pub struct CoverageInner {Show 48 fields
pub id: Option<String>,
pub meta: Option<Meta>,
pub implicit_rules: Option<String>,
pub language: Option<String>,
pub text: Option<Narrative>,
pub contained: Vec<Resource>,
pub extension: Vec<Extension>,
pub modifier_extension: Vec<Extension>,
pub identifier: Vec<Option<Identifier>>,
pub identifier_ext: Vec<Option<FieldExtension>>,
pub status: String,
pub status_ext: Option<FieldExtension>,
pub kind: Kind,
pub kind_ext: Option<FieldExtension>,
pub payment_by: Vec<Option<CoveragePaymentBy>>,
pub payment_by_ext: Vec<Option<FieldExtension>>,
pub type: Option<CodeableConcept>,
pub type_ext: Option<FieldExtension>,
pub policy_holder: Option<Reference>,
pub policy_holder_ext: Option<FieldExtension>,
pub subscriber: Option<Reference>,
pub subscriber_ext: Option<FieldExtension>,
pub subscriber_id: Vec<Option<Identifier>>,
pub subscriber_id_ext: Vec<Option<FieldExtension>>,
pub beneficiary: Reference,
pub beneficiary_ext: Option<FieldExtension>,
pub dependent: Option<String>,
pub dependent_ext: Option<FieldExtension>,
pub relationship: Option<CodeableConcept>,
pub relationship_ext: Option<FieldExtension>,
pub period: Option<Period>,
pub period_ext: Option<FieldExtension>,
pub insurer: Option<Reference>,
pub insurer_ext: Option<FieldExtension>,
pub class: Vec<Option<CoverageClass>>,
pub class_ext: Vec<Option<FieldExtension>>,
pub order: Option<NonZero<u32>>,
pub order_ext: Option<FieldExtension>,
pub network: Option<String>,
pub network_ext: Option<FieldExtension>,
pub cost_to_beneficiary: Vec<Option<CoverageCostToBeneficiary>>,
pub cost_to_beneficiary_ext: Vec<Option<FieldExtension>>,
pub subrogation: Option<bool>,
pub subrogation_ext: Option<FieldExtension>,
pub contract: Vec<Option<Reference>>,
pub contract_ext: Vec<Option<FieldExtension>>,
pub insurance_plan: Option<Reference>,
pub insurance_plan_ext: Option<FieldExtension>,
/* private fields */
}
Expand description
Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.
Coverage v5.0.0
Insurance or medical plan or a payment agreement
Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.
The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers.
Fields§
§id: Option<String>
Logical id of this artifact
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
meta: Option<Meta>
Metadata about the resource
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
implicit_rules: Option<String>
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.
language: Option<String>
Language; Language of the resource content
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
text: Option<Narrative>
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it “clinically safe” for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a “text blob” or where text is additionally entered raw or narrated and encoded information is added later.
contained: Vec<Resource>
Contained, inline Resources
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.
extension: Vec<Extension>
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, 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.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
modifier_extension: Vec<Extension>
Extensions that cannot be ignored
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 and/or the understanding of the containing element’s descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
identifier: Vec<Option<Identifier>>
Business identifier(s) for this coverage
The identifier of the coverage as issued by the insurer.
The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependant. Note that not all insurers issue unique member IDs therefore searches may result in multiple responses.
identifier_ext: Vec<Option<FieldExtension>>
Extension field.
status: String
CoverageStatus; active | cancelled | draft | entered-in-error
The status of the resource instance.
This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid.
status_ext: Option<FieldExtension>
Extension field.
kind: Kind
CoverageKind; insurance | self-pay | other
The nature of the coverage be it insurance, or cash payment such as self-pay.
kind_ext: Option<FieldExtension>
Extension field.
payment_by: Vec<Option<CoveragePaymentBy>>
Self-pay parties and responsibility
Link to the paying party and optionally what specifically they will be responsible to pay.
payment_by_ext: Vec<Option<FieldExtension>>
Extension field.
type: Option<CodeableConcept>
CoverageType; Coverage category such as medical or accident
The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.
type_ext: Option<FieldExtension>
Extension field.
policy_holder: Option<Reference>
Owner of the policy
The party who ‘owns’ the insurance policy.
