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Resource Profile: ISiKVersicherungsverhaeltnisSelbstzahler_obl

Obligation-Profil für ISiKVersicherungsverhaeltnisSelbstzahler. Leitet vom strukturellen Basis-Profil ab und setzt akteurspezifische FHIR-Obligations für Producer (Server) und Consumer (Client).

Usages:

• CapabilityStatements using this Obligation Profile: CapabilityStatement für Rolle ISiKCapabilityStatementVersicherungsverhaeltnisRolle
• This Obligation Profile is not used by any profiles in this Specification

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	ISiKVersicherungsverhaeltnisSelbstzahler	Versicherungsdaten This is an obligation profile that only contains obligations and additional bindings
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier	Σ	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by pattern:$this
identifier:pkv	Σ	0..1	IdentifierPkv(1.6.0-ballot)	An identifier intended for computation Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual | official | temp | secondary | old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/identifier-type-de-basis
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PKV
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system		0..1	uri	The namespace for the identifier value
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!OΣ	1..1	code	Status Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Obligations Actor SHALL:populate-if-known ISiK Producer (Server) SHALL:process ISiK Consumer (Client)
type	OΣ	1..1	CodeableConcept	Versicherungsart Binding: VersicherungsartDeBasisVS (required): Art der Versicherung: Selbstzahler, gesetzliche/private Versicherung, Berufsgenossenschaft oder Sozialamt Obligations Actor SHALL:populate ISiK Producer (Server)
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:VersicherungsArtDeBasis	Σ	1..1	Coding	Codierte Darstellung der Versicherungsart Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
version		0..1	string	Version of the system - if relevant
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
system	OΣ	0..1	uri	Codier-Schema Fixed Value: http://fhir.de/CodeSystem/versicherungsart-de-basis Obligations Actor SHALL:populate ISiK Producer (Server)
code	OΣ	0..1	code	Code Fixed Value: SEL Obligations Actor SHALL:populate ISiK Producer (Server)
beneficiary	OΣC	1..1	Reference(Patient)	Begünstigte Person Constraints: ref-1 Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
reference	OΣC	0..1	string	Patienten-Link Obligations Actor SHALL:populate ISiK Producer (Server)
payor	OΣC	1..*	Reference(Patient | RelatedPerson | Organization)	Kostenträger Constraints: ref-1 Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
reference	OΣC	0..1	string	Personen-Link Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
display	OΣ	0..1	string	Organisations-Bezeichnung Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Coverage.type	Base	required	VersicherungsartDeBasisVS	📦1.6.0-ballot	de.basisprofil.r4 v1.6

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
ref-1	error	Coverage.beneficiary, Coverage.payor	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'))

