| Official URL: https://gematik.de/fhir/isik/StructureDefinition/ISiKVersicherungsverhaeltnisSonstige-obl | Version: 6.0.0-rc | |||
| Active as of 2026-04-02 | Computable Name: ISiKVersicherungsverhaeltnisSonstige_obl | |||
Obligation-Profil für ISiKVersicherungsverhaeltnisSonstige. Leitet vom strukturellen Basis-Profil ab und setzt akteurspezifische FHIR-Obligations für Producer (Server) und Consumer (Client).
Usages:
You can also check for usages in the FHIR IG Statistics
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
![]() |
0..* | ISiKVersicherungsverhaeltnisSonstige | Versicherungsdaten This is an obligation profile that only contains obligations and additional bindings | |||||||
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||||
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url | ||||||
![]() ![]() |
?!OΣ | 1..1 | code | Status Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
| ||||||
![]() ![]() |
OΣ | 1..1 | CodeableConcept | Versicherungsart Binding: VersicherungsartDeBasisVS (required): Art der Versicherung: Selbstzahler, gesetzliche/private Versicherung, Berufsgenossenschaft oder Sozialamt
| ||||||
![]() ![]() |
OΣC | 1..1 | Reference(Patient) | Begünstigte Person Constraints: ref-1
| ||||||
![]() ![]() ![]() |
OΣC | 0..1 | string | Patienten-Link
| ||||||
![]() ![]() |
OΣC | 1..* | Reference(Patient | RelatedPerson | Organization) | Kostenträger Constraints: ref-1
| ||||||
![]() ![]() ![]() |
OΣ | 0..1 | string | Kostenträger-Bezeichnung
| ||||||
Documentation for this format | ||||||||||
| 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 |
| 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 ISiKVersicherungsverhaeltnisSonstige
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
![]() |
0..* | ISiKVersicherungsverhaeltnisSonstige | Versicherungsdaten This is an obligation profile that only contains obligations and additional bindings | |||||||
![]() ![]() |
O | 1..1 | code | Status
| ||||||
![]() ![]() |
O | 1..1 | CodeableConcept | Versicherungsart
| ||||||
![]() ![]() |
O | 1..1 | Reference(Patient) | Begünstigte Person
| ||||||
![]() ![]() ![]() |
O | 0..1 | string | Patienten-Link
| ||||||
![]() ![]() |
O | 1..* | Reference(Patient | RelatedPerson | Organization) | Kostenträger
| ||||||
![]() ![]() ![]() |
O | 0..1 | string | Kostenträger-Bezeichnung
| ||||||
Documentation for this format | ||||||||||
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
![]() |
0..* | ISiKVersicherungsverhaeltnisSonstige | Versicherungsdaten This is an obligation profile that only contains obligations and additional bindings | |||||||
![]() ![]() |
Σ | 0..1 | id | Logical id of this artifact | ||||||
![]() ![]() |
Σ | 0..1 | Meta | Metadata about the resource | ||||||
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||||
![]() ![]() |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||||
![]() ![]() |
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 | |||||||
![]() ![]() |
0..* | Resource | Contained, inline Resources | |||||||
![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url | ||||||
![]() ![]() |
Σ | 0..* | Identifier | Business Identifier for the coverage | ||||||
![]() ![]() |
?!OΣ | 1..1 | code | Status Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
| ||||||
![]() ![]() |
OΣ | 1..1 | CodeableConcept | Versicherungsart Binding: VersicherungsartDeBasisVS (required): Art der Versicherung: Selbstzahler, gesetzliche/private Versicherung, Berufsgenossenschaft oder Sozialamt
| ||||||
![]() ![]() |
ΣC | 0..1 | Reference(Patient | RelatedPerson) | Hauptversicherte Person / Mitglied Constraints: ref-1 | ||||||
![]() ![]() |
OΣC | 1..1 | Reference(Patient) | Begünstigte Person Constraints: ref-1
| ||||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||
![]() ![]() ![]() |
OΣC | 0..1 | string | Patienten-Link
| ||||||
![]() ![]() ![]() |
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). | ||||||
![]() ![]() ![]() |
Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||||
![]() ![]() ![]() |
Σ | 0..1 | string | Text alternative for the resource | ||||||
![]() ![]() |
Σ | 0..1 | string | Dependent number | ||||||
![]() ![]() |
0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | |||||||
![]() ![]() |
ΣC | 0..1 | Period | Coverage start and end dates Constraints: per-1 | ||||||