For example: may be an individual, corporation or the subscriber’s employer.
policy_holder_ext: Option<FieldExtension>
Extension field.
subscriber: Option<Reference>
Subscriber to the policy
The party who has signed-up for or ‘owns’ the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.
May be self or a parent in the case of dependants. A subscriber is only required on certain types of policies not all policies and that it is appropriate to have just a policyholder and a beneficiary when not other party can join that policy instance.
subscriber_ext: Option<FieldExtension>
Extension field.
subscriber_id: Vec<Option<Identifier>>
ID assigned to the subscriber
The insurer assigned ID for the Subscriber.
subscriber_id_ext: Vec<Option<FieldExtension>>
Extension field.
beneficiary: Reference
Plan beneficiary
The party who benefits from the insurance coverage; the patient when products and/or services are provided.
beneficiary_ext: Option<FieldExtension>
Extension field.
dependent: Option<String>
Dependent number
A designator for a dependent under the coverage.
Sometimes the member number is constructed from the subscriberId and the dependant number.
dependent_ext: Option<FieldExtension>
Extension field.
relationship: Option<CodeableConcept>
Relationship; Beneficiary relationship to the subscriber
The relationship of beneficiary (patient) to the subscriber.
Typically, an individual uses policies which are theirs (relationship=‘self’) before policies owned by others.
relationship_ext: Option<FieldExtension>
Extension field.
period: Option<Period>
Coverage start and end dates
Time period during which the coverage is in force. A missing start date indicates the start date isn’t known, a missing end date means the coverage is continuing to be in force.
period_ext: Option<FieldExtension>
Extension field.
insurer: Option<Reference>
Issuer of the policy
The program or plan underwriter, payor, insurance company.
May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).
insurer_ext: Option<FieldExtension>
Extension field.
class: Vec<Option<CoverageClass>>
Additional coverage classifications
A suite of underwriter specific classifiers.
For example, class may be used to identify a class of coverage or employer group, policy, or plan.
class_ext: Vec<Option<FieldExtension>>
Extension field.
order: Option<NonZero<u32>>
Relative order of the coverage
The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care. For example; a patient might have (0) auto insurance (1) their own health insurance and (2) spouse’s health insurance. When claiming for treatments which were not the result of an auto accident then only coverages (1) and (2) above would be applicatble and would apply in the order specified in parenthesis.
order_ext: Option<FieldExtension>
Extension field.
network: Option<String>
Insurer network
The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the ‘in-network’ rate, otherwise ‘out of network’ terms and conditions apply.
network_ext: Option<FieldExtension>
Extension field.
cost_to_beneficiary: Vec<Option<CoverageCostToBeneficiary>>
Patient payments for services/products
A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card.
For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.
cost_to_beneficiary_ext: Vec<Option<FieldExtension>>
Extension field.
subrogation: Option<bool>
Reimbursement to insurer
When ‘subrogation=true’ this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.
Typically, automotive and worker’s compensation policies would be flagged with ‘subrogation=true’ to enable healthcare payors to collect against accident claims.
subrogation_ext: Option<FieldExtension>
Extension field.
contract: Vec<Option<Reference>>
Contract details
The policy(s) which constitute this insurance coverage.
contract_ext: Vec<Option<FieldExtension>>
Extension field.
insurance_plan: Option<Reference>
Insurance plan details
The insurance plan details, benefits and costs, which constitute this insurance coverage.
insurance_plan_ext: Option<FieldExtension>
Extension field.
Trait Implementations§
Source§impl Clone for CoverageInner
impl Clone for CoverageInner
Source§fn clone(&self) -> CoverageInner
fn clone(&self) -> CoverageInner
1.0.0 · Source§fn clone_from(&mut self, source: &Self)
fn clone_from(&mut self, source: &Self)
source
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