Release 4

Financial Management Work GroupMaturity Level: N/AStandards Status: InformativeSecurity Category: Patient Compartments: Patient, RelatedPerson

Mappings for the coverage resource (see Mappings to Other Standards for further information & status).

Coverage
    identifierFiveWs.identifier
    statusFiveWs.status
    typeFiveWs.class
    policyHolderFiveWs.subject[x]
    subscriberFiveWs.subject[x]
    subscriberIdFiveWs.subject[x]
    beneficiaryFiveWs.subject[x]
    periodFiveWs.done[x]
    payorFiveWs.author
CoverageEvent
    identifierEvent.identifier
    statusEvent.status
    beneficiaryEvent.subject
    periodEvent.occurrence[x]
Coverage
    identifierIN1-2
    status
    typeIN1-15
    policyHolderIN1-16, 18, 19-name of insured, address, date of birth
    subscriberIN1-16, 18, 19-name of insured, address, date of birth
    subscriberIdIN1-16, 18, 19-name of insured, address, date of birth
    beneficiaryIN1-16, 18, 19-name of insured, address, date of birth
    dependent- No exact HL7 v2 equivalent concept seems to exist;
    relationship
    periodIN1-12 / IN1-13
    payorIN1-3
    class
        type
        valueIN1-8
        nameIN1-8
    order- No exact HL7 v2 equivalent concept seems to exist;
    network
    costToBeneficiary
        type
        value[x]IN1-8
        exception
            type
            period
    subrogation
    contractIN1-16, 18, 19
CoverageCoverage
    identifier.id
    statusAct.status
    periodAct.effectiveTime
    contractn/a
Coverage
    identifierC02
    status
    type
    policyHolderD01 through D09
    subscriberD01 through D09
    subscriberIdD01 through D09
    beneficiaryD01 through D09
    dependentC17
    relationshipC03
    period
    payorA05
    class
        type
        valueC11 (Division,Section)
        nameC11 (Division,Section)
    order
    networkD10
    costToBeneficiary
        type
        value[x]C11 (Division,Section)
        exception
            type
            period
    subrogation
    contractD01 through D09
Coverage
    identifierC.32, C.33, C.39
    status
    type
    policyHolderC.35
    subscriberC.35
    subscriberIdC.35
    beneficiaryC.35
    dependent
    relationship
    period
    payorC.30
    class
        type
        valueC.31
        nameC.31
    order
    network
    costToBeneficiary
        type
        value[x]C.31
        exception
            type
            period
    subrogation
    contractC.35