haau3 FHIR Implementation Guide (HFIG) - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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: haau3 Coverage — a plan naming a second payer - XML Representation

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<Coverage xmlns="http://hl7.org/fhir">
  <id value="haau3-coverage-two-payors"/>
  <meta>
    <profile
             value="https://haau3.com/fhir/StructureDefinition/haau3-coverage"/>
    <tag>
      <system
              value="https://haau3.com/fhir/CodeSystem/staging-transform-rule"/>
      <code value="coverage.additional_payor_relocated"/>
      <display value="An additional payer was moved onto the record"/>
    </tag>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Coverage haau3-coverage-two-payors</b></p><a name="haau3-coverage-two-payors"> </a><a name="hchaau3-coverage-two-payors"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-haau3-coverage.html">haau3 Coverage</a></p><p style="margin-bottom: 0px">Tag: </p></div><p><b>haau3 Additional Payor</b>: Northgate Supplemental Benefits</p><p><b>identifier</b>: <code>https://haau3.com/fhir/NamingSystem/source-resource-id</code>/Coverage/example-source-record</p><p><b>status</b>: Active</p><p><b>subscriberId</b>: VM-88214</p><p><b>beneficiary</b>: <a href="Patient-haau3-patient.html">Derrick Lin  Male, DoB: 1965-04-12 ( https://haau3.com/fhir/NamingSystem/haau3-patient-id#Haau3PatientId#example-haau3-patient (use: usual, ))</a></p><p><b>relationship</b>: <span title="Codes:{urn:oid:2.16.840.1.113883.3.221.5 01}">01</span></p><p><b>payor</b>: <a href="Organization-c4bb-commercial-organization.html">Organization Commercial Insurance Company</a></p><blockquote><p><b>class</b></p><p><b>type</b>: <span title="Codes:">plan</span></p><p><b>value</b>: Valley Choice PPO</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title="Codes:">group</span></p><p><b>value</b>: GRP-4471</p></blockquote></div>
  </text>
  <extension
             url="https://haau3.com/fhir/StructureDefinition/haau3-additional-payor">
    <valueReference>
      <display value="Northgate Supplemental Benefits"/>
    </valueReference>
  </extension>
  <identifier>
    <system value="https://haau3.com/fhir/NamingSystem/source-resource-id"/>
    <value value="Coverage/example-source-record"/>
  </identifier>
  <status value="active"/>
  <subscriberId value="VM-88214"/>
  <beneficiary>🔗 
    <reference value="Patient/haau3-patient"/>
  </beneficiary>
  <relationship>
    <coding>
      <system value="urn:oid:2.16.840.1.113883.3.221.5"/>
      <code value="01"/>
    </coding>
  </relationship>
  <payor>🔗 
    <reference value="Organization/c4bb-commercial-organization"/>
  </payor>
  <class>
    <type>
      <coding>
        <code value="plan"/>
      </coding>
    </type>
    <value value="Valley Choice PPO"/>
  </class>
  <class>
    <type>
      <coding>
        <code value="group"/>
      </coding>
    </type>
    <value value="GRP-4471"/>
  </class>
</Coverage>