Generated Narrative: StructureDefinition athena-eligibility-profile Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> athena-eligibility-profile 0..* Base #xD; id SΣ 1..1 id Logical id of this artifact #xD; meta Σ 0..1 Meta Metadata about the resource #xD; pid SΣ 1..1 integer 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. #xD; patient 0..1 Reference(Patient) Who/what is the patient for Eligibility #xD; reference 0..1 string Reference to the Patient #xD; display 0..1 string Patient name #xD; patientProfileId SΣ 1..1 unsignedInt Patient specific id for practice management data including financial information #xD; orderForClaims 0..1 integer Claims-order link to the patient visit #xD; patientInsuranceStatus 0..1 string Status of Patient insurance #xD; patientInsuranceGroupId 0..1 string Policy group number #xD; patientInsuranceGroupName 0..1 string Policy group name #xD; claimOfficeNumber 0..1 string Office number of Claim. #xD; insuredId 0..1 string Insured person's insurance ID #xD; patientInsuranceMediGapId 0..1 string The Medigap ID for this insurance carrier if the policy type is set to Medigap. #xD; insuranceCardEffectiveDate 0..1 dateTime Effective date of this insurance policy. #xD; insuranceCardTerminationDate 0..1 dateTime Termination date of this insurance policy. #xD; patientCopayAmount 0..1 Money Patient copay for each Insurance Eligibility 271 parsed response #xD; value 0..1 decimal Money value #xD; currency 0..1 code Currency #xD; patientInsuranceDeductible 0..1 Money Patient Insurance deductible 271 parsed response #xD; value 0..1 decimal Money value #xD; currency 0..1 code Currency #xD; champusBranch 0..1 string A CHAMPUS branch identifies and tracks the branch of the military to which a patient belongs. #xD; champusGrade 0..1 string A CHAMPUS Grade list option identifies and tracks the ranking of a patient in the military #xD; champusStatus 0..1 string A CHAMPUS status identifies and tracks the status of a patient in the military (whether active or retired). #xD; patientRelatedToInsured 0..1 string Relation of patient with the Insured person. #xD; employer 0..1 Reference(Organization) Employer details #xD; reference 0..1 string Insurance Carrier Id refering to employer #xD; display 0..1 string Insurance carrier Name #xD; employeeId 0..1 string Identifier for Employee #xD; eligibilityVerified 0..1 integer Integer code for the eligibility status for this insurance carrier for this patient #xD; eligibilityVerifiedDate 0..1 dateTime Date the eligibility information was verified. #xD; eligibilityVerifiedBy 0..1 string Person who has verified Eligibility. #xD; eligibilityNotes 0..1 string Notes from this insurance carrier about the eligibility for this patient. #xD; patientInsuranceNotes 0..1 string InsuranceNotes related to patient #xD; insurancePolicyTypes 0..1 string Insurance policy type #xD; dateOfServiceFrom 0..1 dateTime Start date of service for this procedure #xD; dateOfServiceTo 0..1 dateTime Stop date of service for this procedure. #xD; otherInsuredId 0..1 string Insured person's another insurance ID #xD; otherIdQualifier 0..1 string OtherId Qualifier #xD; otherCopayAmount 0..1 Money OtherCopayAmt for each Insurance Eligibility 271 parsed response #xD; value 0..1 decimal Money value #xD; currency 0..1 code Currency #xD; familyDeductible 0..1 Money FamilyDeductible for each Insurance Eligibility 271 parsed response #xD; value 0..1 decimal Money value #xD; currency 0..1 code Currency #xD; coInsurance 0..1 Money CoInsurance for each Insurance Eligibility 271 parsed response #xD; value 0..1 decimal Money value #xD; currency 0..1 code Currency #xD; otherDeductible 0..1 Money OtherDeductible for each Insurance Eligibility 271 parsed response #xD; value 0..1 decimal Money value #xD; currency 0..1 code Currency #xD; masterInsuranceCarriersId 0..1 integer If this carrier was imported from the master list, then this is the ID of the carrier that was imported. #xD; inactiveInsuranceCarrier 0..1 boolean Flag for insurance carrier is marked inactive. #xD; insuranceCarrier 0..1 Reference(Organization) insurance Carrier details #xD; reference 0..1 string Insurance Carrier Id refering to Organization #xD; display 0..1 string Insurance carrier Name #xD; collectionsGroup 0..1 string Collections group to which this insurance carrier belongs. #xD; carrierType 0..1 string Carrier type of this insurance carrier. #xD; carrierTypeANSI 0..1 string Carrier type ANSI of this insurance carrier #xD; patientFinancialClass 0..1 string Financial class of this insurance carrier. #xD; insuranceGroupName 0..1 string Insurance Group Name. #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentation for this format
The Eligibility is used by providers and payors, insurers, to exchange the financial information, and supporting clinical information, regarding the provision of health care services.
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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.
Unique Id for this particular athena-eligibility-profile.
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.
Who or what the athena-eligibility-profile is about. The athena-eligibility-profile can be about a person.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
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'))
not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
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.
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.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
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.
Type the reference refers to (e.g. "Patient")
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).
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.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
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.
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).
Patient name for the athena-eligibility-profile is about.
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.
Patient specific id for practice management data including financial information
Internal ID of patient used in non-clinical practice management data.
Order of this visit insurance row relative to the other rows linked to this visit
Policy group number assigned by the insurance carrier.
The Medigap ID for this insurance carrier if the policy type is set to Medigap.
Effective date of this insurance policy.
Termination date of this insurance policy.
Patient copay for each Insurance Eligibility 271 parsed response
Amount of money for patient athena-payment-profile.
The amount of the currency. The value includes an implicit precision in the presentation of the value.
Currency in which the Payment payment has to been done.
A code indicating the currency, taken from ISO 4217.
Patient Insurance deductible 271 parsed response
A CHAMPUS branch identifies and tracks the branch of the military to which a patient belongs.
A CHAMPUS Grade list option identifies and tracks the ranking of a patient in the military
A CHAMPUS status identifies and tracks the status of a patient in the military (whether active or retired).
Relation of patient with the Insured person.
Insurance Carrier Id refering to employer
Integer code for the eligibility status for this insurance carrier for this patient
Date the eligibility information was verified.
Notes from this insurance carrier about the eligibility for this patient.
Start date of service for this procedure
Stop date of service for this procedure.
OtherCopayAmt for each Insurance Eligibility 271 parsed response
FamilyDeductible for each Insurance Eligibility 271 parsed response
CoInsurance for each Insurance Eligibility 271 parsed response
OtherDeductible for each Insurance Eligibility 271 parsed response
If this carrier was imported from the master list, then this is the ID of the carrier that was imported.
Flag for insurance carrier is marked inactive.
Insurance Carrier Id refering to Organization
Collections group to which this insurance carrier belongs.
Carrier type ANSI of this insurance carrier
Financial class of this insurance carrier.