Current Build

Переводит команда Health Samurai . Приглашаем поучаствовать в русификации стандарта FHIR: GitHub , Email.

13.2 JSON Schema for CoverageEligibilityRequest

Financial Management Work GroupMaturity Level: N/ABallot Status: Informative Compartments: Patient, Practitioner

This is a representation of the json schema for CoverageEligibilityRequest, which is just a part of the full JSON Schema.

{
  "$schema": "http://json-schema.org/draft-06/schema#",
  "id": "http://hl7.org/fhir/json-schema/CoverageEligibilityRequest",
  "$ref": "#/definitions/CoverageEligibilityRequest",
  "description": "see http://hl7.org/fhir/json.html#schema for information about the FHIR Json Schemas",
  "definitions": {
    "CoverageEligibilityRequest": {
      "description": "The CoverageEligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.",
      "properties": {
        "resourceType": {
          "description": "This is a CoverageEligibilityRequest resource",
          "const": "CoverageEligibilityRequest"
        },
        "id": {
          "description": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
          "$ref": "id.schema.json#/definitions/id"
        },
        "meta": {
          "description": "Метаданные ресурса. Это такая информация, которая поддерживается инфраструктурой. Изменения этой информации не всегда можно ассоциировать с версионными изменениями ресурса.",
          "$ref": "Meta.schema.json#/definitions/Meta"
        },
        "implicitRules": {
          "description": "Ссылка на свод правил, которым следовали при создании этого ресурса и которые необходимо понимать при обработке этого содержимого. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
          "$ref": "#/definitions/uri"
        },
        "_implicitRules": {
          "description": "Extensions for implicitRules",
          "$ref": "Element.schema.json#/definitions/Element"
        },
        "language": {
          "description": "Основной язык, на котором написан ресурс.",
          "$ref": "#/definitions/code"
        },
        "_language": {
          "description": "Extensions for language",
          "$ref": "Element.schema.json#/definitions/Element"
        },
        "text": {
          "description": "Человекочитаемая описательная часть, содержащая краткое изложение ресурса, которая может использоваться для представления содержимого ресурса человеку. От описательной части не требуется кодировать все структурированные данные, но она должна содержать достаточно сведений, чтобы простое её прочтение человеком было \"клинически безопасным\". Определения ресурсов могут описывать, какое содержимое должно быть представлено в описательной части для обеспечения клинической безопасной.",
          "$ref": "Narrative.schema.json#/definitions/Narrative"
        },
        "contained": {
          "description": "Эти ресурсы не обладают независимым существованием вне ресурса, который их содержит - их нельзя идентифицировать независимо, и они не могут иметь своей собственной независимой транзакционной области действия.",
          "items": {
            "$ref": "ResourceList.schema.json#/definitions/ResourceList"
          },
          "type": "array"
        },
        "extension": {
          "description": "Может использоваться для представления дополнительной информации, не являющейся частью базового определения ресурса. Чтобы сделать использование расширений надежным и управляемым, существует строгий набор управления применительно к определению и использованию расширений. Хотя каждому реализатору разрешается определять расширения, имеется набор требований, которые должны выполняться в рамках определения расширения.",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "modifierExtension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "identifier": {
          "description": "A unique identifier assigned to this coverage eligiblity request.",
          "items": {
            "$ref": "Identifier.schema.json#/definitions/Identifier"
          },
          "type": "array"
        },
        "status": {
          "description": "The status of the resource instance.",
          "$ref": "#/definitions/code"
        },
        "_status": {
          "description": "Extensions for status",
          "$ref": "Element.schema.json#/definitions/Element"
        },
        "priority": {
          "description": "When the requestor expects the processor to complete processing.",
          "$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
        },
        "purpose": {
          "description": "Code to specify whether requesting: prior authorization requirements for some service categories or billing codes; benefits for coverages specified or discovered; discovery and return of coverages for the patient; and/or validation that the specified coverage is in-force at the date/period specified or \u0027now\u0027 if not specified.",
          "items": {
            "enum": [
              "auth-requirements",
              "benefits",
              "discovery",
              "validation"
            ]
          },
          "type": "array"
        },
        "_purpose": {
          "description": "Extensions for purpose",
          "items": {
            "$ref": "Element.schema.json#/definitions/Element"
          },
          "type": "array"
        },
        "patient": {
          "description": "The party who is the beneficiary of the supplied coverage and for whom eligibility is sought.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        },
        "servicedDate": {
          "description": "The date or dates when the enclosed suite of services were performed or completed.",
          "pattern": "^([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1]))?)?$",
          "type": "string"
        },
        "_servicedDate": {
          "description": "Extensions for servicedDate",
          "$ref": "Element.schema.json#/definitions/Element"
        },
        "servicedPeriod": {
          "description": "The date or dates when the enclosed suite of services were performed or completed.",
          "$ref": "Period.schema.json#/definitions/Period"
        },
        "created": {
          "description": "The date when this resource was created.",
          "$ref": "#/definitions/dateTime"
        },
        "_created": {
          "description": "Extensions for created",
          "$ref": "Element.schema.json#/definitions/Element"
        },
        "enterer": {
          "description": "Person who created the request.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        },
        "provider": {
          "description": "The provider which is responsible for the request.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        },
        "insurer": {
          "description": "The Insurer who issued the coverage in question and is the recipient of the request.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        },
        "facility": {
          "description": "Facility where the services are intended to be provided.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        },
        "supportingInfo": {
          "description": "Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.",
          "items": {
            "$ref": "#/definitions/CoverageEligibilityRequest_SupportingInfo"
          },
          "type": "array"
        },
        "insurance": {
          "description": "Financial instruments for reimbursement for the health care products and services.",
          "items": {
            "$ref": "#/definitions/CoverageEligibilityRequest_Insurance"
          },
          "type": "array"
        },
        "item": {
