible.extension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on athena-eligibility-profile.patientInsuranceDeductible.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 58. athena-eligibility-profile.patientInsuranceDeductible.value
        Definition

        Amount of money for patient athena-payment-profile.

        ShortMoney value
        Comments

        Payment amount.

        Control0..1
        Typedecimal
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        The amount of the currency. The value includes an implicit precision in the presentation of the value.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. athena-eligibility-profile.patientInsuranceDeductible.currency
        Definition

        Name of the the Currency

        ShortCurrency
        Comments

        Currency in which the Payment payment has to been done.

        Control0..1
        BindingThe codes SHALL be taken from Currencies
        (required to http://hl7.org/fhir/ValueSet/currencies|4.0.1)

        A code indicating the currency, taken from ISO 4217.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        A code indicating the currency, taken from ISO 4217.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. athena-eligibility-profile.champusBranch
        Definition

        A CHAMPUS branch identifies and tracks the branch of the military to which a patient belongs.

        ShortA CHAMPUS branch identifies and tracks the branch of the military to which a patient belongs.
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        64. athena-eligibility-profile.champusGrade
        Definition

        A CHAMPUS Grade list option identifies and tracks the ranking of a patient in the military

        ShortA CHAMPUS Grade list option identifies and tracks the ranking of a patient in the military
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        66. athena-eligibility-profile.champusStatus
        Definition

        A CHAMPUS status identifies and tracks the status of a patient in the military (whether active or retired).

        ShortA CHAMPUS status identifies and tracks the status of a patient in the military (whether active or retired).
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        68. athena-eligibility-profile.patientRelatedToInsured
        Definition

        Relation of patient with the Insured person.

        ShortRelation of patient with the Insured person.
        Control0..1
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        70. athena-eligibility-profile.employer
        Definition

        Employer details

        ShortEmployer details
        Control0..1
        TypeReference(Organization)
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
        72. athena-eligibility-profile.employer.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        74. athena-eligibility-profile.employer.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on athena-eligibility-profile.employer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 76. athena-eligibility-profile.employer.reference
          Definition

          Reference to employer

          ShortInsurance Carrier Id refering to employer
          Comments

          Insurance Carrier Id refering to employer

          Control0..1
          This element is affected by the following invariants: ref-1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          78. athena-eligibility-profile.employer.type
          Definition

          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

          ShortType the reference refers to (e.g. "Patient")
          Comments

          This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from ResourceType
          (extensible to http://hl7.org/fhir/ValueSet/resource-types)

          Aa resource (or, for logical models, the URI of the logical model).

          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. athena-eligibility-profile.employer.identifier
          Definition

          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

          ShortLogical reference, when literal reference is not known
          Comments

          When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

          When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

          Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

          Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..1
          TypeIdentifier
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. athena-eligibility-profile.employer.display
          Definition

          Name of the the insurance Carrier

          ShortInsurance carrier Name
          Comments

          Insurance carrier Name

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          84. athena-eligibility-profile.employeeId
          Definition

          Identifier for Employee

          ShortIdentifier for Employee
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          86. athena-eligibility-profile.eligibilityVerified
          Definition

          Integer code for the eligibility status for this insurance carrier for this patient

          ShortInteger code for the eligibility status for this insurance carrier for this patient
          Control0..1
          Typeinteger
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          88. athena-eligibility-profile.eligibilityVerifiedDate
          Definition

          Date the eligibility information was verified.

          ShortDate the eligibility information was verified.
          Control0..1
          TypedateTime
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          90. athena-eligibility-profile.eligibilityVerifiedBy
          Definition

          Person who has verified Eligibility.

          ShortPerson who has verified Eligibility.
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          92. athena-eligibility-profile.eligibilityNotes
          Definition

          Notes from this insurance carrier about the eligibility for this patient.

