(ร่าง) Thai NCD Implementation Guide
0.1.0 - ci-build
(ร่าง) Thai NCD Implementation Guide - Local Development build (v0.1.0). See the Directory of published versions
Official URL: https://rathpanyowat.github.io/ncd-th-ig-demo/StructureDefinition/ncdth-coverage | Version: 0.1.0 | |||
Active as of 2022-02-23 | Computable Name: NCDTHCoverage |
ใช้บันทึกข้อมูลสิทธิ์การรักษา
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Coverage
This structure is derived from Coverage
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
identifier | S | 0..* | Identifier | Business Identifier for the coverage |
status | S | 1..1 | code | active | cancelled | draft | entered-in-error |
type | S | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: Thai Government Coverage Type Value Set (required) |
beneficiary | S | 1..1 | Reference(Patient) | Plan beneficiary |
period | S | 0..1 | Period | Coverage start and end dates |
payor | S | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
id | Σ | 0..1 | string | 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) Max Binding: AllLanguages: A human language. | |
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
contained | 0..* | Resource | Contained, inline Resources | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier | SΣ | 0..* | Identifier | Business Identifier for the coverage |
status | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
type | SΣ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: Thai Government Coverage Type Value Set (required) |
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy |
subscriber | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy |
subscriberId | Σ | 0..1 | string | ID assigned to the subscriber |
beneficiary | SΣ | 1..1 | Reference(Patient) | Plan beneficiary |
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 | SΣ | 0..1 | Period | Coverage start and end dates |
payor | SΣ | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy |
class | 0..* | BackboneElement | Additional coverage classifications | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
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 |
order | Σ | 0..1 | positiveInt | Relative order of the coverage |
network | Σ | 0..1 | string | Insurer network |
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 | |
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 | |
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 | Σ | 0..1 | Period | The effective period of the exception |
subrogation | 0..1 | boolean | Reimbursement to insurer | |
contract | 0..* | Reference(Contract) | Contract details | |
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
identifier | Σ | 0..* | Identifier | Business Identifier for the coverage |
status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
type | Σ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: Thai Government Coverage Type Value Set (required) |
beneficiary | Σ | 1..1 | Reference(Patient) | Plan beneficiary |
period | Σ | 0..1 | Period | Coverage start and end dates |
payor | Σ | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy |
Documentation for this format |
This structure is derived from Coverage
Differential View
This structure is derived from Coverage
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
identifier | S | 0..* | Identifier | Business Identifier for the coverage |
status | S | 1..1 | code | active | cancelled | draft | entered-in-error |
type | S | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: Thai Government Coverage Type Value Set (required) |
beneficiary | S | 1..1 | Reference(Patient) | Plan beneficiary |
period | S | 0..1 | Period | Coverage start and end dates |
payor | S | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy |
Documentation for this format |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Coverage | 0..* | Coverage | Insurance or medical plan or a payment agreement | |
id | Σ | 0..1 | string | 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) Max Binding: AllLanguages: A human language. | |
text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |
contained | 0..* | Resource | Contained, inline Resources | |
extension | 0..* | Extension | Additional content defined by implementations | |
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
identifier | SΣ | 0..* | Identifier | Business Identifier for the coverage |
status | ?!SΣ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. |
type | SΣ | 0..1 | CodeableConcept | Coverage category such as medical or accident Binding: Thai Government Coverage Type Value Set (required) |
policyHolder | Σ | 0..1 | Reference(Patient | RelatedPerson | Organization) | Owner of the policy |
subscriber | Σ | 0..1 | Reference(Patient | RelatedPerson) | Subscriber to the policy |
subscriberId | Σ | 0..1 | string | ID assigned to the subscriber |
beneficiary | SΣ | 1..1 | Reference(Patient) | Plan beneficiary |
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 | SΣ | 0..1 | Period | Coverage start and end dates |
payor | SΣ | 1..* | Reference(Organization | Patient | RelatedPerson) | Issuer of the policy |
class | 0..* | BackboneElement | Additional coverage classifications | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..* | Extension | Additional content defined by implementations | |
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 |
order | Σ | 0..1 | positiveInt | Relative order of the coverage |
network | Σ | 0..1 | string | Insurer network |
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 | |
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 | |
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 | Σ | 0..1 | Period | The effective period of the exception |
subrogation | 0..1 | boolean | Reimbursement to insurer | |
contract | 0..* | Reference(Contract) | Contract details | |
Documentation for this format |
Other representations of profile: CSV, Excel, Schematron
Path | Conformance | ValueSet |
Coverage.language | preferred | CommonLanguages Max Binding: AllLanguages |
Coverage.status | required | FinancialResourceStatusCodes |
Coverage.type | required | THGovernmentCoverageTypeVS |
Coverage.relationship | extensible | SubscriberRelationshipCodes |
Coverage.class.type | extensible | CoverageClassCodes |
Coverage.costToBeneficiary.type | extensible | CoverageCopayTypeCodes |
Coverage.costToBeneficiary.exception.type | example | ExampleCoverageFinancialExceptionCodes |