          "description": "Service categories or billable services for which benefit details and/or an authorization prior to service delivery may be required by the payor.",
          "items": {
            "$ref": "#/definitions/CoverageEligibilityRequest_Item"
          },
          "type": "array"
        }
      },
      "additionalProperties": false,
      "required": [
        "patient",
        "insurer",
        "resourceType"
      ]
    },
    "CoverageEligibilityRequest_SupportingInfo": {
      "description": "The CoverageEligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.",
      "properties": {
        "id": {
          "description": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
          "$ref": "string.schema.json#/definitions/string"
        },
        "extension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "modifierExtension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "sequence": {
          "description": "A number to uniquely identify supporting information entries.",
          "$ref": "#/definitions/positiveInt"
        },
        "_sequence": {
          "description": "Extensions for sequence",
          "$ref": "Element.schema.json#/definitions/Element"
        },
        "information": {
          "description": "Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        },
        "appliesToAll": {
          "description": "The supporting materials are applicable for all detail items, product/servce categories and specific billing codes.",
          "$ref": "#/definitions/boolean"
        },
        "_appliesToAll": {
          "description": "Extensions for appliesToAll",
          "$ref": "Element.schema.json#/definitions/Element"
        }
      },
      "additionalProperties": false,
      "required": [
        "information"
      ]
    },
    "CoverageEligibilityRequest_Insurance": {
      "description": "The CoverageEligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.",
      "properties": {
        "id": {
          "description": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
          "$ref": "string.schema.json#/definitions/string"
        },
        "extension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "modifierExtension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "focal": {
          "description": "A flag to indicate that this Coverage is to be used for evaluation of this request when set to true.",
          "$ref": "#/definitions/boolean"
        },
        "_focal": {
          "description": "Extensions for focal",
          "$ref": "Element.schema.json#/definitions/Element"
        },
        "coverage": {
          "description": "Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient\u0027s actual coverage within the insurer\u0027s information system.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        },
        "businessArrangement": {
          "description": "A business agreement number established between the provider and the insurer for special business processing purposes.",
          "$ref": "#/definitions/string"
        },
        "_businessArrangement": {
          "description": "Extensions for businessArrangement",
          "$ref": "Element.schema.json#/definitions/Element"
        }
      },
      "additionalProperties": false,
      "required": [
        "coverage"
      ]
    },
    "CoverageEligibilityRequest_Item": {
      "description": "The CoverageEligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.",
      "properties": {
        "id": {
          "description": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
          "$ref": "string.schema.json#/definitions/string"
        },
        "extension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "modifierExtension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "supportingInfoSequence": {
          "description": "Exceptions, special conditions and supporting information applicable for this service or product line.",
          "items": {
            "$ref": "#/definitions/positiveInt"
          },
          "type": "array"
        },
        "_supportingInfoSequence": {
          "description": "Extensions for supportingInfoSequence",
          "items": {
            "$ref": "Element.schema.json#/definitions/Element"
          },
          "type": "array"
        },
        "category": {
          "description": "Code to identify the general type of benefits under which products and services are provided.",
          "$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
        },
        "productOrService": {
          "description": "This contains the product, service, drug or other billing code for the item.",
          "$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
        },
        "modifier": {
          "description": "Item typification or modifiers codes to convey additional context for the product or service.",
          "items": {
            "$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
          },
          "type": "array"
        },
        "provider": {
          "description": "The practitioner who is responsible for the product or service to be rendered to the patient.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        },
        "quantity": {
          "description": "The number of repetitions of a service or product.",
          "$ref": "Quantity.schema.json#/definitions/Quantity"
        },
        "unitPrice": {
          "description": "The amount charged to the patient by the provider for a single unit.",
          "$ref": "Money.schema.json#/definitions/Money"
        },
        "facility": {
          "description": "Facility where the services will be provided.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        },
        "diagnosis": {
          "description": "Patient diagnosis for which care is sought.",
          "items": {
            "$ref": "#/definitions/CoverageEligibilityRequest_Diagnosis"
          },
          "type": "array"
        },
        "detail": {
          "description": "The plan/proposal/order describing the proposed service in detail.",
          "items": {
            "$ref": "Reference.schema.json#/definitions/Reference"
          },
          "type": "array"
        }
      },
      "additionalProperties": false
    },
    "CoverageEligibilityRequest_Diagnosis": {
      "description": "The CoverageEligibilityRequest provides patient and insurance coverage information to an insurer for them to respond, in the form of an CoverageEligibilityResponse, with information regarding whether the stated coverage is valid and in-force and optionally to provide the insurance details of the policy.",
      "properties": {
        "id": {
          "description": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
          "$ref": "string.schema.json#/definitions/string"
        },
        "extension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "modifierExtension": {
          "description": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
          "items": {
            "$ref": "Extension.schema.json#/definitions/Extension"
          },
          "type": "array"
        },
        "diagnosisCodeableConcept": {
          "description": "The nature of illness or problem in a coded form or as a reference to an external defined Condition.",
          "$ref": "CodeableConcept.schema.json#/definitions/CodeableConcept"
        },
        "diagnosisReference": {
          "description": "The nature of illness or problem in a coded form or as a reference to an external defined Condition.",
          "$ref": "Reference.schema.json#/definitions/Reference"
        }
      },
      "additionalProperties": false
    }
  }
}