          ShortNotes from this insurance carrier about the eligibility for this patient.
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          94. athena-eligibility-profile.patientInsuranceNotes
          Definition

          Patient InsuranceNotes

          ShortInsuranceNotes related to patient
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          96. athena-eligibility-profile.insurancePolicyTypes
          Definition

          Insurance policy type

          ShortInsurance policy type
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          98. athena-eligibility-profile.dateOfServiceFrom
          Definition

          Start date of service for this procedure

          ShortStart date of service for this procedure
          Control0..1
          TypedateTime
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          100. athena-eligibility-profile.dateOfServiceTo
          Definition

          Stop date of service for this procedure.

          ShortStop date of service for this procedure.
          Control0..1
          TypedateTime
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          102. athena-eligibility-profile.otherInsuredId
          Definition

          Insured person's another insurance ID

          ShortInsured person's another insurance ID
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          104. athena-eligibility-profile.otherIdQualifier
          Definition

          OtherId Qualifier

          ShortOtherId Qualifier
          Control0..1
          Typestring
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          106. athena-eligibility-profile.otherCopayAmount
          Definition

          OtherCopayAmt for each Insurance Eligibility 271 parsed response

          ShortOtherCopayAmt for each Insurance Eligibility 271 parsed response
          Control0..1
          TypeMoney
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          108. athena-eligibility-profile.otherCopayAmount.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          110. athena-eligibility-profile.otherCopayAmount.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on athena-eligibility-profile.otherCopayAmount.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 112. athena-eligibility-profile.otherCopayAmount.value
            Definition

            Amount of money for patient athena-payment-profile.

            ShortMoney value
            Comments

            Payment amount.

            Control0..1
            Typedecimal
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            The amount of the currency. The value includes an implicit precision in the presentation of the value.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            114. athena-eligibility-profile.otherCopayAmount.currency
            Definition

            Name of the the Currency

            ShortCurrency
            Comments

            Currency in which the Payment payment has to been done.

            Control0..1
            BindingThe codes SHALL be taken from Currencies
            (required to http://hl7.org/fhir/ValueSet/currencies|4.0.1)

            A code indicating the currency, taken from ISO 4217.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            A code indicating the currency, taken from ISO 4217.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            116. athena-eligibility-profile.familyDeductible
            Definition

            FamilyDeductible for each Insurance Eligibility 271 parsed response

            ShortFamilyDeductible for each Insurance Eligibility 271 parsed response
            Control0..1
            TypeMoney
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            118. athena-eligibility-profile.familyDeductible.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            120. athena-eligibility-profile.familyDeductible.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on athena-eligibility-profile.familyDeductible.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 122. athena-eligibility-profile.familyDeductible.value
              Definition

              Amount of money for patient athena-payment-profile.

              ShortMoney value
              Comments

              Payment amount.

              Control0..1
              Typedecimal
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              The amount of the currency. The value includes an implicit precision in the presentation of the value.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              124. athena-eligibility-profile.familyDeductible.currency
              Definition

              Name of the the Currency

              ShortCurrency
              Comments

              Currency in which the Payment payment has to been done.

              Control0..1
              BindingThe codes SHALL be taken from Currencies
              (required to http://hl7.org/fhir/ValueSet/currencies|4.0.1)

              A code indicating the currency, taken from ISO 4217.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              A code indicating the currency, taken from ISO 4217.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              126. athena-eligibility-profile.coInsurance
              Definition

              CoInsurance for each Insurance Eligibility 271 parsed response

              ShortCoInsurance for each Insurance Eligibility 271 parsed response
              Control0..1
              TypeMoney
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              128. athena-eligibility-profile.coInsurance.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              130. athena-eligibility-profile.coInsurance.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on athena-eligibility-profile.coInsurance.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 132. athena-eligibility-profile.coInsurance.value
                Definition

                Amount of money for patient athena-payment-profile.

                ShortMoney value
                Comments

                Payment amount.

                Control0..1
                Typedecimal
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                The amount of the currency. The value includes an implicit precision in the presentation of the value.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                134. athena-eligibility-profile.coInsurance.currency
                Definition

                Name of the the Currency

                ShortCurrency
                Comments

                Currency in which the Payment payment has to been done.