![]() ![]() |
OΣC | 1..* | Reference(Patient | RelatedPerson | Organization) | Kostenträger Constraints: ref-1
| ||||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||
![]() ![]() ![]() |
ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||||
![]() ![]() ![]() |
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). | ||||||
![]() ![]() ![]() |
Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||||
![]() ![]() ![]() |
OΣ | 0..1 | string | Kostenträger-Bezeichnung
| ||||||
![]() ![]() |
0..* | BackboneElement | Additional coverage classifications | |||||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||||
![]() ![]() ![]() |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. | ||||||
![]() ![]() ![]() |
Σ | 1..1 | string | Value associated with the type | ||||||
![]() ![]() ![]() |
Σ | 0..1 | string | Human readable description of the type and value | ||||||
![]() ![]() |
0..* | BackboneElement | Patient payments for services/products | |||||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||||
![]() ![]() ![]() |
Σ | 0..1 | CodeableConcept | Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified. | ||||||
![]() ![]() ![]() |
Σ | 1..1 | The amount or percentage due from the beneficiary | |||||||
![]() ![]() ![]() ![]() |
Quantity(SimpleQuantity) | |||||||||
![]() ![]() ![]() ![]() |
Money | |||||||||
![]() ![]() ![]() |
0..* | BackboneElement | Exceptions for patient payments | |||||||
![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||||
![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||||
![]() ![]() ![]() ![]() |
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. | ||||||
![]() ![]() ![]() ![]() |
ΣC | 0..1 | Period | The effective period of the exception Constraints: per-1 | ||||||
![]() ![]() |
0..1 | boolean | Reimbursement to insurer | |||||||
![]() ![]() |
C | 0..* | Reference(Contract) | Contract details Constraints: ref-1 | ||||||
Documentation for this format | ||||||||||
| 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. |
| 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 ISiKVersicherungsverhaeltnisSonstige
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
![]() |
0..* | ISiKVersicherungsverhaeltnisSonstige | Versicherungsdaten This is an obligation profile that only contains obligations and additional bindings | |||||||
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||||
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url | ||||||
![]() ![]() |
?!OΣ | 1..1 | code | Status Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
| ||||||
![]() ![]() |
OΣ | 1..1 | CodeableConcept | Versicherungsart Binding: VersicherungsartDeBasisVS (required): Art der Versicherung: Selbstzahler, gesetzliche/private Versicherung, Berufsgenossenschaft oder Sozialamt
| ||||||
![]() ![]() |
OΣC | 1..1 | Reference(Patient) | Begünstigte Person Constraints: ref-1
| ||||||
![]() ![]() ![]() |
OΣC | 0..1 | string | Patienten-Link
| ||||||
![]() ![]() |
OΣC | 1..* | Reference(Patient | RelatedPerson | Organization) | Kostenträger Constraints: ref-1
| ||||||
![]() ![]() ![]() |
OΣ | 0..1 | string | Kostenträger-Bezeichnung
| ||||||
Documentation for this format | ||||||||||
| 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 |
| 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 ISiKVersicherungsverhaeltnisSonstige
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
![]() |
0..* | ISiKVersicherungsverhaeltnisSonstige | Versicherungsdaten This is an obligation profile that only contains obligations and additional bindings | |||||||
![]() ![]() |
O | 1..1 | code | Status
| ||||||
![]() ![]() |
O | 1..1 | CodeableConcept | Versicherungsart
| ||||||
![]() ![]() |
O | 1..1 | Reference(Patient) | Begünstigte Person
| ||||||
![]() ![]() ![]() |
O | 0..1 | string | Patienten-Link
| ||||||
![]() ![]() |
O | 1..* | Reference(Patient | RelatedPerson | Organization) | Kostenträger
| ||||||
![]() ![]() ![]() |
O | 0..1 | string | Kostenträger-Bezeichnung
| ||||||
Documentation for this format | ||||||||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints Filter: ![]() ![]() | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
![]() |
0..* | ISiKVersicherungsverhaeltnisSonstige | Versicherungsdaten This is an obligation profile that only contains obligations and additional bindings | |||||||