This structure is derived from ISiKVersicherungsverhaeltnisSelbstzahler

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	ISiKVersicherungsverhaeltnisSelbstzahler	Versicherungsdaten This is an obligation profile that only contains obligations and additional bindings
status	O	1..1	code	Status Obligations Actor SHALL:populate-if-known ISiK Producer (Server) SHALL:process ISiK Consumer (Client)
type	O	1..1	CodeableConcept	Versicherungsart Obligations Actor SHALL:populate ISiK Producer (Server)
Slices for coding				Content/Rules for all slices
coding:VersicherungsArtDeBasis		1..1	Coding	Codierte Darstellung der Versicherungsart
system	O	0..1	uri	Codier-Schema Obligations Actor SHALL:populate ISiK Producer (Server)
code	O	0..1	code	Code Obligations Actor SHALL:populate ISiK Producer (Server)
beneficiary	O	1..1	Reference(Patient)	Begünstigte Person Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
reference	O	0..1	string	Patienten-Link Obligations Actor SHALL:populate ISiK Producer (Server)
payor	O	1..*	Reference(Patient | RelatedPerson | Organization)	Kostenträger Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
reference	O	0..1	string	Personen-Link Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
display	O	0..1	string	Organisations-Bezeichnung Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	ISiKVersicherungsverhaeltnisSelbstzahler	Versicherungsdaten This is an obligation profile that only contains obligations and additional bindings
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier	Σ	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by pattern:$this
identifier:pkv	Σ	0..1	IdentifierPkv(1.6.0-ballot)	An identifier intended for computation Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual | official | temp | secondary | old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/identifier-type-de-basis
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PKV
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system		0..1	uri	The namespace for the identifier value
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!OΣ	1..1	code	Status Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Obligations Actor SHALL:populate-if-known ISiK Producer (Server) SHALL:process ISiK Consumer (Client)
type	OΣ	1..1	CodeableConcept	Versicherungsart Binding: VersicherungsartDeBasisVS (required): Art der Versicherung: Selbstzahler, gesetzliche/private Versicherung, Berufsgenossenschaft oder Sozialamt Obligations Actor SHALL:populate ISiK Producer (Server)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:VersicherungsArtDeBasis	Σ	1..1	Coding	Codierte Darstellung der Versicherungsart Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	OΣ	0..1	uri	Codier-Schema Fixed Value: http://fhir.de/CodeSystem/versicherungsart-de-basis Obligations Actor SHALL:populate ISiK Producer (Server)
version	Σ	0..1	string	Version of the system - if relevant
code	OΣ	0..1	code	Code Fixed Value: SEL Obligations Actor SHALL:populate ISiK Producer (Server)
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subscriber	ΣC	0..1	Reference(Patient | RelatedPerson)	Unterzeichner der Kostenübernahme Constraints: ref-1
beneficiary	OΣC	1..1	Reference(Patient)	Begünstigte Person Constraints: ref-1 Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	OΣC	0..1	string	Patienten-Link Obligations Actor SHALL:populate ISiK Producer (Server)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
dependent	Σ	0..1	string	Dependent number
relationship		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
period	ΣC	0..1	Period	Coverage start and end dates Constraints: per-1
payor	OΣC	1..*	Reference(Patient | RelatedPerson | Organization)	Kostenträger Constraints: ref-1 Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	OΣC	0..1	string	Personen-Link Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	OΣ	0..1	string	Organisations-Bezeichnung Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
class		0..*	BackboneElement	Additional coverage classifications
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
value	Σ	1..1	string	Value associated with the type
name	Σ	0..1	string	Human readable description of the type and value
costToBeneficiary		0..*	BackboneElement	Patient payments for services/products
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	CodeableConcept	Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
value[x]	Σ	1..1		The amount or percentage due from the beneficiary
valueQuantity			Quantity(SimpleQuantity)
valueMoney			Money
exception		0..*	BackboneElement	Exceptions for patient payments
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.
period	ΣC	0..1	Period	The effective period of the exception Constraints: per-1
subrogation		0..1	boolean	Reimbursement to insurer
contract	C	0..*	Reference(Contract)	Contract details Constraints: ref-1
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Coverage.type	Base	required	VersicherungsartDeBasisVS	📦1.6.0-ballot	de.basisprofil.r4 v1.6
Coverage.beneficiary.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Coverage.relationship	Base	extensible	SubscriberPolicyholder Relationship Codes	📦4.0.1	FHIR Std.
Coverage.payor.type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Coverage.class.type	Base	extensible	Coverage Class Codes	📦4.0.1	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📦4.0.1	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
per-1	error	Coverage.period, Coverage.costToBeneficiary.exception.period	If present, start SHALL have a lower value than end	start.hasValue().not() or end.hasValue().not() or (start <= end)
ref-1	error	Coverage.subscriber, Coverage.beneficiary, Coverage.payor, Coverage.contract	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'))

This structure is derived from ISiKVersicherungsverhaeltnisSelbstzahler

Summary

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	ISiKVersicherungsverhaeltnisSelbstzahler	Versicherungsdaten This is an obligation profile that only contains obligations and additional bindings
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier	Σ	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by pattern:$this
identifier:pkv	Σ	0..1	IdentifierPkv(1.6.0-ballot)	An identifier intended for computation Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual | official | temp | secondary | old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/identifier-type-de-basis
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PKV
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system		0..1	uri	The namespace for the identifier value
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!OΣ	1..1	code	Status Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Obligations Actor SHALL:populate-if-known ISiK Producer (Server) SHALL:process ISiK Consumer (Client)
type	OΣ	1..1	CodeableConcept	Versicherungsart Binding: VersicherungsartDeBasisVS (required): Art der Versicherung: Selbstzahler, gesetzliche/private Versicherung, Berufsgenossenschaft oder Sozialamt Obligations Actor SHALL:populate ISiK Producer (Server)
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:VersicherungsArtDeBasis	Σ	1..1	Coding	Codierte Darstellung der Versicherungsart Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
version		0..1	string	Version of the system - if relevant
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
system	OΣ	0..1	uri	Codier-Schema Fixed Value: http://fhir.de/CodeSystem/versicherungsart-de-basis Obligations Actor SHALL:populate ISiK Producer (Server)
code	OΣ	0..1	code	Code Fixed Value: SEL Obligations Actor SHALL:populate ISiK Producer (Server)
beneficiary	OΣC	1..1	Reference(Patient)	Begünstigte Person Constraints: ref-1 Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
reference	OΣC	0..1	string	Patienten-Link Obligations Actor SHALL:populate ISiK Producer (Server)
payor	OΣC	1..*	Reference(Patient | RelatedPerson | Organization)	Kostenträger Constraints: ref-1 Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
reference	OΣC	0..1	string	Personen-Link Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
display	OΣ	0..1	string	Organisations-Bezeichnung Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Coverage.type	Base	required	VersicherungsartDeBasisVS	📦1.6.0-ballot	de.basisprofil.r4 v1.6

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
ref-1	error	Coverage.beneficiary, Coverage.payor	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'))

