Versicherungsverhältnis

Basisprofil Versicherungsverhältnis

Canonical URL: http://fhir.de/StructureDefinition/coverage-de-basis/0.2

identifierΣ0..*Identifier
statusΣ ?!1..1codeBinding
typeΣ0..1CodeableConceptBinding
policyHolderΣ0..0Reference(Patient | RelatedPerson | Organization)
subscriberΣ0..1Reference(RelatedPerson | Patient, deutsches Basisprofil (Version 0.2))
subscriberIdΣ0..0string
beneficiaryΣ1..1Reference(Patient, deutsches Basisprofil (Version 0.2))
relationship0..1CodeableConcept
periodΣ0..1Period
payorΣ1..*Reference(http://fhir.de/StructureDefinition/organization-de-basis | RelatedPerson | Patient, deutsches Basisprofil (Version 0.2))
dependentΣ0..0string
sequenceΣ0..0string
orderΣ0..0positiveInt
networkΣ0..0string
contract0..*Reference(Contract)

Versicherungsverhältnis in der gesetzlichen Krankenversicherung (GKV)

Canonical URL: http://fhir.de/StructureDefinition/coverage-de-gkv/0.2

einlesedatum-karte0..*Extension(dateTime)
generation-egk0..1Extension(code)
version-egk0..*Extension(code)
gkv-zusatzinfo-geschuetzt0..1Extension(Complex)
gkv-zusatzinfos-allgemein0..1Extension(Complex)
gkv-onlinepruefung-egk0..*Extension(Complex)
useΣ ?!0..1codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ0..1uri
valueΣ0..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
useΣ ?!0..0codeBinding
typeΣ0..0CodeableConceptBinding
systemΣ1..1uriFixed Value
valueΣ1..1string
periodΣ0..1Period
assignerΣ0..1Reference(Organization)
statusΣ ?!1..1codeBinding
systemΣ0..1uriFixed Value
versionΣ0..1string
codeΣ0..1codeFixed Value
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
policyHolderΣ0..0Reference(Patient | RelatedPerson | Organization)
referenceΣ0..1string
identifierΣ0..1Identifier
displayΣ0..1string
subscriberIdΣ0..0string
referenceΣ0..1string
identifierΣ0..1Identifier
displayΣ0..1string
relationship0..1CodeableConcept
startΣ0..1dateTime
endΣ0..1dateTime
referenceΣ0..1string
identifierΣ1..1IdentifierFixed Value
displayΣ1..1string
referenceΣ0..1string
identifierΣ1..1Identifier
displayΣ0..1string
referenceΣ0..1string
identifierΣ1..1Identifier
displayΣ1..1string
dependentΣ0..0string
sequenceΣ0..0string
orderΣ0..0positiveInt
networkΣ0..0string
contract0..*Reference(Contract)

Beispiele

XML-Format

<Coverage>
    <meta>
        <profile value="http://fhir.de/StructureDefinition/coverage-de-gkv/0.2" />
    </meta>
    <extension url="http://fhir.de/StructureDefinition/gkv/zusatzinfos-geschuetzt/0.2">
        <extension url="besonderePersonengruppe">
            <valueCode value="00" />
        </extension>
        <extension url="dmpKennzeichnung">
            <valueCode value="00" />
        </extension>
        <extension url="ruhenderLeistungsanspruch">
            <extension url="beginn">
                <valueDate value="2018-01-01" />
            </extension>
            <extension url="ende">
                <valueDate value="2019-01-01" />
            </extension>
            <extension url="art">
                <valueCode value="3" />
            </extension>
        </extension>
    </extension>
    <identifier>
        <system value="http://fhir.de/NamingSystem/gkv/kvnr-30" />
        <value value="G995030566998765432123456789098" />
    </identifier>
    <status value="active" />
    <type>
        <coding>
            <system value="http://fhir.de/CodeSystem/versicherungsart-de-basis" />
            <code value="GKV" />
        </coding>
    </type>
    <subscriber>
        <reference value="Patient/12345" />
        <identifier>
            <system value="http://fhir.de/NamingSystem/gkv/kvid-10" />
            <value value="G995030566" />
        </identifier>
        <display value="Mustermann, Max" />
    </subscriber>
    <beneficiary>
        <reference value="Patient/12345" />
        <identifier>
            <system value="http://fhir.de/NamingSystem/gkv/kvid-10" />
            <value value="G995030566" />
        </identifier>
        <display value="Mustermann, Max" />
    </beneficiary>
    <payor>
        <identifier>
            <system value="http://fhir.de/NamingSystem/arge-ik/iknr" />
            <value value="998765432" />
        </identifier>
        <display value="AOK Mittelbaden" />
    </payor>
</Coverage>

