USCoreCoverageProfile

US Core Coverage Profile

activeUS Core9.0.0resource16 key elements

The US Core Coverage Profile inherits from the FHIR Coverage resource; refer to it for scope and usage definitions. This profile meets the requirements of the US Core Data for Interoperability (USCDI) *Health Insurance Information* Data Class. It sets minimum expectations for the Coverage resource to record, search, and fetch data related to an individual's insurance coverage for health care. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage
ID
us-core-coverage
Type
Base Definition
Derivation
constraint
Mandatory and Must-Support Elements

Elements with cardinality > 0 or marked as Must Support (S)

PathCard.TypeFlagsDescription
identifier
S
Member ID and other identifiers
:memberid0..1
S
Member ID
identifier.type
S1+
Member Number identifier type
status
S
type
S
subscriberId
S
beneficiary
Reference
S
relationship
S1+
period
S
payor
Reference
S
class
S
:group0..1
S
Group
class.value
S
Group Identifier
:plan0..1
S
Plan
class.value
S
Plan Number
class.name
S
Plan Name