Differential View

This structure is derived from ISiKVersicherungsverhaeltnisSelbstzahler

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	ISiKVersicherungsverhaeltnisSelbstzahler	Versicherungsdaten This is an obligation profile that only contains obligations and additional bindings
status	O	1..1	code	Status Obligations Actor SHALL:populate-if-known ISiK Producer (Server) SHALL:process ISiK Consumer (Client)
type	O	1..1	CodeableConcept	Versicherungsart Obligations Actor SHALL:populate ISiK Producer (Server)
Slices for coding				Content/Rules for all slices
coding:VersicherungsArtDeBasis		1..1	Coding	Codierte Darstellung der Versicherungsart
system	O	0..1	uri	Codier-Schema Obligations Actor SHALL:populate ISiK Producer (Server)
code	O	0..1	code	Code Obligations Actor SHALL:populate ISiK Producer (Server)
beneficiary	O	1..1	Reference(Patient)	Begünstigte Person Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
reference	O	0..1	string	Patienten-Link Obligations Actor SHALL:populate ISiK Producer (Server)
payor	O	1..*	Reference(Patient | RelatedPerson | Organization)	Kostenträger Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
reference	O	0..1	string	Personen-Link Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
display	O	0..1	string	Organisations-Bezeichnung Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	ISiKVersicherungsverhaeltnisSelbstzahler	Versicherungsdaten This is an obligation profile that only contains obligations and additional bindings
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
Slices for identifier	Σ	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by pattern:$this
identifier:pkv	Σ	0..1	IdentifierPkv(1.6.0-ballot)	An identifier intended for computation Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
use		0..1	code	usual | official | temp | secondary | old (If known)
type		1..1	CodeableConcept	Description of identifier Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.de/CodeSystem/identifier-type-de-basis
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PKV
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system		0..1	uri	The namespace for the identifier value
value		0..1	string	The value that is unique
period		0..1	Period	Time period when id is/was valid for use
assigner		0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!OΣ	1..1	code	Status Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Obligations Actor SHALL:populate-if-known ISiK Producer (Server) SHALL:process ISiK Consumer (Client)
type	OΣ	1..1	CodeableConcept	Versicherungsart Binding: VersicherungsartDeBasisVS (required): Art der Versicherung: Selbstzahler, gesetzliche/private Versicherung, Berufsgenossenschaft oder Sozialamt Obligations Actor SHALL:populate ISiK Producer (Server)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:VersicherungsArtDeBasis	Σ	1..1	Coding	Codierte Darstellung der Versicherungsart Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	OΣ	0..1	uri	Codier-Schema Fixed Value: http://fhir.de/CodeSystem/versicherungsart-de-basis Obligations Actor SHALL:populate ISiK Producer (Server)
version	Σ	0..1	string	Version of the system - if relevant
code	OΣ	0..1	code	Code Fixed Value: SEL Obligations Actor SHALL:populate ISiK Producer (Server)
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subscriber	ΣC	0..1	Reference(Patient | RelatedPerson)	Unterzeichner der Kostenübernahme Constraints: ref-1
beneficiary	OΣC	1..1	Reference(Patient)	Begünstigte Person Constraints: ref-1 Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	OΣC	0..1	string	Patienten-Link Obligations Actor SHALL:populate ISiK Producer (Server)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
dependent	Σ	0..1	string	Dependent number
relationship		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
period	ΣC	0..1	Period	Coverage start and end dates Constraints: per-1
payor	OΣC	1..*	Reference(Patient | RelatedPerson | Organization)	Kostenträger Constraints: ref-1 Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	OΣC	0..1	string	Personen-Link Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	OΣ	0..1	string	Organisations-Bezeichnung Obligations Actor SHALL:populate-if-known ISiK Producer (Server)
class		0..*	BackboneElement	Additional coverage classifications
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
value	Σ	1..1	string	Value associated with the type
name	Σ	0..1	string	Human readable description of the type and value
costToBeneficiary		0..*	BackboneElement	Patient payments for services/products
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	CodeableConcept	Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
value[x]	Σ	1..1		The amount or percentage due from the beneficiary
valueQuantity			Quantity(SimpleQuantity)
valueMoney			Money
exception		0..*	BackboneElement	Exceptions for patient payments
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.
period	ΣC	0..1	Period	The effective period of the exception Constraints: per-1
subrogation		0..1	boolean	Reimbursement to insurer
contract	C	0..*	Reference(Contract)	Contract details Constraints: ref-1
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Coverage.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Coverage.type	Base	required	VersicherungsartDeBasisVS	📦1.6.0-ballot	de.basisprofil.r4 v1.6
Coverage.beneficiary.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Coverage.relationship	Base	extensible	SubscriberPolicyholder Relationship Codes	📦4.0.1	FHIR Std.
Coverage.payor.type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Coverage.class.type	Base	extensible	Coverage Class Codes	📦4.0.1	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📦4.0.1	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Coverage	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
per-1	error	Coverage.period, Coverage.costToBeneficiary.exception.period	If present, start SHALL have a lower value than end	start.hasValue().not() or end.hasValue().not() or (start <= end)
ref-1	error	Coverage.subscriber, Coverage.beneficiary, Coverage.payor, Coverage.contract	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'))

This structure is derived from ISiKVersicherungsverhaeltnisSelbstzahler

Summary

Other representations of profile: CSV, Excel, Schematron