![]() ![]() |
Σ | 0..1 | id | Logical id of this artifact | ||||||
![]() ![]() |
Σ | 0..1 | Meta | Metadata about the resource | ||||||
![]() ![]() |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||||
![]() ![]() |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||||
![]() ![]() |
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 | |||||||
![]() ![]() |
0..* | Resource | Contained, inline Resources | |||||||
![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||
![]() ![]() |
?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url | ||||||
![]() ![]() |
Σ | 0..* | Identifier | Business Identifier for the coverage | ||||||
![]() ![]() |
?!OΣ | 1..1 | code | Status Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
| ||||||
![]() ![]() |
OΣ | 1..1 | CodeableConcept | Versicherungsart Binding: VersicherungsartDeBasisVS (required): Art der Versicherung: Selbstzahler, gesetzliche/private Versicherung, Berufsgenossenschaft oder Sozialamt
| ||||||
![]() ![]() |
ΣC | 0..1 | Reference(Patient | RelatedPerson) | Hauptversicherte Person / Mitglied Constraints: ref-1 | ||||||
![]() ![]() |
OΣC | 1..1 | Reference(Patient) | Begünstigte Person Constraints: ref-1
| ||||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||
![]() ![]() ![]() |
OΣC | 0..1 | string | Patienten-Link
| ||||||
![]() ![]() ![]() |
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). | ||||||
![]() ![]() ![]() |
Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||||
![]() ![]() ![]() |
Σ | 0..1 | string | Text alternative for the resource | ||||||
![]() ![]() |
Σ | 0..1 | string | Dependent number | ||||||
![]() ![]() |
0..1 | CodeableConcept | Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | |||||||
![]() ![]() |
ΣC | 0..1 | Period | Coverage start and end dates Constraints: per-1 | ||||||
![]() ![]() |
OΣC | 1..* | Reference(Patient | RelatedPerson | Organization) | Kostenträger Constraints: ref-1
| ||||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||
![]() ![]() ![]() |
ΣC | 0..1 | string | Literal reference, Relative, internal or absolute URL | ||||||
![]() ![]() ![]() |
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). | ||||||
![]() ![]() ![]() |
Σ | 0..1 | Identifier | Logical reference, when literal reference is not known | ||||||
![]() ![]() ![]() |
OΣ | 0..1 | string | Kostenträger-Bezeichnung
| ||||||
![]() ![]() |
0..* | BackboneElement | Additional coverage classifications | |||||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||||
![]() ![]() ![]() |
Σ | 1..1 | CodeableConcept | Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc. | ||||||
![]() ![]() ![]() |
Σ | 1..1 | string | Value associated with the type | ||||||
![]() ![]() ![]() |
Σ | 0..1 | string | Human readable description of the type and value | ||||||
![]() ![]() |
0..* | BackboneElement | Patient payments for services/products | |||||||
![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||||
![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||
![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||||
![]() ![]() ![]() |
Σ | 0..1 | CodeableConcept | Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified. | ||||||
![]() ![]() ![]() |
Σ | 1..1 | The amount or percentage due from the beneficiary | |||||||
![]() ![]() ![]() ![]() |
Quantity(SimpleQuantity) | |||||||||
![]() ![]() ![]() ![]() |
Money | |||||||||
![]() ![]() ![]() |
0..* | BackboneElement | Exceptions for patient payments | |||||||
![]() ![]() ![]() ![]() |
0..1 | string | Unique id for inter-element referencing | |||||||
![]() ![]() ![]() ![]() |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||||
![]() ![]() ![]() ![]() |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||||
![]() ![]() ![]() ![]() |
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. | ||||||
![]() ![]() ![]() ![]() |
ΣC | 0..1 | Period | The effective period of the exception Constraints: per-1 | ||||||
![]() ![]() |
0..1 | boolean | Reimbursement to insurer | |||||||
![]() ![]() |
C | 0..* | Reference(Contract) | Contract details Constraints: ref-1 | ||||||
Documentation for this format | ||||||||||
| 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. |
| 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 ISiKVersicherungsverhaeltnisSonstige
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