JSON-Format

{
    "resourceType":"Coverage",
    "meta":{
        "profile": [
            "http://fhir.de/StructureDefinition/coverage-de-gkv/0.2"
        ]
    },
    "extension": [
        {
            "url":"http://fhir.de/StructureDefinition/gkv/zusatzinfos-geschuetzt/0.2",
            "extension": [
                {
                    "url":"besonderePersonengruppe",
                    "valueCode":"00"
                },
                {
                    "url":"dmpKennzeichnung",
                    "valueCode":"00"
                },
                {
                    "url":"ruhenderLeistungsanspruch",
                    "extension": [
                        {
                            "url":"beginn",
                            "valueDate":"2018-01-01"
                        },
                        {
                            "url":"ende",
                            "valueDate":"2019-01-01"
                        },
                        {
                            "url":"art",
                            "valueCode":"3"
                        }
                    ]
                }
            ]
        }
    ],
    "identifier": [
        {
            "system":"http://fhir.de/NamingSystem/gkv/kvnr-30",
            "value":"G995030566998765432123456789098"
        }
    ],
    "status":"active",
    "type":{
        "coding": [
            {
                "system":"http://fhir.de/CodeSystem/versicherungsart-de-basis",
                "code":"GKV"
            }
        ]
    },
    "subscriber":{
        "reference":"Patient/12345",
        "identifier":{
            "system":"http://fhir.de/NamingSystem/gkv/kvid-10",
            "value":"G995030566"
        },
        "display":"Mustermann, Max"
    },
    "beneficiary":{
        "reference":"Patient/12345",
        "identifier":{
            "system":"http://fhir.de/NamingSystem/gkv/kvid-10",
            "value":"G995030566"
        },
        "display":"Mustermann, Max"
    },
    "payor": [
        {
            "identifier":{
                "system":"http://fhir.de/NamingSystem/arge-ik/iknr",
                "value":"998765432"
            },
            "display":"AOK Mittelbaden"
        }
    ]
}

Versicherungsverhältnis Selbstzahler

Canonical URL: http://fhir.de/StructureDefinition/coverage-de-sel/0.2

identifierΣ0..*Identifier
statusΣ ?!1..1codeBinding
systemΣ0..1uriFixed Value
versionΣ0..1string
codeΣ0..1codeFixed Value
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
policyHolderΣ0..0Reference(Patient | RelatedPerson | Organization)
subscriberΣ0..1Reference(RelatedPerson | Patient, deutsches Basisprofil (Version 0.2))
subscriberIdΣ0..0string
beneficiaryΣ1..1Reference(Patient, deutsches Basisprofil (Version 0.2))
relationship0..1CodeableConcept
periodΣ0..1Period
payorΣ1..*Reference(Organisation, deutsches Basisprofil (Version 0.2) | RelatedPerson | Patient, deutsches Basisprofil (Version 0.2))
dependentΣ0..0string
sequenceΣ0..0string
orderΣ0..0positiveInt
networkΣ0..0string
contract0..*Reference(Contract)

Beispiele

XML-Format

<Coverage>
    <meta>
        <profile value="http://fhir.de/StructureDefinition/coverage-de-sel/0.2" />
    </meta>
    <status value="active" />
    <type>
        <coding>
            <system value="http://fhir.de/CodeSystem/versicherungsart-de-basis" />
            <code value="SEL" />
        </coding>
    </type>
    <subscriber>
        <reference value="RelatedPerson/22334" />
        <display value="Zahlemann, Heinz" />
    </subscriber>
    <beneficiary>
        <reference value="Patient/12345" />
        <display value="Zahlemann, Jeanette" />
    </beneficiary>
    <payor>
        <reference value="RelatedPerson/22334" />
        <display value="Zahlemann, Heinz" />
    </payor>
</Coverage>

JSON-Format

{
    "resourceType":"Coverage",
    "meta":{
        "profile": [
            "http://fhir.de/StructureDefinition/coverage-de-sel/0.2"
        ]
    },
    "status":"active",
    "type":{
        "coding": [
            {
                "system":"http://fhir.de/CodeSystem/versicherungsart-de-basis",
                "code":"SEL"
            }
        ]
    },
    "subscriber":{
        "reference":"RelatedPerson/22334",
        "display":"Zahlemann, Heinz"
    },
    "beneficiary":{
        "reference":"Patient/12345",
        "display":"Zahlemann, Jeanette"
    },
    "payor": [
        {
            "reference":"RelatedPerson/22334",
            "display":"Zahlemann, Heinz"
        }
    ]
}