                Control0..1
                BindingThe codes SHALL be taken from Currencies
                (required to http://hl7.org/fhir/ValueSet/currencies|4.0.1)

                A code indicating the currency, taken from ISO 4217.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                A code indicating the currency, taken from ISO 4217.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                136. athena-eligibility-profile.otherDeductible
                Definition

                OtherDeductible for each Insurance Eligibility 271 parsed response

                ShortOtherDeductible for each Insurance Eligibility 271 parsed response
                Control0..1
                TypeMoney
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                138. athena-eligibility-profile.otherDeductible.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                140. athena-eligibility-profile.otherDeductible.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on athena-eligibility-profile.otherDeductible.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 142. athena-eligibility-profile.otherDeductible.value
                  Definition

                  Amount of money for patient athena-payment-profile.

                  ShortMoney value
                  Comments

                  Payment amount.

                  Control0..1
                  Typedecimal
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  The amount of the currency. The value includes an implicit precision in the presentation of the value.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  144. athena-eligibility-profile.otherDeductible.currency
                  Definition

                  Name of the the Currency

                  ShortCurrency
                  Comments

                  Currency in which the Payment payment has to been done.

                  Control0..1
                  BindingThe codes SHALL be taken from Currencies
                  (required to http://hl7.org/fhir/ValueSet/currencies|4.0.1)

                  A code indicating the currency, taken from ISO 4217.

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  A code indicating the currency, taken from ISO 4217.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  146. athena-eligibility-profile.masterInsuranceCarriersId
                  Definition

                  If this carrier was imported from the master list, then this is the ID of the carrier that was imported.

                  ShortIf this carrier was imported from the master list, then this is the ID of the carrier that was imported.
                  Control0..1
                  Typeinteger
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  148. athena-eligibility-profile.inactiveInsuranceCarrier
                  Definition

                  Flag for insurance carrier is marked inactive.

                  ShortFlag for insurance carrier is marked inactive.
                  Control0..1
                  Typeboolean
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  150. athena-eligibility-profile.insuranceCarrier
                  Definition

                  insurance Carrier details

                  Shortinsurance Carrier details
                  Control0..1
                  TypeReference(Organization)
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                  152. athena-eligibility-profile.insuranceCarrier.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  154. athena-eligibility-profile.insuranceCarrier.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on athena-eligibility-profile.insuranceCarrier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 156. athena-eligibility-profile.insuranceCarrier.reference
                    Definition

                    Reference to Organization

                    ShortInsurance Carrier Id refering to Organization
                    Comments

                    Insurance Carrier Id refering to Organization

                    Control0..1
                    This element is affected by the following invariants: ref-1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    158. athena-eligibility-profile.insuranceCarrier.type
                    Definition

                    The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                    The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                    ShortType the reference refers to (e.g. "Patient")
                    Comments

                    This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from ResourceType
                    (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                    Aa resource (or, for logical models, the URI of the logical model).

                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    160. athena-eligibility-profile.insuranceCarrier.identifier
                    Definition

                    An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                    ShortLogical reference, when literal reference is not known
                    Comments

                    When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                    When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                    Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                    Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..1
                    TypeIdentifier
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    162. athena-eligibility-profile.insuranceCarrier.display
                    Definition

                    Name of the the insurance Carrier

                    ShortInsurance carrier Name
                    Comments

                    Insurance carrier Name

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    164. athena-eligibility-profile.collectionsGroup
                    Definition

                    Collections group to which this insurance carrier belongs.

                    ShortCollections group to which this insurance carrier belongs.
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    166. athena-eligibility-profile.carrierType
                    Definition

                    Carrier type of this insurance carrier.

                    ShortCarrier type of this insurance carrier.
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    168. athena-eligibility-profile.carrierTypeANSI
                    Definition

                    Carrier type ANSI of this insurance carrier

                    ShortCarrier type ANSI of this insurance carrier
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    170. athena-eligibility-profile.patientFinancialClass
                    Definition

                    Financial class of this insurance carrier.

                    ShortFinancial class of this insurance carrier.
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    172. athena-eligibility-profile.insuranceGroupName
                    Definition

                    Insurance Group Name.

                    ShortInsurance Group Name.
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension